Flu season 2018: infectious behavior

Feb 26 2018 Published by under Uncategorized

Walking around campus last week, I was surrounded by students who were hacking and coughing. I dodged an undergrad with red-rimmed, teary eyes and another who was pale and shivering despite being wrapped up in what looked like a blanket. I felt like I was in a scene from a bad zombie movie as I was surrounded by swarms of visibly ill students leaving class. I breathed a premature sigh of relief when I got to lab—where a colleague was coughing uncontrollably as he tried to pipette.

Later that week, when I picked my toddler up from daycare, there was a sign taped to the front door:

“PARENTS!!! Do NOT bring your children to [daycare] when they are SICK!!! We will KNOW if you gave them Tylenol for fever and they will be SENT HOME!!! This is for the good of your child! As well as the STAFF and other CHILDREN!”

If the judicious use of caps and exclamation points in that sign was any indication, my son’s caregivers were as fed up as I was with people’s lack of consideration regarding contagion. We were later notified that the daycare had 6 confirmed cases of influenza.

The flu can cause severe complications, especially for the elderly, pregnant women, infants, and immunocompromised individuals. So it’s really frustrating to see people behave as their though contagious illness is little more than a personal inconvenience, when the reality is that their behavior can create a truly dangerous environment for others.

But, what choice do people have? Vaccines and hand sanitizers can only do so much. Our human bodies still become ill, seemingly at the most inconvenient times. Fortunately for the influenza virus, we don’t often take time off to take care of our sick bodies, and therefore we provide the flu with classrooms and conference rooms full of potential hosts.

The students were going to class because they are highly competitive and had exams and review sessions they couldn’t miss. My colleague came to work because he had time-sensitive experiments to perform—and grant deadlines are even more merciless than exams. Parents drop off the sick kids at daycare because… well, it’s tough enough to get time off for yourself when you’re sick and contagious. It’s even harder when you need additional days off to care for your sick kid.

So, we go to work and send our kids to daycare—with the flu, with gastroenteritis, and other contagious pathogens. And the infectious cycle perpetuates.

Ultimately, we’re not doing ourselves or our employers any favors by coming to work sick: a Danish study showed that the habit of working through short-term illnesses leads to more prolonged health-related absences in the long-term. Still, this can be hard to keep in mind when faced with impending deadlines.

Of course, academics, students, and scientists are certainly not alone in working while sick and contagious. When I dropped off a parcel at the post office on the weekend, a postal employee was displaying the same symptoms as the students on campus—bloodshot glazed eyes, sweating, lethargy, and a hacking cough. I enquired, “You look sick…?” He answered weakly, “Yeah…” I responded, “You really should stay home and rest!” A woman I’m assuming was his supervisor shouted at both of us, “Well, what do you think? That we can all just stay home if we’re sick? NO! If you can still move, you should work!”

I feel like her words poetically summed up America’s attitude towards illness.

Food service workers, for instance, are notoriously not given time off when ill. The number of norovirus outbreaks caused by ill food service employees forced to work through their gastrointestinal distress is stomach-churning and their stories make me never want to eat out again.

Clearly, the behavior of working while sick is dangerous to others. What may come as more of a surprise is that it is also often detrimental to the economic interest of the larger corporation. Chipotle, for instance, lost a billion dollars in value when an employee forced to work while sick spread norovirus to the community. Personally, I wrote a negative review of my local post office branch for forcing its employees to come in when sick.

Coming back to campus– can we, as scientists and educators, influence how people think and cope with contagious illness? I hope so, and that’s one reason I’m writing this blog post.

At very least, let’s lead by example. In the lab, for instance, it’s important to have a degree of redundancy. If a postdoc wakes up with a 104-degree fever one morning, they should be able to stay home and know that their cell lines won’t crash and their mice will be cared for because someone else can at least perform the basic duties required (critical to this is also good record-keeping and labeling—which are good lab citizenry habits regardless of illness). This way, one lab member gets sick instead of five. And that lab member should be thanked for staying home and recovering, and offered help, instead of being made to feel guilty for getting ill.

In the classroom, students should be able to make up or drop an exam missed because of illness. Review sessions can be reiterated in online forums. If a professor or lecturer becomes ill, perhaps they can post recordings of the previous semester’s lectures online. Alternatively, a syllabus can be designed with some wiggle room so that missing one or two lectures won’t throw off the entire course plan. And it should be explicitly stated that students should stay home and take care of themselves while ill. Some honestly seem to believe that showing up while sick will impress their professors!

Unfortunately, illness will always be a fact of life. And, when it happens, it will present a conflict with work. In America, with its vomiting food service workers unable to take a single day off, this conflict seems especially profound. We will never be Sweden (check out Vabbing here and join me in my envy of Scandinavian rationality). I have had to reluctantly accept that I will not be living in Sweden any time in the near future.

But. We do all live in 2018. Germ theory is an accepted truth. Let’s acquiesce to that reality and encourage others to do the same—especially the younger generation who we teach and mentor.

And if all else fails, make people watch her. Preach!

5 responses so far

  • David says:

    This was one of the biggest changes for me when I left school and got a "real" job. Within a few months I got sick, but came in anyway - I was taught by my parents to go to school/work unless you were deathly ill, taught by my schools and PIs to do the same, and I hadn't yet built up sick leave with my new employer. When my coworkers told me I should go home, I replied that I was fine. Then they repeated that I should go home and chastised me for risking their health (it was the first of many times I found out my coworkers cared far more about their own things than any of mine). So I guess I'm lucky to work where the culture is more to the side of take off when you are sick than most.

  • xykademiqz says:

    I have it explicitly written in the group policy documents that group members should stay at home when sick. It helps them recover faster and prevents contagion; both aspects are important. I wish everyone had enough personal days in their jobs to just stay at home and recover when sick. The least I can do is provide that for my group members.

    @David: it was the first of many times I found out my coworkers cared far more about their own things than any of mine

    🙂 Of course. Most people care first and foremost about not getting sick themselves; they don't give a rat's ass about you. Unless they are a close personal friend or family, it's only their (very, very distant!) second concern that you should rest to get better. It's best not to expect too much personal investment or care from one's co-workers, no matter where one works.

  • Bryan says:

    We're kidding ourselves if we think our work is so important that it warrants risking our health and that of others. I teach more students in a term than I care to admit, and I impress on all of them that I WANT YOU TO STAY OUT OF CLASS if you are sick. So do you classmates, and so should you!

    It's also very important to show students that you're interested in their health and well being when they're not obviously sick, particularly at the high-stress periods that coincide with the end of semesters. We're too competitive in this society (me more than most). Teach students care - for themselves and for others - and they just may listen a little more closely to what we're saying in our lectures too.

  • scikap says:

    Great point about leading by example. My first week in my new postdoc, my advisor got a cold. He emailed the whole lab saying “I’m not feeling well, so I’m staying home to rest and so I don’t make everyone else sick”. How wonderful! This trickles down through the whole group so everyone feels comfortable staying home if they are sick. Unfortunately, in my experience, this attitude is very rare.

  • peirama says:

    Yes, this! I yelled at my dad for teaching his classes with the flu!

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