by Greg Lathan

This article is the second in a three part series which focuses on field lessons learned during 6 months of screening over 140,000 employees from their vehicles as they entered work. EI’s vehicular screening process is modeled after the New Rochelle Incident Command COVID-19 screening model to identify potential COVID-19 carriers before they entered the workplace. A brief summary of COVID-19 employee screening operation statistics from Part 1 of this series is provided below.

Part 1 Summary: Key Takeaways – Statistics on Temperature and Questionnaire Monitoring to More Effectively Screen Potential COVID-19 Carriers 
Statistics from EI’s occupational COVID-19 screening operations clearly demonstrated that a body temperature threshold of 100.4 degrees plays a secondary role in identifying potential coronavirus carriers, when compared to those potential carriers identified through the administration of a COVID-19 questionnaire. Several different brands of infrared thermometers were used (for consistency, the same brand of thermometer was used at each facility, if multiple screening stations were needed to expedite vehicular flow). Forehead temperature screening for all brands of infrared thermometers typically read in the range of 96.5 – 98.0 degrees for the vast majority of the employee population. Since this body temperature range was significantly lower than the normal body temperature of 98.6, much closer scrutiny was focused on employees who exceeded a threshold of 99.0 degrees. These additional measures included redundant temperature scans, with some employees subjected to oral temperature confirmation. Employees exceeding 99.0 degrees were also pressed for further details when administering the questionnaire, including details on mild coronavirus symptoms and/or contact with a potential COVID-19 carriers.

As a result, the 99.0 degree threshold doubled the number of potential COVID-19 carriers who were not allowed to enter work from two in 10,000 to four in 10,000 employees screened. Although four in 10,000 may appear to be a low percentage, if a facility has 500 employees, ONE potential COVID-19 carrier per week would be identified (500 employees/day or 2,500 employees screened/week), when using a temperature threshold of 99.0 degrees, versus 1 employee every two weeks using a threshold of 100.4 degrees). Furthermore, COVID-19 screening via questionnaire identified over 13 times the number of potential COVID-19 carriers, than those who exhibited body temperatures greater than 100.4 degrees or 3 in every 1,000 employees. At a facility of 500 employees, this would be equivalent to identifying 3 potential COVID-19 carriers every two days.

Developing rapport with the workforce was critical when administering the COVID-19 questionnaire. Familiarity with the workforce facilitates open dialogue between the screening staff and employees, allowing subtleties to be uncovered when identifying those workers who were symptomatic or have had potential contact with a COVID-19 carrier.

Part 2: Lessons Learned – Preparing Your Workplace for COVID-19 Screenings
Part 2 of the blog series focuses on the major lessons learned from preparing multiple workplaces for occupational COVID-19 employee screening. Feedback on methods EI adopted to improve the efficacy of COVID-19 screening projects were pulled from the experiences of over 30 COVID-19 screening professionals at The EI Group.

Preparing Your Staff to Perform COVID-19 Screening
Adequate planning for an occupational screening process is key for an efficient and effective operation to identify potential coronavirus carriers BEFORE they enter the workspace. Will the screening operation be staffed using the existing workforce or by engaging a third party? If staffed internally, do these “in-house” employees have sufficient training in PPE and bloodborne pathogen control? What types of PPE will be used? If wearing N95 respirators, have they been respirator fit tested and have they been medically cleared to don a respirator? Does the facility have enough PPE supply internally to protect employees who perform screening? If not, is there a Decontamination and Reuse Program in place to assure that reused PPE is sterile and appropriate for reuse?

Strategic Planning
Have the screening professionals been provided guidance on temperature scanning and effective COVID-19 questionnaire administration? Do they understand the importance of engaging employees during questionnaire administration? Additionally, are the COVID-19 screening technicians aware of approximate arrival times for each incoming shift (which can vary over an hour), the number of employees expected to be screened and the staffing requirements needed to perform screening for each shift? During administration of the questionnaire, what are language barriers, if any, and how will the screening team address these communication issues? Ideally, where language barriers exist, it is prudent that to have bilingual COVID-19 screening technicians on the team. If deemed necessary, employ multiple languages in the COVID-19 questionnaire. This is also true when deploying instructional signage to convey instructions to incoming traffic – signage may need to be in multiple languages. Keep in mind that it is vital for screeners to aim at eventually establishing a rapport with the workforce employees to better recognize symptomatic or lifestyle issues that make them suspect COVID-19 carriers. If an employee is deemed a potential coronavirus carrier and are prohibited from entering work, make certain the protocol involves Human Resources or their supervisor. It is imperative to ensure that there are clear and open lines of communication between the screening technicians, the employee screened from entering the workplace and upper management. Make certain the protocol for prohibiting a potentially infected employee from entering work is communicated before initiating the screening process and is fully understood by all three parties.

Since employees will be screened while in their vehicles when arriving to work, has strategic planning made provisions for minimizing bottleneck entry points for arriving vehicles to most efficiently screen employees in a timely manner? It is imperative to understand the layout and spacing in the parking lot to avoid traffic flow issues coming in from the street. Is there adequate lighting in the parking lot for late night and early morning shifts? Have safety equipment requirements for screening been addressed (i.e., reflective vests for screeners, traffic guidance cones and proper signage with specific instructions for employees)? Have provisions been made for spacing of tents through which incoming vehicles pass through?

In the event of inclement weather, how will employees and screening technicians be protected against periods of extreme cold, extreme heat, excessive wind/rain and lightning/thunderstorms? Are tents adequately anchored in the event of high winds? Does the screening staff have protective clothing in the event of heavy rain and extremely hot/cold weather.

Communication of COVID-19 Screening Plans to the Workforce
Advanced communication to the workforce addressing the COVID-19 screening process is imperative. Communication should convey that COVID-19 employee screening is focused on protecting employees from coronavirus transmission in the workplace. Emphasizing why candid and honest replies to the questionnaire is critical. Issues like “paid time off” in the event an employee is not cleared for work should be thoroughly covered. Employees should be made aware whom to contact if they develop symptoms at home or during work. Lack of communication can easily lead to employees being tentative when asked to self-report COVID-19 symptoms. 

As a result, EI recommends the development of SOPs for all occupational COVID-19 screening operations and to convey these SOPs via live training to all employees prior to launching screening operations. There is definitely a learning curve for employees to adjust to a COVID-19 occupational screening operation. This adjustment typically takes several weeks. Providing a physical copy of the COVID-19 screening questions in advance is also very important to familiarizing the workforce with the screening process. If changes in the original questionnaire are made, these changes should also be made available to everyone.

Stay tuned next week for the third part of EI’s “Lessons Learned from Occupational COVID-19 Screening” blog series – “Tips for an Effective COVID-19 Screening Process.” Input for Part 3 was gathered from over 30 EI professionals who performed COVID-19 screening at manufacturing, pharmaceutical and R&D facilities. Some specific areas addressed in Part 3 include the importance of maintaining continuity among screening professionals, the efficient recording of COVID-19 screening information, tips for monitoring infrared body temperature and special considerations for managing contingencies which arise during screening operations.

How Can We Help?
If your facility needs assistance in establishing an occupational COVID-19 screening process, The EI Group can help! Our cumulative “boots on the ground” knowledge amassed over the past 6 months has revealed that proper planning and communication is key to effective/efficient screening of potential workers who may be coronavirus carriers before they enter the workplace. If you would like EI to assist your facility in establishing an occupational COVID-19 screening operation and overseeing this operation until your facility is comfortable in managing it internally, please do not hesitate to contact us at (800) 717-3472 or [email protected].