Vulnerable workers should be given paid leave before they become sick
President Trump last week signed into law the Families First Coronavirus Response Act, which requires paid sick leave for the employees of small and midsize companies and pays employers back with tax credits. Major companies such as Walmart and Whole Foods are also now offering their employees two weeks of paid time off. But in order to qualify for it, one must be diagnosed with the coronavirus or asked to quarantine.
Both policies act too late to protect the people most likely to get seriously sick. People over 60 and those with chronic conditions such as diabetes, lung disease, and heart disease are at a far higher risk of suffering severe illness and dying from the coronavirus, according to the data published by the Centers for Disease Control and Prevention. Giving the elderly or vulnerable paid leave only after they are sick is like buckling the seat belt for someone only after there has been a devastating car accident.
We do not know nearly enough about the coronavirus, which is proving to be the worst pandemic in a century, but we do know for certain that who lives and who dies varies dramatically based on age. People over 64 may be nearly 50 times more likely to die than someone under 44, according to a recent study in China. This explains why Italy has been dealing with such horror and heartbreak. It has the second oldest population on the globe. Nearly all the deaths reported in Italy are of people over 60.
While it seems younger people in the United States are at greater risk of dying than elsewhere, perhaps due to a lack of testing to know who is sick and social distancing to stop the spread, more than 80 percent of deaths are senior citizens. The government now recommends that people over 60 should stay home if they can. It may be difficult for employers to help their older workers stay home without the government covering the cost of protecting the most endangered. There are so many seniors working across the country today, which means so many lives are on the line. The number of working Americans over 65 increased by 35 percent between 2011 and 2016, and there are also more seniors working full time.
Most worrying is that there are more than one million seniors working in sales positions such as cashiers that so many of us count on and perhaps dangerously come into contact with and unwittingly infect. Vermont and Minnesota now classify grocery store employees as emergency workers, mercifully granting them the benefits like child care, the elderly should not be forced to risk their lives to be the heroes for the public.
One reason why age matters is that people are more likely to have chronic conditions as they get older, and people over 80 with underlying diseases need the most protection. The World Health Organization reports people with heart disease have a mortality rate of 13 percent, while 9 percent of people with diabetes and 8 percent with chronic obstructive pulmonary disease die from the coronavirus. Having a medical history of any of these conditions should also be grounds for paid leave, given that the chances of dying if one contracts the coronavirus illness is alarmingly high.
Forcing the vulnerable to work until the day they become sick gambles with not only their lives, but the lives of anyone who falls severely ill from this plague, given limited ventilators and intensive care resources. With current estimates suggesting that every hospital bed will be occupied at the rate we are going in over a month, every person who we can keep out of the hospital is not just a mercy for them, but a mercy for those who end up in desperate need of scarce lifesaving items such as ventilators.
The good news is that there is a simple solution to help those threatened by this pandemic. Our leaders should extend paid leave to the elderly and vulnerable before they become sick, not after, until this crisis is over.
Jason Silverstein is a lecturer and writer in residence with the Department of Global Health and Social Medicine at Harvard Medical School in Boston.