If you are looking for areas where the United States cannot be denied as a globally prominent place, here it is: paid sick leave.

Unfortunately, not in a good way. Of the UN member states, 181 provide paid leave in several forms. Eleven no, including U.S.

That places America in an elite group that includes Pacific Island nations in Tonga, Tuvalu, and Nauru, along with Somalia (which barely functions at all).

One developed country, South Korea, does not provide paid sick leave as such, but gives all workers three weeks’ paid leave that can be used as sick leave.

“We are very isolated,” said Jody Heymann, director of the Center for World Policy Analysis at UCLA and lead author of the new study published by the center sick leave policy in 192 of 193 UN countries. (This study does not cover North Korea, where policy cannot be determined.)

The Center determines that the US lags much in the world in almost every measure of sick leave design.

Although the initial step in providing coronavirus assistance was passed by Congress – the First Family Coronavirus Response Act, which took effect in mid-March – stipulates two weeks of emergency medical leave paid by employers, it frees businesses with 500 or more employees and allows small businesses with less than 50 workers to claim exception to difficulties.

That makes the US the only country in the world to base its paid leave rules on the size of an employer, Heymann told me.

“The big story is that when you free large companies and small companies, you lose a large portion of the country,” Heymann said – an estimated 100 million workers. “Why can we do that during a pandemic?”

The lack of paid sick leave required nationally is both stupid and even stupid under normal circumstances, Heymann said. “Sick leave is paid for itself in increasing productivity and fewer work hours lost due to illness,” he said.

In a regular non-pandemic year, influenza costs US $ 11 billion in economy, and other foodborne illnesses $ 15 billion, including what is spread by food workers who report their work when sick. The Centers for Disease Control and Prevention reported in 2016 that one in five food service workers have worked at least one shift during vomiting or diarrhea in the previous year.

During a pandemic such as the current coronavirus crisis, inadequate sick leave is almost certainly contributing to poor results. Countries that have not offered paid sick leave since the first day of illness include some of the “hardest hit since the start of the global pandemic and have faced an overflowing health care system and loss of many lives,” including Italy, Iran and the US, which the UCLA Study observed .

The US is not the only country, rich or poor, without the right to sick leave that covers everything. But it is resolute among countries that do not yet have the most important features. About three-quarters of all countries guarantee sick leave is paid from the first day of an illness and 76% provide at least six weeks of coverage. Among high-income countries, about two-thirds include self-employed.

About half the countries in the UCLA database guarantee workers at least 80% of their wages if they have worked for at least six months.

As we have reported before, the thin safety net for American workers is an artifact of the country’s choice to place policies in the workplace almost entirely under the control of employers. The harvest is not only the right to mottled sick leave, but the lack of universal health coverage, both of which have been a factor in our inability to reduce the spread of COVID-19.

According to the Bureau of Labor Statistics, about a quarter of all American workers do not have the right to sick leave at all; about 91% of state and local government workers are eligible for paid sick leave, but only 73% of private workers.

In the private sector, moreover, paid sick leave is a privilege that is provided mostly to professionals, managers, and those who are better paid. This is available only for around 58% of service workers – who are most likely to be in contact with the public – less than half of those in the lowest 25% of the income range, and only three out of 10 who are in the lowest 10%. wage earner.

In the absence of a federal mandate for paid sick leave, states and regions have taken up the slack. Fourteen states (including California) and the District of Columbia have enacted paid sick leave laws, as do 20 cities (seven in California) and three counties.

Normally, this law requires sick leave to be paid up to five working days, increased when workers collect working hours, and limits the ability to bring sick days to the following year. California law, which took effect in 2015, allows employees, including part-time and temporary employees, to get one hour of paid leave for every 30 hours worked. Employers can limit accruals to 48 hours, or about six conventional work days.

Without national paid sick leave, the task of looking after people at home to suppress coronavirus is clearly much more difficult. “Paid sick days do a number of things,” Heymann said.

“When people leave because they are so sick that they will never go to work, they make sure they have an economic safety net. That’s obviously very important. But it also means that people who have mild symptoms of infectious disease, but can easily pass it on to others who may be seriously ill, will stay at home. “

In addition, “people’s willingness to be tested when they cough lightly and see if they need to be out of work for two weeks,” Heymann said, “it really depends on the day of illness paid.”

In fiscal terms, there is no reason why the United States cannot join other developed countries in offering workers appropriate comprehensive sick leave. About a quarter of all countries finance their programs from government funds, and another fifth share responsibilities between employers and the government. Low-income countries tend to burden entrepreneurs solely.

Among high-income countries, two-thirds provide sick leave for entrepreneurs and 42% include part-time workers.

The consequences of leaving workers without a financial safety net during the health crisis have been clear in the US since the 2009 H1N1 flu epidemic. An estimated 26 million people were infected from September to November that year, the peak months of the pandemic. But an estimated 8 million continue to work.

The following February, the public health authority estimated that the carrier had infected around 7 million coworkers. “Presenteeism – attending work when sick – among private sector employees without paid sick days may have extended the duration of the outbreak,” a study by Pennsylvania State University concluded.

COVID lessons must last into the future. This disease will not only afflict us at least for 2021, but also reminds the public’s vulnerability to the next pandemic.

In the past two decades, we have had four major respiratory infections that spread globally – SARS in 2002, H1N1 in 2009, MERS in 2012, and now COVID-19, Heymann said. “This is not a problem that just disappears. We need to be prepared for the next one, because we cannot continue to shut down our economy like this. “