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At the height of the pandemic, Meg McNamara’s employer sent her home with symptoms that looked a lot like Covid, but she knew better.

A negative Covid test proved that the 37-year-old’s coughs and red eyes were just her usual allergies. Determined to not be wrongly accused again, the New York-based physician’s assistant turned to over-the-counter medication. She started popping Benadryl every morning to mask her symptoms, but that caused other problems.

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“It was a nasty experience,” said McNamara who often suffered from drowsiness — a side effect of Benadryl. “I’m always tired. For me to have a little bit more fatigue in my life is not acceptable.”

As the pandemic has receded, McNamara is emblematic of the dilemma facing Americans. They’re under pressure to show up for work and social gatherings, yet even the hint of a sniffle can be enough to brand someone an outcast. To cope with these dueling obligations, they’re using more cold and allergy meds to cope — and potentially overtreating themselves in the process.

Read More: You’ve Heard of Long COVID. Long Flu Is a Health Risk, Too

In the US, sales of upper respiratory over-the-counter medications rose 23% to $11.8 billion in the 52 weeks through early December from the same period in 2019 before the pandemic, according to researcher NIQ. Cold and flu treatments, which make up about a quarter of the category, grew faster with a 30% gain — much to the benefit of OTC producers like Reckitt Benckiser Plc, maker of Mucinex, and Procter & Gamble Co., which owns the Vicks and DayQuil brands.

At Kenvue Inc., which was spun off from Johnson & Johnson earlier this year, over-the-counter drugs such as allergy treatments Zyrtec and Benadryl and decongestant Sudafed generate about 40% of revenue. Sales at the division housing those brands rose 10% to $4.9 billion in the first nine months of the year, by far the company’s top-performing unit.

Brands have at times encouraged consumers to load up on over-the-counter meds and carry on — potentially spreading germs. A spot for DayQuil has touted how “life doesn’t stop for a cold.” And one for Robitussin, owned by Haleon Plc, shows a woman downing the cough syrup so she can get back to the office.

In response to a request for comment, Haleon said it encourages staying home from work when sick and returning when symptoms improve, which is what the Robitussin ad is intended to show. P&G said in a statement that it’s best for a person to remain at home if they have a cold or the flu.

Meanwhile, consumers may be harming their health. Taking too much of any medication is generally frowned upon by doctors, and doing so increases the risk of side effects, such as high blood pressure from nasal decongestants and the fatigue McNamara experienced from allergy medication.

‘Knee-jerk’ reaction

It also isn’t good to ignore symptoms or try to suppress them entirely because that can prolong an illness by impacting its natural course, according to Jennifer Bourgeois, a clinical pharmacist at SingleCare, an online pharmacy platform.

“These cough and cold symptoms — because there’s so much overlap with symptoms of Covid – there’s this kind of fear,” Bourgeois said. That leads to a “knee-jerk” reaction to use them, which ups the risk of side effects, she said.

Simon Williams, a psychology researcher at Swansea University in Wales, has studied the pandemic’s impact on social behaviors since 2020. He found that people felt an increasing sense of being judged for coughs and sniffles. And while some of that scrutiny has waned, it’s likely to remain for some time, he said.

The increase in remote work since the pandemic may also be adding to overtreatment. Companies usually guide employees to stay home if ill. But Covid normalized working while sick for many because it could be done in isolation at home without any judgment. And to get through a workday while sick — even from bed — likely takes more meds than just sleeping it off.

Read More: With the Decongestant SNAFU, the FDA Tries Something New

Recent data also suggests that all workers, whether remote or in-person, are calling in sick less often as employers push for more time in the office. A report from the Centers for Disease Control and Prevention showed that fewer people this fall have missed work because of illness than in the previous two years.

Take Courtney Berentsen, a product manager in the San Francisco Bay Area. She has asthma that turns a regular cold into a hacking, but non-contagious, cough that lasts months. Well-meaning coworkers encourage her to work from home in order to set an example for others to stay home when sick.

“It feels like I’m setting a bad precedent by coming to work sick, but it will be like a month before I come back if I have to wait until I have no cough,” she said. Her job’s return-to-work policy won’t allow for that. So she uses Mucinex to help control her symptoms. “I don’t know what would happen if I didn’t take it.”

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