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While the reasoning for this rule is sound, its effects may have been dangerous: to avoid taking a sick day and falling behind on work, many people would have gone to their office, risking transmission.
Many companies now have policies against going into workplaces when ill, but it has taken a global pandemic to highlight what should be a basic ethical norm: an individual should be responsible for reducing the risk of passing on the pathogens they catch. One of the lessons of the covid-19 pandemic is that public health is everyone’s responsibility – or it should be.
People feel a lot of pressure to work regardless of how they feel. A 2021 report from the Chartered Institute of Personnel and Development found, for example, that 75 per cent of surveyed UK employees reported presenteeism – continuing to work when sick or injured – in the workplace over the preceding 12 months. Presenteeism has a long history, but it seems that not even a global pandemic can stop it.
Laws in the UK and the US explicitly prohibit intentionally or recklessly infecting another person with diseases, including covid-19 and sexually transmitted infections. And yet many people continue to work and expose themselves to others when sick, without legal consequences.
Should these countries consider prosecuting a majority of working adults for breaking the law? Or decide that this behaviour isn’t obviously reckless? Neither, of course, is palatable.
We need a cultural shift, not a legal framework, to encourage employees, family and friends to recover from illness before returning to their daily lives. Companies must also play a role: sick leave should be expanded to protect other employees and the public, rather than be seen as solely the sick employee’s benefit.
Behaviours like presenteeism perpetuate the transmission of the illnesses infecting us every year. One example is how we live with flu. Despite the fact that many experience it as a mild infection, seasonal flu kills as many as 650,000 people annually. That’s 6.5 million deaths in a decade – 2 million more than have died due to covid-19 in its short history. So when politicians like UK health secretary Sajid Javid say that we should live with covid-19 much as we live with flu, they are asking us to accept millions of preventable deaths.
In an article published earlier this year in Public Health Ethics, philosophers Neil Levy and Julian Savulescu, both at the University of Oxford, argue that covid-19 highlights the social norms we ought to change, not only when we face future pandemics, but with any pathogens that pose an ongoing public health threat.
This will be true regardless of whether covid-19 is, as some people argue, here to stay. Between other coronaviruses, flu and the hundreds of infectious pathogens humans carry with unknown health implications, avoiding contact with others while we are symptomatic will stymie transmission and save lives.
Rather than treating covid-19 like flu, we should treat yearly outbreaks of flu and other pathogens more like covid-19. Our comfort with spreading viruses that we don’t consider deadly is, itself, an ethical failing.
And to the degree that we don’t change our norms around contagion, we disrespect the millions of lives we have lost over the past 18 months, and that we lose every year to other diseases.