Background: Working while ill, or presenteeism, has been documented at substantial levels among healthcare personnel (HCP) along with its consequences for both patient and HCP safety. Limited literature has been published on HCP presenteeism during the COVID-19 pandemic, and specific motivations for this behavior are not well described. Understanding both individual and systemic factors that contribute to presenteeism is key to reducing respiratory illness transmission in the healthcare setting. We characterized the frequency of and motivations for presenteeism in the workforce of a large academic medical center during the COVID-19 pandemic. Method: We deployed a voluntary, anonymous electronic survey to HCP at University of North Carolina (UNC) Medical Center in December 2021, which was approved by the UNC Institutional Review Board. We received 591 responses recruited through employee newsletters. Respondents recounted their frequency of presenteeism since March 2020, defined as coming to work feeling feverish plus cough and/or sore throat. In total, 24.6% reported presenteeism at least once, with 8.1% reporting twice and 5.3% 3 or more times. Asking more generally about any symptoms while working, the following were most common: headache (26%), sinus congestion (20%), sore throat (13%), cough (13%), and muscle aches (9.3%). Results: Motivations for presenteeism fell broadly into 4 categories: (1) perception of low risk for COVID-19 infection, (2) concerns about workplace culture and operations, (3) issues with sick leave, and (4) concerns about employment record and status. Among HCP reporting at least 1 instance, the most common motivations for presenteeism included feeling low risk for COVID-19 infection due to mild symptoms (59.9%), being vaccinated (50.6%), avoiding increasing colleagues’ workload (48.3%), avoiding employment record impact (39.6%), and saving sick days for other purposes (37.9%). Asked to identify a primary motivation, 40.3% reported feeling low risk for COVID-19 infection due to mild symptoms or vaccination, 21.2% reported a workplace culture issue (ie, increasing colleague workload, perception of weakness, responsibility for patients), 20.6% reported sick leave availability and use (including difficulty finding coverage) and 17.8% reported employment record ramifications including termination. Conclusions: This survey coincided with 2the onset of the SARS-CoV-2 ο (omicron) variant locally, and as such, risk perceptions and motivations for presenteeism may have changed. Responses were self-reported and generalizability is limited. Still, these results highlight the importance of risk messaging and demonstrate the many factors to be considered as potential presenteeism motivators. Mitigating these drivers is particularly critical during high-risk times such as pandemics or seasonal peaks of respiratory illness.

Funding: None

Disclosures: None

Based on the theology of Emil Brunner, this article seeks to demonstrate the relevance, even the imperative nature, of personal encounter both for the work of dogmatics and for theological existence. In particular it assesses what impact the personalness of God's self-revelation should have, not just on one's doctrinal conclusions, but also on one's self as a theologian. A range of Brunner's writings forms the backdrop for this focused study of a paradigm which shapes his theology and methodology: personal encounter. I start by introducing the broader context of Brunner's presuppositions about the theological task, including his regard for divine self-communication. With this in mind, attention will be paid to the relationship between revelation and scripture, and in particular to the Christocentric, personal and enduring character of God's unveiling. Brunner's regard for the apostolic witness as the authoritative testimony to God's full disclosure in Christ is high and determines the position that he affords the Bible throughout his work. A summary of Brunner's treatment of the divine-human encounter will follow, with a view to understanding him on this subject in his own terms. His small publication by the same name, The Divine-Human Encounter, serves as the focus of this examination. The term ‘personal correspondence’ requires special consideration for the central position it enjoys in Brunner's conception of divine revelation and its relationship to dogmatics. Further expressions related to this theme will come to light in the process of answering two questions regarding the connection between personal encounter in scripture and the work of theology. First, how true is our doctrine when its expression becomes distanced from the language of divine-human encounter which characterises revelation? Second, what is the relationship between scripture as theology's primary source and the ongoing revelation of God to the believer in personal encounter? The suggestion that theology cannot be restricted to intellectual pursuit will not be universally applauded, but the proposal that God's self-unveiling obliges a change in existence and not just an adjustment in knowledge is one that Brunner deems unavoidable. In this light I conclude by suggesting that the personal encounter of revelation issues an imperative for both individual and communal existence which must be considered by all who undertake the theological task.