People walk on the waterfront in Toronto as wildfire smoke fills the city on July 15.Laura Proctor/The Canadian Press
Jesse McLaren is an emergency physician and member of the Decent Work and Health Network member based in Toronto.
Monika Dutt is a public health and family physician and a member of the Decent Work and Health Network member based in Sydney, N.S.
During the pandemic, doctors called for paid sick days because we saw our patients going to work because they couldn’t afford not to, even when public health officials urged people to “stay home when sick” to avoid exposing others to a virus.
Now wildfires are raging and we see patients with asthma and other conditions suffering while governments urge people to “stay inside” to avoid smoke. Just like with COVID-19, the health impacts of the wildfires are not evenly distributed, and legislating paid sick days for all is essential for worker and community health.
Wildfires from the Northwest Territories to Ontario, and smog that blankets cities from Vancouver to Toronto, can make it seem like a pandemic where “we are all in this together.” But COVID-19 disproportionately affected racialized and migrant workers in low-paid and precarious employment – from farms to factories and long-term care homes – along with those with chronic health conditions. Similarly, Health Canada notes that those at greatest risk of the health effects of wildfires include those who work outdoors, those with lower income and precarious employment, and those with chronic health conditions.
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Like the pandemic, these employment conditions create barriers to public health. Health Canada advises that “if you’re among the groups who are most likely to be impacted by wildfire smoke, you should reduce or reschedule strenuous activities outdoors, and seek medical attention if experiencing symptoms of wildfire smoke exposure.”
But how are those who work outdoors supposed to follow this advice if taking a sick day could cost them their wages or their job? How are low-income workers supposed to seek medical care if they can’t take a day off to see their family doctor? Increasingly, indoor workers are also being impacted, as it is difficult to completely avoid the smoke.
As the Decent Work and Health Network summarized in its report on sick days in Canada, the evidence was clear from before the pandemic that paid sick days encourage workers to stay home when ill, for their children to stay home from school when unwell, and for workers and their children to see their family doctors rather than relying on emergency departments. In jurisdictions that expanded paid sick days before the pandemic, from San Francisco to New York, workers used them judiciously without evidence of abuse or harm to the economy.
As Dr. Theresa Tam, Canada’s former chief public health officer, explained in her annual report in 2020, paid sick days are “essential to protect worker and community health.” Following this advice, some governments legislated paid sick days – including five days in B.C. and 10 for federally regulated workers. Others, such as Ontario, provided only temporary paid sick days during the pandemic.
But the health threat has only taken a new form, from viral to smoke particles, demonstrating what a mistake it was to cut paid sick days. Unfortunately, a new “consultation” and “review” of the Canada Labour Code, which enshrines 10 paid sick days for federally regulated workers, has been quietly launched by Prime Minister Mark Carney. There is a risk that the government will restrict or even cut the allotted sick days.
This would be a mistake that would create additional strain on Canada’s health care dollars while also putting more workers – and their respective communities – at risk.
Instead of cutting access to paid sick days, or insisting on costly and unnecessary doctors’ notes for short-term absences, 10 legislated paid sick days should be implemented in every province and territory. As Dr. Tam advised in her 2021 report, “we must act now to ensure that our post-pandemic future is different from our pre-pandemic past.”
It was pre-pandemic gaps in paid sick days and other protections that fuelled the pandemic, and the failure to close these gaps post-pandemic is undermining the public health response to the wildfires.
The ever-worsening climate crisis requires expanding protections, and the pandemic response reminds us how to tackle public health crises: through an equity approach that highlights who is disproportionately affected, and by expanding permanent labour protections for worker and community health.