It’s time to pay people to self-quarantine

It’s a devastating fact: More than a million Americans could die from the novel coronavirus. But we can prevent this catastrophe through simple measures like sleeve sneezing, washing our hands and staying home when we’re sick. Problem is, nearly everyone goes to work when they’re sick. We need to fix that. Consider this scenario, which is based on my experiences in every hospital I’ve ever worked in. Monica is a certified nursing assistant. She spends every minute of her shift with patients, most of them elderly, at the largest hospital in town. Monica makes $15 an hour, has two kids to support and has just arrived for work with a runny nose, sore throat and cough. With those symptoms, you may be wondering why Monica is even at work. Like so many other Americans, Monica is working while she’s sick because she can’t afford not to. And Monica’s decision will kill someone. She is endangering not only her sick and frail patients, but her coworkers and their families by exposing them to a virus that they will carry into their communities, their homes and their vulnerable loved ones. In a study published last year, 90 percent of employees in the United States admitted to going to work while sick. That means there are 143 million Monicas in America. They could be handing you change at the grocery store, filling your prescription at the pharmacy or sitting across from you at a mental health clinic. Those sick employees may be caring for your newborn while you work, leaning over your child’s desk at school or helping your elderly loved one out of bed at the nursing home. This is how viruses go viral. This is how people die. Like Monica, most people who go to work when they’re sick do so because they don’t have sick leave, don’t have enough sick leave, or want to save their sick leave days for something more serious than “just a cold.” Bottom line: Americans are bringing their viruses to work because they can’t afford not to. It’s time to consider how much it would cost to pay sick people to stay home. There are about 158 million salary or wage earners in the United States, earning an average of $936 per week. That means that if a third of these workers showed symptoms of the novel coronavirus, and we wanted them to stay home for two weeks, it would cost $98 billion to replace their lost wages. That’s a hefty price tag, but let’s add some perspective. This is what else $98 billion amounts to:

• Less than 6 weeks of military spending
• About two-thirds of the of the money spent on the 2008 Great Recession Stimulus Act
• Roughly 6.5 percent of the recent liquidity injection to the financial markets
• Less than half a percent of the national debt

  So, about that $98 billion. How do we pay for it? Option 1. Just do it The United States government was literally founded with the mission to promote the general welfare of its citizens. If providing for the common defense of those same citizens from a potentially lethal viral epidemic isn’t in line with that mission, what is? We’re talking about adding another 0.4 percent to our national debt. This, in an effort to stop up to 150 million Americans from contracting a preventable virus — and up to 1.5 million Americans from dying from it.   Option 2. Quarantine Loans Of course, not everyone will be on board with tacking on even 0.4 percent to our national debt. So here’s an alternative. The federal government could encourage people to take the sick leave they need by guaranteeing what I’ll call Quarantine Loans. Imagine if Monica could instantly obtain a low-interest loan to cover two weeks of lost wages — a loan she could pay back through automatic payroll deductions over six years. In Monica’s case, two weeks of wages would be $1200 and her monthly payment (assuming an interest rate of 4 percent) would be just $19.   Pay now, or pay later While the COVID-19 situation continues to evolve, this much we know: It’s highly contagious, it can kill, and there’s no doubt it can easily overwhelm our medical system if it gets out of control. And it will absolutely get out of control if we don’t find a way to encourage Monica and the millions of other workers like her to stay home when they are feeling sick. The critics will no doubt argue it is too expensive to pay people to self-isolate. I would urge those critics to look at the costs of this epidemic: The lost productivity, medical bills, funeral costs, and the hit to the GDP. In doing so, I think those critics will find the cost of prevention pales in comparison to the cost of inaction.     Disclaimers This article summarizes the results and conclusions of articles published in the medical literature. It is for general information. It is not a substitute for medical advice, and readers are admonished not to enact or change treatments based on this article. Always seek the advice of your doctor before starting or changing treatment. The thoughts, views, and opinions expressed in this article are my own and do not reflect or represent the policy or position of Northeast Ohio Medical University