In our post-pandemic world, many people feel a tension between “getting on with life” and being a responsible citizen when they feel sick. One of the big questions is, Can I go to work with COVID?

This seemingly simple question has become surprisingly confusing, especially with at-home flu and COVID tests readily available.

It’s human nature that when a tragedy like a pandemic affects all of our lives and changes everything about how we live, work, and interact, we eventually want to lower our guard and get back to normal. But here’s what I want you to remember: COVID, to an immunocompromised or just unlucky person, can still cause significant harm.

We’re not talking about only the immediate illness, but also the long-term effects that can occur after some COVID infections.

So what do we do? How do we get on with life while keeping COVID — and other upper respiratory illnesses — in mind?

Our Responsibility When We’re Sick

Before COVID, we took perhaps a less responsible approach to upper respiratory illnesses as a society. In many quarters, we just went to work anyway, either because we wanted to or because it was required. But COVID showed everyone just how dangerous an upper respiratory infection can be, especially for those with less robust immune function.

The world is different now. Our general respect for the damage these viruses can do has increased, and we know how to act responsibly when we catch them. So, even though the current strains of COVID are less severe than the original, we must consider that certain behaviors are still irresponsible if we’re sick, such as:

• Going to work
• Flying
• Attending an event or family function

I’ll get into the details about going to work with COVID in a moment, but let’s address the other two activities first.

Regarding flying, I highly recommend taking out travel insurance when planning a trip. It’s usually inexpensive, and it provides you the means to cancel your flight if you become ill without suffering financial loss.

Of course, we don’t want to spread COVID at a large event or a family gathering, but here’s a related thought. If you have a family wedding coming up and a concert the week before, you may want to weigh the importance of the concert versus the wedding. Is the concert important enough to risk getting COVID (or the flu, or RSV) before you see your family, or would it be better to skip the entertainment to be sure you can wish your cousin well on her big day?

Can I Go to Work With COVID? Understanding the Timeline

The evolution of COVID recommendations has been constant since 2020. Here’s what you need to know about COVID back-to-work rules and guidelines today.

There are essentially two types of people: those at high risk and those at low risk. For high-risk individuals, the recommendations haven’t changed in five years.

People with COVID are contagious for 10 days, starting from day zero — either the first day of symptoms or the first day of a positive test without symptoms. On the 11th day, that person is no longer considered contagious.

The Five-Day Exception

We have an exception for people with mild illnesses. After five days, if you’ve been without a fever for 24 hours (without taking fever-reducing medicine like Tylenol) and your symptoms are improving, your rate of spreading the illness goes down significantly.

As long as they’re not healthcare workers, these individuals can return to work on day six with proper precautions:

• Wearing a mask for another three or four days
• Keeping hands clean
• Avoiding close contact with others

Healthcare Workers Have Different Rules

Healthcare workers still need the full 10-day isolation period because of the risk of exposing weakened or immunocompromised patients.

If you’re going back to work after COVID sooner than the usual 10 days as a healthcare worker, you have to test negative on two separate occasions, 48 hours apart. The soonest someone can return without restrictions is seven days, but only if these criteria are met.

The Reality of Flu Season: It’s Not Just the Flu Anymore

Flu season isn’t just about the flu anymore. It now includes a host of upper respiratory illnesses, including COVID, influenza, and RSV. All these viruses behave similarly when it comes to being infectious and easily spread.

But here’s something fascinating: During the first two years of COVID, I rarely saw anyone in my office with a common cold. Why? Because everyone was washing their hands, wearing masks, and limiting exposure. It was amazing, and all my colleagues said the same thing during that time period.

People took great care with their medical hygiene, and it showed.

While it’s unrealistic to maintain the level of vigilance we adopted during the pandemic, we can still take steps to prevent the transmission of preventable illnesses.

For example, you needn’t worry if someone sneezes across the street or on the bus. But if a person appears ill, it’s prudent to stay away from them. And if you’re that person, you can be prudent and protect others so you don’t infect them.

Why We Require Testing Before Office Visits

When patients call my office with an apparent respiratory illness, our standard is to have everyone test with a COVID, influenza A, and influenza B home test. These tests cost between $15 and $25 each, and everyone (my patient or otherwise) should have several in their home.

If a patient tests positive, we’ll ask them to stay at home and we’ll have a visit with them over the phone.

Why do we do this? Do we not care about our patients? Of course we do!

If a person has COVID or another highly contagious respiratory virus, it’s true that we don’t want that virus to spread to our other patients or staff members. But this isn’t because we ourselves are afraid of illness. It’s because if someone in the office does catch COVID, we’ll have to shut our practice down for 10 days.

This has happened twice in the last five years, and it significantly hinders our ability to provide healthcare to all our patients. We want to avoid it if possible.

We absolutely still care for our patients with upper respiratory viruses; we just do it over the phone. Through conversation, we can assess their condition and recommend appropriate treatment, which they don’t need to come into the office for anyway.

Decisions about going to work with COVID can follow a similar logic — protecting both your coworkers and your business operations. If you’re able, working from home for the quarantine period can be an excellent option.

COVID Back-to-Work Rules: Final Thoughts

The overall stakes may be lower now than they were five years ago, but COVID and other respiratory illnesses shouldn’t be dismissed. Individuals can still suffer greatly, and we as individuals must still be responsible for our own health.

As we navigate the post-pandemic era, remember that being a responsible citizen means weighing the need to “get on with life” against a responsibility to protect others. If you’re wondering, “Can I go to work with COVID?” remember that it’s about not just your own recovery, but the health of your colleagues, their families, and the broader community.

The good news? With at-home testing readily available and clear guidelines about contagiousness, you have the tools to make responsible decisions — both for COVID and other upper respiratory illness.

Take advantage of those tools. And remember, wash your hands, avoid proximity to others with obvious illnesses, and take care of the Four Pillars of Health so your body has the best chance of fighting off what the world throws at it.