The guy streams 70 hours per week minimum[1]. That two day -more like one day- break cost him over $100,000, and cut his following (and salary, I guess? No clue how Twitch works.) by almost 20%[2]. There's no option to pick more PTO and trade off salary. He's stuck with this. Even as a "temporary" solution, that shit will take years off your life, and there are people who do this to just scrape by.
It's illustrative of how shitty a "profession" it is that the top streamers have to put in such an insane amount of work with no compromise ever.
[1]: https://www.twitchmetrics.net/c/19571641-ninja [2]: https://kotaku.com/ninja-takes-two-day-break-loses-40-000-su...