This season, parents are being forced to choose between working for pay and caring for sick children flattened by the “tripledemic” of flu, respiratory syncytial virus and covid-19. The plight of parents is real. But there’s something seriously off here: Why are discussions about the need to care for sick children so often framed around the effects on working adults? Why aren’t we foregrounding what children need and deserve?
Americans are so conditioned to think of “benefits” such as paid sick leave in terms of what adults can wrest from their employers that it can be hard to acknowledge when such arrangements are absurd. This part of life is one of those moments: It makes no sense for the care of sick children to depend on state laws or the generosity of individual businesses toward their workers.
Grown-ups deserve paid sick leave for themselves. But this country owes children a sick-leave policy of their own — one that guarantees they’ll be tended to by their best advocates.
It is an unfortunate truth of early childhood that kids get sick a lot as their immune systems are seasoned through contact with the outside world. When kids get sick, schools and child-care systems oblige them to stay home, to protect their peers and teachers.
But there’s no organized system to help children meet that obligation. Parents are the safety net — yet they’re often actively deterred from catching their kids.
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Just 13 states and D.C. (as well as a few large cities in other states) have laws in place allowing parents and other primary caregivers to earn paid sick leave and to use that time to care for sick children.
This means that in the 37 U.S. states without paid-sick-leave laws, a distressing number of parents and guardians must choose between a child and a paycheck. As we face down a brutal winter flu and RSV season, we need to grapple with what this means in real terms for American families.
According to calculations from the National Partnership for Women and Families, between April 14 and Aug. 16 of 2021, just 13 percent of Arkansas parents and 14 percent of Mississippi parents were backstopped by paid sick leave when they had a child who was too sick to attend school or day care. A mere 18 percent of parents in Florida, Georgia, Michigan and Texas were able to take paid time off to care for their sick children. Workers in some industries don’t have paid sick days at all. Employees in the rail industry nearly went on strike to protest their employers’ practice of penalizing them for taking unpaid leave.
These appalling policies mean that more than 80 percent of children in some states might not get to spend a sick day with the most comforting figures in their lives. And it’s easy to imagine those numbers rising this winter, as more children become ill, more teachers and day-care workers call out sick, and more employee absences make it difficult for managers to be flexible and understanding.
What happens to children whose parents can’t stay home? They might get shuffled to a neighbor or a relative. But there are limits to what those caregivers can do. Most parents probably don’t have notarized forms on hand saying someone they’ve tapped in an emergency can authorize medical care for their children.
Even if a child packed off to a hastily deputized babysitter arrives with an insurance card and an authorization form as well as a beloved stuffed animal, that fill-in caregiver might not know allergies by heart or be alert to the subtle shifts in behavior that suggest a child is getting sicker. They certainly won’t have a preexisting relationship with a child’s pediatrician or be the most comforting choice if a child needs invasive testing or uncomfortable treatment.
Worse is the prospect of a sick child being left home alone. That terrible outcome is easy to imagine when both parents work and many people live far from extended family. In the best of circumstances — healthy child, kid-proof house, ready-made lunch in the refrigerator — leaving a child alone is highly risky. But even the smartest, most capable children can’t be expected to monitor their own temperatures accurately, take appropriate doses of medication at the right times or swiftly make adult decisions in an emergency.
If parents do choose to forgo a paycheck, or even risk a job, to care for a sick child, there’s an impact on that child, too. Lost wages can mean food shortages or a lack of winter clothes. A lost job can be even more devastating.
Creating a program that guarantees sick children the best possible care won’t be easy; the American economic system isn’t set up to guarantee children much of anything. But there are plenty of models available in countries with more broadly sane leave policies. Belgium, for instance, offers a lifetime pool of 52 weeks of caregiving time, to be used before children turn 8. Switzerland provides three adult sick days each time a child falls ill.
Accomplishing anything like this will require a huge attitude shift. A good place to start: Let’s think of paid sick leave not in terms of what employers owe employees, but in terms of what we all owe children at their most vulnerable.