It costs an estimated $20 billion. That seems like a high price tag, the type that’s reserved for walls at the Mexican border. It’s not. This is the cost of getting sick — a cold, a virus, anything illness that keeps employees home from work.

Every winter, employers pay more than $20 billion in sick days and more than 200,000 of those who’ve caught a bug end up at the hospital. Here in eastern North Carolina, residents have yet to feel the bite of cold, but winter’s coming, as well as the bugs that come along for the ride.

The key to health over the harsher months of the year is being proactive. Keeping up the steady use of hand sanitizer is one of the most obvious preventative courses, but there are some less obvious ways to make sure that what’s going around doesn’t catch you.

One of the more interesting ways is to use your own pens; in fact, go ahead and get a stockpile of them. Germs can easily be spread hand to hand and using an infected person’s pen —whether a waiter’s pen when signing a bill at a restaurant or one attached to the deposit slip table at the bank — is a quick way for those germs to make the leap. Moving more is another way to boost the immune system. While the cold weather makes some want to hunker down for the long haul, the more moderate activity one does, the less chance a person will get sick. Also interesting is the idea of getting out more and engaging in more social interaction. According to Carnegie Mellon researchers, those with larger social networks produce more flu-fighting antibodies than those who tend to keep to themselves or stick to smaller groups.

So take a multivitamin. Always carry a pen. Move more. Socialize more.

Employees getting sick might have a financial impact on employers, but being knocked out by an entirely preventable illness has an even greater toll in coughs, sneezes, aches and pains galore.