For workers in the time of coronavirus, a troubling choice: work sick, or lose pay?

Nurses and other caregivers at the University of Southern California's hospitals protested last month about changes in their sick leave benefits.FREDERIC J. BROWN/AFP via Getty Images

The advice is clear, and it’s repeated often: Stay home if you’re sick.

But what if doing so could cost you your job? Or your rent money?

Workers groups around the country are calling for changes in sick leave policies that penalize workers who take time off to recover from an illness. Nationally, only half of the lowest 25 percent of workers get paid sick leave, according to the Bureau of Labor Statistics.

“The best thing you can do if you feel sick is stay home. If your kid feels sick, stay home,” said Jodi Sugerman-Brozan, executive director of the Massachusetts Coalition for Occupational Safety and Health. “But that’s not an option for everybody.”

What are the symptoms of coronavirus, and how is it treated?

The US Centers for Disease Control says little is known about the virus, but it still has some tentative answers.

Two major labor unions, the American Federation of Teachers and Unite Here, recently called for a national policy on paid sick time.

While many employers are making arrangements for people to work remotely, only 29 percent of workers can do their jobs from home, according to the Bureau of Labor Statistics. Among Black workers, fewer than 20 percent can work remotely, and for Latino workers, it’s just over 16 percent.

Jobs that can’t be done remotely are often the lower-paying service jobs in restaurants and hotels. And more than half of workers in food services and related jobs don’t get paid sick time, according to the Economic Policy Institute, a left-leaning think tank.

Restaurant workers who rely on tips for the majority of their incomes may be reluctant to call in sick, said Sarumathi Jayaraman, cofounder of the advocacy group Restaurant Opportunities Centers United. “The only way to get tips, if you’re a tipped worker, is to go to work,” she said.

Many restaurant owners don’t comply with the requirement that they pay the difference if employees’ tips don’t bring them up to the state minimum wage — 84 percent of restaurants violate wage and hour laws, according to a 2013 University of California Berkeley study — and there’s little chance those employers would pay employees the full minimum wage if they’re out sick, she said.

Nearly 60 percent of food workers reported working while ill, according to a 2013 study by the Environmental Health Specialists Network at the Centers for Disease Control and Prevention. Those with a cough were much more likely to report to work than those who were vomiting, the study found.

"Their vulnerability, I think, will expand the crisis if we don't do anything about it," Jayaraman said. "And the crisis expands their vulnerability."

Among those who can’t work at home are people who clean airplanes and provide wheelchair assistance and other passenger services at Logan Airport.

Nonunion workers there are at risk of losing pay if they stay out sick, said Roxana Rivera, vice president of local 32BJ of the SEIU, which represents hundreds of airport workers and is trying to organize 1,000 more. “Workers shouldn’t have to burn through their sick days and be forced to go without pay if they catch the coronavirus, particularly when the cause is their own workplace,” Rivera said.

For airport workers who have a union contract, SEIU is negotiating alternative arrangements to cope with the virus, Rivera said.

Among all workers, more than three-quarters have nine or fewer days of paid sick time, which would not cover the recommended quarantine period of 14 days, according to the Economic Policy Institute.

Massachusetts law requires 40 hours of paid sick time per year. But the law leaves some gaps:

♦ People must accrue the time, earning no less than one hour of sick time for 30 hours of work. New employees may not be eligible for sick pay.

♦ The sick-leave requirement doesn’t apply to companies with fewer than 11 employees or to contractors.

♦ Even for those who have earned it, 40 hours won’t cover a two-week quarantine.

♦ And, even when sick leave is paid for, many employers tally “points” for each sick day taken; employees who accrue too many points fear getting disciplined or fired, even though this type of retaliation is against state law.

“Even with the paid sick leave we have, this is going to leave a lot of people in a difficult situation,” said Nancy Lessin, a retired AFL-CIO health and safety coordinator. People tend to save their sick days for when their children are ill, she said, soldiering through their own ailments. “So many people go to work feeling ill, even with fevers.”

Lawmakers from Washington state and Connecticut last week introduced a bill in Congress that would require all employers to let workers accrue seven days of paid sick time a year and give them 14 paid sick days in the event of a public health emergency.

But there already is guidance on the books, Lessin noted. During the 2009 swine flu pandemic, Lessin and others persuaded the CDC to recommend that employers have “flexible” sick leave policies “consistent with public health guidance”; allow employees to care for a sick family member; and refrain from requiring a doctor’s note as proof of sickness to avoid overwhelming medical offices.

That advice remains in place, Lessin said, although it’s not binding. “It’s in there. But there’s no one really publicizing this issue," she said.

Some companies are stepping up on their own.

Amanda Rositano, president of NETA, a cannabis retailer with 800 employees, said the company is updating its policy to waive the points that accrue for absences. “The policy will be updated so that during a time of crisis such as this one, employees won’t need to be concerned as to whether or not they’re being tracked,” she said.

Amazon has also said warehouse workers and other employees won’t accrue points for absences and unpaid time off won’t be counted during the month of March.

Ride-hailing companies Uber and Lyft said they would compensate drivers diagnosed with the coronavirus or affected by quarantines, according to news reports; Uber is offering up to 14 days of sick time, although it’s unclear how much money drivers will get. Delivery companies DoorDash and Instacart are also reportedly in talks about compensating their workers.

Darden Restaurants, the parent company of Olive Garden and the Capital Grille, among other chains, is now offering paid sick leave for all hourly workers.

After a Walmart worker in Kentucky tested positive for the virus, the company waived its attendance policy through the end of April, allowing people who are unable to work or uncomfortable at work to stay home, using their regular paid time off benefits. Workers under quarantine will get up to two weeks of pay, and those with confirmed cases will get an additional two weeks of pay.