Canada still lacks universal paid sick leave — and that’s a public health problem as we approach flu season

As Canadians head into another flu and COVID season, many workers still face an impossible choice if they fall ill: stay home and lose pay, or clock in sick and risk spreading illness. This is more than an individual dilemma; it’s a predictable public health failure — one the government already knows how to fix.

Paid sick leave is good for both health and business, reducing the spread of illness while supporting workforce productivity, promoting better health outcomes and increasing labour force participation.

So why don’t all workers in Canada have it?

A lesson we’ve failed to learn

The costs of sick people going to work were starkly evident during the COVID-19 pandemic.

In 2021, Peel Region in Ontario became a hotspot for transmission. Research from Peel Public Health found that one in four employees went to work while showing symptoms of COVID-19, and about one per cent did so even after testing positive.

Mississauga Mayor Bonnie Crombie called these figures “evidence” that workers were being forced into a dangerous trade-off between “losing a paycheque and putting food on the table.”

And yet, Canada still lacks a comprehensive paid sick leave system. Access remains patchy, depending on the province, sector or employer. The Canada Labour Code mandates 10 days of paid sick leave, but only for federally regulated employees.

At the provincial level, only British Columbia (five days per year), Québec (two days) and Prince Edward Island (one to three days, depending on tenure), have permanent paid sick leave. Ontario briefly offered three days during the pandemic but ended the program in 2023.

Even where these programs exist, they don’t cover everyone. Independent contractors and gig workers are excluded, and many low-wage and part-time employees still lack coverage altogether.

Gig workers, in particular, fall through the cracks. They’re classified as self-employed and left without the basic protections that most employees take for granted.

Canadian unionized workers are more likely to have paid sick days negotiated into their contracts, but coverage remains uneven and far from universal. In sectors with low union density, such as hospitality and agriculture, workers are least likely to have access to any form of paid sick leave at all.

The case for paid sick leave

Every year, workers bring colds, flu and other contagious illnesses to work because they cannot afford to stay home. Presenteeism — working while ill — harms recovery, spreads infection and increases workplace outbreaks.

Research shows that high job demands and low resources drive presenteeism, which in turn reduces job satisfaction and organizational effectiveness. It’s a lose-lose equation: employees suffer, productivity drops and illness spreads faster.

The evidence shows that paid sick leave improves both public health and business outcomes. A 2023 review of 43 studies found that paid sick leave is linked with higher job satisfaction, better retention, fewer workplace injuries, reduced contagion and even lower mortality.

Other research shows that employees without paid sick leave experience greater psychological distress, while simply knowing that such policies exist improves attitudes and trust toward employers.

Although some studies note short-term costs for organizations, the previously mentioned 2023 review found these costs are outweighed by long-term gains, including stronger employee loyalty, lower turnover and improved public health outcomes.

Building on what works

To address this, Canada should integrate paid sick leave into systems similar to workers’ compensation for workplace injuries and fatalities.

Canada already has well-established mechanisms, such as provincial Workers’ Compensation Boards and the Federal Workers’ Compensation Service, that provide income replacement and rehabilitation support for employees with work-related illnesses and injuries.

Extending this logic to illness, especially when it spreads through communities, would prevent workers from being penalized for following public health guidance while helping organizations avoid widespread disruption.

Governments and employers could draw lessons from the successes and shortcomings of existing compensation systems to design a program that is fair, efficient and responsive to routine illness and public health emergencies.

For instance, the workers’ compensation programs have long provided reliable, no-fault coverage for physical injuries, but they also struggle with uneven access, complex claims procedures and limited recognition of mental health conditions.

Leadership is also crucial. Leaders who prioritize employee well-being and model prosocial safety behaviours can reduce presenteeism and strengthen safety culture. They are also crucial for setting examples and encouraging employees to use sick leave without fear.

When leaders communicate that taking time off while sick is responsible, not risky, they help rewrite the social norms that keep people working through illness and ensure paid sick leave policies translate into healthier workplaces.

Paid sick leave is a public health imperative

Policymakers, business leaders, unions and the public need to support the creation of a paid sick leave system that is robust, fair and capable of protecting all workers and workplaces. The COVID-19 pandemic revealed the need for expanded sick leave policies, and it remains just as urgent today.

Paid sick leave is basic public health infrastructure. During the COVID-19 pandemic, paid sick leave enabled workers to stay home when they were exhibiting symptoms, which reduced transmissions, workplace outbreaks and worker absenteeism.

A universal sick leave system would help Canada better manage seasonal illnesses and future outbreaks, protect economic stability and prepare for emerging crises, from new pandemics to climate-related health shocks.

Lives depend on it. Organizational health rests on it. Society’s well-being requires it.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Alyssa Grocutt, University of Calgary; Julian Barling, Queen's University, Ontario, and Nick Turner, University of Calgary

Alyssa Grocutt receives funding from the Social Sciences and Humanities Research Council of Canada.

Julian Barling receives funding from the Borden Chair of Leadership and the Social Sciences and Humanities Research Council of Canada (SSHRC).

Nick Turner receives research funding from Cenovus Energy Inc., Haskayne School of Business's Future Fund, Mitacs, and the Social Sciences and Humanities Research Council of Canada (SSHRC).