America Runs on a Sick Workforce

It always has

Shot of a businessman blowing his nose while sitting in the boardroom with colleagues
LaylaBird/E+/Getty Images
Jacob Bacharach
Can You Cover My Shift?

Two full years and five or six waves, or surges, or spikes — whatever your preferred terminology — into the Covid-19 pandemic, with more than 850,000 dead and millions more lives, families, and communities still staggering under the weight of the loss of life and the prospects of lifelong debilitating illness for many who survived the disease, America’s editorialists, Chambers of Commerce, armchair epidemiologists, and much of our political class have determined that the country, at last, faces a truly grave crisis. Too many Americans are calling off sick. They are actually taking their sick days, or even taking unpaid time off, to care for themselves and for their families, which they are not supposed to do. These cashiers and pre-K teachers, dental assistants and chicken packers, call-center employees and delivery drivers are violating one of the core principles of American capitalism: your time, your health, and your life are not your own.

Throughout the pandemic, the voices of economic orthodoxy, from academic economists to biostatisticians to politicians and commentators across a surprisingly diverse ideological range in these supposedly fractious, polarized times, have loudly worried that policy interventions to prevent, or even to slow, the spread of the novel coronavirus would have grave impacts on the last god that humanity has left standing, the Economy. Occupancy restrictions, temporary business closures, public indoor masking, limited quarantines, individual cash assistance, child tax credits, and even workplace vaccine requirements — all have at some point come in for the same wearyingly self-similar criticisms: that they disrupt business and consumption; that they keep workers off the job; and that, therefore, these piecemeal responses to a plague represent the graver threat to some totemic “return to normal” than that plague itself.

These arguments have settled in as conventional wisdom, though as usual in the American commentariat, the loudest spouters of the most banally conventional opinions insist that they, in fact, are the bold iconoclasts. Governors have lifted mask mandates and are rolling back vaccine requirements; the Supreme Court — increasingly America’s only remaining, functioning national government, albeit as thorny a collection of crackpots and weirdos as you’ll find at the craziest local school-board meeting — has ruled that OSHA, the occupational safety and health organization, cannot regulate occupational safety and health. The feckless Biden administration “is plotting a new phase of the pandemic response aimed at containing the coronavirus and conditioning Americans to live with it.” Happy days are here again.

But there are many millions of loose bits of human machinery grinding in the gears of American capitalism, like the four-plus million workers quitting their jobs every month, and the nine million who are calling out. This is not a policy response to Covid; it is, in a sense, precisely the highly individualized risk-response environment that the let-her-rip, open-it-up, get-back-to-normal brigade has been loudly demanding almost since the first case appeared in America in the winter of 2020.

Some voices, eager to blame America’s abused and underpaid teachers, are trying to shift the blame to overzealous quarantine and isolation policies for supposedly asymptomatic positive tests, or for so-called mild cases. But this is only a fraction of the American workforce, and it’s plain that disruptions are extending to all sectors of the economy. The CDC has already tried to intervene, reducing its recommended post-infection isolation period to five days in a hilariously transparent sop to its complaining corporate partners. Private-sector companies have rushed to cut the tiny, inadequate sick benefits they temporarily extended to their frontline workers.

America was already among the most backward countries in the world in its attitudes toward sickness, an extraordinary outlier in having neither any mandatory national paid sick leave or indeed any paid leave of any kind. This, by the way, isn’t only the case in comparison to the world’s other rich, “advanced” economies, compared to whose state-mandated health and leave benefits America’s miserly non-efforts fall incomparably short. Most of the “undeveloped” and “developing nations” which Americans have been trained to believe are barely civilized and hardly human give their workers more generous leave and sick benefits as well.

Even before the pandemic, the outcomes of America’s broad disinterest in the health and wellbeing of its citizens was obvious. We lack any semblance of a national health system, having Balkanized the country into a barely functional and easily overwhelmed system of corrupt private regional health monopolies. We are the only country in the world that has even a conceptual category for “medical bankruptcy.” We have a shockingly low life expectancy, which peaked in the mid-2010s and has been declining ever since.

America was already among the most backward countries in the world in its attitudes toward sickness.

Amid this great national health squalor, it has been the unspoken, but almost universal, labor policy of America that workers should, and must, come to work sick. Offices, restaurant kitchens, schoolrooms, and factory floors have been full of sniffling, dripping, rheumy-eyed, feverish, flushed, chilled, aching, foggy, fatigued, and — this is essential — contagious employees for the whole modern history of the country. It is dishonorable, even unethical to miss a day. Our schools give out awards for “perfect attendance.” In many companies, it is considered a badge of honor and a bragging right never to have taken a sick day!

Meanwhile, in parallel to industrial and retail policies that have substituted efficiency for resiliency, cutting stocks and material holdings to absurd minimums based on a superstitious belief that there could be no interruptions to just-in-time manufacturing and just-in-time deliveries, American employers have cut staff to preposterously low levels — this is true for white-collar and blue-collar professions alike, for service industries and for manufacturing and agriculture. Managers have ruthlessly pared organizational charts, larding most jobs with absurd collections of barely related responsibilities, and depending on the fact that people cannot, or will not, take time off — not for their own health, not for their children’s, not for their elderly parents or sick spouses — and that they will not leave their jobs, which they depend on for the health benefits that they can still barely afford to use, if they’re lucky enough to have even those.

Even in non-pandemic years, sickness-related absence presented a labor-force problem, albeit a mostly seasonal one. But the sheer magnitude of Covid-19, especially the titanic Omicron spike in caseloads, combined with an unusually tight labor market that has given even individual job-seekers more options and more bargaining power than they’ve had in decades, has resulted in a perfectly foreseeable business conundrum that America’s business leaders, as usual, failed to foresee. People with better offers quit, and people whose households are overrun with illness will, finally, stay home. And there are not enough people in our denuded businesses left to pick up the slack.

This is the grand national tradition of reaping what we sow and then pretending to be morally aggrieved at the bitter harvest. America assumed it could force sick and unhappy people to work anyway — after all, it worked for 50 years. It devoutly assumed that its efficient market deity wouldn’t allow any exogenous shocks to interrupt its supply chains or its human resource pipelines; now it cries that that god must be angry or missing, to allow such a thing to happen: not misery, not suffering, not death on a scale unimaginable outside of war, but unreturned emails, a few classes on Zoom, spotty customer service, and an intolerable extra week or two waiting for a PS-5.

Jacob Bacharach is a writer in Pittsburgh.