September 27, 2019
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Despite sick leave policies, many health care personnel work while ill

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Hilary Babcock, MD, MPH
Hilary M. Babcock

Five months of active surveillance of acute respiratory viral infections among patients and staff at a long-term care facility revealed that 89% of staff with an acute respiratory illness reported going to work when they were ill, even though the facility had policies against working while sick.

“As ID physicians, it’s helpful for us to be an advocate for policies around sick leave and time off that encourage people to take that time and stay home,” Hilary M. Babcock, MD, MPH, president of the Society for Healthcare Epidemiology of America and professor of medicine at Washington University School of Medicine in St. Louis, told Infectious Disease News. “Anything that can remind people that staff can get sick as well and that it’s important to have policies that can facilitate them staying home is helpful.”

Babcock and colleagues conducted active surveillance at a 120-bed long-term care facility between Dec. 2, 2015, and April 30, 2016. They defined a case of acute respiratory illness (ARI) as experiencing two or more of the following symptoms: a fever of 37.3°C (99.1°F) or higher, headache, sore throat, shortness of breath, chills, muscle and/or joint pain, coughing, wheezing, fatigue, congestion or runny nose, or change of mental status or confusion. Specimens were collected at multiple timepoints throughout the study period.

All patients were offered the influenza vaccine, and a mandatory staff influenza vaccination policy at the facility resulted in a 97% vaccination rate for the 2014 to 2015 season.

The final study population included 76 health care providers (HCP) and 105 patients. Among the 12% of patients and 32% of HCP who reported “any respiratory symptoms,” 31% of patient symptoms and 75% of HCP symptoms met the study definition for ARI. According to the study, 44% of HCPs with an ARI reported a household member had been sick prior to illness onset.

The researchers observed 28% of HCP with an ARI take sick days compared with 89% who reported working with an ARI. This group also included four HCP who also used sick days.

According to a press release, the researchers had anticipated a higher detection of infections. They suggested that the facility’s high vaccination rates and sound infection control practices, combined with a mild respiratory virus season were driving factors behind the low infection rate.

Improved communication and strengthened enforcement of work restriction/sick leave policies is critical, according to Babcock and colleagues. They also noted that it is important to determine the feasibility of existing work restriction policies.

“More research would be helpful to try and understand better what types of policy structures really work to discourage people from coming to work when they are sick,” Babcock said. “But I think there are a lot challenges in designing that kind of research and carrying out that kind of research.” – by Marley Ghizzone

Disclosures: The authors report no relevant financial disclosures.