Health and Economic Consequences of Universal Paid Sick Leave Policies During the COVID-19 Pandemic
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Abstract
Importance
Universal paid sick-leave (PSL) policies have been implemented in jurisdictions to mitigate the spread of SARS-CoV-2. However empirical data regarding health and economic consequences of PSL policies is scarce.
Objective
To estimate effects of a universal PSL policy in Ontario, Canada’s most populous province.
Design
An agent-based model (ABM) to simulate SARS-CoV-2 transmission informed by data from Statistics Canada, health administrative sources, and from the literature.
Setting
Ontario from January 1 st to May 1 st , 2021.
Participants
A synthetic population (1 million) with occupation and household characteristics representative of Ontario residents (14.5 million).
Exposure
A base case of existing employer-based PSL alone versus the addition of a 3-or 10-day universal PSL policy to facilitate testing and self-isolation among workers infected with SARS-CoV-2 themselves or because of infected household members.
Main Outcome(s) and Measure(s)
Number of SARS-CoV-2 infections and COVID-19 hospitalizations, worker productivity, lost wages, and presenteeism (going to a workplace while infected).
Results
If a 3- and 10-day universal PSL were implemented over the 4-month study period, then compared with the base-case, the PSL policies were estimated to reduce cumulative SARS-CoV-2 cases by 85,531 (95% credible interval, CrI -2,484; 195,318) and 215,302 (81,500; 413,742), COVID-19 hospital admissions by 1,307 (-201; 3,205) and 3,352 (1,223; 6,528), numbers of workers forgoing wages by 558 (-327;1,608) and 7,406 (6,764; 8,072), and numbers of workers engaged in presenteeism by 24,499 (216; 54,170) and 279,863 (262,696; 295,449). Hours of productivity loss were estimated to be 10,854,379 (10,212,304; 11,465,635) in the base case, 17,446,525 (15,934,321; 18,854,683) in the 3-day scenario, and 26,127,165 (20,047,239; 29,875,161) in the 10-day scenario. Lost wages were $5,256,316 ($4,077,280; $6,804,983) and $12,610,962 ($11,463,128; $13,724,664) lower in the 3 day and 10 day scenarios respectively, relative to the base case.
Conclusions and Relevance
Expanded access to PSL is estimated to reduce total numbers of COVID-19 cases, reduce presenteeism of workers with SARS-CoV-2 at workplaces, and mitigate wage loss experienced by workers.
Competing interests
The authors have no competing interests relevant to this article to disclose.
Funding
Supported by COVID-19 Rapid Research Funding (C-291-2431272-SANDER). This research was further supported, in part, by a Canada Research Chair in Economics of Infectious Diseases held by Beate Sander (CRC-950-232429). The study sponsor had no role in the design, collection, analysis, interpretation of the data, manuscript preparation or the decision to submit for publication.
Author Contributions
Conceptualization: PP, JDR, BS, DN
Data Curation: PP, JDR, BS, DN
Formal Analysis: PP, JDR, DN
Methodology: PP, JDR, BS, DN
Supervision: PP, DN, BS
Validation: PP, JDR, BS, DN
First Draft: PP, JDR, BS, DN
Review and Edit
PP, JDR, BS, DN
Key points
Question
What could be the health and economic consequence of more generous paid sick leave policies in the context of the COVID-19 pandemic?
Findings
More generous policies are estimated to reduce SARS-CoV-2 infections (and thus COVID-19 hospitalizations), lost wages and presence of individuals with infection at workplaces.
Meaning
More generous paid sick leave can be a valuable addition to other COVID-19 public health interventions.
Article activity feed
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SciScore for 10.1101/2022.01.13.21268270: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has limitations: reduced long-term post-COVID-related disability, deaths prevented or quality-adjusted life years gained were not assessed; we assumed that workers would not forego wages in order to self-isolate except for severe COVID-19 disease; reduced unemployment or other increases in economic activity due to a reduction …
SciScore for 10.1101/2022.01.13.21268270: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has limitations: reduced long-term post-COVID-related disability, deaths prevented or quality-adjusted life years gained were not assessed; we assumed that workers would not forego wages in order to self-isolate except for severe COVID-19 disease; reduced unemployment or other increases in economic activity due to a reduction cases were not explicitly modeled; and the probability of employer-based PSL was obtained from 2016 census data. Further, we did not consider the effect of PSL to enable earlier diagnosis of SARS-CoV-2. Further research could include cost-utility analyses and studies focussed on macroeconomic outcomes.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a protocol registration statement.
Results from scite Reference Check: We found no unreliable references.
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