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COVID-19: The new economics of our daily lives

This is a global pandemic: Why do employees still come to work sick?

Aleksandra Luksyte and Gillian Yeo

Despite the serious public health crisis we find ourselves in, people still tend to show up for work sick. Aleksandra Luksyte and Gillian Yeo examine what motivates employees to do so, how this behaviour has changed over the course of the pandemic, and what organisations and employers can learn from this in order to promote a healthy and safe work environment in the long run.

On Wednesday 26 February 2000 a man arrived in Tasmania and experienced cold-like symptoms the following day. He developed further symptoms the next week and contacted the public health hotline on the Friday. He was tested for COVID-19 and was advised to self-isolate until the test results came back, but he ignored the advice and attended work the next day. This man was the second confirmed case of COVID-19 in Tasmania .

The man described above engaged in presenteeism – wherein people turn up to work despite their illness, injuries and other medical conditions . There are different reasons why people engage in presenteeism: some are worried about their job security, others do so because they are passionate about their jobs.

Turning up to work sick can harm co-workers and the organisation. For example, our own research showed that fear of contagion explains why employees become disengaged and demotivated when their co-workers (particularly those of the same sex and race) turn up to work sick.

However, the potential consequences of presenteeism are even more dire during a global pandemic—during this time, it represents a public health and safety hazard. Yet, surprisingly, as our opening example shows, even during a global pandemic of a highly contagious disease, presenteeism occurs.

Why do people come to work even though they are sick, and might be sick with a potentially deadly virus that may infect others?

To answer this question, we have started to track presenteeism behaviour across the various stages of the COVID-19 pandemic. We are particularly interested in examining organisational factors that may influence employees’ presenteeism. Some organisations can inadvertently create a presenteeism climate by not having in place sick leave policies or by putting pressure (even implicitly) on employees to work long hours irrespective of their wellbeing.

Can organisations reduce presenteeism, particularly during a pandemic, if their leaders promote healthy habits and role model health-conscious behaviours such as staying at home when one is sick? To answer these questions, we have started to track working adults in Australia and the USA throughout the COVID-19 pandemic.

The World Health Organization declared COVID-19 a pandemic on 12 March. In early February 2020, with only several confirmed cases of COVID-19 in Australia and the USA, we collected data on presenteeism and organisational norms and policies around sickness attendance from 600 working adults from both countries, serendipitously providing us with a baseline measure of presenteeism. We aim to follow-up with the same participants several more times during various stages of this pandemic.

We are currently collecting the second wave of data. We followed up with the same 600 employees in early May—the peak of this pandemic globally and in the USA particularly. We now discuss some preliminary results from the two data collection points: early February (beginning of the pandemic) and early May (peak of the pandemic). These results are based on the 118 employees to date who have responded to our surveys in both February and May.

Our preliminary results, based on descriptive and correlational analyses, suggest that employees reported engaging in fewer presenteeism behaviours as the pandemic worsened. Using a 5-point scale (1 = strongly disagree to 5 = strongly agree), their agreements to statements about their presenteeism behaviours, such as “ Although I felt sick, I still forced myself to continue to work ” or “ I have continued to work when it might have been better to take sick leave ” was a mean of 3.64 in early February.

We have asked the same people to respond to those questions in relation to the time since early February until now, and the mean rating has dropped to 2.38 . Despite this seemingly encouraging news about presenteeism reduction during the COVID-19 pandemic, we found that presenteeism persists.

Our data are showing that, on average, people reported that they worked even though they were sick or not feeling well 4.25 days since early February. Perhaps not surprising, engaging in presenteeism was positively correlated with workplace anxiety, suggesting that working while sick is a stressful work experience.

To understand why presenteeism persists even during a pandemic, we looked at employee motivation. The significant correlations suggest that employees reported that they continue working while sick because: (1) they are worried about losing their jobs or burdening their colleagues ( avoidance motivation), or (2) they believe they have to persevere, be loyal to their team schedule and their customers ( approach motivation).

Notably, the correlations between presenteeism and approach motivation were similar in size in February and May data. Yet, the correlations between presenteeism and avoidance motivation was weaker in May than in February data. This suggests that employees may have good intentions of engaging in presenteeism, even during a pandemic.

How can organisations curb presenteeism? We examined the correlational evidence and found that presenteeism climate , wherein working long hours irrespective of one’s wellbeing is encouraged, is positively related to presenteeism. But, the good news is that participants who reported that their organisation had put in place measures that are designed to prevent COVID19 from spreading, such as encouraging washing hands, social distancing and disinfecting items, also reported less presenteeism.

This negative correlation suggests that people tend to stay at home when they are sick when these preventative measures are implemented. Doing so may remind employees about the seriousness of this pandemic and the need to take their own health and the wellbeing of others seriously.

These preliminary results have important implications for organisations and policymakers striving to better manage the health and well-being of their employees.

First, organisations may benefit from putting in place policies, procedures and expectations about employee sickness and health. As our preliminary results showed, such policies and measures could signal to employees that their health and wellbeing is valued and taken seriously. Organisations could reinforce these signals by providing paid sick leave and enforcing it by empowering supervisors and fellow workers to remind sick and present employees to stay at home and get well. The COVID-19 pandemic has reminded us all that in doing so, it is critical for not just employees’ own wellbeing, but the health of their peers.

Second, we agree it is important to drop our “soldier on” mindset and stop going to work sick, as has been recently suggested by the Chief Medical Officer, Brendan Murphy. This advice is aligned with our preliminary findings, which are suggesting that presenteeism climate, wherein taking sick leave is frowned upon and being absent from work due to a health problem is viewed as a lack of commitment to work, may contribute to presenteeism prevalence, even during a pandemic.

Organisations may be able to discourage such a culture by not rewarding working long hours. The message should be clear – working long hours is not an indicator of good performance. Good performance is such an indicator, of which staying at home while sick and protecting the health of peers is a key.

Aleksandra Luksyte is an Associate Professor and deputy Head of Department, Management and Organisations, in the UWA Business School. She is a recipient of Australian Research Council Early Career Researcher (DECRA) Fellowship. Alex research focuses on three domains: (1) presenteeism, (2) overqualification or underemployment, and (3) demographic and cultural diversity at the workplace.

Gillian Yeo is Professor of Organisational Behaviour and Head of Department, Management and Organisations, in the UWA Business School. She primarily examines self-regulation at work—that is, how individuals regulate their motivation, emotions and cognitions in relation to learning, performance and wellbeing. The outcomes of her research have informed training, performance management, and occupational health practices in a variety of work settings.