The United states ranks at the top of the list of countries who are individualistic as opposed to community minded. This can be a strength. It can also be a weakness. Many people strive to be their best, to work their hardest, to be ambitious, driven and productive. Once they have “arrived” their tendency is to believe it is their hard work and total determination that got them there. In fact, perhaps without being consciously aware of it, they believe that suffering in order to succeed makes the succeeding virtuous.

Many a now CEO or other high level manager has under-slept due to late work nights, worked an inordinate number of hours per week, and dragged themselves to the office sick to “powered through” while coughing, sneezing, feeling feverish and weak, but also feeling they are therefore more dedicated, tougher, hardworking and willing to suffer for their jobs.

In that vein, it is common for people at the top of work environments to believe that everyone they hire should feel and do the same things they did. After all, if they suffered through it, everyone else should too. If it made them virtuous, it will be the same for their employees, and productivity will suffer all around if everyone doesn’t come in every day.

In reality, going to work sick hurts productivity by sharing your illness with everyone, diminishing the community’s ability to be productive overall. Even if you go into the office, if you are sick, you are less productive, and if you push yourself often enough you risk prolonging your illness. Workers often know it would be better, for themselves and for the work community they serve, to not go into the office sick. But they also know that the message from above is, don’t miss work….period. How do they know this? Most companies give just 2 or 3 sick days, the message being you are expected to be sick more than 2 to 3 days per year. While you might not be deathly ill 2 days a year, most people have a communicable virus more than that.

Employees want to please and to survive. There is often the feeling, perhaps accurately, that in the competitive work environment, it’s “them or me.” “If they never stay home sick, and I do, I risk my job.” “They are pleasing the boss, they are showing they are invincible or tougher, they are willing to be a martyr.” The fear of job loss, or even loss of any edge at work – edge that might lead to a promotion, more money, higher opportunities, and more – drive people to go in under any circumstance, even when they know they are contagious and risk infecting other people.

This issue is not new. What is new is the current Coronavirus outbreak. With highly communicable viruses, like Covid 19, it is clear that one of the very few things any of us can do to curtail the spread, and not overwhelm the health care system all at once, is to avoid collections of groups of people with someone who has the virus. Businesses are cancelling large conferences, and my hospital just asked all of our psychiatrists to not come to any grand rounds presentations and instead view the teaching presentation on our computers via Zoom.  

As a society we can probably agree that if someone develops a fever and coughing right now, it is best they do NOT go into their office and expose everyone there to the illness they have. But on an individual level, that is not what happens. Our longstanding bias towards “work at all costs” has people continuing to do what they usually do, go to work, please the boss, not risk loss of pay. In addition because, generally speaking, people feel frightened by the idea of contracting Coronavirus, many who get fever and cough will tell themselves it is just a common cold, as our brains often deal with overwhelming anxiety through denial. So people will convince themselves and believe they are doing what’s best and not hurting anyone by going to work. Health organizations having been telling people with flu symptoms to stay home from work rather than infect others for years now, but managers are not agreeing to or restating that message and the result is that the flu infects numerous more people each year than need be.

With the World Health Organization officially recognizing Burnout as a mental health issue affecting many, many workers, some companies are talking the talk. They create policies of work-life balance, by offering unlimited vacation time, telling employees to not answer non-urgent emails after work hours, and allowing more sick leave. But many of the same companies are finding employees are not following these policies. Why? They see the boss, the people at the top, ignoring them. Employees will not feel able to “do as I say, but not as I do” because it sends a mixed message. Failing to lead by example sends the message that while your boss may be giving you the option to take care of yourself, they don’t really see it as laudable or consider it necessary because they are not doing it themselves. Employers have to model best practices for employees. If they feel work-life balance and taking time off when sick is important, they need to walk the walk. 

There is no way to change this system without the people at the top creating reasonable ground rules and policies – then personally following them. Employers must acknowledge that human beings get sick and when you hire someone you agree to pay them, even if they do get ill from time to time. Managers need to make it clear they want anyone who has symptoms to stay home, further noting that they believe it it the right thing to do, and that one will not only NOT be rewarded for coming in sick, they will be sent home until they are better. Human Resource illness policies must be clear-cut outlining simple steps and procedures that are easily emailed, and read by all employees.

We all must do unto others as we would hope others would do unto us. Perhaps most importantly, we cannot manage the intermittent pandemic that may come along… Flu, Measles, SARS, Covid 19, without policies that allow sick workers to stay home and not infect an entire office. This cannot happen without management directly stating their expectations – then following those policies as well.


  • Dr. Gail Saltz

    Psychiatrist, psychoanalyst, bestselling author and mental health commentator

    Dr. Gail Saltz is best known for her work as a relationship, family, emotional wellbeing, and mental health/wellness contributor in the media and frequently shares her expertise and advice in print, online, on television and radio including  timely commentary on the mental health aspects of current/breaking issues and news. She is a bestselling author of numerous books (including two for children) and the go-to expert on a variety of important psychological topics, as well as the Chair of the 92nd Street Y "7 Days of Genius" Advisory Committee. She also serves as a Medial Expert for the Physicians for Human Rights and is the host of the "Personology" podcast from iHeart Radio. Her most recent book,The Power of Different: The Link Between Disorder and Genius, is a powerful and inspiring examination of the connection between the potential for great talent and conditions commonly thought to be “disabilities."  She is also the host of the "Personolgy" podcast from iHeartRadio. Dr. Saltz is an Associate Professor of Psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine, a psychoanalyst with the New York Psychoanalytic Institute and has a private practice in Manhattan.