As a front-line health provider, December brought me two rays of hope: a COVID-19 vaccine and a private member’s bill in Canada’s largest province to legislate permanent paid sick days.

While vaccination has begun, action on paid sick days is stalled again after the Ontario legislature was closed early for the holidays. After nearly half a million infections and more than 15,000 deaths across Canada, both the vaccine and paid sick leave are crucial to preventing COVID-19.

It was heartening to see first recipients of the vaccine were a long-term care resident in Quebec and a personal support worker in Ontario, and it’s important that the vaccine rollout be guided by equity. As chief public health officer Dr. Theresa Tam explains, “the equitable allocation of vaccines where there is limited supply needs to take into account who is most at risk of exposure and severe outcomes.”

As we’ve learned through the first two waves of COVID-19, risk of exposure is not a reflection of the virus but of social and economic conditions.

Low-wage, racialized workers who have been most impacted by COVID-19 must be among the priority groups for receiving the vaccine. These are the workers in health care, cleaning, warehouses, grocery stores and other sectors who have kept our economies going, often in precarious working conditions without paid sick days. Just as vaccination should strive for universal coverage and be guided by equity, governments should legislate paid sick days on the same basis.

On Dec. 8 in Ontario, NDP MPP Peggy Sattler introduced the Stay Home If You Are Sick Act to provide seven permanent paid sick days with an additional 14 days for public health emergencies. But the same day Premier Doug Ford’s conservative government adjourned early, leaving workers still facing the impossible decision between staying home when sick and their financial security. Action is needed immediately from provincial governments across the country to support paid sick leave.

There are many reasons why vaccination and paid sick days go hand in hand. A mass vaccination campaign will take months, but there are currently more than 6,000 COVID-19 infections and 100 deaths every day across the country. We cannot sit back while the death toll mounts, when there is effective and complementary legislation that could be enacted tomorrow.

Legislating paid sick days would have an immediate impact on reducing workplace transmission — as it did in the U.S., where states that gained access to paid sick leave through federal legislation saw 400 fewer COVID-19 cases per state per day — and serve as a bridge to prevent COVID-19 until mass vaccination.

People need to take time out of their day to get vaccinated. Both workers with paid sick days and their children have higher vaccination rates against the flu and better access to other preventive health services. Evidence shows paid sick days increase vaccination rates. But as it stands, paid sick days are denied to those at greatest risk of COVID-19: low-wage workers in precarious front-line jobs, who are disproportionately women, racialized people and migrants.

The COVID-19 vaccine is safe, effective and crucial to addressing the pandemic, but it is not a panacea. Its effect on asymptomatic transmission is not yet known, nor is the duration of protection. None of this takes away from the importance of the vaccine, but it does indicate that we need additional levels of public health protections like paid sick days to complement vaccine prevention.

The COVID-19 vaccine only works against COVID-19. It will do nothing to stop the spread of flu in long-term care homes, the spread of gastroenteritis in restaurants, the higher rate of workplace injuries among workers who go to work sick or the spread of future pandemics.

"Just as vaccination should strive for universal coverage and be guided by equity, governments should legislate paid sick days on the same basis," writes emergency physician Jesse McLaren. #onpoli

Paid sick days are essential to allow workers to stay home when sick, regardless of the illness. That’s why health providers with the Decent Work and Health Network had been calling for paid sick days years before COVID-19, and more recently in a report, which explained why a pandemic response must include permanent paid sick days available to all workers on the first day of symptoms.

Responding to COVID-19 will require addressing vaccine hesitancy, but also hesitancy around legislating paid sick days. Just as there are vaccine myths, there are also paid sick day myths — from claims that they invite abuse or that they’re bad for the economy.

But jurisdictions from San Francisco to New York that legislated paid sick years ago found no widespread abuse or impact on jobs numbers, and support from small businesses. In fact, many businesses report that paid sick leave increases employee retention and creates long-term cost savings.

There are rising calls for paid sick days — from the Toronto Board of Health to mayors of Ontario’s largest cities to the Ontario Medical Association. Tam calls paid sick days “essential to protect worker and community health.”

It’s time that governments across the country recognize both the vaccine and paid sick days as essential, evidence-based and complementary policies. In the face of a rising second wave, both must be rapidly rolled out, guided by equity and with a goal of universal accessibility.

Jesse McLaren is an emergency physician and member of the Decent Work and Health Network.