When Sick, Stay Home or Go to Work?

cold and flu, flu season 2013

Cold and flu season is now fully upon us. During these next few months, many of us will experience illness but not all of us have the luxury of unlimited paid time off to get well. When you have symptoms, you may need to take a serious look at the pros and cons of either going in to work or staying home. Medical experts offer a quick checklist to help you decide.

According to the Centers for Disease Control and Prevention, more than half of the states in the US are experiencing high levels of flu-like illness, and flu activity continues to rise. Currently, 29 states and New York City are reporting high levels of influenza-like illness and another nine states are reporting moderate levels. And the season is not yet at its peak.

“Reports of influenza-like-illness are nearing what have been peak levels during moderately severe seasons,” said Dr. Joe Bresee, chief of the Epidemiology and Prevention branch. “While we can’t say for certain how severe this season will be, we can say that a lot of people are getting sick with influenza, and we are getting reports of severe illness and hospitalizations.”

In a perfect world, everyone would stay home when they are contagious. But we are far from perfect. A recent survey found that nearly 80% of office workers go to work when they are sick. Some workers feel they cannot chance taking time away from work with the economy as shaky as it is. Some workers, such as part-time employees, do not have paid time off and lose money when they don’t go in.

Showing up to work or school when you should probably stay home has been termed “presenteeism.” Presenteeism costs the American economy up to $150 billion per year as ill workers perform well below their usual levels. They also spread the illness to others which adds to the decrease in productive time. Respiratory infections such as cold and flu are responsible for 21% of presenteeism costs.

“People are concerned about calling in sick, but if you’re really feeling unwell and especially if you have a fever, you need to stay home,” says Catherine Cummins, MD, MSN, a health sciences assistant clinical professor at the University of California-Irvine School of Medicine. “A little bit of common sense goes a long way.”
For the most part, if you can take one day off from work as soon as you experience cold or flu symptoms, you will be doing yourself and your co-workers a favor to stay at home. You are most contagious within the first 24 hours of symptom onset. However, if that is just not possible, use the following guide to decide whether you stay home or go into work:

What symptoms should keep me at home?

• You have a fever of any kind (anything over 100.3 degrees) - you could be contagious. If you have a fever plus white patches on your tonsils, you may have strep throat, which is highly contagious and requires antibiotic treatment. Call your doctor for a strep test.
• You're suffering from achy joints. Chills and aches usually accompany a fever.
• You have a persistent cough accompanied by green mucus buildup and a runny nose.
• You have a severe sore throat.
• You are throwing up or have diarrhea.
• Your eyes are bright red and have a discharge.
• If you have a decreased appetite, that is a sign that your immune system is low and it would be best to take a day of rest. Going through a full workday could add stress to the body and slow the recovery process.
• Other questions to ask yourself – How well can I carry out my duties? (If you won’t be at your normal level, it might not be worth the risk to go in.) Do any of the medications I am taking affect my ability to think, work, operate machinery, or drive? (Do not attempt to go to work while taking a medication that would impair your performance or be dangerous to yourself and others.)


What symptoms are normally OK to go to work with?

• You are sniffling, but don't have a fever. You could have allergies.
• Your throat tickles or you have postnasal drip.
• Your ear aches. You may need an antibiotic for an ear infection, but you are probably not contagious.
• You have a sinus infection. If you have pain around the eyes, top of the forehead, the cheekbones, and even the top of your teeth, it may be a symptom of a sinus infection. These aren't typically contagious, but you will likely feel better if you can take the day off and visit the doctor for an antibiotic.
• You have a dry cough with little or no mucus.
• If you are recovering and are no longer contagious — and feel up to it — you should be able to go to work, as long as you do your best to avoid contact with others. You should also tell your colleagues that you are getting over an illness, but no longer pose a threat to their good health.
• If you feel the urge to cough or sneeze, try to back away from others and cover your mouth and nose. If you do not have a tissue handy, sneeze or cough into the crook of your arm and not into your hands. This keeps the hands from carrying germs and passing them to others.

What can I do to avoid getting sick at work from others?

• Avoid direct contact with an obviously ill co-worker. Do not use their telephone or workstation.
• Wash your hands frequently, employing proper hand washing techniques (plenty of soap and warm water, rubbing your hands together vigorously for at least 20 seconds). Hand sanitizers are also helpful (but do not replace proper handwashing)
• Avoid surfaces that may be contaminated - such as in washrooms, close to where other people might wash their hands but not quite as well as you do. Do not use another person’s desk or workstation equipment if they are displaying symptoms.

Caring for Someone Else Who Is Sick

Once your cold symptoms resolve, you may find that you're caring for another family member with a cold. Of course, for parents, when a child is sick, it likely means more time off from work. A study from CS Mott Children’s Hospital notes that about half of parents report that they had to miss work in the last year to take care of sick children. Thirty-one percent of parents reported that they did not have enough paid sick time to cover the days missed.

Most schools have policies that spell out how sick is too sick to go to class. Although policies vary from one community to the next, in general, children should go to school if they have cold symptoms without a fever and stay home if they have an infectious condition or a cold with fever. In addition, students should stay home if they have any of the following:

• Diarrhea
• Vomiting
• Coughs that produce phlegm
• Thick, yellow nasal discharge
• Fever of more than 100 degrees that lasts more than 24 hours
• Flu

In addition to following these guidelines when your child is sick, consider your child’s ability to interact with others and pay attention in class. Even if a child is recovering from an illness and is technically well enough to go to school, it may be in the child’s best interest to stay home and rest. If they’re still very sleepy and irritable, they’re going to have a harder time learning and socializing in school.

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