Yesterday I was berated on social media, and we need to have a conversation about it because there should be no cause for disagreement here.
What did I post?
Hi friends! A quick friendly reminder to stay home if you’re suffering from flu-like symptoms. The worst of the season is behind us, but influenza B is circulating at exceptionally high levels this year, and continues to show numbers now that are three times higher than they were at last year’s peak. Influenza B is typically much less prolific (A strains like H1N1 and H3N2 are more likely to cause pandemics) but are much more dangerous for our youngest and older populations. We can all suffer from flu B, but it’s our kids under 5 and adults over 65 who are at highest risk from the most severe effects of B strains.
Okay, so now you might be thinking that you work in an office full of healthy adults. No problem, right?
Wrong. Because many of those adults might be going home to young kids or older family members, and when you pass on the flu to a seemingly healthy person in your community, you’re also putting every person they come in contact with at risk.
Don’t do that. Stay home and get well. One family sending a sick child to school meant a classroom full of sick kindergarten kids and a dead toddler in our house. Don’t be that person. No one’s happy when a sick person comes in to work. If you have no other option, do everything possible to reduce your chance of spreading illness to others, and remember that kids absolutely can’t be in school within 24 hours of fever, vomiting, or diarrhea (48 hours in some places, so check for your local rules). Make alternate arrangements. It’s hard, but when we all do this we reduce the amount of illness that spreads around and we’re all better for it.
And we prevent deaths like Jude’s. Do that. That makes you a hero.
I posted this yesterday because a month from today will be the second anniversary of Jude’s death and the flu is still circulating, even though it doesn’t feel like it should be. It didn’t feel like it was then, either, but it was – and not even at the same levels we’re experiencing right now. Flu season isn’t over. More people are going to get sick. More people are going to end up in the hospital. More families are going to need to plan funerals.
I’ve posted messages just like this countless times over the last 18 months. After vaccination, staying home when you’re sick is one of the best ways to prevent the spread of the flu. You can’t pass it on if you aren’t sharing space with people. Let’s be clear: we aren’t talking about colds. Kids get an average of six colds every single year and we can’t keep them home for all of them. Coughs and sniffles happen and it’s up to us to use our judgement in those cases to decide whether our kids are well enough to go in and participate and learn.
So what are we talking about? The three key symptoms we need to watch for are fever, vomiting, and diarrhea. If your kids have experienced any of these, they shouldn’t be in school until they’ve been free of these symptoms for a minimum of 24 hours without medication. In other words, if they wake up with a fever, treating it with Tylenol and sending them to school isn’t appropriate because the Tylenol isn’t resolving the cause of the fever, it’s masking the symptom.
Alright. So this is a pretty standard rule. You’ll find this (and more strict) at most schools and care centres, because it’s considered a basic standard for preventing infectious disease in groups of children. If you have kids you know how quickly they pass germs around, and when one sick kid comes to school, it’s not long before it makes its way through the class. In our case, someone came to school with influenza B, and we only found out that ‘a nasty bug’ had been circulating after it came home to us, a week and a half after it had first appeared in the class. No one suspected the flu – it was the end of April when the first kids came down with it, and we don’t realize how late it continues to go around. It wasn’t until Jude’s final pathology results came back to complete his autopsy (four months later) that we learned that it had been the flu making all of these kids sick.
It’s easy to get confused about which illness is which. We tend to call everything the flu, and that’s why it’s tricky when people recommend you stay home with flu-like symptoms. The important thing to know about the flu is that it’s not a stomach bug and it’s not just a bad cold. It’s a serious respiratory illness that has the ability to shut down organs and systems. I had no idea. I knew it could be serious. I didn’t know how quickly it could become dangerous. I didn’t realize that by the time you realize something is seriously wrong it can already be too late, even with medical intervention.
I just didn’t know. And the more I talk to people, the more I find other people don’t know, so I’m going to keep talking about it and hopefully we can break this conversation open and prevent more stories like ours. Here’s a quick reference chart to help you know if the symptoms you’re dealing with are flu-like or something more benign.
So that’s why I wrote the post. That’s why I write all of these posts. I have a box of ashes that used to be my hilarious little boy and that shouldn’t be something that anyone should ever be able to say.
Now let me tell you what was apparently so appalling: the suggestion that people need to keep sick kids home from school or stay home sick from work.
I was told that the post was appalling because it’s harder for some people to stay home when their kids are sick. Some people can’t afford to miss a shift. Some people’s bosses will fire them for taking a sick day. And so because of those things, the suggestion that we need to stay home sick is appalling and I’m wrong to suggest it.
No. I don’t accept that. I grew up in a single-parent home after losing my dad at a very young age. We didn’t have a lot and my mom had to work hard to look after us. I know it was a hardship for her to miss work when we were sick, but she did it. As a student I put myself through school with OSAP and retail jobs. I worked every hour I could get and it still was never quite enough. If I didn’t work enough I didn’t have enough for rent and food. I’ve worked for some wonderful people, and some incredibly unreasonable people. I once worked for someone who wrote me up for having curly hair. This same person told me I wouldn’t be able to take any sick days for the remainder of the year after having eight days off for surgery in January, as approved three months earlier. I had not previously taken any sick time in my years with the company.
I know single-parent families. I know poverty. I know ridiculous bosses.
I know finding your child’s dead body in his bed.
I know there is nothing in the world that is more important than preventing someone from losing their life or their loved one.
But despite the way it was communicated, I hear the root frustration.
It is appalling that people don’t earn a living wage. It is appalling that there isn’t better support for single-parent families. It is appalling that there isn’t more flexibility for employees in every single industry. There’s no reason that someone should be forced to go to work when they’re sick, especially with an infectious disease that they can pass on to people they come in contact with, and if someone has kids, there needs to be flexibility so they can look after them when they’re sick. Here in Ontario a lot of changes have been made to address these problems and it’s getting better, but that isn’t the case everywhere. This is a place where you can take action. Vote. Vote for candidates who want to make your life better. If your representatives aren’t doing that, send them packing. Choose candidates who choose you and your interests at every level.
But it is not appalling to remind people that there are rules about when our kids can and can’t be in school. Those rules are in place to protect our children. I recognize how difficult that can be for some families and I join you in your anger. Part of what we hope to achieve by opening up the conversation about flu prevention is to get people rethinking our approach to public health. Together, all of us, so that we can really start to do what’s needed to prevent thousands of unnecessary deaths and hospitalizations every year. There is a great deal of personal responsibility in successful public health, and we all have a part to play to keep ourselves and everyone around us safe. Our best efforts for ourselves are vital, but we rely a lot on everyone around us doing the same. You can do everything right, but if your coworker isn’t doing the same you can still be exposed, still get sick, still bring illness home to your family. The person next to you on the bus can do everything right but if you sit down next to them with what you’re fighting, you can pass it on to them, and you don’t know if it’s something their body can survive. You can do everything right, but someone can send their sick kid to school and pass on an illness your toddler can’t fight. You don’t want that to happen to you. Don’t be the reason that happens to someone else. I promise you there is no excuse that sounds important enough for someone to sacrifice their child for.
Tell me. Tell me that one day of whatever job you do is more important than the life he should have had ahead of him.
This is hard. I’ll never suggest that it isn’t. We have a lot of competing responsibilities and we all constantly have to figure out the best way to live each day, for ourselves and everyone around us. But we’ve come to a point where it’s become easy to let health be the sacrifice when we’re juggling priorities, and not just for ourselves. We’re willing to sacrifice other people’s health for a day of work. This is costing other people time off work. This is putting people in the hospital. This is killing people. The idea that a job is more important than a person is…
Appalling.
We have to stop what we’re doing, all of us. We have to step back and reevaluate the way we’re prioritizing health against everything else in our lives. Employers need to be more flexible, and we need to push for that. And at the same time, we need to recognize and practice our own personal responsibilities to public health. We have to do whatever we can to prevent passing illness to people around us. ‘Try not to put each other in danger‘ is not an unreasonable ask from each of us, and you should expect that from the people around you, as those people should expect from you. There will be things that are out of our control, but if we all do our best to limit the risk we pose to each other, we’ll all be healthier. We’ll all need fewer sick days. We’ll all need less time off to care for sick kids.
How do we do this?
1) Prevention.
Prioritize illness prevention, especially if you’re in a position where you can’t take time off when you’re sick. Make sure you’re up to date on all vaccines, including adult boosters. I just did this last week. It was 15 minutes out of my day and I’m set until I’m due again in ten years. Get your annual flu shot. It’s not a guarantee. If it were, Jude would still be alive and I wouldn’t know anything more about the flu than I did when all we worried about was getting everyone vaccinated each year. But it’s your best first defense. Don’t believe me? The free flu shot program in Ontario has reduced flu cases by 61%, while only 34% of us participate. Despite the fact that it’s not perfect, it’s protecting a lot of people, and even in those who contract the flu following the shot, there’s a much lower rate of hospitalization and death. What if more of us participated? What would our flu rates look like then?
Wash your hands frequently, at least eight times a day during flu season. Avoid touching your face, and cough and sneeze into your sleeve. Sanitize frequently touched surfaces like doorknobs and counters, and wash your hands again if you’ve been in an elevator, or at the mall, or anywhere you’ve touched a communal surface. This can make a huge difference.
If you’re planning to see someone and find out they’re sick, plan for another day when they’re well.
2) Avoid spreading illness.
You have it. Now what? Don’t pass it on. At the risk of redundancy, don’t go to work, and don’t send your sick kids to school. Your coworkers and their families don’t want your illness, your kids’ classmates and their families don’t want it, and it’s not their teachers’ jobs to care for your sick children while teaching 25 others.
Have plans? Let the other people know so they can cancel. We might think that what we’re fighting is no big deal, but we might not understand someone else’s health and how serious something that’s small for us could be for them.
Are you in a position of management? Consider the impact of a sick person in your workplace. How will it affect the rest of your staff if someone brings illness in and it spreads? Is the sick person vital enough to risk an office full of sick people, or can you manage without them for a few days while they recover? Will the impact be greater if you end up with more people out sick? Are there provisions in place for people to work from home? Do employees receive paid sick days? If not, are their opportunities to make up the hours? Will your employees’ jobs be at risk if they need time off for illness? How will you personally be impacted if you contract illness from someone on your staff? These are all things to consider, and if you haven’t already worked through all of these, please know that many workplaces do and these are all reasonable considerations. Your flexibility and compassion when it comes to employees’ health and their families’ health is good for your staff, good for your business, good for your community, and good for you. Can you do more to help protect people’s lives?
We’re doing this wrong, but it doesn’t have to be that way. Right now, ~3500 Canadians and ~36,000 Americans are dying from the flu every single year. The flu. In Canada that number is almost twice the annual death rate from car accidents, and with our winter roads this is astonishing to me. Why? Why is that number so big, and why aren’t we more concerned about doing whatever we can to bring that number down? Why don’t we want to keep each other home when we’re sick so that we can recover and come back when we’re well, instead of making other people around us just as miserable with what we have? Why aren’t we doing more to prevent contracting and spreading infectious diseases? Why is it seen as a bad thing to take a sick day?
It starts with each of us doing our part and pushing for better from everyone around us. It’s reasonable to expect a more compassionate cultural attitude towards illness, and it’s our responsibility to make sure that we’re not part of the problem. Do your best not to put someone else in danger. We can all do that, can’t we?