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Swine flu: Without paid sick leave, workers won't stay home

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In addition, 15 states have proposed mandatory sick-leave laws, and New York City is following the lead of San Francisco, Milwaukee, and Washington, D.C., which have passed some form of mandatory sick-leave measures.

The swine flu outbreak "ties back to the issue of employment rights and social support," says Marc Rodwin, author of "Medicine, Money and Morals." "There's a conflict between what's good for the public and what's good for the individual."

An estimated 100 million workers stand to lose pay if they follow Mr. Obama's advice and stay home. Some 60 million of these Americans – 48 percent of all US workers – have no sick leave at all, according to the independent Institute for Women's Policy Research, in Washington. (The US Labor Department put the figure at 43 percent in 2007.) Others lack flextime that would let them to stay home to care for family members. These data have helped to create momentum to reform labor laws. So have events on the ground.

Though the Obama administration has urged schools to stay open, 351 were closed in the third week of October because of swine flu. Some 600 have closed temporarily this school year, according to the Associated Press.

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