Dr. Tam: paid sick leave is “essential to protect worker and community health”

By Dr. Jesse McLaren 

Dr. Theresa Tam, the Chief Public Health Officer of Canada, released a report calling for an equity approach both to understand COVID-19 and to take action. As she summarized, “no one is protected until everyone is protected.” The report summarizes the first wave of the pandemic in the context of a broader public health perspective. It also outlines key areas of action that are urgently needed to reduce the second waves of COVID-19 and to strengthen public health in general. Below are five key points of the report related to decent work and health.                                                                        

1. Long-term care crisis fueled by precarious work

Canada ranked #79 in total cases per million but #26 for deaths per million, and this disproportionately higher fatality is based on the COVID-19 crisis in long-term care (LTC)—where residents comprise 15% of cases but 80% of deaths. As the report explains, the outbreaks were not just because of the precarious age and comorbidities of the residents but also because of precarious work. Over 10% of COVID-19 cases across the country were LTC workers, who had to work in multiple facilities without paid sick days or adequate PPE. This demonstrates how precarious work is a health hazard, especially for women and racialized workers on the frontlines, and that improving their working conditions is crucial to confronting COVID.

As Dr. Tam wrote, “workers in low-income occupations are working in jobs that put them at greater risk; this is particularly true for women, immigrants, and racialized workers…These disadvantages include economic and employment insecurity, a lack of paid sick leave, and the need to work multiple jobs to make ends meet. For example, these factors were identified as consequential for personal support workers in long-term care homes.” The report calls for “full-time quality jobs with benefits such as paid sick leave” as a key area of action to achieve safe and supportive LTC.

2. Migrants: essential workers denied essential projections 

Other major sites for COVID-19 outbreaks have been meat processing and agricultural work. While migrant workers provide much of this essential work, they are denied essential protections like safe shelter, paid sick days, access to healthcare, or the encouragement to report symptoms and get tested without fear of reprisals.

As Dr. Tam wrote “Advocates for migrant workers have pointed to structural issues such as the dependence on employers for housing and sanitation…We need to ensure good pay and conditions for every worker along the food production chain, while also addressing the specific needs of temporary foreign workers.” This not only explains how denying protections for migrant workers fuels the pandemic, it also credits the migrant justice movement for highlighting these issues and joins the call to action—echoing years of work by migrant justice organizers.

3. How to ‘stay home when sick’: paid sick days for all 

For years before the pandemic, the Decent Work and Health Network (DWHN) called for paid sick days for all. During the pandemic we’ve emphasized this is essential to allow workers to stay home when sick. The report explains why the lack of paid sick days undermines pandemic response, and echoes the call for paid sick days for all.

As Dr. Tam wrote, “Only 42% of working Canadians who are older than 18 years reported having access to paid sick leave. Without paid sick leave, employees may lose income if they become ill and are unable to work. Without employment security, they may lose their jobs if they stay home when sick. In either case, and particularly if they are economically insecure, workers may feel unable to comply with public health guidance to stay home when sick…Paid sick leave is also essential to protect worker and community health.”

4. A broader vision for decent work and health 

For years the DWHN and the broader $15 and Fairness movement have been advocating for a broader vision of decent work—including higher wages, fair schedules, protection for migrant workers, and paid sick days. Drawing from public health knowledge and the experience of the first wave, the report includes all these as evidence-based areas for action—both to tackle COVID-19 and to create a healthier society.

5. Reports as organizing tools 

This is not the first report applying an equity approach to the pandemic, it’s the fourth. In June, the Migrant Workers Alliance for Change released its report, “Unheeded Warnings: COVID-19 And Migrant Workers In Canada.”  Reflecting the experiences and voices of migrant workers themselves, this report details the conditions that put them at risk of COVID-19 (which Dr. Tam summarized and referenced in her report) and outlines calls to action. In August, the Decent Work and Health Network released its report, “Before It’s Too Late: How to Close the Paid Sick Days Gap During COVID-19 & Beyond.” This included interviews with frontline workers—from grocery workers to LTC workers—on the lack of paid sick days, summarized years of evidence of paid sick days applied in other jurisdictions before and during COVID-19, and outlined principles for guaranteeing effective paid sick days for all. In October, the Caregivers’ Action Centre and others released their report “Behind Closed Doors: Exposing Migrant Care Worker Exploitation during COVID-19.” This amplifies the voices of migrant care workers, whose exploitation has intensified during COVID-19, and includes calls to action.

These reports, and all the years of organizing they reflect, are now being echoed by the Chief Public Health Officer of Canada. This vindicates all the organizing work before and during the pandemic, and provides a resource to strengthen this work going forward—using an equity approach to understand the pandemic, and to change it. As Dr. Tam concludes, “While the COVID-19 pandemic affects us all, the health impacts have been worse for seniors, essential workers, racialized populations, people living with disabilities and women. We need to improve the health, social and economic conditions for these populations to achieve health equity and to protect us all from the threat of COVID-19 and future pandemics.”

Dr. Jesse McLaren is an emergency physician and member of the Decent Work and Health Network's steering committee.

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