A Sickening Situation

For corporate America, flu season means countless lost man-hours. For healthcare professionals, it means 40 million doctor consultations, 750,000 hospitalizations and an estimated 200,000 deaths this season, according to the Centers for Disease Control. For wealthy clients who employ domestic employees to help run their households, the health and financial exposures are more serious than they probably imagined.

Families that employ domestic workers should be aware that the greater threat of flu is not that employees will call in sick–it is that they will drag their sick selves to work. A Cornell University study found that going to work in a contagious state–what human resources experts call “presenteeism”–accounted for 60% of the total cost to employers from employee illnesses. Recent figures put the annual cost of presenteeism to U.S. employers at anywhere from $150 billion to $250 billion.

From exchanging business cards to using the same salt shaker in the lunchroom, the possibilities for transferring viruses in the workplace are numerous. These same concerns exist in domestic work settings, but to an often higher degree. Many office workers who take ill can attend to pressing work matters from home, for example, via telecommuting. Sick domestic employees, meanwhile, do not have that luxury. Rooms must be dusted; groceries put away, mail collected. This contact with personal property allows flu to rapidly cycle through the employer’s home.

At the same time, employers often contend with more than a few family members bringing home a virus from work or school. They can have one or more domestic workers also bringing in a flu contracted from spouses or children or coworkers at a second job. That creates an exponentially larger web of communicability inside the client’s home. Also, the uniquely skilled and experienced domestic worker (personal chef, nanny) is not likely to have someone on staff that can readily step into their shoes. This creates extra pressure to work sick rather than disappoint an employer in a bind.

More importantly, if a flu victim happens to be one of the 57 million American workers who receive no sick benefits, calling in sick may mean sacrificing much-needed pay. In this scenario, flu-bitten domestic employees feel more pressure to take their viruses to work. This is a serious concern for several reasons. Domestic workers often have direct in-home contact with–and specific duties caring for–the very young and very elderly, the two demographic groups most susceptible to flu.

A toddler or aging parent with flu could trigger a major family medical crisis. Just as worrisome is the prospect of a houseguest being sickened. New flu strains are making it harder to say who is at elevated risk, too. Take older teens and younger adults. With their strong immune systems, both tend to resist the worst a seasonal flu can dish out. Yet the American Journal of Roentgenology found the new H1N1 virus seriously sickens many of them. It also found H1N1 could cause “unusual” lung damage such as pulmonary emboli in patients. Without the added early-detection step of an X-ray, and treatment with a specific antiviral therapy, the condition can easily turn fatal.

The wisest course for households with an active flu bug may be to postpone plans to entertain anyone who has yet to be exposed to either seasonal flu or the H1N1 virus. Likewise, guests who visited just before an employee or family member first began to show symptoms should be told they might have been exposed to the virus in its early contagious stage.