Does remote work make it easier to work while sick? Yes—and that flexibility can either help employees adapt or make it harder to stop working, according to a new review by researchers at Manchester, National Taiwan and Soochow universities. They argue that “presenteeism” now includes working while unwell from home, not only turning up sick at a workplace.
What is presenteeism?
Presenteeism traditionally means attending work despite being ill. That definition made intuitive sense when work was tied to a factory, shop, office or other physical site. Email, messaging platforms and video meetings have weakened that link.
An employee can now stay at home with a fever, avoid commuting and still complete a full day of tasks. Another person may log in only to handle an urgent request. Both are working in a state of poor health, but their situations—and the likely consequences—are different.
What new definition do the researchers propose?
The paper defines presenteeism as attending work while in suboptimal health, with varied choices of location and degree of engagement. Its framework uses three dimensions:
- Health: whether the problem is physical or mental.
- Location: whether the person works on-site or remotely.
- Engagement: whether they maintain a normal schedule or reduce their hours and effort.
Combining those dimensions produces eight forms of working while unwell. The framework separates, for example, an employee completing a full shift on-site with a physical illness from someone experiencing anxiety who handles a limited set of duties at home.
Why does the distinction matter?
Working while ill is not automatically good or bad. A person with a manageable condition may value the option to complete essential work at a slower pace without travelling. For someone else, constant notifications and an expectation of availability may delay rest and recovery.
Traditional surveys can miss that difference if they ask only how many days someone “went to work” while sick. Better measurement could help researchers examine which arrangements protect health and which create harmful pressure.
How can flexibility become a trap?
Digital work reduces the practical barrier to logging in. A laptop is nearby, colleagues can see online status and unfinished tasks remain visible. Even when a manager has not explicitly asked for work, employees may feel they should answer messages to prove reliability or prevent work from accumulating.
The “always-on” problem also extends beyond physical illness. The researchers argue that mental-health-related presenteeism deserves more attention, since established measures have often focused on colds, pain or other physical symptoms.
Does everyone have the same choices?
No. Remote work is unevenly distributed. Many roles in healthcare, retail, manufacturing, transport and hospitality require physical presence. Office-based employees may be able to reduce travel or adjust their hours, while frontline workers have fewer ways to modify location.
That inequality makes a single policy difficult. Praising employees for “powering through” can normalise unhealthy behaviour, but banning all work during a mild illness may remove useful autonomy. The relevant question is whether the worker has genuine control over location, workload and time—or feels compelled to remain available.
What should employers change?
Managers can make sick-day expectations explicit: an employee who is off should not be expected to monitor email, while someone choosing limited work should be able to define what “limited” means. Teams can provide backup ownership for urgent tasks so illness does not create a personal crisis.
Organisations should also examine incentives. Attendance bonuses, understaffing, ambiguous leave policies and visible online-status tools can all push people toward working while unwell. Measurement should include remote activity and mental health rather than treating absence from the office as evidence of rest.
What is the practical takeaway?
Remote work has not eliminated presenteeism; it has made it less visible and more varied. The useful management distinction is not simply “working” versus “off sick”. It is whether an ill employee has safe, voluntary flexibility—or an always-on obligation wearing the label of flexibility.
Source note: The review was published in Health Psychology Research. Read the University of Manchester summary and the paper at DOI 10.36922/HPR026130066.