A new survey has revealed that many workers continue to work when sick, even when showing symptoms of fever.
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‘At the time of the present COVID pandemic it is important to realize that healthcare workers, despite feeling moderately sick during flu seasons, feel the obligation to work.’
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In order to better understand the phenomenon of working while sick for healthcare workers and non-healthcare workers alike, Tartari and colleagues conducted an opt-in cross-sectional online survey of the members and international networks of the International Society of Antimicrobial Chemotherapy (ISAC) Infection Prevention and Control (IPC) Working Group from October 2018-January 2019. 
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In total, 533 respondents from 49 countries participated--of these, 249 were healthcare workers (46.7 percent) and 284 non-healthcare workers (53.2 percent). A clear majority from both groups (99.2 percent of healthcare workers and 96.5 percent of non-healthcare workers) would work through "minor" symptoms like a sore throat, sneezing/runny nose, or cough. 58.5 percent of respondents stated they'd continue to work when sick with an influenza-like illness (including major symptoms like muscle aches and fever), with no significant variation between healthcare workers and non-healthcare workers.
Healthcare workers did significantly diverge in some ways: 26.9 percent of healthcare workers would continue to work even when experiencing a fever (one of the most major symptoms), compared with 16.2 percent of non-healthcare workers; similarly, only 45.8 percent of healthcare workers would avoid a colleague exhibiting influenza-like symptoms, compared with 60.9 percent of non-healthcare workers. Healthcare workers were also more willing to receive the influenza vaccine (81.1 percent, versus 56.7 percent of non-healthcare workers).
Though this study is limited by the fact that the participants were self-selected, with 90 percent of respondents coming from high-income countries, the results are concerning, since over half of both healthcare and non-healthcare workers report being willing to continue working through major influenza symptoms, despite international guidelines.
In the midst of a pandemic, future strategies to prevent the transmission of influenza-like illnesses in work settings--especially healthcare, where workers often care for immunocompromised patients--are crucial, and the authors note that a broad cultural change is required, in addition to sufficient sick leave and access to the influenza vaccine.
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