Ethics and Viruses

[Dream of Freedom]

I have been told that it's immoral to go to work sick because you just spread it to your coworkers. Is it? If so, how far does this idea extend? Is it immoral to not wash your hands whenever it is convenient, like after you go to the bathroom? Is it immoral not to get a flu shot? Where do you draw the line?

[jacob]

I think the most interesting example of a different ethics in action is the Japanese attitude. Ostensible originating in the 1919 pandemic, you'll see a lot of Japanese wearing surgical facemasks (ala N95 masks) in public if they're sick, if others are sick (something is going around), or simply when venturing out in public. If you're ever been to Japan and especially on public transport (planes, subway), you'll see it.

No doubt, this is effective. (Surgeons don't dress up and wash their hands because they're cosplaying) Ethically, it poses the same question as vaccines, sewerage, and other public health issues.

In developed countries, sewerage is generally solved... we don't have diseases like cholera in war-torn areas (like Yemen). OTOH Vaccinations are backtracking and humanity were doing better 20 years ago then they do now (blame the internet and stupid celebrity outreach). Whereas people aren't dumping their literal shit in the streets and spreading various viruses and bacteria, some people still spread diseases by breathing and touching other humans.

Two ways to prevent this: Vaccines ... and social behavior such as wearing masks and not going to work.

So Japan is much ahead of the Western world in that regard. It's possible to eradicate diseases by not allowing them to carry on infecting ... but it seems that the word lacks the ability appreciate that. (Compared to sewage.)

Morally, I suppose it comes down to sins of omission vs sins of commission which are generally considered worse even if the result is the same. Going to work sick and infectious is like littering. It makes you better off and it makes everybody else slightly worse off. It's a bandit-type of behavior that's an act of commission. Not washing your hands is also a bandit behavior, but that's an act of omission.

It's possible to somewhat compensate for other people's uncivilized behavior by wearing masks, not touching your face with unwashed hands, and staying away from sick people.

[Riggerjack]

+1 to everything Jacob said.

I'm still a working stiff, so I use sick time. Or vacation, or personal time. Being sick sucks, sick at work is worse. And since work is my primary disease vector, I resent the hell out of coworkers unwilling to extend me the same courtesy.

As I brought up in the Ebola thread, we keep a pandemic drawer. It has bleach, rubber gloves, surgical masks, alcohol, etc. If we get a serious flu, this is the stuff that disappears. In a pandemic, odds are good the situation will last longer than supplies, so depending on public resources is... More trusting in the general competence of others than I am comfortable with.

That I also have the right tools to deal with epoxies, paints, flu, cold, fumes, dust, etc is just a side benefit.

[OTCW]

I'm off work yesterday and today sick. I don't want anybody there to get sick and I wouldn't be at all productive. I don't consider that acting morally, just being considerate.

[jacob]

My major vector is DW bringing stuff home from work (mostly colds and minor flus). Unfortunately, she's regularly visiting dozens of offices and thus touching hundreds of door handles that are touched by tens of thousands of customers in the process. Not to mention the people who breathe and sneeze all the time, damnit. It's close to working daycare.

Over the past couple of years, I've been running a behavioral experiment. If either of us demonstrate any symptoms, we forego kissing and hugging. until end of symptoms + 1 week. Handwashing frequency goes way up. And we sleep in separate rooms because I can't imagine having a sick person breathing on you from 1.5 ft away all night long is constructive.

So far, this approach has worked perfectly. It used to be that whenever she brought something home, I'd catch it 3-10 days later.

PS: As far as I've been able to understand through my reading, chlorine is da'bomb for all things infectious. A ghetto way of wrapping ebola samples is ziploc + chlorine soaked gauze + ziploc + more chlorine soaked gauze + ziploc. I'd be interested in some professional confirms/rejections?

[Jason]

Many years ago, I lost a friendship over this topic.

The contention was somewhat over the ethical issue, but there was, as usual, an economic fault line running under the argument. We worked for the same company, but I was an employee granted health insurance and sick time. He was an independent contractor without either. The financial repercussions of him staying home were obviously much greater and "sick" to me was not "sick" to him. Obviously said divide has only grown since then, at least in this country (US) and plays into the discussion.

[bryan]

No doubt, this is effective. (Surgeons don't dress up and wash their hands because they're cosplaying)

Ethically, it poses the same question as vaccines, sewerage, and other public health issues.
...
Two ways to prevent this: Vaccines ... and social behavior such as wearing masks and not going to work.
...
It's possible to somewhat compensate for other people's uncivilized behavior by wearing masks, not touching your face with unwashed hands, and staying away from sick people.

It's pretty common for folks to go to work (or school) sick (in the US). When they do take a sick day or two, it's only when they are at their worst. Few reasons for that. If I had a company I would 1) make it clear that you should take (provided) sick days, 2) make managers send workers they think are sick home, and 3) if you come to work thinking you or others may be infectious wear a (provided) mask.

I bought a nice mask a while ago and have taken to wearing it if 1) I am sick, 2) if there's a poor air quality, 3) if I'm on a flight. People definitely give you looks if you wear a mask; it's a bit mad.

[OTCW]

I will add I don't have sick or vacation time as a part time employee. If I'm not at the office, I don't get paid. Because of ERE, I don't really need the money so it is not an economic hardship. If it was, I can see where I might be more inclined to work sick. If on the other hand, I had paid time off, I would use it and stay out of the office. Morally gray I guess.

[jacob]

@Jason - Yeah, I had added a paragraph about that in my first response but deleted it because I figured it would risk a "tangential complication" early-on in the thread.

It comes down to risk/return and discount rates. Current behavior is set by what current culture is willing to tolerate in terms of diseases weighed against the need to make money (on average) or otherwise keep things going without major personal/career hassle. Vis-a-vis, the need to live now vs the desire to not die or miss out on a possible pay raise later.

I remember when ebola hit US shores some five years ago. What is an individual to do? I saw 1 (one) person on the L-train (Chicago subway) wearing a mask. (I didn't.) First time ever and never later. Chicago actually had an ebola alarm (close but no cigar) at the time: Major hospital about 5 miles from where I live. Overall, IIRC, the US had 3(4?) incidences with 1 dead (the first guy who died after a false negative (he was sent home after going to the ER) because nobody were prepared/knew what to look for ... two nurses that treated him after he went back to the ER a second time came down with ebola but lived because US health care is awesome once people are willing and capable of paying; otherwise, not so much ).

I digressed ... what I wanted to say is that we're in such a way that "sending and catching" a cold is not seen as a big deal/social faux pas and would therefore be an acceptable argument in defense of lower pay/employment. Whereas infecting someone with HIV is some degree of manslaughter and knowingly infecting someone with ebola is prob. seen as "terr'ism". I don't know where measles rank at present. So it's all a matter of degree.

In terms of matters of kind, there's also stuff like culture and religion... in the US, for example, measles were considered eradicated for a while ... but it has come back because of the anti-vaxxers---and now you can even get mumps by going to college... like seriously?!? But yes, mumps!; thinking that maybe humans should run their offspring through the natural discourse of suffering and render them randomly sterile, because natural. What humans don't understand in this case is that it's not a case of how what doesn't kill you makes you stronger ... rather it makes you stranger (sterile, poxmarked, iron lung, ... ).

Part of this, I bet, is that current generations [on average] lack the experience of how sucky some of these diseases actually are, especially when they hit you as an adult (shingles, anyone?). When the zeitgeist forgets, there's a decreasing tendency to take it seriously, and thus funding/interest goes down ... and that sets it up for the next one. It's kinda like kindling and wildfires ... but in terms of politics, health care, and stupid.

Anycase... you can't fix stupid, so we just gotta try work around it.

The US is particularly vulnerable because it has a larger than average gap between the healthy and the unhealthy and perhaps also a larger than average gap between stupid and intelligent as well as the rich and poor, not necessarily the same thing. Germs don't care either way... and they will use the unhealthy poor as an amplifier to infect the healthy rich. It's all meat to them anyway. Americans last learned this lesson back in the 1920s... so it's probably been mostly forgotten by now.

[Solvent]

My organisation grants the same amount of sick leave to me regardless of my location. Since moving from Geneva to Addis Ababa I have found this to be a problem. The disease burden is much higher here.

[Riggerjack]

At the lower compensated end of the economic spectrum, the folks with minimal benefits, and irregular work, working sick is expected and encouraged.

Back when I ran a crew, we had a temp agency we used to augment the crew as needed. They sent me someone very sick, to work in an occupied cube farm. I talked to him, and his recruiter told him "well you can be sick at home, or sick at work, but you don't get paid to be home." So I called that recruiter (not my job) and said if he ever sent anyone sick to my site again, not only would he not do business with us again, but I'd give his name to every foreman in town, and he'd need a new career. (A overstatement of my capabilities, to be sure, but it worked.) Then had the sick guy spend the day up a ladder in the ceiling, dressing cable. So nobody could see him, and he was isolated from everyone. I made sure he got the pay for the day, and that he knew not to come back until he was better. I couldn't send him home with pay, as I would have liked.

My point is that sick leave is a luxury. And some bosses are self centered, self serving, and short sighted. The less you make, the more likely these are both true.

I prefer to build a model where I am less dependent on other people to do the right thing, thus the Ebola drawer.

For what it's worth, my wife grew up with disease controls similar to what Jacob describes. To the point where they touch elbows as a greeting if anyone has a sniffle or cough. I didn't, and I have the ignorant attitude Jacob describes. If my wife is sick, I'm kissing her. If I'm sick, I'm kissing her. F it, if we are both sick, we'll hang out in bed and play old video games. But it happens rarely. Maybe that would change if something more serious than flu came through.

What doesn't kill me, wasn't trying hard enough.

[7Wannabe5]

damnit. It's close to working daycare.

Nothing is as bad as working daycare. I once had a part-time job at a daycare center which mostly entailed being the person who patted the backs of all the restless children during nap time while mellow music played on the radio. I rather enjoyed it until the Day of the Diarrhea in the two year old room. They went down like a stack of dominoes, one after another.

Of course, adults are already carrying immunity to many tiny tot germs. I keep catching colds that turn into asthmatic bronchitis from the elementary school age children I teach, but my BF has not yet caught one from me. He is definitely on the germaphobe/neatnik end of the spectrum, so he won't kiss me, and he makes me swallow a concoction of lemon and pine tar, but he can't resist a cuddle even when I am coughing like a chain-smoking coal miner.

[Sclass]

My boss once criticized me for repeatedly pretending to be sick a day and showing up the next day looking well. “Sclass if you want to take a day on the boardwalk just sayso, you don’t need to tell me you’re sick.” My habit was to take a day if my throat got a bit itchy or my nose ran uncontrollably. It often cured itself in a day if I just took it easy at home. She on the other hand would show up at meetings with her own tissue box and Chlorasceptic spray visibly ill. It was just a matter of ethics I guess. Perhaps she thought of herself as a martyr.

I’ve never had sick leave, all my employers had flexible time offwhich got abused by sick people trying to save their vacation days. Guys would come into work wearing thick padded jackets with eyes dilated by extreme doses of DayQuil. Gross. Really selfish folks.

[phil]

In Holland (and perhaps elsewhere) it is not uncommon for companies to pay a bonus to their employees depending on how many days of sick leave they took in the previous year. Like for each day of sick leave, 20% of the bonus is scrapped. This is somehow legal (salary cannot be withheld during sick leave but bonuses can). My previous employer did this and it was also the policy of a company that offered me a job. I still remember the HR woman justifying this by saying "if you enjoy your work, you don't get sick" .

[Jason]

I still remember the HR woman justifying this by saying "if you enjoy your work, you don't get sick" .

I hope I’m not disparaging anyone here, but it seems to me that the occupational historic antecedent of the Human Resources Department was slave trading. It’s like once all those jobs became extinct, they came up with the Human Resources euphemism to apply their job skills without any need of retraining.

[EdithKeeler]

I think it’s terribly selfish to go into work sick, but in the US anyway, Human Resources And/or management created/contribute to the problem. I’m a professional well compensated employee... and I get 3 days of sick time. Beyond that I have to use my 3 weeks of vacation, much of which is used for taking my mom to the doctor and such. This fall I was hit with a bad fall where I banged my knees really badly—missed 2 days for hospital visit and a “keep your legs elevated” day. Then I was hit with back to back shitty colds that turned into bronchitis. I called in a couple days there and my boss said “why not work at home and you won’t have to take time off?” Because my head hurts, I can’t breathe and my eyes feel like someone is pushing my eyeballs out from the inside. All I wanted to do was sleep. Granted, I could have half-assedly “worked” at home, but that option gets me new cases assigned that I have to do certain work on. IOW, no one wants me to come in sick, but no one wants to cut anyone any slack when they get sick.

And I actually work for a pretty good company compared to a lot of people.

(I’m writing this while home for a snow day. I had to take it as PTO because we are expected to work at home during inclement weather but my internet (which I pay for, btw) has been down for two days).

[OTCW]

I missed all 5 days this week with the flu. Hopefully good to go on Monday, but if not, I'm not going in. My boss has texted me a few times if he needed to call hospice - he comes into work with all kinds of illnesses and after really short surgery recoveries. I feel some pressure to go on in, but I know it will make the recovery period drag on. I shouldn't be contagious anymore, so my coworkers would be safe, but I just want to get past this as soon as I can.

[phil]

@EdithKeeler, I knew employees in the US have ridiculously few holidays, but I didn´t know about the limited sick time thing. In Europe employees are much better protected in that area. In Holland, where I live and work, I can report sick and my employer can basically do nothing for a week or so (at which time they can demand that I go see a doctor that will report to my employer). I can be sick for months and my employer has to continue paying my salary (most companies have insurance for these kind of scenarios). As far as I can see, this system does not give rise to widespread abuse. And only the worst of workaholics go to work when they are really sick.

However, it is not deemed acceptable to call in sick when you have a mild cough or sneeze or a running nose. What determines whether you ´have the right´ to call in sick is how you are feeling. Sure, a running nose can be a bit annoying, but if you are otherwise feeling ok, just bring a box of paper tissues. The issue of contagion seems to play no role whatsoever.

Which brings me to the issue of ethics. I think it is too simplistic to say that ´you shouldn´t go to work when you are sick´. Sickness comes in various degrees and kinds. Furthermore, what is the probability that my mild cold will be transfered to the person next to me, or to another random colleague through door handles and such? Are there any data available on this? I have always found the common practice in my country - to not take any precautions when having a mild cold and to just go to work - unproblematic. But I suppose my belief is based on common folk wisdom and not on hard data.

[phil]

To give some more context, I have two little kids, one going to daycare, the other to primary school. In the winter season, they (and therefore my wife and I) have colds on and off. I am perhaps with a cold one third of the time. In 90 percent of the cases the symptoms are mild. So what should I do? I believe it would be unfair to my employer and my teammates if I would be off sick one third of the time...

[jennypenny]

@phil -- We've always gone by the rule that if we have something that might require someone else to go to the doctor (like strep, flu, roto/noro virus) then we stay home. If it's a simple cold, sinus infection or mild stomach bug, we don't worry about it and go when we feel up to it. Just take extra precautions so as not to infect others (don't use the Keurig while sick, etc).