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COVID-19: Screening and Testing Best Practices

Navigating the waters of a global health crisis is probably not something you expected to do this year, and if you’re in panic mode, you’re not alone. This is unknown territory for many.

From executing daily screenings for essential workers to providing mass screenings for those returning to campus after working remotely, you’ll quickly see that planning ahead is instrumental if you want to keep your business open and get back to normal operating procedures safely.

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Here’s the bottom line: you want your people to come back to the workplace healthy and you want them to stay well when they get there. So, how can you accommodate their return today and the unforeseeable tomorrow?

Safety First

First and foremost, make sure everyone is safe. The Centers for Disease Control and Prevention (CDC) now recommends the following to help decrease the spread and impact of COVID-19 in the workplace:

  • Promote frequent and thorough hand washing or use of alcohol-based hand rubs containing at least 60% alcohol.
  • Encourage workers to stay home if they’re feeling sick.
  • Encourage respiratory etiquette, including covering coughs and sneezes.
  • Practice social distancing by maintaining approximately six feet from others.
  • Consider video or teleconferencing to minimize face-to-face interactions.
  • Perform routine environmental cleaning and disinfection.
  • Educate employees on how to reduce the spread of COVID-19.
  • Wear cloth face coverings in public places like the grocery store where social distancing is difficult to maintain. However, do not use cloth facing coverings if someone has trouble breathing, is unconscious, incapacitated, cannot remove a mask by themselves, or is under the age of two. It’s also important to note that cloth masks are different from surgical masks or N-95 respirators, which are critical personal protective equipment (PPE) and should be reserved for healthcare workers and other medical first responders.

The CDC also recommends that employers coordinate with their local and state health officials to ensure they have the most timely and accurate information to guide prompt identification and isolation of potentially infectious individuals in the workplace.

As healthcare providers carry out virtual or in-person screening and testing, ensure they have appropriate PPE like masks, gloves, hand sanitizer and eye protection. Next, you’ll want to make sure logistics like building entry, parking and screening patterns are properly controlled to further ensure both provider and employee safety.

Screening Best Practices

Return-to-the-workplace plans and protocol may look different for each organization. From manufacturing plants that are continuing to operate through the pandemic to expansive tech campuses whose employees are working remotely, having a plan will make a big difference in your ability to recover and resume normal operations after stay-at-home mandates have been lifted.

Essential Businesses and Workers

For businesses that have been deemed essential, the screening process can take place at the beginning of every day, each shift, and throughout the day as workers and visitors enter and exit the building. This should be conducted in-person provided screening personnel have the appropriate PPE needed to facilitate temperature screenings. If possible, screenings should be conducted outside the actual building or campus to prevent a contagious person from entering the workplace. This action helps prevent the need for potential evacuation and deep cleaning. If it is not possible to screen outside or prior to building entry, designate a specific, isolated area of the building for screenings that can be cleaned appropriately and daily without forcing an evacuation. This type of screening may be accomplished virtually without measuring temperature.

Remote Workers Returning to the Office or Campus

Once work-from-home restrictions have been lifted and buildings open back up, remote employees returning to the workplace can be screened before they re-enter the building at the beginning of every day, each shift, and throughout the day. Ideally this would take place in-person provided appropriate PPE is available to facilitate temperature screenings. This may also be done virtually either by phone, video chat, or secure messaging.

Quarantined Individuals Returning to the Workplace

Employees who have a presumed or confirmed COVID-19 diagnoses, and are in quarantine, should be screened based on the CDC’s latest guidelines and clinical evidence. This process should take place virtually either by phone, through video chat, or secure messaging. A virtual-first approach keeps healthcare workers safe and reduces potential exposure to others in the workplace.

Testing Best Practices

There are two basic types of tests available for COVID-19: diagnostic (PCR) and antibody (serology).

1. Diagnostic (PCR) Testing

According to the CDC, not everyone needs to be tested (diagnostic) for COVID-19. Amid a pandemic with a disease that has essentially no known treatment it is important to determine who should be tested and who should not, given the limited supply of tests and an overburdened healthcare system.

When to use a Diagnostic Test for COVID-19

If you have a suspected case of COVID-19 in the workplace, an initial screening is the first place to start. This process involves a series of questions that may sound something like this:

  1. Do you have any reason to believe you have been exposed to coronavirus (COVID-19)?
  2. In the past 24 hours, have you experienced symptoms including:
    a. A fever of a 100.4°F (38.0°C) or higher?
    b. A cough?
    c. Difficulty breathing?

If the individual answers “yes” to one or more of the questions or has a temperature of 100.4°F (38.0°C), there’s a chance they may have the virus and should be separated from others. Based on the individual’s response to the screening questionnaire, testing may be necessary and should be considered on a case-by-case basis. Decisions about testing are at the discretion of state and local health departments or the patient’s primary care provider.

When Not to Use a Diagnostic Test for COVID-19

Those who present with mild symptoms and do not have underlying medical conditions like heart or lung disease, as well as diabetes, may not need to be tested for COVID-19. Most people have mild illness and can recover at home – this is referred to as self-isolating. If someone is sick and self-isolates, they should closely monitor their symptoms in case their condition gets worse and additional medical attention is needed.

For those not tested for COVID-19, the decision to end home isolation may be considered if certain criteria have been met. The decision to end home isolation should be made in consultation with the individual’s healthcare provider and state and local health departments.

Challenges Associated with Diagnostic Testing for COVID-19

There are several challenges associated with diagnostic testing at this time. As the United States is in the mitigation phase of pandemic response, there is little clinical value to be gained from diagnostic testing. Those patients who display a variety of symptoms associated with COVID-19 are treated as presumptive positive and a positive test result will not change the course of treatment. In addition, sample collection is hazardous to both the healthcare provider and others in close proximity. Plus, diagnostic testing is PPE-intensive. Given the country’s limited supply of PPE, appropriate decisions around use must be taken into consideration. Lastly, the test itself has not been shown to be very accurate, often leading to retesting and increased consumption of resources.

2. Antibody Testing

The Food and Drug Administration (FDA) recently approved the first antibody test for COVID-19, which identifies whether someone once had the virus and, potentially, whether they’re immune to the disease. The ability to identify someone who is immune, or susceptible, to COVID-19 could enable those who are no longer at risk to return to work sooner and offer support to vulnerable friends, family, and others in the community.

Antibody testing differs from diagnostic testing in several important ways. First, there is significant value to be gained from the test, specifically population health management and herd immunity. Second, it is a relatively safe test to administer and does not require as much PPE as the diagnostic test.

Our Recommendation

Premise recommends organizations utilize both screening and antibody testing when solving for the preservation of workplace and workforce health and safety. Whether used for the continued work of essential employees or the reopening of a building or campus as a work-from-home workforce returns to the physical workplace, screenings will help identify high-risk, contagious individuals, and antibody testing will help track immunity across the workforce. We recognize helping employees continue working or return to work safely is critical to preserving jobs and companies, as well as preventing future outbreaks.

Reassurance That Comes with a Plan

During these challenging times, having a plan is crucial as you navigate the immediate and future needs of your workforce and their families. Even more important is having a trusted partner who can guide you through the process.

Premise Health is committed to protecting and promoting the health and safety of team members, members, and their families. As the COVID-19 outbreak evolves, our teams can play a critical role in reinforcing the country’s healthcare infrastructure. By delivering care through a virtual first approach at our health centers and pharmacies, we can alleviate the burden on community resources and provide continued access to high-quality healthcare. And by delivering mass screenings and antibody testing, we can facilitate a quicker, safer return to normal for businesses and workers, leading to a faster, more sustainable health and economic recovery.

From pandemic preparation and screening to response and return to the workplace, we can help your organization strategically navigate this unprecedented and challenging time.

Contact us.

  • If you are a Premise Health member with questions, call your health center.
  • If you are a Premise Health client with questions, please contact your director of client operations.
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Premise Health is the leading direct healthcare provider offering onsite wellness centers, as well as nearsite and virtual access points. 

April 10, 2020
Premise Health
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