Public Hygiene and Vaccination: They're Not For You, They're For...

...the rest of us. Shorter version: you are an ambulatory germ dispersal unit, so be responsible.

I try to make it a regular habit to go through the ScienceBlogs 24-hour feed, and in doing so, I came across this post by ScienceBlogling Jason Rosenhouse talking about his experience with what might have been TEH SWINEY FLOO!, and my jaw dropped when I read this:

I didn't even cancel any of my classes, though I did cancel some office hours to get home and back into bed more quickly.

I became more troubled as none of the commenters seemed bothered by this. Fortunately, Orac showed up and responded far more tactfully than I would have (the Mad Biologist does not do tactful very well...):

I hate to tell you this, but that was highly irresponsible of you. You put your students and coworkers at risk for catching whatever it was that you had. You should have stayed home from work. It's attitudes like yours that spread the flu, be it the swine flu or the regular seasonal flu.

Orac was dead on target, but I think this little episode represents a lack of internalization of what a major, if often not explicitly stated, rationale for public hygiene and vaccination is.

Public hygiene measures (e.g., isolation, hand washing) and vaccination are not used to protect you from other people.

They are used to protect other people from you.

Now, we usually don't phrase it this way, although you might have heard the phrase 'herd immunity.' After all, these measures do significantly lower and prevent infection of those who engage in them. But we are dealing with infectious, transmissible agents. To the extent that you can't be infected--and therefore infectious--the rest of us are safer.

Most people don't like being told that they're ambulatory germ dispersal units, but that's what you (and me too!) are.

In these situations, it's always easy to come up with justifications for practicing poor public hygiene, such as 'everyone' already has been exposed, or it won't make anyone really sick. And you know this how exactly? The magic epidemiology lab in your head? There's a reason why so many people here at ScienceBlogs encourage both vaccination and good public hygiene: it prevents illness and save lives.

If each of us to takes personal responsibility and protects each other, we will save lives. It's that simple. If you won't lose your job, please take the time off when you're sick.

Update: A Cornell student has died from swine flu, on a campus with 520 diagnosed cases.

Mandatory disclaimer: Inevitably, someone will talk about people who can't take time off from work, else they lose their jobs (something I've discussed too). That's a lousy deal--it's also a really stupid business policy, as employees come down with the bug. But I don't know of a single university that has encouraged employees to show up sick; most have strongly discouraged this behavior.

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But, but Jenny McCarthy said it's okay not to wash or get vaccinated as long as we eat Grape Nuts.

Having spent some time on faculty in the Rocky Mountain region, I enjoyed a quote I posted from the Durango (CO) Herald News about the congruence of vaccination with the Code of the West:

Getting vaccinated is not only sensible in terms of personal health, it is the socially responsible thing to do. It is essentially a civic duty, not unlike how trimming flammable brush protects the neighbors' homes from fire as well.

There have been some grumbles from right-wingers in the UK about the relatively high number of sick days in the National Health Service, with suggestions that management should attempt to reduce this for the sake of efficiency (with the implication that the number of sickies is due to NHS staff being slackers).

It had to be quietly explained to the nasties that there will inevitably be more sick leave in the NHS than comparable organisations, because medical staff, especially those in contact with immune-compromised or generally weak folk, are under strict instructions to stay away if they are ill. Not so much slacking, more conscientious behavior.

Were things better or worse back before, what was it, 2004? 2002? When there was that flu vacciene shortage and everyone running for election made a big point of how manly they were by forgoing vaccination and making subtle digs at their opponents for being old and infirm , as evidenced by their getting vaccinated?

"If you won't lose your job, please take the time off when you're sick."

that's a problem...i know many who WOULD lose their job if they spent a few days off from work. i live in a poor area in SC (ask if Rep Joe Wilson knows where it is!) where people don't have those great jobs with great benefits.

Inevitably, someone will talk about people who can't take time off from work, else they lose their jobs (something I've discussed too).

[...]

But I don't know of a single university that has encouraged employees to show up sick; most have strongly discouraged this behavior.

Do they need to? The deadlines are punishing enough even without having to take time off. The lab expenses run whether they're full or empty, subordinates need to be paid whether or not their supervisor is around, grants run by calendar time and don't have call-in-sick extensions, etc.

By D. C. Sessions (not verified) on 14 Sep 2009 #permalink

@DC Sessions:

much of that activity sounds like it could be dealt with whilst working from home.
After all if you are well enough to go to the office you are well enough to actually do something useful whilst refraining from giving your coworkers your germs.

Well, if one is in a workplace where management likes to deny sick time, it is incumbent upon those with contagious diseases to visit said managers and sneeze or cough according to the right symptoms. After all, misery needs to produce the right kind of company.

I suspect that universal health care would provide a triage system for hospitalizing those who need the support of IVs and strong meds.

I actually worked at a place once which decided to "solve" the problem of people calling in sick Monday to get a three-day weekend (a problem I think mostly existed in the head of the manager proposing the "solution") by decreeing that one could not call in sick on a Monday. Instead, if you were too sick to work on a Monday, you commuted in anyways and then asked if you could go home sick.

I don't think it actually happened like this, but when I did fall pretty ill on a day that happened to be a Monday, my memory of it was that, true to the manager's ridiculous demands, I did indeed commute over an hour to get to the workplace. I then vomited on the floor in front of her desk and asked politely if I could go home sick.

By Name Redacted (not verified) on 15 Sep 2009 #permalink

I'm at Cornell and there are a lot of people walking around sick. My advisor is sick as well, but at least he stayed at home. However, the cashier at the cafeteria has been sick since early last week and she is still working near food/the register...

I work in a government office and we are taking bets on whether a co-worker will show up sick. Last year, she almost crawled in she was so bad...which prompted a number of us to complain to management to kick her the hell out when/if she shows up like that again. Given her proclivities, I'd take the disclaimer and post it in two foot tall letters in her cube, just in case she didn't get the message.

I never get the flu, and I'm only 58, so I've never had a flu shot before. But I live with my elderly mother who was hospitalized with pneumonia this year and last, and this post (and identical advice from my brother Mike) led me to get the jab yesterday. My left deltoid is still a trifle tender.

Were things better or worse back before, what was it, 2004? 2002? When there was that flu vacciene shortage and everyone running for election made a big point of how manly they were by forgoing vaccination and making subtle digs at their opponents for being old and infirm , as evidenced by their getting vaccinated?