Pharmacist Miki Vespoli knows working while sick is neither a good health practice nor a good business one — but she's used to doing it anyway. Vespoli, 41, works for an independent pharmacy in Careywood, Idaho, and is sometimes the only one behind the counter.
One of the few times she considered calling out sick was when she contracted Covid earlier this year. She still took her work home with her.
Health-wise, "you don't get better as quickly," Vespoli tells CNBC Make It. And productivity-wise, "I can't perform at the same level as when I'm well. But our patients depend on us to give them their meds."
These days, Vespoli says running a fever no longer means taking a day off — it only means doing what she can from home.
In March 2020, as the novel coronavirus made its way to the U.S., workplace experts said the best way companies could support their people was pretty simple: make sure they have ample paid sick time. Some even posited Covid could finally prompt a long-awaited national paid leave policy, including mandated paid sick time for workers whose companies don't offer it.
Now in the pandemic's third year, we're nowhere near that.
If anything, people are working through Covid — logging into their laptops from home even as they deal with runny noses, sore throats, fatigue and brain fog.
But doing so could make recovery that much harder, experts say.
In many cases, like Vespoli's, the drive to keep working while sick stems from deep-seated workplace pressures to keep up productivity, even through a once-in-a-lifetime global health crisis.
"The American mentality is that we just don't know how to relax and rest," says Dr. Michael Daignault, an ER doctor in Los Angeles. In more recent waves of the virus, he's seen a trend among patients who try to "push through," whether it's continuing to work remotely or exercise from home.
People who've been vaccinated and get Covid are more likely to experience mild symptoms. And if you have a runny nose or sore throat, you might think "you can power through that stuff because that's what people are used to," Daignault says. If your workplace is short-staffed, you may feel extra pressure to keep going.
But evolving symptoms with the latest Covid variants, especially neurological effects like brain fog, are "continuing to surprise us," Daignault adds. People may not know how to recognize, let alone manage, these symptoms. Others may have no choice but to work through the impacts of long Covid.
Even when physical symptoms are mild, "the mental and emotional burden of contracting Covid can be high," says Allison Rutledge-Parisi, senior vice president of people at Justworks, an HR tech company.
People who tend to work through feeling a little sick might ignore the emotional impacts of their quarantine or isolation period and keep working anyway, she says. This can lead to burnout and continued challenges balancing work with recovery.
Then, there's the issue of separating work and home if you're able to telework. Just as work is no longer equated with an office, Rutledge-Parisi says, home is no longer thought of as just a place for rest.
And those who don't have access to remote work or paid leave have no option but to rush through recovery to get back to work and get paid.
But trying to push through and work after contracting Covid is a bad idea, Daignault says.
"All your resources at that time are focused on bolstering your immune system responding to the virus," he says. "If you're focusing on other things mentally for work or trying to continue your workout regimen, it diverts a limited amount of resources your body has to those things instead of fighting the virus and recovering."
Anecdotally, Daignault has seen some elderly patients have milder symptoms and recover faster after resting while sick, whereas younger people who continue working from home or rush back into fitness routines end up having a harder recovery.
He wonders: "Are we having worse symptoms because we try to push through it?"
Daignault's best recommendation is to "just rest and learn to do nothing for a week or 10 days or until you test negative."
He also urges that people don't rush back into their normal routines, whether that's at work or for exercise. "Ramp up slowly. It's almost like in the days of acute illness of Covid, this virus is able to decondition you for a lot longer of a period of time — for weeks and months."
Of course, not everyone is guaranteed paid sick leave for Covid or otherwise.
In the early days of the pandemic, federal Covid relief provided two weeks of paid sick leave to some in-person workers if they tested positive or had to quarantine because of Covid, but it expired at the end of 2020.
Bon Garland, 31, holds an in-person government job in Lynnwood, Washington, and says their employer's sick policy "hasn't changed one bit" since the pandemic began.
Garland, who has a chronic illness, contracted Covid last week but doesn't have any more paid sick days and must wait to accrue them each month. Because their job is 100% onsite, they'll have to take sick leave without pay unless they pursue medical leave offered through the state, "which is a long, complicated process itself."
"My workplace is basically leaving people to their own devices if their sick bank was depleted from another condition, like mine was," Garland says.
Rutledge-Parisi says employers can do better by having several buckets of Covid-related leave and be explicit about taking paid time off even if you're not physically feeling symptoms. For example, in addition to Covid sick leave, employers can provide caregiving leave for workers to take care of sick family members, mental health days or additional time off for workers to manage lingering physical and psychological symptoms even months later.
Garland says their workplace's relaxed Covid safety measures could push them to quit. "It has impacted me to the point I'm seeking other work and in entirely different industries," they say.