You wake up in the morning and you know you don’t feel right, but you can’t afford to be sick. Meetings to attend, deadlines to meet, kids to get to school—it’s not going to go away because you don’t feel good. Matthew Weissman, MD, MBA, a primary care doctor with the Mount Sinai Health System, offers some common-sense advice about when to stay home, and when to keep your kids home.
As New Yorkers, we feel this drive to keep going all the time. So many of us feel compelled to go to work even when they don’t feel well. When should people stay home from work?
Lots of us feel this pressure to show up to work, be tough, and work through it. But we’re doing a disservice to our colleagues and ourselves by doing that. Helping each other as good New Yorkers means that if you have symptoms such as fever, sneezing, runny nose, muscle aches, or fatigue, you should stay home. You should give your body—and your colleagues—a break and stay home.
How long should you stay home?
If you have a fever, you should stay home at least 24 hours after the fever goes away. And when flu symptoms are present, you should probably stay home for a week from the time the symptoms start. Maybe you can find an alternative way to work, like working from home, but that’s not an option for everyone. Perhaps you can find time to work when others aren’t around, or find a space that’s a bit secluded. But pushing yourself is never a good idea. It will just take that much longer to recover.
The other thing is that people are contagious 24 hours before they start showing signs of the flu. So that’s even more reason to practice good hand hygiene all the time, get your flu shot, and don’t share drinks, food, or toothbrushes with other people. You really have to be on alert all the time—not just when someone near you is coughing or sneezing.
What about keeping my kids home from school?
I know it’s tough on kids to miss school, so perhaps checking with your pediatrician is a good idea. If it’s just the sniffles and no fever, it may be okay for them to go. Or perhaps they can find a way to video chat into some classes. You certainly want to help prevent spreading colds and flu around the class. That’s why it’s important to teach kids about good hand hygiene, and to cover their cough with their elbow instead of their hands.
Sometimes when you’re sick, you are a bit torn. You wonder if it’s in your head, and you think about all the stuff you have to do.
It’s a balancing act. But think about it as an investment in the future. If you get some rest now, you’ll be more productive at work in the future. It may not be in our nature to slow down, and it may not seem like it’s what everyone else is doing. But it’s really important to protect our ability to function down the line. Because the flu will wipe you out for a week, at least, and then you’re really playing catch up.
The flu isn’t always just a few days of being under the weather. People forget that it’s a deadly disease, and can lead to other complications like pneumonia. So if you’re going to err, it might as well be on the side of safety.
Another thing that people wrestle with is, “Is this just a cold or is it the flu?”
That’s true. Many people confuse the flu with a cold, so it’s important to know the difference and to get checked out when appropriate, since the flu can be deadly. Colds tend to come with just runny noses, sneezing, and head symptoms, while influenza tends to have more bodily symptoms like muscle aches and fever. If it is the flu, treatment like Tamiflu is most effective in the first few days of symptoms. If it’s a bacterial infection, you may need antibiotics. If it’s a cold, the best thing you can do is rest and get plenty of fluids. Many times people come to us and feel they should have antibiotics. It’s important that doctors only prescribe antibiotics when needed; otherwise, patients may experience unnecessary side effects, or the antibiotics may not be as effective when you really need them.
And of course, you have New Yorkers who don’t want to give up their workout. Is it a bad idea to work out when you don’t feel well?
If you really have the flu, you’re going to feel debilitated and not feel like working out anyway. But if you just have the sniffles, you might feel better after a little exercise. Certainly you don’t want to contaminate people. But if you have a slight cold, it might feel better to get the blood pumping and your airways opened up. And you definitely want to wipe down the treadmill with an antiseptic wipe, and wash your hands before and after your workout. The gym is one of those places where you can come into contact with all kinds of germs.
Always listen to your body and let that (and your doctor) be your guide.
Matthew A. Weissman, MD, MBA, is Chair of Medicine at Mount Sinai Downtown and Associate Professor of Medicine (General Internal Medicine), and Pediatrics, at Icahn School of Medicine at Mount Sinai