The Omicron variant of COVID is surging throughout the world, including in the United States, which is still being hit hard by the Delta variant, too. New cases in the United States are up more than 20% from two weeks prior.

There is strong evidence that financial challenges for low-wage workers are both reducing vaccination rates and hindering the success of COVID mitigation strategies. With soaring budget surpluses and plenty of unspent American Rescue Plan Act (ARPA) funding available, states should invest in paid sick and family leave, financial support to low-wage workers, and active vaccination efforts to protect lives and public health.

The rapid spread of the Omicron variant is the result of policy choices

Policymakers at the state level who ought to know better are nonetheless claiming that the public health emergency is over and that COVID spread is now solely the fault of individuals who choose not to get vaccinated. Indeed, one Illinois Democratic representative introduced (and then, in the face of public reaction, withdrew) a bill to require the unvaccinated to pay for the full costs of medical care if they get COVID.

It is absolutely the case that deliberate misinformation and fearmongering about vaccines are causing real harm. There remains a core of Americans who choose not to get vaccinated, and their decision jeopardizes the health of everyone. Additionally, it is abundantly clear that COVID spikes are the main driver of unemployment and inflation, and containing COVID is necessary to a full economic recovery.

However, limiting the spread and lethality of COVID is not simply a matter of personal choice. Unvaccinated Americans are disproportionately in low-income households. According to Julia Raifman of Boston University and Aaron Sojourner of the University of Minnesota, a majority of unvaccinated adults earning less than $50,000/year want to get vaccinated.

This is a public policy failure. Two-thirds of low-wage workers still don’t have paid sick leave, and therefore have to choose between their jobs and their health. Low-wage workers, especially Black and Brown workers, are also less likely to have health insurance, even though government policies can increase the number of insured and reduce racial disparities. Researchers at the State Health Access Data Assistance Center at the University of Minnesota have shown that people without health insurance are more skeptical of the healthcare system, less confident the vaccine will really be free, and less comfortable reaching out to health care providers to schedule vaccines.

How states can use federal recovery funds to mitigate the spread of COVID

Beyond vaccination, the federal government did a number of things in 2020 and early 2021 that helped mitigate the effects of COVID. Expanded unemployment benefits kept millions out of poverty. The eviction moratorium prevented many people from losing their housing. Many workers could also use the paid leave provisions of the CARES Act. Also, while the White House has pledged to distribute 500 million free at-home COVID tests, it makes sense to send COVID tests to every home on a regular basis. Every household could be sent N95 masks, too. And so on—there is much government can do to help people get vaccinated and stay safe.

For the present, though, we cannot expect the federal government to pass paid sick leave, extend pandemic unemployment benefits, or reinstate the eviction moratorium. It is time for states to act by using use the funds provided for them under the American Rescue Plan Act (ARPA).

States have more than $90 billion in unspent Fiscal Recovery Funds from ARPA, and another $150 billion will be delivered in 2022. Because the overall fiscal picture of states is as rosy as anytime in recent memory, ARPA funds will in most cases not be needed to meet revenue gaps in 2022.

ARPA funds should be used to prioritize an equitable recovery for workers. Too many states are not taking that path, choosing instead to fund unemployment insurance trust funds (with no useful economic impact) or paying for new prisons that will do nothing to mitigate COVID.

We are far enough along in this pandemic that we know what steps we can take to help. State policymakers should pass paid sick and family leave to take care ourselves and our families. New York, for example, provides paid sick leave to many residents, and even clarified that it can be used for vaccine side effects even without formal medical documentation; it’s no surprise the state has one of the highest vaccination rates in the nation. Policymakers should expand unemployment benefits and fund mobile vaccine centers to go to poor neighborhoods, even going door to door as necessary to make sure everyone has a chance to get vaccinated.

Containing COVID and promoting equity are complementary goals. Paid sick and family leave will enable people to stay home and care for themselves and others, and it will do much to reduce racial disparities in the workplace. Expanding the scope and scale of unemployment benefits to mid-2020 levels would protect workers from COVID-induced business closures, and would surely help reduce poverty rates for Black and Hispanic households, too. Simplifying access to vaccines and providing tests and masks to homes, shelters, and businesses would ensure that vulnerable populations are protected. Premium pay for essential workers would do much to raise the living standards of Black and Brown workers and women.

The present state of the pandemic is the result of public policy choices. States are in a position to take swift action to increase vaccination rates, mitigate the spread of COVID, and reduce the economic impacts of the Omicron variant. Failure to take those actions is also a choice, one that will have devastating consequences in the new year.