UAE: First signs of the flu - is absenteeism justified?
We speak to a cross section of people in the country to find out
Dubai: To go or not to go? That is the quintessential dilemma many office-goers and school-bound students face when they are coming down with a possible cold or flu. It’s the initial stage, the first signs or symptoms, that we are talking about, because once the symptoms aggravate and the clinical diagnosis is out, the protocols of whether one should stay home are very much in place.
Take the case of Shibin, a senior journalist in Dubai. He said he could not think of missing work when he woke up with a heavy head and a bad throat recently.
“I thought it would pass and continued to go to the office for the next two days. But on the third day, I was forced to see a doctor as I developed high fever. I was diagnosed with Influenza A and had to be hospitalised,” he shared.
Looking back now, Shibin makes a confession. “I regret not taking leave earlier on. By going to the office, I had not only exerted myself, I had also put others at risk of catching my infection. Much to my embarrassment, some colleagues even made an effort to keep a distance from me.”
Across organisations, it’s a Catch 22 for those who find themselves in a similar situation like his. In many cases, employees do not skip work at the first signs of the flu because they cannot afford to do so.
But how prudent is it not to isolate oneself in the build-up to a flu? How does one know when a slightly runny nose, a bout of sneezing or a sore throat can develop into a full-blown case of influenza? And more important, at what stage do these symptoms become contagious?
Doctor’s prescription
According to Dr. Ghada Badri, Specialist-Internal Medicine, Thumbay University Hospital, “Influenza is highly contagious, and it is important to be aware of the symptoms and stages of transmissibility to prevent spreading the infection to others. The virus can start spreading to others approximately one-two days before symptoms begin.”
She said, “Once symptoms appear, the contagious period typically lasts for about three-five days. During this time, individuals are capable of transmitting the virus to others. It is also important to note that individuals can remain contagious until they are completely symptom-free. Specifically, they should be free of fever for at least 24 hours without the use of fever-reducing medications before they are considered no longer contagious.”
She said continuing to attend office while symptomatic significantly heightens the risk of spreading the influenza virus to colleagues, which could potentially lead to widespread outbreaks within the workplace and impact the broader community.
“Moreover, remaining at work while ill may extend the duration of the individual’s sickness, potentially resulting in more severe health complications. Additionally, the employee’s productivity and performance are likely to suffer due to fatigue and discomfort, which in turn can adversely affect team efficiency and output. It is specifically recommended that individuals remain on sick leave until they have been free of fever for at least 24 hours without the aid of fever-reducing medications,” she added.
The Ministry of Health and Prevention (MoHAP) also said during the launch of the flu vaccine campaign in Dubai last week that patients must observe five days of quarantine once tested positive for Influenza; 10 days or more in the case of young children depending on the symptoms.
Employer policies
But how do employers view absenteeism at the first signs of a flu?
Although there are no defined protocols to address the early symptoms phase, many employers post COVID-19 are comfortable with allowing such employees to take leave or work from home.
Ravi Jethwani, CEO of the Innovations Group, said, “Our employees get sick leave as per UAE labour laws. They are encouraged to use these leaves when they are unwell. To avail these leaves, they need to inform their reporting manager on the day of taking the leave.”
But what about the first signs/symptoms? “Yes, our employees can work from home for a few days if they feel they cannot make it to the office because of health reasons,” he said. “A sick certificate is required if they are taking sick leave for more than one day at a stretch.”
Asked if employees feel stigmatised when they come to work with a cold or are coughing, he said, “I won’t say they are stigmatised but yes, we do encourage them to work from home in that scenario, to contain the spread of the flu and protect our other team members from falling sick.”
Elsewhere, Trisha Gulati, Head- People & Culture, CEO’s Office, Ajmal Perfumes, said, “At the onset of the first signs of illness, we always advise employees to take precautions and avoid coming to the office for their own wellness and to prevent the spread of infection in the workplace. Depending on the nature of their role and the severity of their symptoms, employees are allowed to work from home with the approval of their reporting manager and HR. This flexibility ensures they can rest while remaining productive, and return to work fully recovered.”
She said, “For employees experiencing symptoms like a cold or cough, we advise taking necessary measures, such as wearing masks, sanitising their work desk and pantry areas, and considering working from home or taking sick leave. This approach helps prioritise their health and that of their colleagues. Our work culture emphasises mutual respect and support, ensuring everyone feels comfortable addressing any health issues without fear of judgment.”
Employees are required to produce a sick leave certificate when they are absent from work due to illness, she said, adding, they should visit a doctor, obtain proper treatment, and secure a certificate from authorised health authorities.
“We expect employees to inform us of their sickness and submit the sick leave certificate to ensure their leave is properly recorded and work can be managed accordingly.”
Students’ best interests
The flu season can prove to be tricky for school students too.
A Sharjah-based father, two of whose three children have come down with a cold, said, “They have stayed back home today, but are worried that they will be missing out on their lessons.”
Brighton College Dubai’s Sarah Brannon, Head of Preparatory School, put it in perspective. “When considering pupil illness and the balance between feeling unwell and missing school, it is essential to prioritise a caring and supportive ethos. A child’s wellbeing must come first.
"If a pupil is unwell, they will struggle to engage with new learning or perform at their best. While we all want pupils to attend school regularly and benefit from the full curriculum, this should never be at the expense of their health,” she said.
“At Brighton College Dubai, we aim to make sensible, informed decisions. If a child shows symptoms, appears lethargic, has a fever, or is acting out of character, they should go home to recover. Fortunately, we have a full-time qualified doctor and two nurses on staff who assess each case individually and work closely with parents to ensure the best outcome for the child,” she explained
According to her, “If a child is absent for more than two days or returning from a more serious illness, a doctor’s note is required. Upon returning to school, the child will receive catch-up sessions with their teacher, and any missed work will be shared with them.”
Early diagnosis
Dr Badri said it is critical to get an appropriate diagnosis and treatment plan when managing the development of flu-like symptoms, such as an abrupt high-grade fever, headache, and muscular aches (myalgia), nasal congestion, and a dry cough. “First and foremost, a diagnostic test for influenza needs to be performed. Usually, a nasal swab is used for this in order to look for influenza viruses. Because it directly affects clinical decisions and management plan, early testing is essential.”
She said timely identification of influenza reduces the needless testing for other possible reasons of respiratory symptoms, lessens the improper use of antibiotics, and improves the efficacy of antiviral medication. Furthermore, in order to effectively control infection and stop the virus from spreading, a timely guidance is crucial.
“Early intervention with antiviral medications, ideally within the first two days of symptom onset, can significantly improve treatment effectiveness and reduce the severity of influenza. Alongside medical treatment, it is important to stay well-hydrated by drinking plenty of fluids to compensate for fluid loss associated with fever and other symptoms,” she added.
What to do at the first signs of flu
- See a doctor within the first two days of symptoms onset
- Stay well-hydrated
- Limit close interactions with family, friends and colleagues
- Practise good respiratory hygiene by sneezing into your elbow rather than your hands
- Dispose of used tissues immediately and in a proper trash receptacle
- Wear a mask
- Carry disinfectant and wipes to clean surfaces you frequently touch.