The government is urging people who are sick to stay at home to help prevent the spread of coronavirus. But for workers who don’t have paid sick leave, staying home when they aren’t feeling well can be financially devastating.

“Missing a day of work can be financially catastrophic for them and mean the difference between making rent or not, making a car payment or not or feeding their family or not,” said attorney Donna Ballman, who heads an employee advocacy law firm in Florida.

There is no federal law requiring companies to provide paid sick leave and almost a quarter of all US workers don’t get it, according to 2019 government data.

Who’s not getting paid sick leave

More than half of private sector workers in the leisure and hospitality industries, which tend to have a lot of face-to-face time with the public at places like restaurants and hotels, don’t have access to paid sick leave.

“We know that when people go in sick they infect other people and when we talk about lower-wage workers in the service sector who are handling food without paid sick leave and other benefits like health insurance, that is really dangerous and a public health concern,” said C. Nicole Mason, president and CEO of the Institute for Women’s Policy Research.

In addition, nearly 60% of part-time workers don’t get paid sick leave, according to the Labor Department.

An executive order signed by former President Barack Obama requires federal government contractors to offer paid sick leave. And some state and local governments have passed laws that require companies to offer paid sick leave.

But some workers may still be hesitant to take advantage.

“Even in cities and states that have passed paid sick days for workers, they still don’t take it,” said Stephanie Luce, professor of labor studies at the City University of New York. “They are afraid if they call out sick, the employer might retaliate in some way.”

What happens during a public health crisis?

As the coronavirus outbreak continues to spread across the globe, some companies are taking precautions to keep their workforce safe by telling employees to work from home, limiting travel and canceling big events and presentations.

“There is clearly a natural tension between wanting to alert people to be as safe as they can be, but not create hysteria,” said Johnny C. Taylor, Jr., CEO of the Society for Human Resource Management.

He encourages employers to offer paid sick leave during a public health emergency like coronavirus, even if they don’t normally offer it.

“For this purpose, you should make exceptions. If you are sick with evidence and symptoms that you could have coronavirus, you should stay home and [your employer should] pay you. It would be dumb not to do that,” he said.

He recommended sending a very clear written policy detailing the expectations, including how long the leave would be offered and what symptoms would qualify.

Employers that make workers come in while they have coronavirus may be violating Occupational Safety and Health Administration [OSHA] regulations, according to Ballman

“Making someone work if they have coronavirus puts other employees at risk. Making someone work with someone else who has it, absent protective gear, puts that employee at risk,” she said.

OSHA laws require employers to provide workers “employment and a place of employment, which are free from recognized hazards that are causing or are likely to cause death or serious physical harm.”

But worries alone aren’t justification for taking time off, according to Taylor. “Employees are required to work unless they have a reasonable basis for believing they are being asked to work in an unsafe workplace,” he said.

Companies and employees can take additional steps to help keep the office healthy. Taylor recommends limiting physical contact like handshakes and instead opting for a fist bump or head nod, being more diligent with keeping commonly-touched items like doorknobs and elevator buttons clean, and posting reminders about washing hands.

“It’s times like this that we really see the need for stronger public policies like paid sick leave and paid family medical leave,” said Mason.