It's a situation every employee has grappled with at some point: do you stay at home or go into work when you're feeling under the weather? Tempting though it might be to bury yourself under the duvet and settle in for a long session of daytime TV, it may not be feasible to take time off whenever you're feeling suboptimal.
Unlike more serious illnesses - which surely justify some real recovery time - a bad cold occupies a tricky grey area. On the one hand, you're feeling grotty, and may not be working as effectively as normal. On the other hand, you're probably still capable of turning up at work and soldiering on irrespective.
"Given that coughs and colds are so common, it would be impractical to take time off work with every viral infection," says Dr Daniel Fenton, clinical director at the walk-in GP clinic, London Doctors Clinic.
"It is important to understand that the vast majority of coughs are self-limiting and very few will last more than a week or so. That said, if you do work in a small office space and are feeling really under the weather, then you might want to consider taking some time off to recover. You also reduce the risk of infecting your work colleagues."
Most GPs agree with Fenton that in the majority of cases, you likely don't need to take a sick day for a minor cold. In a recent Patient.info survey of 261 doctors, only 10% of respondents said they would always recommend their patients take time off for this type of illness.
The problem with presenteeism
However, whether or not to take time off for colds turns out to be a surprisingly complex issue. Each workplace is likely to have its own take on the subject, with some more forgiving than others.
"Not all organisations will pay for sick leave, and many individuals can't afford to take time off when they're not well, so push on regardless," says Jack Evans, lead business psychologist at Robertson Cooper. "It's also common for things like promotions or bonuses to be made available only to those individuals with very good absence records, which creates financial pressure to go into work."
To put it simply, many organisations will seek to minimise employee absences in a variety of ways. Since they're so easy to track, absence rates are often used as shorthand for the workforce's overall health and well-being.
Unfortunately, this can lead to 'presenteeism' - people going into work when they're mentally or physically unfit to be there.
In fact, presenteeism may represent a significant 'hidden cost' to workplaces. According to a survey by CIPD, presentee rates have more than tripled since 2010, with 86% of survey respondents saying they had observed presenteeism in their organisation over the last year. And in the 2017 Britain's Healthiest Workplace study by VitalityHealth, the average employee reported that they spent 27.7 days a year underperforming due to ill health.
"Research doesn't yet clearly outline the impact of presenteeism, but it certainly shows that organisations need to take it seriously," says Evans. "The other side of presenteeism is that when it comes to people feeling physically unwell, by going to work we may pass on that illness to someone else in the team, who then is presented with the same choice."
From the company's point of view, having one employee function at 75% might not be such a problem. However, if they sneeze and cough their way around the office, other members of the workforce might end up functioning at 75%, which could be a less desirable outcome than having that first employee stay home.
With this in mind, Evans thinks organisations need to focus on workers' underlying health, well-being, pressures and resilience, rather than looking exclusively at absence figures.
When should you stay home?
For the employee who is really struggling with a bad cold, a couple of days off work will probably be to their advantage. As Fenton puts it, rest is an underestimated therapeutic intervention.
"As working professionals, we all feel the need to be at work and meet deadlines," he says. "However, when we are unwell, our immune system is working at full capacity to tackle the virus. Without rest, we are diverting some of our energy away from the immune system, to carry out our day-to-day tasks."
He stresses that the term 'rest' doesn't mean you need to confine yourself to bed for days on end, but rather entails a simple reduction in strenuous, non-essential activities.
"Eat well, drink plenty to keep yourself hydrated, and ensure you are taking some simple pain relief such as paracetamol or ibuprofen to help with the sore throat, joint aches and headache and fever that may sometime be associated," he says.
Whether you can do all this while still going into work probably depends on your job - not to mention the severity of your illness. There are no hard and fast rules on the symptoms that definitively mean you must stay at home.
Indeed, 87% of GPs surveyed said that symptom severity would determine whether or not you should stay home; with 76% in agreement that your decision to take a sick day also depends on your line of work. For instance, if your job involves working with people who may have compromised immune systems, such as children or the elderly, it may be wise to stay home.
And certainly don't soldier on if it could be a more serious illness.
"I would consider taking time off if you have a very high temperature, with shivers and shakes, not settling with paracetamol or ibuprofen," says Fenton. (These symptoms are not seen with the common cold and may suggest a more serious problem.)
He adds you could also consider taking time off work if your symptoms are getting worse rather than better over the course of a week. The same applies if you have a condition that suppresses the immune system such as diabetes, heart disease or significant lung disease.
"I would also recommend booking in to see you GP in these circumstances, or if conventional over-the-counter treatments and rest have failed to help after a week or two," he says.
So should employees stay at home when they have a cold? The answer, in short, is: "It's complicated.". If it really is just a cold, the illness will resolve on its own and (depending on your workplace) is rarely worth incurring an absence for. However, if you think you may be suffering from a more serious illness, like flu, you should absolutely make recovery a priority.