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Comment by Fnoord | Hacker News Reader

> Relative to Other Countries, US Labor and Healthcare Policies are a Perfect Storm for Pandemics

> Zero universal guaranteed paid sick leave [1]

The United States of America in the same list as India, North Korea, South Korea, Somalia, Angola, Liberia, and Guinea-Bissau. Some of these countries are poor or low income. The USA isn't one of them though. I'd be ashamed of my country.

In The Netherlands, an entire [large] province (North Brabant) has been ordered to stay home if they have anything resembling illness. People are asked to work from home. Children can't go to school. Still, working from home is better than nothing.

Also, some people are in quarantine. The people who have COVID-19 but otherwise don't have it severe can stay home, in quarantine, instead of in the hospital.

One thing I wish I knew way earlier is that COVID-19 victims rarely suffer from a runny nose. I recently got it from Our World In Data [2], it was linked here on HN. I did not read about this in our local media, sadly.

[1] https://www.worldpolicycenter.org/policies/for-how-long-are-...

[2] https://ourworldindata.org/uploads/2020/03/Coronavirus-Sympt...

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> Zero universal guaranteed paid sick leave

This is a false statement. There are 12 states which require paid sick leave, amounting to 30% of the population [1]. Federal employees are guaranteed paid sick leave days [2]. According to the Bureau of Labor Statistics, 61% of workers have paid sick leave, 78% have paid vacations, (80%/90% in large employers with 500 or more workers) [3].

That whole section is just political garbage. There's plenty of reasons to believe that businesses will take precautions themselves to limit the spread of the virus internally, which includes offering paid sick leave to encourage people to be extra careful.

[1] https://www.ncsl.org/research/labor-and-employment/paid-sick... [2] https://www.opm.gov/policy-data-oversight/pay-leave/leave-ad... [3] https://www.bls.gov/ncs/ebs/benefits/2009/ownership/private/...

It is a literally true statement. Universal means covering everybody. That some slices of the population have it in no way contradicts that. Indeed, most of your numbers prove that sick leave in the US is not universal.

Oddly, in this instance, "Zero" seems like the wrong description for something that is binary.

It's not "oddly", it's deliberately deceptive and trying to exaggerate the problem to advance a political narrative.

I read it as relating to the quantity of leave. E.g., a country could have "7 days per year of universal guaranteed paid sick leave".

Being charitable, it's not actually binary, because sick leave has both a quantity axis and an accessibility access. The "universal" qualifier makes the accessibility axis binary. There's still a big difference between universal 1-day-per-year paid sick leave and universal 30-day-per-year paid sick leave or what have you.

>Universal means covering everybody.

Wouldn't this mean it is an impossible goal since unemployed people don't have it. This might sound a bit snarky, but I am being serious because unemployed does account for people who are working under the radar, often through illegal means. An illegal sex worker, panhandler, or someone doing odd jobs and taking straight cash payments are likely not covered even in places that would be said to have universal paid sick leave.

Definitely not impossible. Plenty of countries give money to unemployed people: https://en.wikipedia.org/wiki/Unemployment_benefits

But that doesn't covered the sick leave portion of the claim, and in general unemployment benefits do not cover everyone who is unemployed (such as children, which is another group who may be working under the radar). It would effectively require a UBI, and even then it wouldn't qualify as being sick leave.

This is the problem with reducing it to a fully binary clarification where everything but fully true is false. 99.999% is so much easier to hit than 100%.

I'm afraid I don't understand what "sick leave" for children or people already receiving benefits would mean.

Are you trying to make an actual point about real-world responses to pandemics? Or is this just some sort of language-is-imperfect cul-de-sac you're in? If the latter, please leave me out of it.

Children work. Be it mowing a yard, working on a farm, or illegally violating labor laws and having an actual job. In some places, even in first world countries, there are children who are working under the radar (children of undocumented immigrants or children who are undocumented immigrants being an example). These children do not get paid sick leave, and thus if the standard for 'universal paid sick leave' is 'everyone gets it', then nowhere meets that standard. If you make your definition require perfection to meet it, then it won't be met. You set the standard on being literally universal a few comments ago, and I'm just showing that nowhere meets that standard.

> Or is this just some sort of language-is-imperfect cul-de-sac you're in?

Come now, have you forgotten when you said the following?

>It is a literally true statement. Universal means covering everybody. That some slices of the population have it in no way contradicts that.

Please do not suggest me being in some language-is-imperfect cul-de-sac when you were the one driving.

Or even just someone that is self employed. There's no federal law requiring them to have an agreement with themselves about what they do on days that they don't feel well.

I realize that this sounds like a really stupid comment to make.

I think it is a great counter example given the word play people are engaging in. It is a silly example, but if a silly example fits, then it suffices to show the standard itself is also silly.

It seems a variant of reductio ad absurdum but I'm not fully certain it qualifies.

Actually my point was that focusing on situations where there is not an employee-employer relationship is a tedious digression. Of course only employed people get sick time from their employer, that is what it is.

>employee-employer relationship

This seems a bit difficult to define to begin with (look at the cases with countries deciding differently for gig workers at places like Uber), and it doesn't seem to have been a qualified exception to the universal that the original comment called out.

It also achieves much the same effect as the very original article in that it allows a sort of propaganda by being able to say no countries in Europe have universal sick leave. And being able to technically make such statements, be their reasoning extremely tedious or not, is the topic at hand.

If I may nitpick your response: the data from the Bureau of Labor Statistics is from 2009. 2018 data suggests 71% of workers receive paid sick leave. [1]

BUT, the data is highly skewed if you look at income. [also 1] The worst paid workers also have much less paid sick leave. Only 45% of the lowest 25% income group do. According to the BLS there were 130 million workers in 2019, thus leaving roughly 15 million people (130 x 0.25 x 0.45) without paid sick leave and likely without the financial means to go on unpaid sick leave or get medical help (like testing).

Also, the average paid sick leave varies between 6-10 (working) days. Suggested quarantine is 14 days. [2] Only 3% of workers have sick days "as needed". [3] This supports the argument that these circumstances make matters worse. I tend to agree to the general argument.

[1] https://www.bls.gov/opub/ted/2018/higher-wage-workers-more-l...

[2] https://www.bls.gov/opub/ted/2019/private-industry-workers-w...

[3] https://www.bls.gov/ncs/ebs/benefits/2019/ownership/civilian...

> Also, the average paid sick leave varies between 6-10 (working) days. Suggested quarantine is 14 days.

All the more reason to treat coronavirus as an exception that needs to be considered, as-needed, business by business. Or state-by-state, or county-by-county. Just because something like coronavirus happens every so often doesn't mean we need a 1-size fits all policy for every year and occasion.

I think businesses should be encouraged to play a role in helping limit the spread of the virus, but if everyone just decides they need to take 2 weeks off because of the cold, that's going to cause some economic troubles. Maybe something like that is needed this year, but for every year, that would be excessive and not help.

Yep.

Paid sick leave except for the people who, y'know, prepare food, handle groceries at checkout, and move packages around warehouses.

Better than nothing... but is it though? Like really?

Does this count people who receive PTO that made be used as paid sick leave? If so, I'm not sure it should be counted.

A person who doesn't have any paid sick leave nor PTO they can use it place of it has to take a sick day doesn't get paid for that day. One way of thinking about it is that they do get paid, but then have to give up pay equal to what they get (and all this is calculated before tax purposes). A person who has to use a PTO day that isn't only for sick leave is giving up something with a near value equal to a day of pay. In most cases, any benefits or the like are not cut for either person, meaning they still receive some level of pay when you look at the averaged out of those benefit values over the day.

This may feel like a needless distinction, but I think it matters because when a person without paid sick leave or PTO is sick they have to weigh staying home against not making money, while a person who doesn't have paid sick leave but is allowed to use PTO has to weigh staying home against losing a day of PTO that they can't use for vacation. A person with true sick leave has no such calculation, sick leave they can only use when they are sick means they aren't giving up anything. Well, there is an argument to be made for the day's worth of experience and other such matters are still loss, which for some positions can be enough to choose to work even when there is paid sick leave.

So 22% don't have any vaccation.That is insane.

If the sick leave is limited, it isn't worth much.

38% without any sick leave is already pretty bad. How many of the rest can take 14-21 days of payed sick leave?

There's plenty of reasons to believe that businesses will take precautions themselves to limit the spread of the virus internally

It's not even on their radar. Not too long ago, a major university hospital in the Southern US held a town hall on the coming plague. It was an embarrassment. Several times, members of the audience asked about sick leave, in case they are under quarantine or have to care for dependents. Crickets from the leadership.

What is going to happen is that hourly support staff will drag themselves to work sick - that actually happened at an Atlanta school, a substitute teacher collapsed at work with Coronavirus and had to be taken away in an ambulance - and will spread disease to those lucky enough to enjoy better benefits.

Where is political discussion about this threat to public health?

Yes, a dry cough, sore throat, and a temperature over 101°F are the most common symptoms of the virus. It shouldn't affect the sinuses too much.

Sore throat is not a known common symptom to COVID-19. The standard list being propagated by public health organizations[1] is: fever (nothing about 101F specifically that I'm aware of), cough, and breathing trouble (e.g. shortness of breath, pneumonia, chest tightness). Upper respiratory symptoms like sore throat are significantly less common with COVID-19 than they are with most viral infections, though obviously the instance isn't going to be zero.

Obviously to some extent this is just pedantry, but at times like this it's really important that we get these things right consistently. If all you have is a sore throat you are very unlikely to have COVID-19 given what we know right now.

[1] Here's the Mayo clinic's: https://www.mayoclinic.org/diseases-conditions/coronavirus/s...

The WHO report has sort throat listed in about 13% of cases, so yes not very common.

As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include:fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgiaor arthralgia (14.8%), chills(11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%)

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https://www.who.int/docs/default-source/coronaviruse/who-chi...

FYI I work for UHG. They're currently spending tens of millions on infrastructure so that their entire workforce can be remote if this gets any worse. If people self-quarantine, they won't lose sick or vacation days and can work remotely.

Several states are proposing bills to protect people who are in hourly or contract roles where if they do self-quarantine, their jobs are covered and they will still be paid.

I feel like companies and the states are able to do more for their people than the government can. I've never been a huge fan of UHG, but they're putting their money where their mouth is this time and protecting their employees and working to contain the spread of the virus within the company.

That's great to hear! At times like these, it makes sense that we society protect the weak from dying. Its also we as society who carry the burden of a less prosperous economy (on the short term).

Today I read in the news that 4% of all employees of hospitals in North Brabant, The Netherlands have COVID-19.

I’m a little skeptical of that sick leave data source, since it claims that Australia offers 6 months or more “paid leave for personal health needs through employers and the social security system,” while Australian unions are campaigning for government support for 3.3 million casual workers with no sick leave: https://www.sbs.com.au/news/unions-call-for-quarantined-casu...

Keyword is casual workers which I suppose is the same as interim and flex workers. These have different rights [1] than people who have a contract. Same with self-employed.

[1] This has its pros and cons but that is beyond the scope of the point.

That's right. It's not beyond the point because in both countries, these millions of casual retail and hospitality workers are the source of the risk discussed in the article (they won't self-quarantine because it would cost them their income). It would be wrong to look at the chart you linked, which shows Australia and Western Europe as green and the USA as orange, and conclude that the USA is unique among developed economies in having a casualised workforce and "zero universal guaranteed paid sick leave."

Lies, damn lies, and...

What I meant with "beyond the scope of the point" is that the discussion of the pros and cons of such system (of casual workers / interim) i a tangent I'm not going on about.

In this context it'd be proper to include an amount/percentage of people who have such a job versus those who have a normal job (with permanent contract). I'm also interested in differentiation between different states, but then again there might also be differences in say Germany's provinces.

On another note, the USA is not unique among developed economies in this context; South Korea is also a developed economy.

> One thing I wish I knew way earlier is that COVID-19 victims rarely suffer from a runny nose

Definitely worth knowing, especially with hay fever season just about to kick off.

>Also, some people are in quarantine.

A day late and a dollar short, breaking news in the last half-hour or so suggests a one-mile containment zone is being setup in New York (New Rochelle), National Guard troops have been sent.

https://www.bbc.com/news/world-us-canada-51826317

Damn it. I intellectually knew it was only a matter of time before it hits hard in the US, but it's different seeing it happen. Next, it will be my city...

What proportion of our population actually works without paid sick leave?

What proportion in countries with guaranteed sick leave is pressured into coming to work anyway by social stigma?

Not everything needs to be legislated. Especially not at a federal level.

At the risk of being confrontational, I have to question whether you have ever had a low-paying job in the USA or if you have even taken the time to look at the typical "benefits" and work requirements attached to such jobs. The absolute and unquestionable reality for millions of workers in the USA (food industry, customer service, transportation, and many others) is that they have zero paid sick leave and are also subject to work requirements that allow for their termination with little to no warning for any form of work absence. It follows logically that there is a great deal of people who work while sick and are afraid of missing work for any reason - they have minimal rights, live paycheck to paycheck, can barely afford healthcare, and have almost zero job security.

This is the environment that rabidly pro-business regulation and the erosion of worker protections has created; assertions that the hideously benighted situation of low-paid workers in the USA will magically "self-resolve" without strong legislation go against the entire history of the labor rights movement and basic common sense.

>The absolute and unquestionable reality for millions of workers in the USA (food industry, customer service, transportation, and many others) is that they have zero paid sick leave and are also subject to work requirements

I don't doubt that - but I'm asking for numbers because I also know that some proportion of supervisors even in shitty jobs are understanding enough to offer sick days. And just as in this current system some people are understanding enough to give people time off, under legislation there will also be some proportion of people who ostensibly are doing nothing illegal but indirectly pressure employees not to take time off - the same way people often accumulate vacation time from the same pressures!

That's why I'm legitimately asking for numbers. Because neither case is going to be black or white. Laws are hard do undo and frequently have unintended consequences. Some things are better solved through social reform, if they are necessary at all.

It's like the oft quoted idea that millions of Americans are struggling working multiple jobs to make ends meet and this requires some form of price floor - but if you look at official BLS reports, less than a couple percent (can't remember exactly) are actually in this state. For decisions which affect millions of people, numbers are everything.

The idea that the number of employers who might pressure their employees into not using legally-enshrined sick leave could be comparable to the number of employers who, through the goodness of their hearts, currently offer sick leave to their low-wage employees in the absence of a requirement to do so doesn't hold water. Furthermore, the (quite real) threat that employers will attempt to violate the spirit of a worker protection law should not be justification for society to not implement such laws. History clearly shows us that the goal of improving the lives of American citizens cannot rely upon charitable behavior from corporations.

I agree that neither case may be black or white; however, one is dark, dark gray and the other is eggshell.

Research how many states have pushed hard to break up unions of nearly every type. Wisconsin's governor made the news repeatedly pulling through "right to work" laws (I don't know details but I was shocked at how little pushback I heard about at all).

Here in IL and IA we've been "right to work" for a good while. Most purposefully misleading euphemism ever.

I'd vote for anyone who had a reasonable shot at forcing those laws to be rescinded and basic worker termination protection restored.

> Wisconsin's governor made the news repeatedly pulling through "right to work" laws (I don't know details but I was shocked at how little pushback I heard about at all).

Wisconsinite here: We really love to screw ourselves over. It's our state pastime. Scott Walker went to blue collar neighborhoods and said "I'm going to take away your right to organized negotiation!" and we said "Yes, I LOVE that!" We put his signs in our yards. Then as a joke we voted to remove, and then changed our minds.

When our some of our legislatures refused to go to work because some silly people stood outside the capital with signs, we decided to unelect the ones that stayed in the capital throughout the protests, and reward the ones that left the state entirely. We just love it :)

There's another side to that argument ("the right to make it damn hard to get hired") but maybe this thread isn't the place for meta social/political discussions.

The immediate problem needs the best fix possible and I do have to say the response from the federal government so far has been underwhelming at best.

I think asking vague questions and mouthing hazy principles is a very bad response to a specific, acute situation. If you want to argue against sick leave, fine, take a swing at it. But please do it with specifics and enough data that you have an argument worth taking seriously.

There are places where people are pressured to work while sick? Not because they can’t afford to be home, but due to pressure from peers and/or management?

Where is that? And why? A five year old would realize that sick people hurt productivity by infecting others?

How about a startup, for starters? Where people spend years burning themselves out?

How about when you have a big project coming up for a client and your team is depending on your contributions?

I'm not advocating for this sort of pressure, but I'm saying that even a law requiring paid sick leave is not going to guarantee that people go home when they're sick. Even in low paying jobs, managers still have to cover shifts. There's always pressure to work. Laws aren't magic.

Both of those are examples where it’s typically possible to work from home while ill. That I realize can be a pressure everywhere. There’s a difference between being pressured to work and being pressured to come to work.

It’s the second that is counterproductive.

If it’s the deadline day and you can afford three people to be off next week so long as the one sick person comes in this week, then it’s a conscious tradeoff at least. But in general it’s short sighted and counterproductive, not to mention rude to coworkers.

The pandemic hasn't even officially started yet; you're making a lot of assumptions about how the situation will unfold that are nowhere near justified. Pieces of paper saying that everything should be alright are one of many things that do not have an impact on the virus. The US has officially done better than most countries with a sick leave policy, although the real state of affairs we won't know for a while and is likely to be horrible.

From afar, the biggest problem looks like the CDCs iron clad grip on test kit certification slowing the response by a month. This compounds a general view of mine that the American healthcare system is crippled by existing regulation that links insurance to employment. Linking emergency response funding to employment is another terrible idea that will hardly assist the situation.

What everyone needed was a disaster preparedness plan. Forcing companies to pay money that they are probably not going to have in a pandemic is a great way to obscure from people how much planning they need to do. Companies don't have magically deep pockets.

> The US has officially done better than most countries with a sick leave policy

This isn't true though. We're simply behind them on the infection timeline, thanks solely to geographical proximity and luck. We're several weeks behind Italy, Korea, Japan, and Iran in terms of how long the virus has been spreading here, and months behind China. You can't compare us now to them now.

The US is one plane flight from China and Italy is one plane flight from China. And their testing has reportedly been weak compared to many countries; they might be in a more advanced state of trouble than it appears.

But the major point here I am happy to concede; it is far to early to start comparing how the US is doing with how everyone else is doing.

The flights don't matter anymore. It's already here, and it's clear we won't start doing anything about it until the hospitals start overflowing, so whether that point is in a month or three doesn't seem that much different to me.

I hate to sound so bleak, but I believe it is mostly accurate.

We're behind them on the timeline because the president restricted travel from the epicenter back at the end of January [1], and the US is the best prepared country in the world for an epidemic [2]. Italy got its 3rd coronavirus case on Feb. 6 [3], and now its totals are at 10k.

Take a look at the cases/country chart on [4] and sort by cases/population. The US is many orders of magnitude better than European countries. It's absolutely worth comparing for specifically the reasons mentioning in OP's post, that being ahead of this makes all the difference in the world.

[1] https://www.nytimes.com/2020/01/31/business/china-travel-cor... [2] https://www.statista.com/chart/20629/ability-to-respond-to-a... [3] https://www.reuters.com/article/us-china-health-italy/third-... [4] https://www.worldometers.info/coronavirus/

And then we proceeded to waste all of that lead time and did nothing with it. We didn't even have a working test until recently.

Meanwhile, we're gonna be at 1,000 confirmed cases in the US in another day or so and the exponential increase is continuing. We're not doing better than European countries by any stretch; what's happening there is going to be happening here in a month's time.

And being "best prepared for an epidemic" may have been true back in 2016, but it's certainly not true under Trump. He fired the highly successful crack epidemiologist team that was initially assembled to fight ebola, and the administration's response to the crisis so far has been largely incoherent, focusing more on the stock market than actually preventing the spread of the disease, and with officials continually contradicting each other and downplaying the serious of the pandemic. Pence, the man in charge of the response, is notable for having presided over an HIV epidemic in his home state. We simply don't have the right people at all in charge to manage this, and that matters greatly. And we still have way too many people not making a livable wage, who aren't guaranteed paid sick days and can't afford to not work.

The US is not testing sufficiently to make any claim about having less cases than European countries.

I'm not a Trump fan, but he made the right choice by shutting down China travel. However, preparedness -- what does that mean? Does that mean we can usually successfully contain illnesses before they break out? That's great, but it's not going to help us anymore. It's already here.

What we need are hospital beds and ventilators. Are we doing ANYTHING to prepare those? Anything at all? Or will we wake up when people are literally dying in the streets, like as is certainly happening in other places in the world?

This column by a conservative columnist does a good job of explaining how the extra time gained by that decision was unfortunately completely wasted: https://www.nytimes.com/2020/03/07/opinion/coronavirus-trump...

Also, the low rate of recorded infections in the US just might have something to do with the regulation-imposed shortages of tests.

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