Your Health: When to call in sick
by Terry Hollenbeck, M.D.
Nov 29, 2012 | 1515 views | 0 0 comments | 7 7 recommendations | email to a friend | print

It’s getting to be the time of year when respiratory illnesses, such as colds, coughs and the flu, begin to make more of us ill.

I’m frequently asked by patients whether they can return to work or school or resume exercising when feeling sick. I’d like to offer some guidelines to help make such decisions.

I know missing work or school can mean falling behind on one’s workload, but going to work or school while ill can not only prolong an illness, but also spread it to others.

It seems employers and educators are becoming more tolerant of excused absences due to illness. They realize that not only will workers or students who are sick be less productive, but they may cause others to become ill and affect the entire office or classroom.

In fact, it has been reported that more than two-thirds of all health-related productivity losses are the result of sick employees who show up and perform poorly — not those who miss work to recover.

As a rule, stay home when ill:

- If you have a fever (100 degrees or higher).

- If you experience frequent coughing or sneezing.

- If you are taking medication that may make you dizzy, lightheaded or unable to concentrate.

- If you have vomiting or diarrhea.

Consider returning to work or school when the above symptoms have cleared up.

Meanwhile, you can take several precautions — whether at home, at work or at school — to help keep from spreading illness to others.

Wash your hands frequently with soap and water or with a hand sanitizer, and keep your hands away from your face.

Cover your face when sneezing or coughing, using tissue paper or the sleeve on your arm.

Try to stay several feet from face-to-face contact with those around you.

I can’t emphasize enough the importance of keeping distance between those who are sick and others who are not. Germs are spread through respiratory droplets from our noses and mouths. In normal conversation and breathing, those droplets from the mouth may extend out one or two feet from you, but a sneeze or cough can spread them an estimated six to eight feet.

Those who are healthy need to act defensively when in the presence of someone who is showing symptoms of an illness.

Mild to moderate physical activity is usually OK if you have a common cold and no fever. Don't exercise if you have a fever, fatigue or widespread muscle aches.

If you do choose to exercise when you're sick, reduce the intensity and length of your workout. Exercising at your normal intensity when you have more than a simple cold puts you at risk for a more serious illness.

Let your body be your guide. If you have a cold and feel miserable, take a break. Scaling back or taking a few days off from exercise when you're sick shouldn't affect your performance. Resume your normal workout routine gradually as you begin to feel better.

- Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website,, or email him at Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.
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