It’s Monday, so it must be Swine Flu- Swine Flu rise points to Monday sickies

A weekly rise in cases of swine flu across the country on Mondays suggests that employees are using the pandemic as an excuse for throwing a Monday morning “sickie”.

While the rate of infection in recent weeks has risen and fallen in line with experts’ predictions – and a similar if staggered trend for flu elsewhere in the world – health specialists have found the weekly fluctuations more puzzling.
Swine Flu- Monday morning sickies
Regardless of the total number of cases recorded each week, data from the official National Pandemic Flu Service show a consistent pattern for a maximum number of cases on Monday, declining steadily on every subsequent day before peaking again seven days later.

“We just don’t know why,” said Sir Liam Donaldson, chief medical officer, last week when asked to explain the “Monday effect”, adding that there was no obvious medical reason. The World Health Organisation also said it was unaware of any weekly pattern.

One possible explanation is that people socialise more over the weekend, increasing their likelihood of infection. But with flu symptoms typically taking two days to develop, any peak in demand for help should come on Tuesdays or Wednesdays. Friday evening socialising is often with colleagues, suggesting little more risk of infection than on other days of the week in the workplace.

With clinics closed or open for only limited hours over the weekend, many doctors’ show a surge in consultations on Mondays for all sorts of ailments that have developed over the weekend.

But the government’s dedicated pandemic flu service, which began operations in July, operates by both telephone and internet around the clock, including on weekends, offering no such barriers to access outside working hours.

People might wrongly believe that the service is closed on weekends and wait until Monday before getting in touch. But data from NHS Direct, open 24 hours a day for phone consultations on all medical conditions, shows the proportion of calls is roughly equal on each working day of the week, with peaks at weekends.

On Mondays, those calling in specifically with suspected colds or flu in the 12 months to May accounted for 13 per cent of weekly calls, against 12 per cent for the rest of the working week, rising to 19 per cent on Saturdays and 20 per cent on Sundays.

One difference between NHS Direct and the pandemic flu line is that the latter offers a code allowing access to the antiviral drug Tamiflu, and a receipt that can be used to justify sick days and insurance claims.

Aaron Ross, chief executive of FirstCare, a consultancy that manages sickness-related absences from the workplace, said 43 per cent of all his calls each week for all causes take place on Monday. “The only natural conclusion is that people are using the service as a reason to take time off work,” he says.

“A number of employers we have spoken to are suggesting employees are calling the hotline, requesting Tamiflu and then using it as justification to phone their manager to start an absence.”

That does not explain the steady decline over the rest of the week. But if a second “wave” of flu takes place later this year as predicted, employers should be braced for a new peak in absences, especially on Mondays.

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