"I do believe Walmart is creating a public health threat by encouraging workers to come to work [sick]," said Robert Field, professor of Health Management and Policy at the Drexel University School of Public Health. "It is in a position, as a retailer, to create particular exposures for the public... It's such a ubiquitous store and it particularly caters to families and kids are the ones most likely to spread the disease."
Elizabeth Casman, associate research professor in Public Policy at Carnegie Mellon University in Pittsburgh, Pa., said that about one out of three flu cases may be spread by mucus on the hand touching an object and pointed out that this makes certain situations, such as the checkout counter at a store, for example, a high risk area.
The CDC recommends people remain home until 24 hours after flu symptoms disappear to prevent spreading infection, and they estimate that a sick worker can infect one in 10 co-workers.
But the company does not feel they are endangering customers or employees and say their policies are sufficient to deal with the declared H1N1 pandemic.
"As in the past, Walmart is encouraging our associates who may be ill to stay at home, get well and avoid infecting customers and other associates," said Greg Rossiter, another spokesperson for Walmart.
He also refuted the NLC's claim that they automatically dock pay from sick workers.
"We do not automatically deduct eight hours of sick time from worker's wages," Rossiter said. "With vacation, personal time and accrued sick time, an associate can continue to receive pay or compensation when they're sick and that's our goal."
He added that the company has increased efforts to educate employees on the importance of proper hygiene and cough and sneeze etiquette to prevent illness.
Meanwhile, emergency legislation, introduced Tuesday in Congress, promises five paid sick days to those who are ill at work and are sent home by their employers.
However, experts are lukewarm that the bill, if passed, will be effective at stopping the spread of H1N1, noting that despite being sent home, a sick person in a work environment for any period of time can spread infection.
And Field said such legislation could have a paradoxical effect, inducing a sick worker to come to work to be sent home with pay rather than stay home in the first place without pay.
Nor is Kernaghan impressed with the bill.
"It might help low wage workers or workers at near minimum wage," he said, adding that Walmart employees typically earn above minimum wage, even if some live paycheck-to-paycheck. "But I'm not sure it will help Walmart workers. Managers are not going to tell workers to go home sick because they tell them to come into work sick."
And, regardless of company policies on sick leave or attendance, for some, the drive to move forward with work and earn a paycheck can override the need to protect oneself or others from infection.
"People make choices that defeat good policy," Casman said. "It makes it difficult to legislate communicable disease."
Nor do many yield to CDC guidance.
"It's not unusual not to follow CDC recommendations," Horovitz said, citing those who chose not to get vaccinated against seasonal influenza, let alone H1N1.