Doctors prepare for more sick note requests as flu season and back-to-school approach

With more cases of COVID-19 in Manitoba and flu season approaching, doctors are trying to figure out how they're going to manage an influx of sick note requests from patients nervous about going to work or sending their kids to school. 

The pandemic has raised new situations where patients are asking for sick notes, including people wanting accommodations to work from home because they're nervous about catching COVID-19, and some parents who want notes for vulnerable kids to get accommodation from schools for home learning.

Pediatrician Dr. Stan Lipnowski says he's already been flooded with requests from parents worried about back-to-school season. 

"We started seeing it yesterday, and I have more and more phone calls today, and I anticipate as we get closer to the school year that there will be many, many, many more requests for this service," he said. 

In the province's back-to-school plan, students with symptoms must stay home when sick, and sick notes won't be required. The same goes for teachers.

Students who are "medically advised" not to return to school will be able to continue remote learning with school support in certain circumstances. 

Lipnowksi will write notes for children with a medical condition or on a medication that suppresses the immune system.

The province also announced Wednesday it will be mandating face masks for kids in grades 4 through 12. 

Lipnowski said he hasn't received any requests yet from parents who want their child exempt from the mask requirement, and he doesn't anticipate getting many. 

Lipnowski would give a doctor's note for kids who have developmental issues or significant behavioural issues that would make it difficult for them to keep the mask on.

It would be very rare for a child not to be able to wear a mask because of a physical issue, he said. 

Guidelines for doctors 

Doctors Manitoba issued guidelines on sick notes during the pandemic this spring, after several physicians raised concerns that requests for notes were coming from people who were afraid of catching COVID-19 at work or bringing it home to their families.

Guidelines posted to Doctors Manitoba's website say doctors should consider different factors that would put someone at greater risk of a serious outcome from COVID-19. 

A spokesperson for Doctors Manitoba said the guidelines are meant to offer some advice to physicians so they can support patients who have legitimate medical concerns, but also help patients understand what their actual level of risk is. 

Employers are asked to waive the requirement for sick notes related to cold or flu symptoms, said Dr. Cory Baillie, president of Doctors Manitoba. 

"Certainly access to medical care can be challenging [during the pandemic], and we don't want to overload the system with patients needing to see their physicians just for sick notes," he said.

"But it's important to tell them not to put their health on hold if they do have concerns about COVID-19 or other medical issues. We want them to call their doctor. We're here to help them."

Requests peaked in spring 

Dr. Abdallah Rizk, a family doctor who co-owns the Seine River Medical Centre, said he saw a lot of requests for sick notes in spring from people who were very anxious about potentially catching COVID-19. 

"At that time, April, May and June, there was a lot of people asking for sick notes for anxiety because they were so stressed when going back to work, having nightmares or were worried about passing it on to their families." 

Those requests have tapered off now, but he expects flu season and kids going back to school will cause a lot of anxiety again as people wonder if their symptoms are just the flu or the coronavirus. 

"This will be the time I'm expecting there could be a lot of panic and anxiety," he said. 

However, he doesn't think he'll see the same demand for sick notes as in spring, because people have gotten used to living with the pandemic.