You might believe that store and restaurant workers in the United States who catch Covid-19 stay at home to recover and keep the public safe.

However, millions of front-line workers are unable to do so without missing a paycheck. As a result, many Americans who work in precarious, low-wage jobs in the service industry are unable to stay at home — even if they contract the virus or are exposed to someone who has been infected.

Some workers are unable to obtain or afford testing to determine whether they have been infected. Many people do not have paid sick leave and must work to pay their bills. Others are afraid of repercussions from their bosses if they call in sick or feel extra pressure to work due to severe staffing shortages.

Unlike most industrialized countries, the United States lacks national paid sick leave laws, leaving large gaps in paid sick leave access, particularly in service sector jobs. According to the most recent Bureau of Labor Statistics data, 41 percent of service sector employees lacked paid sick leave in March 2021, compared to 23 percent of all private sector workers.

Part-time jobs in the service industry are also more common, and they are far less likely to include paid sick leave than full-time positions. According to the Kaiser Family Foundation, the lower likelihood of paid sick leave for part-time workers has a disproportionate impact on women, who are more likely than men to work part-time.

When an assistant store manager at a Pandora jewelry store in Orlando, Florida, was exposed to someone who tested positive for Covid-19 during the final week of 2021, she was forced to miss work without pay because she lacked paid leave.

She is concerned every time she begins to feel ill because she does not have paid sick leave. She’s sent workers home after they called in sick — and felt bad about it because she knew they’d be late for work.

According to a Pandora spokesperson, the company provides full-time employees with 40 hours of paid sick leave per year. Employees who test positive for Covid-19 or are quarantined may use paid sick, vacation, or personal PTO. Franchise stores, such as the one where this assistant store manager works in Orlando, have their own policies in place regarding paid sick leave, Covid-19 leave, and other benefits.

Bill Thompson, a cook at a Burger King in Independence, Missouri, lacks paid sick leave as well. He is concerned about being exposed to coworkers who are bringing Covid-19 because they cannot afford to miss work.

Even before the Covid-19 pandemic or Omicron variant emerged, the lack of paid sick leave and the service sector’s short-staffing model drove economically insecure workers to work despite being sick, according to Harvard University sociologist Daniel Schneider.

Workers are often left wanting more hours and needing to stay in their managers’ good graces to get them, which is another reason workers may be hesitant to call in sick. The number of hours worked also frequently determines whether employees are eligible for health care and other benefits provided by their employers.

The pandemic and the Great Resignation phenomenon have exacerbated the issues caused by a lack of paid sick leave for workers and the pressure to work due to skeleton staffing levels.

In Shift Project surveys conducted from September to November, approximately 65 percent of the 6,600 hourly workers who reported being sick for any reason, not just Covid-19, worked anyway. When asked the reasons why they did so, 55% of them said they needed the pay and 30% said it was because they didn’t have paid sick leave.

However, staffing had an impact on their decision to come to work sick. 45% said they didn’t want to disappoint their coworkers, and 40% said they couldn’t find anyone to cover their shift.

Other workers were concerned that calling in sick would jeopardize their job status: 44% of workers were concerned that they would be fired if they called in sick.

Isaac Pierce, a grocery manager at a Vons supermarket in San Diego, California, reported that some of his coworkers have coughs and cold symptoms. They “play it off” and say it isn’t Covid-19, but he has no way of knowing.