Now that the initial sense of panic about the H1N1 virus (formerly known as swine flu) has died down, can we have a discussion on how some of our policies actually put us at greater risk as a nation for a pandemic outbreak?
US health officials urged Americans to wash their hands frequently and to avoid contact with others if 1) they were sick and 2) people around them were sick. We were told to stay home from work if we were sick and to keep our kids out of school if they were sick. That’s just common sense. Avoiding contact or “social distancing” is the best way to stop the spread of contagious disease. Before the advent of antibiotics and vaccines, health officials put quarantine signs on homes where a family member had a contagious disease. Today, thanks to modern medicine and to an increased awareness of the civil liberties aspects of quarantine, such efforts in the US are largely limited to points of entry and to various agricultural products. Additionally, hospitals have the capability to isolate individuals — either to protect them in the event of compromised immune systems or to protect others from an infectious disease. The most notable recent case was the individual who had contracted a highly drug-resistant form of TB. That individual was placed in isolation, largely against his will, while undergoing treatment.
The spread of the H1N1 virus seems to be slowing in the US as flu season draws to a close. But public health officials warn that it may well return next winter. And if efforts fail to develop and produce an effective vaccine in sufficient quantities, as the World Health Organization is reporting could well occur, social distancing will be even more necessary to slow or stop the disease from spreading.
While voluntary social distancing is an effective strategy for slowing the spread of infectious disease, public policy makes that strategy difficult to implement. When people, especially low-wage earners, do not have paid time off in the event of illness, it is difficult for them to take the responsible action of staying home, whether to care for themselves or for a sick child.
The United States is the only one of the 22 most affluent nations — the ones ranked highest on the UN’s “human development” index — that lacks a mandated paid sick leave or paid sick days policy. Without that protection, particularly during a time of economic dislocation, there is a clear disincentive to remain home. Staying home might cost the person his or her job, and with high unemployment rates, that becomes a greater and more immediate risk than the possibility of infecting others.
Those who oppose such things as paid vacations, employer-provided health insurance, worker safety requirements, and even a minimum wage will, no doubt, argue against paid sick leave or paid sick days. But that argument fails in its persuasiveness when US policy is compared to the other 21 most affluent nations. One might even argue that such policies in fact contribute to a nation’s affluence.
In the meantime, a bill has been proposed by Rep. Rosa DeLauro (D-Conn.) to mandate seven days of paid sick leave per year — leave that could spell the difference between a normal flu season and a pandemic in the US, should the H1N1 virus strike again next winter. If viewed as a public health measure, this bill should be passed with near unanimous support.
