As many states and businesses recently lifted shelter-in-place orders, San Diego Entrepreneurs Exchange (SDEE) hosted a virtual round table on July 21, 2020 to discuss what businesses can do to reopen safely. Paul Ryan, a health and safety specialist at Bristol Myers Squibb (BMS) in New Jersey, gave a presentation entitled Workplace COVID testing: what you need to know. During his presentation, Paul shared slides from Dr. John Howard from the CDC on COVID-19 and the Workplace.
The main two types of testing for SARS-COV-2 are viral (or PCR) testing and antibody (or serological) testing. The PCR test detects the virus itself and, thus, can tell whether a person is currently infected. The antibody test detects IgG against the virus and, thus, informs on whether somebody has been infected and has developed an immune response against the virus. The PCR test is very sensitive, and people can test positive even a week or so before they develop symptoms. However, infected people can test negative if their viral load is very low.
Asymptomatic individuals are the main concern for businesses and the community in general, because they can spread the virus unknowingly. For this reason, temperature screening is not a very effective tool and BMS did not implement it. However, temperature screening can be an indicator of how serious a business or community is in taking steps to control the virus.
Companies like BMS have implemented viral or antibody testing to prevent the entry of infected workers and prevent the spread, and also, to allow employees to return to work safely after they have been infected. BMS has contracted nationally with a testing company to test all employees in all BMS locations. The process of testing can be very efficient if testing is scheduled appropriately and people are on time. If possible, samples should be collected outdoors, and everybody needs to wear masks. Ideally, employees should be tested routinely, for example, monthly; however, the low availability of testing reagents and supplies may prevent this. Pooled sampling is a way to screen many people at once; however, it is cost effective and time saving only in large companies with low positivity rate. Small companies can use mobile testing services that do the testing in the parking lot. If the company pays for the mobile service, the company gets the results of the test. Regardless of how the test is done, employees need to give their consent and the company needs to consider privacy laws. Nurse practitioners or occupational health professionals can help navigate privacy laws, confidentiality issues, and results reporting.
If employees become ill, separate them from others, transport them at home safely, and initiate isolation. Viral testing for all close contacts and contact tracings are recommended. In addition, the CDC recommends that people who tested positive but had no symptoms can return to work 10 days after their positive test or after they had 2 negative tests 24 hours apart. People who tested positive and exhibited symptoms are required to self-quarantine and can return to work at least 10 days (or 20 days in more severe cases) have passed since symptoms first appeared, or had no symptoms and 2 negative tests 24 hours apart. Importantly, employers should not require a test result or a healthcare provider note for employees to validate their illness, qualify for sick leave, or return to work. In other words, employers should trust their employees’ words and avoid that sick people come to work because they do not have the means to stay home.