IStock Photo 9158538 © dra_schwartz

By now the warnings are familiar: To avoid seasonal or swine flu, get vaccinated if you can, wash or sanitize your hands, and avoid coming into close contact with people who are sick. If you feel sick yourself, don’t go to work until you’re fever-free for 24 hours. It’s all straightforward advice, but there’s one big catch: the odds are 1 in 3.03 that an employed adult in the US does not have paid sick leave. Even if you’re not one of the 50 million or so in that category, the grill cook at your local coffee shop or the teaching aide in your child’s classroom could be on the job with swine flu as you read this story.

Among the 15 most economically competitive countries, only the US does not mandate paid sick leave. Nor does any US state—but, spurred partly by worries about H1N1 flu, at least 15 states debated mandatory sick leave proposals in 2009 (some were rejected, while others are still pending). Only the District of Columbia, San Francisco, and Milwaukee have enacted minimum paid sick leave requirements.

Beyond the public health impact, paid sick leave is a priority for labor advocates because they argue that it discourages employers from pressuring workers to stay on the job when they’re ill. The odds that an employed adult thinks staying home sick will jeopardize his or her job are 1 in 3.23. Even if it won’t lead to firing, the odds that an employed adult fears sick days could lead to a poor performance review are 1 in 3.03. Among people 16 or older, the odds that a person without paid sick days has ever worked with a contagious illness are 1 in 1.47 (68%), compared to 1 in 1.89 (53%) for a worker who does have paid sick leave.

The swine flu pandemic, combined with the economic recession, creates a powerful argument for paid sick leave, since workers are extra-vulnerable to financial pressure when jobs are tight. But business leaders say that now is exactly the wrong time to burden employers with extra personnel costs.

“As our economy begins to recover from the most severe recession since the Great Depression, businesses need to maintain flexibility in order to survive, grow and provide jobs,” Capitol Associated Industries President A. Bruce Clarke said at a House hearing last November on the Emergency Influenza Containment Act (H.R. 3991), which would guarantee up to five paid days of leave for workers sent home with contagious illnesses like swine flu. Clarke argued that many employers already provide benefits like flextime (days off for any purpose) and telecommuting to support sick employees.

President Obama supports another pending bill, the Healthy Families Act (H.R. 2460), which would obligate companies with 15-plus employees to provide up to seven days of compensated sick leave annually. In support, the Administration could cite a recent survey by the Urban Institute. It found that employers in San Francisco, which has required businesses to offer paid sick leave since 2006, were experiencing “minimal to moderate effects on their overall business and their bottom line”—but that many businesses said that they would rather have a state or national requirement, since it would make their competitors comply as well and even out the impacts. As one spokesperson at a large company put it, “We don't want a patchwork and want to see laws at the federal level, whether we like the laws or not.”