Contradictory Disease Advice

DoublethinkDoublethink Admin, 8th Day Host
edited January 2 in Purgatory
I have a cold.

According to the NHS, a common cold lasts one to two weeks. The main recommended treatment is rest.

You remain infectious for one to two weeks - basically as long as you have symptoms.

My NHS work sickness policy allows me to self-certify illness for up to 7 calendar days, after which I would need a “fit” note (government speak for a sick note) from a GP. (Though they refer you to occupational health if you are sick more than a certain number of times in 12 months, I believe 6 episodes regardless of length, The average adult gets two to four colds a year.)

GPs don’t like to give you a note for before they’ve seen you, but it is also difficult to get same day appointments.

GPs don’t want to see you for a cold virus, because they can’t treat it unless you have now developed a bacterial infection.

According to the NHS, you should see your GP if a cough lasts more than three weeks. Or if you have underlying conditions such as diabetes and asthma, (I have both but not very severely and I am fairly certain they don’t want me to rock up immediately every time I have a cough.)

These time periods do not sync up.

It strikes me that it would be helpful if there had been any research trials of whether workers coming in whilst still symptomatic with colds (but not prostrate) leads overall to more lost work days in the workforce as a whole, than them coming in only once they are no longer infectious.

I know I will go back to work on Monday and probably be referred to occupational health, but to do what ? I can’t change my crappy lungs, there is a winter surge of respiratory viruses and I don’t think giving my patients and colleagues an infection will ultimately improve patient care. I will wear a mask whilst I am still coughing for another week or so.

Comments

  • LouiseLouise Epiphanies Host
    I think the mismatched advice is a symptom of a wider problem- institutional ablism which doesn't take into account that a 'cold' or other respiratory infection is not nothing for lots of people with underlying disabilities ( and in the case of Covid also produces those disabilities)

    I had to go back to work with a cold recently because of the 7 calendar day rule - but luckily was able to work from home. I was flattened by it because I have underlying conditions and because it disturbs my already poor sleep.

    Equally these same workplaces that love their 7 calendar day, Doctor's line and 'off you go to occupational health' rules dont take masking and clean air seriously. They generally dont monitor air quality, invest in air purifiers and normalise masking which would cut all these respiratory infections.

    I caught the cold probably because I'd had to travel on my own on public transport and was afraid of being picked on and bullied if I masked - because we haven't normalised masking in winter in indoor public spaces or ensured clean air for them and we dont have easily available help against harassment on most public transport.

    So basically it's assumed we're all fit and young, and so it's nothing and if you say it isnt without a doctor's note you're a malingerer, but workplaces won't actually do their bit to minimise spreading infection - they prefer just to blame us for not being splendid examples of eugenically fit little worker bees
  • DoublethinkDoublethink Admin, 8th Day Host
    edited January 2
    It’s infuriating, not just for myself, but also because I know I am working closely with at least one colleague a with serious life limiting autoimmune condition who has survived sepsis, and a proportion of my patients are immune-compromised.

    I got this cold from my mother, it was pretty much unavoidable because I had to help her with her personal care over Christmas.

    To be fair my manager is pretty good about this sort of thing - but sickness policy just doesn’t seem to recognise its inherent contradictions. And then people wonder why patients rock up to A&E of GP with transient illnesses of this kind - they need the documentation.

    I had whooping cough as a child, which left me with an area of lung damage, and when I have a cold I always get it badly. I can’t take any over the counter meds for cold symptom relief with an evidence for efficacy (e.g. decongestants) as they either interact with my asthma or the other medications I take. (I checked when I had a bad combo cold and hayfever in the spring.)

    I once accidentally took a decongestant a few years ago and it irritated my lungs so much the coughing made me vomit.
  • It strikes me that it would be helpful if there had been any research trials of whether workers coming in whilst still symptomatic with colds (but not prostrate) leads overall to more lost work days in the workforce as a whole, than them coming in only once they are no longer infectious.

    It must surely make a difference what work you do. Some people work outdoors, or in a private office, or otherwise with less contact with colleagues, whereas others work in a soup of virus exchange. Those who work with people who have vulnerable immune systems should probably have more stringent rules about viruses than the average person.

    And, as @Louise mentions, traveling to work on packed public transport is not the same as driving a private car or walking/cycling.
  • The trouble here in the U.S. is, the very occupations that are most likely to spread anything contagious are the ones that get little or no time off for anything short of major surgery (lots of them not that, either). These are jobs like nursing where it's expected that you'll work your shift even when you're feeling like death and likely to have pneumonia, and all the service jobs like waiting on tables and retail.

    I get decent sick leave (after a lifetime of crappy benefit jobs) but I hardly need it, because my work permits me to work from home. I donate as much of my leave as I'm permitted to people earlier in their careers because they accrue fewer days more slowly and also tend to have little germ factories, oops, children, still at home. But I'm only allowed to donate a week each year. This makes no sense.
  • KarlLBKarlLB Shipmate
    The idea of a fixed amount of sick leave is bizarre. It's not like a trip to the seaside which you can schedule.
  • Gramps49Gramps49 Shipmate
    Today, NPR had a discussion on childhood vaccinations for Influenza. The recent CDC decision is children do not need it, but it is between the parents and their doctor. This creates a problem because previously local health districts would have drive up clinics. The kids would have been able to get the shots while seated in the back of the car. Not allowed anymore, just when the flu season is exploding in the US. We have Kennedy to thank for this one.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    edited January 13
    By contrast, in Scotland we get a request for consent sent out through schools and then the NHS nurses come and administer the flu vaccine via nasal spray. No doctor or jab required.
  • Gramps49Gramps49 Shipmate
    By contrast, in Scotland we get a request for consent sent out through schools and then the NHS nurses come and administer the flu vaccine via nasal spray. No doctor or jab required.

    That's the way it used to be in the US. I remember getting three polio shots that way. Then the oral doses about three years later.
  • BullfrogBullfrog Shipmate
    edited January 15
    The trouble here in the U.S. is, the very occupations that are most likely to spread anything contagious are the ones that get little or no time off for anything short of major surgery (lots of them not that, either). These are jobs like nursing where it's expected that you'll work your shift even when you're feeling like death and likely to have pneumonia, and all the service jobs like waiting on tables and retail.

    I get decent sick leave (after a lifetime of crappy benefit jobs) but I hardly need it, because my work permits me to work from home. I donate as much of my leave as I'm permitted to people earlier in their careers because they accrue fewer days more slowly and also tend to have little germ factories, oops, children, still at home. But I'm only allowed to donate a week each year. This makes no sense.

    Caretaker/DSP relates!

    I remember when COVID came out and I kvetched to my boss about the absurdity of staying home whenever I had respiratory symptoms because my mild asthma means that I can carry a sinus infection for weeks, sometimes a couple months at a time.

    Before COVID when I was a full timer, I'd go to work with borderline pneumonia because I knew there was no way in hell I'd have any PTO left if I took days off every time I got moderately to seriously sick. It was a joke.

    So yes, America sucks. The idea of having public health policy that's in line with common sense is, to me, akin to having public transit that runs on solar power and arrives when and where you need it. I can't even imagine having it so good.
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