Pretty much no one wants to work when they’re sick—it’s miserable for you and for anyone you’re around. And medical professionals don’t want us to either. The official recommendation from the Centers for Disease Control and Prevention (CDC) is that people should stay home if they have symptoms associated with a cold, the flu, or COVID-19, and you’ll hear the same advice from doctors about most common illnesses. But even though everybody gets sick, not everybody can stay home from work when they do.
“It’s long been a cultural norm to work through a viral upper respiratory infection,” Nicole J. Van Groningen, MD, an internal medicine specialist at Cedars-Sinai Medical Center in Los Angeles, tells SELF. “Unfortunately, the pandemic hasn’t changed that, though many had hoped it would.”
Jay Varma, MD, a professor of population health services at Weill Cornell Medicine in New York City, tells SELF that in his time as a physician, he’s noticed people tend to work through upper and lower respiratory infections, stomach issues (like food poisoning), and urinary tract infections especially often.
The federal government doesn’t require private employers to provide their employees with paid sick leave, and in 2022, 23% of these workers did not have paid sick leave. That number jumps to 27% for those working in transportation, and 38% for people in service occupations. There are also racial disparities in who holds jobs with access to paid sick leave. According to a 2022 paper in the Journal of Racial and Ethnic Health Disparities, Black workers are more likely to hold jobs as bus drivers, home care aides, and food service workers—positions which, the study’s authors write, “are less likely to have health insurance, access to affordable health care, or the availability of sick leave.”
Even folks who have paid sick leave can find it difficult to actually stay home when they don’t feel well. For example, people with PTO might still feel the pressure of productivity culture, and workers who are technically able to take sick leave may still be required to provide a note from a doctor verifying their illness in order to access that time off. But not everyone has the time, money, transportation, childcare, or insurance coverage necessary to see a doctor and get a note—and some people are just too sick (and contagious!) to be able to make it happen.
As Oni Blackstock, MD, founder and executive director of anti-racist health-equity consulting organization Health Justice, tells SELF, “Going to work sick not only negatively impacts the individual and their work but also puts coworkers at increased risk for illness if the illness is contagious.” This is particularly true when it comes to trying to work through COVID-19 (the most common variant right now is especially infectious when compared to circulating influenza strains.)
At the same time, Dr. Blackstock also says that far too many people are forced to work sick due to economic precarity and lack of paid sick leave.
The good news here (or at least, the slightly less bad news) is that even if you can’t take time off, you can still take care of yourself and reduce the likelihood that you’ll get others sick.
How to take care of yourself when you have to work while sick
“First of all,” says Dr. Van Groningen, “don’t panic.” Working through an illness “doesn’t necessarily mean you’re going to develop worsening symptoms or double your recovery time.” (This depends on what, exactly, is causing your illness, of course.)
There are steps you can take to care for yourself—and you’re probably familiar with some of them already.
If you are able to contact a health care provider, Dr. Blackstock recommends reaching out to a doctor to see if they can prescribe anything that will help. (If you don’t have a primary care doctor, consider contacting your local urgent care clinic.) For example, if you think you have the flu, Dr. Varma suggests asking about a medication that can speed up your recovery time, such as Tamiflu if you take it shortly after symptoms start. Both doctors also suggest asking a health care provider if Paxlovid is right for you, if you’ve tested positive for COVID-19. When that’s not possible, either because you don’t have a doctor or because there aren’t any prescription remedies for a good old-fashioned cold, you can still find effective options at the drugstore.
When evaluating OTC meds, make choices based on symptoms, and be sure to check with a pharmacist, if the store has one, about possible interactions to be aware of if you’re taking more than one medication. SELF spoke to some doctors who recommend the following for managing cold, flu, or COVID-19 symptoms:
- Runny or stuffy nose: Look for decongestants that contain pseudoephedrine (like Sudafed). (Note: If you know you have heart problems or high blood pressure, you need to consult a health care provider before taking this.) You can also look for an OTC saline nasal spray to help clear out your sinuses. Ayr is a good option, and drugstores will also have plenty of store brand options.
- Cough and/or sore throat: Look for cough drops (especially those including honey), throat sprays (like Chloraseptic or Vicks VapoCool), OTC saline nasal spray, cough suppressants that contain dextromethorphan (like Delsym 12-Hour Cough and Vicks DayQuil Cough), and expectorants (like Mucinex and Robitussin Chest Congestion).
- Digestive troubles: Look for medicine that has bismuth subsalicylate (Pepto-Bismol) for diarrhea, upset stomach, and acid reflux. You can also try an antidiarrheal with loperamide, like Imodium.
- Fever, body aches, and headache: Start taking a fever reducer like acetaminophen (Tylenol) or ibuprofen (Advil) to help keep your fever and aches in check so you’re more comfortable.
Dr. Van Groningen says that you can also alternate taking acetaminophen and ibuprofen to get better, round-the-clock control of a fever or pain that isn’t responding to one alone. “I will often recommend that my patients stagger them roughly four hours apart.” If you don’t want to juggle an alternating schedule, you can also buy tablets that combine the two.
Any time you’re taking over-the-counter medications, make sure you’re following the dosage instructions on the package and keeping track of everything you take and what time you take it. Using a notes app on your phone, the Apple Health app, or a handwritten note can help you stay on top of this.
Of course, while options like these can help you manage symptoms long enough to get through a shift, they’re only one piece of the puzzle.
Dr. Van Groningen says that if there are ways to make your work day a bit lighter, now is the time to take those steps. If you normally go above and beyond, do what you can to stay below and near in an effort to give your body as much downtime as possible to recover. If you can, take extra breaks, trade shifts to accommodate more rest, and ask coworkers or a supportive manager to help with more taxing tasks.
When your shift ends, do your best to make it an extra early night. Not getting enough sleep has been shown to increase your risk of acquiring a respiratory infection, and sleep is when your body performs necessary tune-ups to all your systems, including your immune system. “The consensus of experts is that too little sleep can prolong your illness,” says Dr. Varma. Feeling under the weather can sometimes make it harder to sleep, but you can try doing relaxing things before bed (like a quick meditation or putting your phone away earlier than usual).
As SELF has previously reported, it’s important to stay on top of your fluid intake when you’re ill. Sick people lose fluids more easily through excess sweating, vomiting, and diarrhea. Couple any of those symptoms with a job where you sweat due to physical labor, or a work setting where you can’t have food or drinks outside of designated times, and you could find yourself getting dehydrated.
If your job offers little opportunity for repeatedly refilling a water bottle or taking hydration breaks, Dr. Van Groningen recommends drinking electrolyte-rich Pedialyte versus water alone. She also swears by an old standard: “Chicken noodle soup is the perfect blend of fluid and sodium, as well as protein and carbohydrates.” In the immortal words of Ina Garten, store-bought soup is fine—and there are lots of break-room-friendly microwavable options that’ll make it even easier to consume.
If you’re having symptoms that make it hard to eat or keep food down, Dr. Varma says Gatorade, in addition to Pedialyte, can also be a good source of both sugar- and electrolyte-aided hydration. If it’s been 24 hours and you still can’t keep food or drink down, or you’re experiencing continual vomiting and diarrhea, he advises getting to a doctor to make sure you��re not dangerously dehydrated or sick with something that will need further treatment to improve.
Dr. Van Groningen, Dr. Blackstock, and Dr. Varma all agree that the precautions we all became familiar with early in the COVID-19 pandemic are good ways to prevent the spread of infectious illnesses in general. These include wearing a well-fitting, high-quality mask like a KN95 or N95; staying up-to-date on your recommended vaccinations; frequent and thorough hand washing; social distancing; and good ventilation.
“Most workers have no control over their offices,” says Dr. Varma, “but, in an ideal world, they would be able to open windows and/or use portable air purifiers in their work areas.”
Also, pay attention to where you are in your illness journey, as that can be a clue to the risk you pose to others. According to the Mayo Clinic, when it comes to common causes of stomach bugs like norovirus and rotavirus, you can remain contagious for a few days or two weeks, respectively, after you recover. If you have COVID-19, keep in mind that research has shown the five-day isolation period currently recommended by the CDC is likely not long enough to ensure you’re not contagious. Because you can still spread germs even after you’re feeling better, continue to be careful for at least a week after your symptoms clear up.
Remember that the ultimate cure is structural change.
Ultimately, any systems that require workers to push through illness are forcing individuals to take responsibility for a structural problem that disproportionately impacts members of marginalized communities like Black and Hispanic workers, LGBTQ+ workers, as well as those with the lowest-paying jobs. One of the most effective ways to avoid both having to work while sick and being vulnerable to illness in the first place, is policy change, which, of course, happens at a structural level.
The good news is that sick leave policies have been at the center of recent labor negotiations and bills in state legislatures. Fourteen states plus Washington, DC, require private sector employers to provide paid sick leave, and cities and counties can mandate it as well, so reach out to your local representatives to encourage them to take action, or consider looking into the steps needed to introduce an initiative at your city’s next council meeting. It’s also worth noting that workers represented by unions are more likely to have access to sick leave, so forming a union can be an important step toward creating a healthier workplace overall.
Ultimately, structural solutions are key to helping reduce workplace illness and improving public health. “We need federal legislation requiring employers to provide paid sick leave to their employees,” says Dr. Blackstock. Until then, we’ll do our best to look out for each other.
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