It’s fine. Not that good suggests he is still sick. However, this is more certain: I’ve been sick since Monday.
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Perfect StrangerShouldn't he have said I've gotten ill or I've got ill?No, that wouldn’t be very natural.
Perfect StrangerDo people ever say I've gotten ill or I've got ill.Not too often. Most people would just say I’m sick / ill / under the weather.
Perfect StrangerWhat if the guy didn't say not so good... what if he just said I got ill ?Then we wouldn’t know for certain whether he was still sick.
Perfect StrangerI use under the weather when I feel down. Is it incorrect?I would say it’s unusual. That idiom usually denotes a slight physical illness. You could, however, say I am mentally under the weather; that would be clear.