More than two years into the COVID-19 pandemic, when Dr. Anthony Fauci tested positive for the coronavirus, his federal agency announced that he would “continue to work from his home.”
So did U.S. Secretary of Transportation Pete Buttigieg, who announced on Twitter that after testing positive, “I plan to work remotely.” And so did San Francisco Mayor London Breed, whose office announced she would conduct meetings from home after testing positive.
As vaccines and new treatments have eased some of the alarm around a COVID-19 diagnosis, continuing to work — but from home — has become a familiar practice among professionals who can do their jobs remotely. Fauci was vaccinated and boosted and said he was experiencing mild symptoms, like other officials who said they would stay on the job from home.
Physicians caution, however, that rest is an important part of weathering a COVID-19 infection. Plugging away from home is better than putting others at risk of getting infected, but it can still strain the immune system, worsening the toll of a COVID infection, experts say.
“Sleep equals immunity,” said Dr. Susan Cheng, a cardiologist, researcher and professor in the Smidt Heart Institute at Cedars-Sinai Medical Center. As it fights off the virus, “you want to have your immune system not distracted by anything else,” including stress from work.
People forget that COVID-19 is not the common cold, she said — and even for a common cold, “you do not want to be going 100% or even 80%.” Cheng pointed to studies done long before the pandemic, which found that mice infected with “garden variety viruses” fared much worse if they were forced to swim.
“You really want your body to recover,” Cheng said. “Give it as much rest as possible, to recover as fully as possible.”
Family medicine specialist Dr. Caitlin McAuley said that “in any acute illness — and COVID especially — we know that rest is important.”
“Getting adequate sleep lets the immune system rebalance,” along with hormones, said McAuley, who sees patients through the COVID Recovery Clinic at Keck Medicine of USC. In addition, “we often don’t acknowledge the fact that when we’re sick, we’re not functioning appropriately mentally as well. So decision making may be impaired.”
“At a minimum, you really should unplug for three to five days,” McAuley said.
The public messages from prominent officials saying they’ll keep working from home are “minimizing the risk of long COVID and encouraging others to think, ‘If I have the virus, I can just push through it,’ “ said David Putrino, director of rehabilitation innovation for the Mount Sinai Health System.
Long COVID occurs when symptoms persist for months or longer beyond an initial infection. So far, data tracking rest and COVID outcomes are sparse, “but point us towards the idea that individuals who did not adequately rest had a higher incidence of persistent symptoms,” Putrino said.
The pressure to keep working with COVID — even if it’s from home — has also troubled labor and disability advocates who see it as normalizing working through illness.
When prominent officials test positive and say they will keep working from home, “it is a way of saying, ‘I am still a powerful person who is able to continue doing my job,’ “ said Jaime Seltzer, director of scientific and medical outreach at #MEAction, the Myalgic Encephalomyelitis Action Network. If the goal was to craft a public message based on the best evidence, “we would say that when you become ill, you should be resting.”
Healthy people are used to being able to push through fatigue, rest for the night, “and wake up more or less feeling back to normal,” Seltzer said. “But we have to recognize that when your immune system is being challenged … that’s simply not true anymore. And we shouldn’t expect ill bodies to behave like healthy bodies.”
