Hannah Free, MPH, NIOSH; Matthew R. Groenewold, PhD, NIOSH; Marie Haring Sweeney, PhD, NIOSH; Sara E. Luckhaupt, MD, NIOSH; Rachael Billock, PhD, NIOSH; Rebecca Guerin, PhD, NIOSH; Andrea Okun, DrPH, NIOSH

We wanted to know the proportion of all people working outside the home and the subset of those working outside of the home who were diagnosed with COVID-19 that had access to paid or non-paid sick leave between June/July and September/October 2020.

Working outside of the home poses a risk of work-related exposure to SARS-CoV-2. The CDC recommends that if an employee appears to have symptoms or feels sick, they should stay home. Access to sick leave can reduce the transmission of SARS-CoV-2 by allowing employees to manage their own health at home without compromising their financial stability or physical distancing recommendations. With the increased need for standard sick leave and quarantine leave for the general population, did employers change access to sick leave in 2020, especially for those sick with COVID-19?

The HealthStyles surveys are a series of nationally representative annual online surveys administered by the marketing research firm Porter Novelli to a sample of panelists recruited by probability-based sampling methods.

The National Institute for Occupational Safety and Health or NIOSH added questions to the 2020 Porter Novelli Styles summer and fall surveys to see if respondents were able to take sick leave from work during the pandemic. We also measured the change in the proportion of workers working outside the home with access to sick leave from summer to fall of 2020. Using these data, we estimated the proportion of people working outside the home who had access to both paid or non-paid sick leave and what proportion had symptoms or was diagnosed with COVID-19.

Using R Studio, we calculated the proportion and 95% confidence intervals of sick leave availability among those currently working outside of the home in the summer and fall survey. We measured sick leave availability in both surveys by total population and the subset of those diagnosed with COVID-19. Differences in question wording across surveys did not allow for paired analyses of response subsets and test results, so we first analyzed the surveys separately. We then dichotomized all responses as yes/no for any kind of paid sick leave and performed McNemar?s test of paired proportions on the dichotomized data from the subset of respondents who answered in both surveys. We are currently in the process of finalizing the analysis and preparing the manuscript.

In the unpaired analyses, 56.6% (95% CI: 53.1, 60.0) of respondents could take paid leave in the summer vs 44.0% (95% CI: 40.6, 47.4) in the fall. Of those symptomatic or diagnosed with COVID-19, 62.4% (95% CI: 40.6, 84.3) could take paid leave in the summer. Of those who tested positive in fall, 63.7% (95% CI: 37.6, 89.8) could take paid leave. Paid leave policies specifically for COVID-19 applied to 55.5% of fall respondents.

Among the 1,061 respondents who completed both surveys, 399 respondents had access to paid sick leave related to COVID-19 in both the summer and fall and 374 did not have access to paid sick leave related to COVID-19 during both periods. Between summer and fall, 72 respondents gained sick leave and 216 respondents lost sick leave. The McNemar?s test was highly significant with a value of 78.95 and a p-value of 2.2e-16.

In the US, the availability of paid sick leave or any kind of leave is not universal. The BLS estimates in 2020 that 78% of U.S. civilian workers and 75% of private industry workers had access to paid sick leave. Despite the high prevalence of COVID-19 in fall of 2020, the number of workers with paid sick leave declined significantly from summer to fall 2020.

This is one of the few studies to examine the proportion of workers who tested positive for COVID-19 and had access to paid sick leave. Policies giving paid leave only for those with COVID-19 applied to over half the fall respondents who tested positive for COVID-19. For respondents who were waiting on test results and could not take advantage of COVID-19-specific leave policies, this could incentivize working while sick until officially diagnosed. The analysis was subject to at least four limitations: the data are self-reported, so there is potential for recall and response biasnly those who were currently employed and worked outside of the home were included. The variance might be underestimated because no sample design variables were available from Styles and the survey testing measures are differed as updated questions were asked as new information became available. Because of this, we could not compare these equivocally between the surveys without the recoding of responses.

Between Summer and Fall 2020, the proportion of people working outside of the home with access to paid sick leave decreased significantly. Future investigation is needed to examine the reasons for the decrease.

Tags: Applicable to all occupations/industries, Best Practices in Creating Healthy Workplaces, Comprehensive Approaches to Healthy Work Design and Well-Being, COVID-19, Emerging Issues, Interventions in the Workplace, Surveillance, Total Worker Health