At 4 a.m. in the emergency department during the peak of the Omicron wave, I was asked to assess a man presenting with an ominous shortness of breath. His chest X-ray was all-too-familiar – undeniably characteristic of COVID-19 pneumonia.
As a part-time factory worker with multiple side jobs, my patient was one of many Ontario workers failed by the provincial government.
The public health order to “stay home when sick” without 10 paid sick days was impossible for countless workers, including my patient whose rent and groceries depended on his day-to-day income. While many office-based employees enjoyed the luxury of working remotely from home, precarious workers who perform essential, yet low-paying jobs were exposed to workplace infection and shared the greatest burden of the pandemic.
I feel immensely grateful for the privilege of caring for those directly affected by COVID-19 as a resident physician. While this experience has been rewarding and meaningful, I am frustrated and exhausted from repeatedly observing preventable cases of COVID-related illnesses. I have struggled to understand how idle the government has been in response to the disproportionate impact of COVID-19 on low-income workers.
COVID-19 has not affected us all equally; low-wage workers have struggled with higher rates of viral transmissions, outbreaks, and deaths. Despite the plethora of evidence supporting the effectiveness of paid sick days to protect workers, the Ontario government has obstinately refused to introduce a paid sick-days policy that is universal, immediately accessible, fully paid by employers, adequate in number and permanent.
How many more workers must suffer before our policymakers decide to implement an evidence-based strategy of 10 paid sick days to protect all workers? The solution certainly is not the temporary, belated, three-day paid sick-days scheme.
The stories I hear from my patients make me wonder how three days of paid sick leave can possibly be adequate. A worker who already used a day for each vaccine shot would no longer have any remaining days. It would be impossible to quarantine for at least seven days or to take time off to fully recuperate after an infection.
And these temporary days expire in July. It’s past time for 10 paid sick days and as Ontario goes into election, we must demand this as a policy focus. The Decent Work and Health Network (DWHN), a network of health providers across Ontario, maintains that an effective paid sick-day policy must be 10 days with an additional 14 days during a pandemic. This is the bare minimum required to protect our most vulnerable workers. Now is the time for the government to act.
It is not a surprise that income has been the factor that most reliably determined whether one survived the pandemic or not.
This pandemic has also put a spotlight on low wages. As health providers, we know income is a powerful social determinant of health. Lower income patients are more likely to be impacted by chronic diseases and flu outbreaks and have overall poorer health. Nonetheless, in 2018, the newly elected Ontario government cancelled the planned $15 minimum wage, reversed equal pay for equal work legislation, and cut paid sick days, sending workers into a pandemic with lower wages and fewer protections. This created the conditions for the virus to disproportionately impact low-income workers, many of whom are racialized.
It is not a surprise that income has been the factor that most reliably determined whether one survived the pandemic or not. And income inequality most certainly will be a factor in post-pandemic recovery as many workers will continue to live paycheque to paycheque.
I often wonder whether the patient I met in the emergency department could have avoided workplace infection in the first place if he had a full-time job with an adequate minimum wage that obviates the need to work multiple jobs.
I wonder how many workers, especially those who are racialized, women and migrant workers, could have avoided the virulence of COVID-19 if they were adequately paid and had access to proper working conditions.
Ultimately, after years of pressure from workers, the provincial government finally increased the minimum wage to $15 in January 2022. A legislated cost of living adjustment will bring it to $15.50 in October. However, especially with the cost-of-living skyrocketing, this is far from adequate.
As we near a provincial election, it is important to advocate for policies that increase the minimum wage to $20 per hour, legislate equal pay for equal work, and deliver 10 permanent paid sick days, as recommended by the DWHN. Thus far, only the NDP and Green Party have committed to do so.
Our responsibilities as health providers must entail more than just prescribing Remdesivir or Paxlovid. We must reflect upon the poorly formed policies that are driving our patients to illness and address the root issues of inadequate paid sick days and inequitable wages.
Our patients and all workers deserve better.
The full list of recommendations from the DWHN can be found at https://www.decentworkandhealth.org/endorse_report.