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Harvard Business Review: January 2005

On average, says Dr Kristin Nichol of the Minneapolis Veterans Affairs Medical Centre, a normally healthy working adult who contracts influenza will be sick - and highly contagious - for five to six days. And he or she will miss, on average, one to three days of work. Those numbers speak volumes about the work ethic - or the sheer necessity - that propels people to work even when they are sick.

"People who don't think twice about keeping a child home from school won't think to stay home two days later when they have the same symptoms," says Roslyn Stone, an executive of Corporate Wellness who serves as chairwoman for the American Medical Association's and Centers for Disease Control's Workplace Flu Prevention Working Group.

When sick workers come to work, it's no bargain for employers. Presenteeism (the opposite of absenteeism) costs companies as much as US$150 billion in lost productivity, higher healthcare expenses and cascading absences due to contagion.

While many human resources departments have begun to get the message, this year's shortage of flu vaccine comes at a time when presenteeism and the forces that cause it are in full blossom. A fitful economic recovery in the US has left employers scrambling to do more with downsized workforces, and it has fostered insecurity among employees.

In recent years, the number of workers with no paid sick leave has increased. Large employers have been trimming sick days, or collapsing them, along with workers' vacation time and personal days, into a single pool of paid time off. And 91 per cent of large employers surveyed recently said they sought to control absenteeism by penalizing workers who overuse their sick days - either by docking their pay or by entering a negative report in their personnel files.

All these developments, say experts, encourage sick workers to come to work anyway, no matter how many clients, customers or co-workers they infect, and no matter how poorly they work.

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