Along with scarce vaccine and shrinking stocks of antivirals, the United States faces another enemy in the fight against swine flu: workers who go to work when they're ill because they don't get paid sick leave.
The A(H1N1) virus "is causing an emergency for workers and families across the country," Democratic Senator Chris Dodd told a Senate subcommittee hearing Tuesday on paid sick leave in a time of pandemic flu.
The United States is one of only five countries in the world without a national policy on paid sick leave, Dodd said.
"We're in the company - and I say this respectfully of these countries - of Lesotho, Liberia, Papua-New Guinea and Swaziland. Those countries and the United States are the five that don't have paid sick leave," Dodd said.
"Five nations, four of whom are struggling economies, barely surviving as nation-states, and the richest country in the world," he told a hearing in the Senate health, education, labor and pensions subcommittee.
Many of the 57 million US private sector workers who don't get paid if they take a day off because of illness are in low-paid jobs such as catering or the hotel industry.
For them, contracting the swine flu "means you have a choice: either go into work sick and risk infecting your co-workers or stay home and lose a day's pay," Dodd said.
Swine flu has infected as many as 5.7 million people in 48 US states since it first broke out in April. Nearly 700 people have died in the United States, including at least 129 children, data from the Centers for Disease Control and Prevention (CDC) show.
The United States and other countries around the world threw everything they had at the virus and rushed to develop what they didn't have, namely a safe, effective vaccine.
But pharmaceutical companies found themselves up against a slow-growing virus and outdated technology to make it.
As of Tuesday, only around a quarter of the 160 million doses of (A)H1N1 vaccine that the government initially promised would be delivered by October were available, Anne Schuchat, a CDC expert on immunization and respiratory diseases told the hearing.
Two weeks ago, the United States lost another weapon in the fight against swine flu as officials announced there was a scarcity of Tamiflu for children, one of five groups at high-risk of dying from (A)H1N1.
And now, in spite of admonitions from the CDC for people to stay at home if they are sick, the issue of paid sick leave is creating another obstacle.
"Our current system forces too many sick workers to go to work and too many working parents to send sick children to school and day care," Deputy Secretary of Labor Seth Harris said at the hearing.
Doing that is a sure-fire way to spread (A)H1N1 flu, said Dodd, citing CDC statistics that show that a sick employee in the workplace risks infecting 10 percent of their colleagues.
Dodd, a Democrat, has introduced emergency legislation which would give US workers paid sick days if they fall ill with swine flu or seasonal flu.
Republican Senator Mike Enzi was opposed to legislating on paid sick leave, saying it would hurt the already aching economy by imposing inflexible policies and new financial burdens on small businesses.
"Hitting small businesses and startups with new costs and unfunded mandates is never advisable and even irresponsible" during times of economic hardship, Enzi said.
But Harris of the Department of Labor said employers stand to lose, too, if workers with flu come into work.
"Instead of one sick worker staying at home, an employer could end up with dozens of unproductive, sick workers making their co-workers unproductive," Harris said.
"It's common sense and good business sense: workers should be able to stay home if they're ill," he said, backing the legislation proposed by Dodd.