COVID-19 Diagnostic Testing and Temperature Screenings for Employees

Posted by: Scott Appnel
Date: June 22, 2020

Should employers start to test asymptomatic employees?

Now that states and counties are reopening to business, employers are looking for ways to ensure their workforce is safe and can safely interact. For many that means obtaining some sort of assurance that employees are not currently infected with COVID-19.

The “go to” test since the outbreak of COVID-19 has been the PCR test (a.k.a. a “swab test”).  While this test has been at the forefront throughout the pandemic, because of prioritization it has been reserved for those exhibiting COVID symptoms. Capacity has improved to the point where this test can now be offered for asymptomatic employees (showing no symptoms of infection) to determine their current infection status.

Temperature checks, combined with select CDC-guided screening questions, have also been widely used, especially among health care systems, as a way to monitor those who may be infected with coronavirus.

What is the PCR test and how accurate is it?

PCR stands for “polymerase chain reaction,” a specific type of nucleic acid test. The PCR test involves inserting a long swab into a person’s nose, all the way to the back of the nasal passage. Done correctly, the swab collects cells and fluid down to the base of the nose and back of the throat. The swab is contained and sent for analysis, which looks for traces of the coronavirus’ genetic material.

There are two particularly important aspects to keep in mind when using PCR testing. First, when someone is exposed to COVID-19, the disease begins to populate in the upper respiratory tract. The more virus there is, the easier it is to detect. Therefore, if you do a swab test too early, it may not indicate infection when the person does in fact have the disease.

Second, testers can sometimes be reluctant to insert the swab far enough into the nasal cavity to obtain a good specimen. The nature of the test can cause the patient’s eyes to water and can possibly trigger a gag reflex. However, if a sample is not collected properly, the results will not be accurate. For this reason, it’s important to have the test administered by clinicians who are well-trained and experienced in taking the specimens.

What considerations accompany temperature checks?

Taking an employee’s body temperature with a thermometer is another method of possibly determining presence of coronavirus. It is not foolproof, as a significant (but minority) number of COVID cases don’t manifest an elevated temperature. Regardless, it remains the most indicative, quantitative screening method.

There are number of items to think about before attempting to implement temperature screenings at work, such as:

  • What type of thermometer? Non-contact or forehead contact thermometers are recommended but need to be cleaned after each use. Oral thermometers are not recommended, but if used, need special disposable mouth pieces.
  • Who will be screened? Employers need to ensure temperature checks are conducted in a non-discriminatory manner.
  • Where will you screen? Will you do a drive-through, or check employees as they walk through the door? Either way, protective measures need to be put in place, and proper distancing and signage applied.
  • What is the policy for handling employees whose temperatures are above normal? A plan needs to be prepared, so that all contingencies surrounding this outcome are addressed.

Beyond the temperature screening, it’s recommended to include screening questions based on CDC guidelines. A concise list of “yes” or “no” questions can be developed and implemented to ask employees upon entry. As with temperature screening, it’s important to have a policy and specific direction for employees based on the answers received.

Do these practices make sense for employers?

Taking the step to test and/or monitor employees’ temperatures is not a simple decision. Medical experts generally advise that testing and temperature checks be parts of a return-to-work strategy, but not the only elements. Employers might consider contacting an occupational health provider whose staff is knowledgeable about COVID-19 testing for advice. They can help sift through any problems or contingencies, and ensure a program is conducted in an ethical and effective manner. As we are seeing with the current pandemic, being prepared with a plan, knowing the facts, and protecting ourselves and others are the weapons that will ultimately win out.

For more information about return to work services including testing, temperature checks, and well-being:

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