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Prescribing Paid Sick Leave—An Important Tool for Primary Care During the Pandemic

  • 1Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Harvard Medical School, Harvard University, Boston, Massachusetts
  • 3Alston & Bird LLP, Atlanta, Georgia

“14 days—no work, no outings. Please stay home.”

It is a conversation unfolding thousands of times daily across the US, as the coronavirus disease 2019 (COVID-19) pandemic spreads. On the telephone, via video consultation, or—increasingly rare these days—during an actual office visit, a primary care physician tells a patient, “Your symptoms sound like COVID-19.”

And many patients—the 25-year-old man working to stock grocery shelves, the 50-year-old woman driving a city bus, the restaurant line-order cook preparing takeout—ask anxiously, incredulously, or tearfully: “Stay home from work? I can’t.” Or “No puedo.”

Although primary care faces many new pressures and challenges due to the pandemic, no real clinical tools are available to actually treat patients with severe acute respiratory syndrome coronavirus 2 infection in the outpatient setting. The most common COVID-19–related interaction many primary care physicians have during the pandemic is trying to persuade patients who feel lousy—but not gravely sick—to stay home from work and other activities for 2 weeks (or even 7-10 days after a positive test result because quarantine guidelines have shifted).

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