by Greg Lathan

This article is the third in The EI Group’s blog series which has focused on field lessons learned during six months of occupational COVID-19 screening of over 145,000 employees as they arrived to work in their vehicles at manufacturing, pharmaceutical and R&D facilities across the US. EI’s vehicular occupational screening process was based on the New Rochelle Incident Command COVID-19 model, which identified potential COVID-19 carriers before they enter the workplace. A brief summary of COVID-19 employee screening operation statistics from Parts I and II of our blog series is provided below.

Part I: “Key Takeaways from Statistics on Body Temperature and Questionnaire Monitoring During Occupational COVID-19 Screening” highlighted that closer scrutiny of those employees with elevated temperatures exceeding 99.0 degrees, in lieu of 100.4 degrees, doubled the number of potential coronavirus carriers. EI identified approximately 15x as many potential coronavirus carriers via administration of an interactive COVID-19 questionnaire (approximately 3 in 1,000 employees) than were identified using a threshold temperature of 100.4 degrees (approximately 2 in 10,000 employees). 

Part II: “Preparing for a COVID-19 Screening Program for Your Workforce” addressed how to adequately prepare your “in-house” staff to perform COVID-19 screening, key aspects of strategic planning for a COVID-19 occupational screening program and the importance of communicating your facility screening program to employees, managers and the healthcare community.

Part III: Tips for an Effective COVID-19 Screening Process

Continuity of COVID-19 Screening Staff
Maintaining continuity of technicians who perform screening is one of the most important aspects for the effective identification of coronavirus carriers. Developing rapport with employees during COVID-19 screening, especially when administering the COVID-19 screening questionnaire, is imperative. Having consistent personnel perform COVID-19 screening day after day creates an environment of trust. Familiarity with the workforce allows COVID-19 screeners to more effectively extract information from suspect employees during questionnaire dialogue. Enhanced dialogue allows for better identification of additional lifestyle details or specifics on mild coronavirus symptoms that may be overlooked by self-screening programs where employees complete the same COVID-19 questionnaire programs daily or when providing simple “yes/no” with no specifics to screening professionals. Trust is the key element in public health screening/intervention. As they developed further rapport with the workforce, EI’s screening professionals also noticed that employees became more apt to self-report mild symptoms on arrival so as not to endanger their fellow staff members.

Efficient Recording of COVID-19 Screening Information
Recording results of COVID-19 temperature/questionnaire screening for every employee may not be practical or recommended for privacy reasons. EI recommends the use of employee ID badges, in lieu of recording employee names to expedite the screening process. Using employee badge numbers is especially useful for expediting incoming traffic flow. Employee badge numbers in lieu of employee name also creates a feeling of privacy, especially when temperature and questionnaire data is entered into iPads or other tablet devices. The EI Group utilizes tablets at some testing sites to expedite data entry and recordkeeping in an easy-to-use proprietary app. The data can be easily exported, stored and referred to with appropriate considerations for HIPAA compliance. Be sure to consider weather conditions and water resistance in your recordkeeping planning!  

Tips for Infrared Temperature Monitoring
When using hand held infrared thermometers, it is a good idea to use the same manufacturer or model to measure forehead temperature for consistency. Also, make certain to train technicians who perform temperature screening to always hold the thermometer 2-3 inches from the subject when measuring forehead skin temperature. As emphasized in EI’s previous blog, over 98% of forehead temperature readings ranged from 96.5-98.0 degrees. Therefore, if your facility’s “trigger level” for elevated temperature is 100.4 degrees, remember to take redundant temperature readings for those employees whose temperature exceeds 99.0 degrees, as an additional measure of caution. Confirmation readings should be performed with the infrared thermometer, as well as a skin contact thermometer or oral thermometer. If subsequent temperature monitoring confirms the subject’s temperature exceeds 99.0 degrees, additional time should be spent analyzing their responses to potential mild symptoms such as headache, loss of taste or smell, gastrointestinal issues, sore throat or dry cough. More pointed questions should also be directed to determine if the subject has had potential contact with a COVID-19 carrier. REMEMBER: Most infrared body temperature thermometers are NOT accurate below outside temperatures of 50 degrees.

During cold weather, always remind employees to turn off their vehicle heaters and during warm weather auto AC systems should be turned off to prevent false readings when monitoring forehead temperature. Reminder signs to “turn off auto heating and air conditioning systems” are very helpful. For those employees requiring additional temperature scans for confirmation of an initial reading, make certain there is an area for them to exit from the incoming traffic line and park away from incoming traffic to avoid creating a traffic bottleneck, which will slow the screening process.

Other Special COVID-19 Screening Considerations
If severe inclement weather prohibits outdoor screening, prepare for options to temporarily screen employees who are arriving to work indoors. If COVID-19 screening is moved inside the facility, the use of free standing or tabletop plexiglass partition will minimize airborne exposure between the screening technicians and employee. Create a one way flow for incoming traffic in an effort to prevent screened employees from passing employees waiting to be screened for work. If the exterior of the workplace has covered entrances, consider allowing only one person inside to be screened at any time. If this is not possible, use marks on interior floors in screening areas which promote six feet of distancing between employees, while they wait to be COVID-19 screened. Make certain the inside area where back-up screening is conducted has adequate ventilation to improve indoor air quality and lower the concentration of airborne contaminants, including biological aerosols which potentially carry coronavirus. Require ALL employees to wear a mask BEFORE entering the building while waiting to be screened.

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].