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If someone showed up at work with a fever, sneezing or a hacking cough in the pre-pandemic days, the worst they probably faced were dirty looks from co-workers and maybe a stern suggestion from the boss to go home and get better.

Yet even before Covid-19, this kind of “presenteeism” — showing up for work when sick — had more repercussions than just infecting colleagues.

“Presenteeism is important in that it might exacerbate existing medical conditions, damage the quality of working life and lead to impressions of ineffectiveness at work due to reduced productivity,” noted Concordia University researcher Gary Johns in the Journal of Organizational Behavior.

Today, with more people than ever working from home to keep the coronavirus from spreading, working while sick has become a big problem for employee well-being, experts say.

A study conducted last year for over-the-counter cold treatment ColdCalm found that seven out of 10 Americans reported working from home while ill during the pandemic. In addition, 66 percent said that taking time off for anything less severe than Covid would be looked down upon by their employer, while 57 percent said they felt that working remotely through their illness enhanced their credibility with co-workers.

Presenteeism with a twist

Such studies and first-hand observations of remote workers not taking needed time off is worrisome to professionals in the human resources, occupational health and legal fields.

For years, many U.S. companies have been expanding their time-off policies to give workers the recovery time they need, both in line with their wellness philosophies and to meet state and federal regulations.

While the “how sick are you?” standard is often left up to the worker, companies can play a role in encouraging staff to take the time they need to recover from an illness, says Tracey Diamond, an attorney and partner at the labor and employment practice of Troutman Pepper, a law firm based in Princeton, New Jersey.

“It is important for companies to put written policies in place that are compliant with all state and local laws regarding sick leave,” she said. “For example, many states now have paid sick-leave laws that allow employees to accrue a certain number of days of paid sick leave per year.  In addition, some jurisdictions have paid and/or unpaid sick-leave laws related specifically to Covid-19.”

She also notes that the Family and Medical Leave Act allows eligible employees to take as many as 12 weeks of unpaid leave per year for their own serious health condition and/or to take care of a family member with a serious health condition.

To stay on the right side of the law, Diamond recommends that employers have a solid system for tracking hours worked, sick-leave accruals and the actual sick leave taken by all employees, whether in the office or working remotely.

That also helps them comply with the U.S. Fair Labor Standards Act, which says non-exempt employees should be paid for all work performed and paid overtime for working more than 40 hours in a workweek.

Expanded policies

Many companies have tried to make it easier to encourage people to take time off when they are sick by adopting policies that group sick days, family emergencies, doctor’s appointments, mental health days, personal days, family obligations and even vacation time into discretionary paid time off (PTO).

During the pandemic, business-software company Jaggaer found in employee surveys that staff were very stressed out from working remotely and needed encouragement to take sick days, says Michele Hamill, chief human-resource officer for the global company based in Raleigh, N.C.

The company’s Earned Time Off program lets people accrue paid time off to use for any personal reason.

“We want to encourage people to take time to keep themselves well,” she said, adding that the policy helped employees better manage their time off, since the traditional boundaries between work and private life were often blurred.

“People may be able to take time off during the day and work at night, if that is that works better for them,” Hamill said. “[With our policies,] we’re helping people establish those new patterns and habits within their home to turn work off.”

Sick or sick and tired?

Physical illness isn’t the only reason for needing a day off, according to a 2020 mental-health study done by Boulder, Colorado-based job site FlexJobs and its remote work consulting arm for businesses, Remote.co.

“Our survey indicated that 75 percent of people have experienced burnout at work, with 40 percent saying they’ve experienced burnout specifically during the pandemic,” said Brie Weiler Reynolds, a career-development manager and coach at FlexJobs and Remote.co. “This is not surprising, given that 37 percent of employed respondents say they are currently working longer hours than usual since the pandemic started.”

The research found that only one in five people said they were able to have open, productive conversations with HR about solutions to their burnout.

“Fifty-six percent went so far as to say that their HR departments did not encourage conversations about burnout,” she said.

“Whether a physical or mental issue, there are friction points between work and personal responsibilities and focuses, even in the best of times,” Reynolds added. “This is especially the case with remote work, where work and personal responsibilities are happening in the same space. The pandemic has amplified all those issues for all of us.”

Employers can play a role in helping reduce that friction, she says.

“It’s a smart business practice because it helps employees regarding their productivity, satisfaction, stress levels and more. And all of that is a net positive for any company,” she said.

Remote.co and FlexJobs several years ago eliminated the distinction between sick time and vacation time and instead offered no-questions-asked PTO, according to Reynolds. In addition, the company in October began giving its entire workforce every other Friday off through the end of this year to give people a much-needed mental break.

“We knew how hard everyone had been working throughout the pandemic, and with so many added burdens and stresses every day, we wanted to make sure people were taking time for themselves and not getting burned out,” she said.

Managers matter</strong 

Policies are one thing, but making sure employees take sick time and that managers encourage that is dependent not only on communication but also the unspoken signals a company sends about productivity, experts say.

In a National Institutes of Health report called “Occupational Health Science in the Time of Covid-19: Now more than Ever,” experts recommended that companies keep a close eye on their employees’ physical and mental health, either in or out of the office.

“Supervisors and managers have a critical role in providing care, compassion and support to workers during, and following, the Covid-19 pandemic when employees are under additional, atypical, stress,” wrote Leslie B. Hammer, an occupational health professor at Oregon Health & Science University and psychology professor at Portland State University.

“Such stress can vary from the front-line essential workers’ fears for their own health and safety and their concerns about the safety and health of family members, to concerns related to job security during a time of significant job loss, to stress resulting from managing remote work and childcare together,” she said. “The role of supervisors and managers in understanding and responding to occupational health, safety and well-being concerns has never been so important.”

She also noted that training supervisors to meet that role can lead to the improved performance, retention, health and well-being of employees. An important resource is the Centers for Disease Control’s guidance pages for workplaces and businesses.

“Employers should establish a culture where employees feel comfortable speaking up when they need time off,” said Diamond of Troutman Pepper. “Training managers to respect employees’ needs helps to instill the message that employees [make] a valuable contribution to the company’s success.  Now, more than ever, the focus is on keeping a safe and healthy workforce.”

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