How Much The Pressure To Come To Work Sick Is Costing Us

‘Presenteeism’ isn’t just killing us – it’s killing our productivity.

You’re at the office and a coworker drops by your desk to ask a question, sounding suspiciously stuffed-up. You ask if she’s sick, and she says she’s fine – her allergies are just acting up. But her glassy eyes and flushed cheeks suggest otherwise. When she leaves, you whip out your antibacterial gel pump and slather it from the tips of of your fingers all the way up to your elbows, just to be safe.

We’ve all been there. And most of us have been on the other side, too – pretending we’re fine and soldiering through an illness so as not to miss a day of work. Because as much as no one wants to share their work space with a germ vector, it seems no one really wants to admit they’re sick and take the day off either – even if you’re working the most horrible job of your life.

Turns out there’s a name for this phenomenon: it’s called ‘presenteeism,’ and it’s costing companies billions of dollars. A study led by healthcare researcher and analyst Walter (‘Buzz’) Stewart estimated that presenteeism costs American companies $150 billion a year.

Although that study was done more than ten years ago, the problem hasn’t gone away over the last decade. If anything, it’s growing worse in the current work climate, as companies eliminate jobs and expect the remaining employees to cover duties that used to be shared by more than one worker. The pressure to perform has never been greater.

The irony is, research shows that coming in to work when you’re sick as a dog doesn’t improve your performance at work at all – it actually makes it worse. And human resources experts are aware of this: they agree not only does going to work sick negatively impact your own productivity and quality of work, it gets other people sick too.

So why do we do it? And why don’t companies do something about it?

The social factor

Gary Johns, a management professor at Concordia University in Montreal, has studied presenteeism extensively. He says the social aspect of showing up to work can’t be underestimated, and that people who work in groups, and on team projects, are more likely to report to work while ill. This is even more so if people in leadership positions set the status quo by rocking up to work coughing and sneezing; it’s something Johns says can lead employees to “feel socially obligated to attend work despite illness.”.

Rather alarmingly, Johns reports that the people who are most likely to work sick are teachers and caregivers – pretty much exactly the people you’d hope aren’t walking around with a contagious illness.

The “There’s no one else to do the work” factor

Another major reason people still haul their achy, feverish selves to work is feeling like there simply isn’t anyone else who can cover for them.

“I knew that if I stayed home, work would just keep piling up on my desk,” a close friend recently complained.

“There’s just no one else to do the work. If I stay home sick, I know I’m going to have twice as much work when I come in the next day.”

At a time when many companies are trying to get as much out of their employees as possible, while not compensating them for the extra work, or providing benefits – like sick days and comprehensive health insurance coverage – that would make it possible for them to function up to their full potential, it only makes sense that people are feeling like they have to drag themselves into the office, even when they feel like they’re on the brink of death.

The financial factor

Besides social pressure and fear of work stacking up, another reason many people go to work sick is that they aren’t compensated for sick days. Sure, you might be able to get someone to cover your shift – but they’ll get paid for it, not you. People who work in the retail and restaurant business aren’t usually given paid time off – meaning if you don’t show up, you don’t get a paycheck.

Unfortunately, like caregiving and teaching, jobs like these are also the type of jobs that can’t be done from home. You’ve got to be there to do the work. That’s a conundrum for both workers and employers.

The US Department of Labor estimates four out of 10 people working in the private sector don’t get paid sick days. Among low-wage workers, it’s even more dire: seven in 10 don’t get any paid time off when they’re unwell.

And getting paid sick time does make a difference: a survey found that 55 per cent of workers who didn’t get paid sick days went to work when they were ill, and possibly contagious. Only 37 per cent of workers with paid time off reported going to work sick.

But in the United States, where workers generally aren’t given much mandated sick time, vacation, or other compensated time off, the Department of Labor is trying to institute policies that offer solutions for presenteeism. More and more cities and states are requiring employers to offer paid sick leave.

“I believe that in 30 years, we will look back at this as the moment we began to turn the corner, when a sleeper issue finally began to awaken and when grass-roots momentum began to gather steam and roll toward a broad national consensus,” US Secretary of Labor Thomas Perez said in a statement last year.

An outside-the-box solution

There’s a big difference between being too sick to go to work, and being too sick to actually work. Plenty of times, a nasty cough, headache and sniffly nose are too uncomfortable (not to mention gross) to take to the office, but not severe enough to stop you answering emails, filling out spreadsheets, or formulating marketing strategies.

When you’re not too sick to perform the actual duties of your job, but you need to carry them out from the comfort of your bed – preferably with a box of tissues on hand and a heating pad behind your neck – it’s a huge plus to have a job that allows you to work remotely. Many companies are getting on board with this, enacting flexible work policies that let their employees work from home whenever they need to, using their own discretion.

While many companies don’t explicitly say people can work from home whenever they want, there’s often an unspoken consensus you’re allowed to do your job from home when you’re sick, or have an ill child at home to care for. However, because these work-from-home policies aren’t always completely official, friends I talked to were reluctant to name the companies they work for and advertise their flexibility, possibly rocking the boat or upsetting an emotionally abusive boss.

“Everyone knows that if you’re sick or your kid is sick, or even if you’re waiting for the cable guy to come, you can call in and say you’re working from home,” said one office employee.

“But we try not to talk about it a lot, because we don’t want anyone to think we’re taking advantage, or we’re slacking off.”

It seems that many companies informally offer remote work options, but don’t like to advertise it.

“The perception is if you’re working from home, you might not really be working,” said another worker.

“Because of that, when I’m working from home, I’m often putting in longer hours and working harder than I would if I was in the office.”

Seeing the bigger picture

There’s an old saying that ‘an ounce of prevention is worth a pound of cure.’ When it comes to the decision whether or not to go to work sick, this is one of grandma’s old pearls of advice that’s worth heeding. Studies have found that when people take time off to recuperate from an illness, they actually miss less work in the long run.

“Last winter I came down with a bad cold, and I didn’t think a cold was a good enough reason to miss work,” a friend admitted recently over coffee.

“So I kept going in to the office, taking over-the-counter medicine for this hacking cough and headache that wouldn’t go away. I ended up with bronchitis, and I missed four days of work after I finally went to the doctor. I was trying to look good, like a hard worker, and I ended up looking bad because I screwed up.”

Cutting through the taboo

Even though presenteeism costs companies money and makes other people sick (which costs more money), many businesses prefer to focus on how much absenteesim, not presenteeism, is costing them.

“Estimating the cost of absenteeism is more tangible than counting the impact of presenteeism,” explains Johns.

Although research is clear we should stay home when we’re sick, and advances in communications and technology have made working remotely possible in many fields, there’s still a stigma associated with admitting you’re too ill to go to work, and an even bigger fear it’ll make us look like less committed workers. Then there’s the issue of jobs like teaching, caregiving, and serving, where working from home just isn’t possible.

It seems better labor laws, as well as a sea change in attitudes toward the importance of rest, self-care, work/life balance, and our own health, will have to happen in order for us to stop making ourselves – and the people around us – sick with working so much.

GIFs via

Comment: Do you feel pressure to go to work when you’re sick?