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新冠感染病例再次上升,數(shù)百萬(wàn)美國(guó)人急需帶薪休假

Christine Mui
2022-07-21

在富裕國(guó)家中,美國(guó)是唯一一個(gè)沒(méi)有聯(lián)邦政府規(guī)定的病假的國(guó)家。

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奧密克戎新變異毒株來(lái)襲,美國(guó)員工是否有足夠多的病假呢?圖片來(lái)源:PAUL BERSEBACH—MEDIANEWS GROUP/ORANGE COUNTY REGISTER/GETTY IMAGES

早在2020年,新冠疫情爆發(fā)之初,阿普麗爾·帕策爾就失去了帶薪病假的資格——加入了3300多萬(wàn)美國(guó)人的行列。

為了在新冠疫情期間保持財(cái)務(wù)穩(wěn)定,這位49歲的雇主取消了每周工作時(shí)間少于25小時(shí)的員工的福利。她擔(dān)心遭到報(bào)復(fù),拒絕透露姓名。但是,位于美國(guó)阿拉斯加州費(fèi)爾班克斯的醫(yī)學(xué)實(shí)驗(yàn)室科學(xué)家帕策爾并不是自愿做兼職的。

她告訴《財(cái)富》雜志:“我是受《美國(guó)人殘疾人法案》(American With Disability Act)保護(hù)的殘疾人。懲罰一個(gè)無(wú)法選擇全職工作的殘疾人似乎不公平?!?/p>

上周,帕策爾和她的家人首次感染了新冠病毒,她的丈夫住進(jìn)了重癥監(jiān)護(hù)室。由于沒(méi)有帶薪休假,她已經(jīng)丟掉了六天的工資,這一情況還在繼續(xù),她只能依靠朋友發(fā)起的GoFundMe募捐活動(dòng)來(lái)度過(guò)難關(guān)。

帕策爾說(shuō):“我在專業(yè)的基本工作環(huán)境中接受過(guò)專業(yè)教育。你會(huì)認(rèn)為它會(huì)相對(duì)穩(wěn)定和安全,并且有很多好處,但在有些情況下,這不是真的。如果在這種情況下發(fā)生這種事情,那么那些沒(méi)有那么幸運(yùn)找到這份好工作的人怎么辦?”

在富裕國(guó)家中,美國(guó)是唯一一個(gè)沒(méi)有聯(lián)邦政府規(guī)定的病假的國(guó)家——盡管全球疫情使這個(gè)問(wèn)題成為人們關(guān)注的焦點(diǎn)。2020年3月通過(guò)的《家庭首次感染冠狀病毒應(yīng)對(duì)法案》(Families First Coronavirus Response Act)要求一些雇主給員工提供兩周的帶薪休假。但這項(xiàng)保護(hù)已經(jīng)在2020年年底到期,激勵(lì)企業(yè)繼續(xù)執(zhí)行這項(xiàng)政策的稅收抵免也于去年9月結(jié)束。

然而,新冠疫情似乎一波接一波地持續(xù)著。據(jù)美國(guó)疾病控制與預(yù)防中心(CDC)估計(jì),新近推動(dòng)美國(guó)確診病例飆升的是奧密克戎亞型變異毒株BA.4和BA.5,占新確診病例的81%。澳大利亞最近的指導(dǎo)意見(jiàn)表明,與其他毒株幾個(gè)月的免疫期相比,新冠肺炎患者康復(fù)后28天內(nèi)就可能再次感染這些亞型變異毒株。

一個(gè)數(shù)百萬(wàn)人在感染后無(wú)法待在家里拿工資的國(guó)家,是否準(zhǔn)備好應(yīng)對(duì)這種情況了?

就新冠疫情而言,帶薪病假的現(xiàn)狀如何?

在沒(méi)有帶薪病假的國(guó)家標(biāo)準(zhǔn)的情況下,美國(guó)讓每個(gè)地方——在沒(méi)有當(dāng)?shù)胤傻牡胤?,每個(gè)雇主——決定自己的帶薪病假政策,從而讓員工在感染新冠病毒后康復(fù)、照顧隔離的親屬或接種疫苗。根據(jù)研究和倡導(dǎo)非營(yíng)利組織PHI National最近的一項(xiàng)研究,在新冠疫情的頭一年半時(shí)間里,超過(guò)一半的州沒(méi)有為直接護(hù)理和其他重要工作人員提供任何帶薪病假或危險(xiǎn)工作津貼。

針對(duì)最新的變體,公共衛(wèi)生專家在新冠疫情開(kāi)始時(shí)反復(fù)強(qiáng)調(diào)、如今再次強(qiáng)調(diào)的一個(gè)關(guān)鍵信息是:“如果生病了,請(qǐng)待在家里?!币恍┝餍胁W(xué)家,比如薩拉·安德烈亞表示,這說(shuō)起來(lái)容易,做起來(lái)難。

位于美國(guó)俄勒岡州的OHSU-PSU公共衛(wèi)生學(xué)院(OHSU-PSU School of Public Health)的助理教授安德烈亞指出:“這個(gè)問(wèn)題仍然普遍存在,個(gè)別解決方案無(wú)法解決這個(gè)問(wèn)題。你不能對(duì)一個(gè)人說(shuō)‘如果你生病了就不要來(lái)上班’,而不賦予他們這樣做的能力。”

截至2020年,大約四分之一的美國(guó)員工無(wú)法享受帶薪病假。帶薪休假也因?yàn)槁殬I(yè)和收入而大不相同。美國(guó)勞工統(tǒng)計(jì)局(Bureau of Labor Statistics)的數(shù)據(jù)顯示,收入排在前25%的員工中,有94%的人有某種形式的帶薪病假,但對(duì)于那些收入排在后25%的員工而言,這一幾率就像拋硬幣一樣。

安德烈亞說(shuō):“在與很多人打交道的地方工作的人,例如在雜貨店工作的人、在餐館工作的人等等,他們往往是那些無(wú)法享受這些帶薪休假政策的人。他們是根據(jù)有限的選擇來(lái)做決定的,其中之一就是:‘我付不起房租,吃不飽飯,或者,我就有傳染同事的風(fēng)險(xiǎn)?!?/p>

對(duì)于那些有帶薪病假的人來(lái)說(shuō),病假時(shí)間也并不長(zhǎng)。根據(jù)美國(guó)勞工統(tǒng)計(jì)局的數(shù)據(jù),即便是擁有20年以上工作經(jīng)驗(yàn)的私營(yíng)企業(yè)員工,平均也只能享受7天帶薪病假。兩天的時(shí)間用來(lái)接種疫苗和接種加強(qiáng)針,另外還有五天時(shí)間用來(lái)遵守美國(guó)疾病控制與預(yù)防中心的隔離指南,而新冠感染人數(shù)已經(jīng)超過(guò)了平均水平。

同一年內(nèi)感染兩次新冠病毒?這對(duì)病假意味著什么

雖然奧密克戎亞型變異毒株BA.5相對(duì)較新,但它很快就成為在美國(guó)傳播的主要毒株。盡管關(guān)于再感染的數(shù)據(jù)有限,但像紐約市這樣的地方已經(jīng)看到最新的亞型變異毒株導(dǎo)致病例激增,包括一些接種過(guò)疫苗的人,他們?cè)诮衲暝缧r(shí)候感染了新冠病毒,最近剛康復(fù)。

位于美國(guó)波士頓的塔夫茨醫(yī)學(xué)中心(Tufts Medical Center)的傳染病醫(yī)生兼醫(yī)院流行病學(xué)家希拉·多倫告訴《財(cái)富》雜志,在奧密克戎出現(xiàn)之前,再感染新冠病毒很罕見(jiàn),原因有二。直到今年2月,大多數(shù)人才至少感染過(guò)一次新冠病毒。在此之前,變體之間的差異并不大,所以人們的免疫力更好地延續(xù)了下來(lái)。

多倫表示:“與之前或最近傳播的變體相比,一種變體的免疫侵入性越強(qiáng),你就越有可能看到這種現(xiàn)象,即與前奧密克戎時(shí)代相比,有人在更短的時(shí)間內(nèi)再次感染新冠病毒。在奧密克戎出現(xiàn)之前的同一年內(nèi),我們沒(méi)有看到再感染現(xiàn)象,而現(xiàn)在,我們看到了再感染現(xiàn)象?!?/p>

當(dāng)被問(wèn)及今年晚些時(shí)候的第二次感染將如何影響她的家人時(shí),帕策爾皺著眉頭說(shuō):“哦,天哪,那真的會(huì)讓我陷入深淵?!彼a(bǔ)充道,隨著天然氣和石油價(jià)格的上漲,而她在寒冷的阿拉斯加的家要取暖,就需要使用這些能源,“這真的會(huì)讓我們陷入困境,因?yàn)槲覀儸F(xiàn)在收支相抵?!?/p>

澳大利亞的衛(wèi)生官員建議,感染后的免疫期應(yīng)該從12周縮短到28天,他們認(rèn)為再次感染可能會(huì)更早發(fā)生,在上一次感染后不到一個(gè)月就會(huì)發(fā)生。美國(guó)疾病控制與預(yù)防中心沒(méi)有表示將會(huì)縮短免疫時(shí)間窗口。

在美國(guó)前總統(tǒng)貝拉克·奧巴馬的政府里擔(dān)任美國(guó)疾病控制與預(yù)防中心主任的湯姆·弗里登說(shuō),一種新的亞型變異毒株, BA.2.75,幾乎沒(méi)有時(shí)間登上全國(guó)頭條,“似乎比BA.5更具傳染性”。人們擔(dān)心的是,隨著疫情早期的帶薪病假政策到期,疫情將會(huì)擴(kuò)散。

弗里登警告稱:“這提醒我們,應(yīng)該推廣帶薪病假。生病時(shí)要去上班的壓力——尤其是對(duì)依賴定期工資的低收入工人來(lái)說(shuō)——將導(dǎo)致新冠病毒和其他傳染病的傳播?!?/p>

如果感染新冠,并非每個(gè)人都有能力在家遠(yuǎn)程工作。根據(jù)安德烈亞的說(shuō)法,如果沒(méi)有足夠的帶薪病假,面對(duì)面交流的工作給疾病在工作場(chǎng)所傳播帶來(lái)最大風(fēng)險(xiǎn),而教師就是一個(gè)很好的例子。從 8 月開(kāi)始,美國(guó)最大的公立學(xué)校系統(tǒng)之一休斯頓學(xué)區(qū)(Houston ISD)將不再延長(zhǎng)新冠肺炎帶薪病假,教師必須使用他們擁有的任何常規(guī)休假時(shí)間。一項(xiàng)針對(duì)200多名社區(qū)成員的推特(Twitter)民意調(diào)查暗示了這可能帶來(lái)的影響。

如果你感染了新冠并且沒(méi)有病假了,你會(huì)怎么做?

——houstonisdwatch(@houstonisdwatch),2022年7月13日

在美國(guó)馬里蘭州的蒙哥馬利縣,一項(xiàng)允許公立學(xué)校教師由于新冠疫情相關(guān)原因(包括接種疫苗)而休最多80小時(shí)的補(bǔ)充帶薪休假協(xié)議在本月沒(méi)有續(xù)簽。當(dāng)?shù)亟處煿?huì)主席詹妮弗·馬丁告訴《財(cái)富》雜志,她擔(dān)心協(xié)議未續(xù)簽可能會(huì)影響感染后留在家中和選擇接種第二劑加強(qiáng)針的員工比例——美國(guó)總統(tǒng)喬·拜登的政府官員表示,他們本周正在考慮這一情況。

馬丁說(shuō):“你最不希望看到的就是生病的人來(lái)工作,這可能會(huì)使學(xué)校成為疾病的傳播媒介。 人們?cè)诫y有時(shí)間打疫苗,接種疫苗達(dá)到預(yù)期目標(biāo)的可能性就越小?!保ㄘ?cái)富中文網(wǎng))

譯者:中慧言-王芳

早在2020年,新冠疫情爆發(fā)之初,阿普麗爾·帕策爾就失去了帶薪病假的資格——加入了3300多萬(wàn)美國(guó)人的行列。

為了在新冠疫情期間保持財(cái)務(wù)穩(wěn)定,這位49歲的雇主取消了每周工作時(shí)間少于25小時(shí)的員工的福利。她擔(dān)心遭到報(bào)復(fù),拒絕透露姓名。但是,位于美國(guó)阿拉斯加州費(fèi)爾班克斯的醫(yī)學(xué)實(shí)驗(yàn)室科學(xué)家帕策爾并不是自愿做兼職的。

她告訴《財(cái)富》雜志:“我是受《美國(guó)人殘疾人法案》(American With Disability Act)保護(hù)的殘疾人。懲罰一個(gè)無(wú)法選擇全職工作的殘疾人似乎不公平?!?/p>

上周,帕策爾和她的家人首次感染了新冠病毒,她的丈夫住進(jìn)了重癥監(jiān)護(hù)室。由于沒(méi)有帶薪休假,她已經(jīng)丟掉了六天的工資,這一情況還在繼續(xù),她只能依靠朋友發(fā)起的GoFundMe募捐活動(dòng)來(lái)度過(guò)難關(guān)。

帕策爾說(shuō):“我在專業(yè)的基本工作環(huán)境中接受過(guò)專業(yè)教育。你會(huì)認(rèn)為它會(huì)相對(duì)穩(wěn)定和安全,并且有很多好處,但在有些情況下,這不是真的。如果在這種情況下發(fā)生這種事情,那么那些沒(méi)有那么幸運(yùn)找到這份好工作的人怎么辦?”

在富裕國(guó)家中,美國(guó)是唯一一個(gè)沒(méi)有聯(lián)邦政府規(guī)定的病假的國(guó)家——盡管全球疫情使這個(gè)問(wèn)題成為人們關(guān)注的焦點(diǎn)。2020年3月通過(guò)的《家庭首次感染冠狀病毒應(yīng)對(duì)法案》(Families First Coronavirus Response Act)要求一些雇主給員工提供兩周的帶薪休假。但這項(xiàng)保護(hù)已經(jīng)在2020年年底到期,激勵(lì)企業(yè)繼續(xù)執(zhí)行這項(xiàng)政策的稅收抵免也于去年9月結(jié)束。

然而,新冠疫情似乎一波接一波地持續(xù)著。據(jù)美國(guó)疾病控制與預(yù)防中心(CDC)估計(jì),新近推動(dòng)美國(guó)確診病例飆升的是奧密克戎亞型變異毒株BA.4和BA.5,占新確診病例的81%。澳大利亞最近的指導(dǎo)意見(jiàn)表明,與其他毒株幾個(gè)月的免疫期相比,新冠肺炎患者康復(fù)后28天內(nèi)就可能再次感染這些亞型變異毒株。

一個(gè)數(shù)百萬(wàn)人在感染后無(wú)法待在家里拿工資的國(guó)家,是否準(zhǔn)備好應(yīng)對(duì)這種情況了?

就新冠疫情而言,帶薪病假的現(xiàn)狀如何?

在沒(méi)有帶薪病假的國(guó)家標(biāo)準(zhǔn)的情況下,美國(guó)讓每個(gè)地方——在沒(méi)有當(dāng)?shù)胤傻牡胤?,每個(gè)雇主——決定自己的帶薪病假政策,從而讓員工在感染新冠病毒后康復(fù)、照顧隔離的親屬或接種疫苗。根據(jù)研究和倡導(dǎo)非營(yíng)利組織PHI National最近的一項(xiàng)研究,在新冠疫情的頭一年半時(shí)間里,超過(guò)一半的州沒(méi)有為直接護(hù)理和其他重要工作人員提供任何帶薪病假或危險(xiǎn)工作津貼。

針對(duì)最新的變體,公共衛(wèi)生專家在新冠疫情開(kāi)始時(shí)反復(fù)強(qiáng)調(diào)、如今再次強(qiáng)調(diào)的一個(gè)關(guān)鍵信息是:“如果生病了,請(qǐng)待在家里?!币恍┝餍胁W(xué)家,比如薩拉·安德烈亞表示,這說(shuō)起來(lái)容易,做起來(lái)難。

位于美國(guó)俄勒岡州的OHSU-PSU公共衛(wèi)生學(xué)院(OHSU-PSU School of Public Health)的助理教授安德烈亞指出:“這個(gè)問(wèn)題仍然普遍存在,個(gè)別解決方案無(wú)法解決這個(gè)問(wèn)題。你不能對(duì)一個(gè)人說(shuō)‘如果你生病了就不要來(lái)上班’,而不賦予他們這樣做的能力?!?/p>

截至2020年,大約四分之一的美國(guó)員工無(wú)法享受帶薪病假。帶薪休假也因?yàn)槁殬I(yè)和收入而大不相同。美國(guó)勞工統(tǒng)計(jì)局(Bureau of Labor Statistics)的數(shù)據(jù)顯示,收入排在前25%的員工中,有94%的人有某種形式的帶薪病假,但對(duì)于那些收入排在后25%的員工而言,這一幾率就像拋硬幣一樣。

安德烈亞說(shuō):“在與很多人打交道的地方工作的人,例如在雜貨店工作的人、在餐館工作的人等等,他們往往是那些無(wú)法享受這些帶薪休假政策的人。他們是根據(jù)有限的選擇來(lái)做決定的,其中之一就是:‘我付不起房租,吃不飽飯,或者,我就有傳染同事的風(fēng)險(xiǎn)?!?/p>

對(duì)于那些有帶薪病假的人來(lái)說(shuō),病假時(shí)間也并不長(zhǎng)。根據(jù)美國(guó)勞工統(tǒng)計(jì)局的數(shù)據(jù),即便是擁有20年以上工作經(jīng)驗(yàn)的私營(yíng)企業(yè)員工,平均也只能享受7天帶薪病假。兩天的時(shí)間用來(lái)接種疫苗和接種加強(qiáng)針,另外還有五天時(shí)間用來(lái)遵守美國(guó)疾病控制與預(yù)防中心的隔離指南,而新冠感染人數(shù)已經(jīng)超過(guò)了平均水平。

同一年內(nèi)感染兩次新冠病毒?這對(duì)病假意味著什么

雖然奧密克戎亞型變異毒株BA.5相對(duì)較新,但它很快就成為在美國(guó)傳播的主要毒株。盡管關(guān)于再感染的數(shù)據(jù)有限,但像紐約市這樣的地方已經(jīng)看到最新的亞型變異毒株導(dǎo)致病例激增,包括一些接種過(guò)疫苗的人,他們?cè)诮衲暝缧r(shí)候感染了新冠病毒,最近剛康復(fù)。

位于美國(guó)波士頓的塔夫茨醫(yī)學(xué)中心(Tufts Medical Center)的傳染病醫(yī)生兼醫(yī)院流行病學(xué)家希拉·多倫告訴《財(cái)富》雜志,在奧密克戎出現(xiàn)之前,再感染新冠病毒很罕見(jiàn),原因有二。直到今年2月,大多數(shù)人才至少感染過(guò)一次新冠病毒。在此之前,變體之間的差異并不大,所以人們的免疫力更好地延續(xù)了下來(lái)。

多倫表示:“與之前或最近傳播的變體相比,一種變體的免疫侵入性越強(qiáng),你就越有可能看到這種現(xiàn)象,即與前奧密克戎時(shí)代相比,有人在更短的時(shí)間內(nèi)再次感染新冠病毒。在奧密克戎出現(xiàn)之前的同一年內(nèi),我們沒(méi)有看到再感染現(xiàn)象,而現(xiàn)在,我們看到了再感染現(xiàn)象?!?/p>

當(dāng)被問(wèn)及今年晚些時(shí)候的第二次感染將如何影響她的家人時(shí),帕策爾皺著眉頭說(shuō):“哦,天哪,那真的會(huì)讓我陷入深淵?!彼a(bǔ)充道,隨著天然氣和石油價(jià)格的上漲,而她在寒冷的阿拉斯加的家要取暖,就需要使用這些能源,“這真的會(huì)讓我們陷入困境,因?yàn)槲覀儸F(xiàn)在收支相抵?!?/p>

澳大利亞的衛(wèi)生官員建議,感染后的免疫期應(yīng)該從12周縮短到28天,他們認(rèn)為再次感染可能會(huì)更早發(fā)生,在上一次感染后不到一個(gè)月就會(huì)發(fā)生。美國(guó)疾病控制與預(yù)防中心沒(méi)有表示將會(huì)縮短免疫時(shí)間窗口。

在美國(guó)前總統(tǒng)貝拉克·奧巴馬的政府里擔(dān)任美國(guó)疾病控制與預(yù)防中心主任的湯姆·弗里登說(shuō),一種新的亞型變異毒株, BA.2.75,幾乎沒(méi)有時(shí)間登上全國(guó)頭條,“似乎比BA.5更具傳染性”。人們擔(dān)心的是,隨著疫情早期的帶薪病假政策到期,疫情將會(huì)擴(kuò)散。

弗里登警告稱:“這提醒我們,應(yīng)該推廣帶薪病假。生病時(shí)要去上班的壓力——尤其是對(duì)依賴定期工資的低收入工人來(lái)說(shuō)——將導(dǎo)致新冠病毒和其他傳染病的傳播?!?/p>

如果感染新冠,并非每個(gè)人都有能力在家遠(yuǎn)程工作。根據(jù)安德烈亞的說(shuō)法,如果沒(méi)有足夠的帶薪病假,面對(duì)面交流的工作給疾病在工作場(chǎng)所傳播帶來(lái)最大風(fēng)險(xiǎn),而教師就是一個(gè)很好的例子。從 8 月開(kāi)始,美國(guó)最大的公立學(xué)校系統(tǒng)之一休斯頓學(xué)區(qū)(Houston ISD)將不再延長(zhǎng)新冠肺炎帶薪病假,教師必須使用他們擁有的任何常規(guī)休假時(shí)間。一項(xiàng)針對(duì)200多名社區(qū)成員的推特(Twitter)民意調(diào)查暗示了這可能帶來(lái)的影響。

如果你感染了新冠并且沒(méi)有病假了,你會(huì)怎么做?

——houstonisdwatch(@houstonisdwatch),2022年7月13日

在美國(guó)馬里蘭州的蒙哥馬利縣,一項(xiàng)允許公立學(xué)校教師由于新冠疫情相關(guān)原因(包括接種疫苗)而休最多80小時(shí)的補(bǔ)充帶薪休假協(xié)議在本月沒(méi)有續(xù)簽。當(dāng)?shù)亟處煿?huì)主席詹妮弗·馬丁告訴《財(cái)富》雜志,她擔(dān)心協(xié)議未續(xù)簽可能會(huì)影響感染后留在家中和選擇接種第二劑加強(qiáng)針的員工比例——美國(guó)總統(tǒng)喬·拜登的政府官員表示,他們本周正在考慮這一情況。

馬丁說(shuō):“你最不希望看到的就是生病的人來(lái)工作,這可能會(huì)使學(xué)校成為疾病的傳播媒介。 人們?cè)诫y有時(shí)間打疫苗,接種疫苗達(dá)到預(yù)期目標(biāo)的可能性就越小?!保ㄘ?cái)富中文網(wǎng))

譯者:中慧言-王芳

Back in 2020, at the onset of COVID-19, April Patzer became ineligible for paid sick leave—joining a group of over 33 million Americans.

In a move to stay financially stable during the pandemic, the 49-year-old’s employer, who she declined to name fearing retribution, eliminated benefits for anyone working fewer than 25 hours a week. But Patzer—a medical laboratory scientist in Fairbanks, Alaska—doesn’t work part-time by choice.

“I’m ADA disabled,” she told Fortune. “It doesn’t seem fair to penalize a disabled person who isn't making the choice to not work full time.”

Last week, Patzer and her entire family contracted COVID-19 for the first time, landing her husband in the ICU. Without paid leave, she has lost out on six days’ worth of wages and counting, relying on a GoFundMe fundraising drive started by a friend to get through her hardship.

“I have a specialized education in a professional essential worker setting,” Patzer said. “You would think it would be relatively stable and secure and have lots of good benefits, yet there are circumstances where that’s not true. If that can happen to this kind of situation, what about all those people out there who weren't that lucky to have this good of a job?”

Among wealthy countries, the U.S. is an outlier as the only one that doesn’t have federally mandated sick leave—even as the global pandemic drew a spotlight to the issue. Passed in March 2020, the Families First Coronavirus Response Act required some employers to grant two weeks of paid leave to their workers. But that protection expired at the end of 2020, and tax credits incentivizing companies to carry on the policy also ended last September.

Yet the pandemic has persisted in seemingly never-ending waves. Driving the U.S.’s latest spike are Omicron subvariants BA.4 and BA.5, responsible for 81% of new COVID-19 cases, according to CDC estimates. Recent guidance from Australia suggests that reinfections with these subvariants could occur as soon as 28 days after recovering from a previous COVID-19 case, compared to the few months of immunity seen with other strains.

Is a country where millions lack the ability to stay home and keep their paycheck if infected ready to handle that?

What is the current state of paid sick leave when it comes to COVID-19?

Without national standards on paid sick leave, the U.S. lets each locality—and where no local laws exist, each employer—decide its own policies regarding paid time off to recover from COVID-19, care for a relative in isolation, or get the vaccine. Left to the states, more than half didn’t implement any paid sick leave or hazard pay for direct care and other essential workers during the first year and a half of the pandemic, according to a recent study by research and advocacy nonprofit PHI National.

A key message that public health experts repeated at the start of the pandemic is being stressed again for the latest variants: “Stay home if sick.” Some epidemiologists, like Sarah Andrea, say that’s easier said than done.

“We still have this widespread problem, and individual solutions aren’t going to cut it,” said Andrea, an assistant professor at Oregon’s OHSU-PSU School of Public Health. “You can’t say to a person ‘don't come to work if you’re sick,’ and not offer them the ability to.”

Roughly one in four American workers do not have access to paid sick leave at all, as of 2020. Access also varied widely by profession and income. While 94% of workers earning in the top 25% reported having some form of paid sick leave, the odds drop to that of a coin flip for those earning in the bottom quarter of wages, per the Bureau of Labor Statistics.

“Folks in grocery stores, folks who work in restaurants, and so on, where they’re interacting with a great number of people, are often the ones that don’t have access to these paid leave policies,” Andrea said. “They’re making a decision based on what limited options are available to them, and one of them is, ‘I can’t pay my rent and put food on the table, or I risk exposing my coworkers.’”

For those with paid sick leave, it’s not plentiful. Even private industry workers with over 20 years of experience receive seven days of paid sick leave on average, according to the Bureau of Labor Statistics. Just taking two days off to get vaccinated, another for the booster, and five more to follow CDC isolation guidelines while infected with COVID-19 already exceeds that average.

Two cases within the same year? What that could mean for sick leave

Though the Omicron subvariant BA.5 is relatively new, it quickly took over as the dominant strain in the U.S. Data on reinfections is limited, but places like New York City have seen the newest subvariants drive a spike in cases, including among some vaccinated people who recently recovered from COVID-19 in the surge earlier this year.

Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told Fortune that reinfections were rare before Omicron for two reasons. It wasn’t until this February that most people had COVID-19 at least once. And previously, variants were not as different from each other, so people’s immunity better carried over.

“The more immune invasive a variant is compared to the previous or recent ones that have been circulating, the more you might see this phenomenon of somebody getting reinfected in a shorter period of time than what we saw in the pre-Omicron era,” Doron said. “We did not see reinfection within the same year before Omicron came around, and now, we do.”

When asked how a second infection later this year would affect her family, Patzer winced, “Oh god, that would really screw me up,” adding that with the rising price of gas and oil to heat her home in frosty Alaska, “It’s going to really throw us off financially because we're kind of balancing right now.”

Australian health officials suggested reinfections could occur even sooner, less than a month after a previous infection, in their recommendation that the period of post-infection immunity should be narrowed from 12 weeks to 28 days. The CDC has not indicated it will reduce its time window.

Tom Frieden, who served as CDC Director during the Obama administration, said a newer subvariant, BA.2.75, that has barely had time to hit national headlines “appears to be even more transmissible” than BA.5. The fear is that cases will spread as paid sick leave policies from earlier in the pandemic expire.

“This is a reminder that paid sick leave should be universal,” Friedan warned. “The pressure to show up to work when sick – particularly for low-income workers who are dependent on regular paychecks – will result in the spread of COVID and other infectious diseases.”

Not everyone has the ability to work remotely from home if they get COVID-19. According to Andrea, jobs heavy on face-to-face interactions hold the greatest risk of workplace transmission if there isn't enough paid sick leave, and teachers are a prime example. Starting in August, one of the country’s largest public school systems, Houston ISD, will no longer extend COVID-19 paid sick leave, and teachers must use whatever regular leave time they have instead. A Twitter poll of more than 200 community members hinted at the impact that could bring on.

What are you doing if you catch COVID and are out of sick days?

— houstonisdwatch (@houstonisdwatch) July 13, 2022

In Maryland’s Montgomery County, an agreement that allowed public school teachers to take up to 80 hours of supplemental paid leave for COVID-related reasons, including vaccinations, was not renewed this month. The president of the local teachers union, Jennifer Martin, told Fortune she worries losing the agreement could affect the proportion of staff that stays home when infected and opts for a second COVID-19 booster—which Biden officials said they are considering this week.

“The last thing you want is for sick individuals to be coming into work and potentially making the school a place that's a vector of disease,” Martin said. “The harder you make it for people to have the time to get a shot, the less likely you are to get the reach you want with inoculations.”

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