To Test or Not to Test: COVID-19 Test Guidance for Employers
Workers have been working from home for much of the year, as a result of the restrictions caused by the coronavirus pandemic. However, six months into the pandemic, many employers have begun to ask their workers to return to work. For the employees, the question is: how would our employers keep us safe at work? and for employers, the most important step in curbing the spread of the virus in the workplace is identifying at-risk workers and isolating them from the rest of the workforce. This begs the question of whether or not employers should test workers for COVID-19?
Some businesses are moving ahead with testing, nonetheless. Cameron Manufacturing in New York, which produces conveyor belts and other equipment for food processing, began routine PCR testing for sales and engineering workers who mostly travel to customers’ work sites. The company test workers before and after they travel and would ask workers to quarantine for several days if found positive. The tests are conducted and analyzed by US BioTeck Laboratories in Seattle.
Similarly, meat processors Tyson Foods and JBS also adopted the strategy after coronavirus outbreaks were linked to meat processing plants across the country. The companies have now commenced routine testing of workers - even asymptomatic workers.
But there are questions. Should employees be tested at all? What are the requirements for testing? Is workplace testing even legal? What happens if a worker refuses testing? Health experts have provided guidance for these gray areas of coronavirus testing.
The US Centers for Disease Control and Prevention (CDC) issued a guidance in July titled SARS-CoV-2 Testing Strategy: Considerations for Non-Healthcare Workplaces, which provides considerations for coronavirus testing using certain testing scenarios.
Testing Asymptomatic Workers
This scenario is the most common concern for many employers. Should testing be done as a return-to-work strategy? Although the Equal Employment Opportunity Commission (EEOC) discourages the use of coronavirus testing as a return-to-work strategy, it may be valuable in certain settings.
In high-density workplaces in which workers remain on-site for long periods, say 8-12 hours per shift, and have prolonged close contact (within 6 feet for at least 15 minutes ) with other workers, testing all workers before returning to work or at scheduled dates may be pivotal to curbing transmission of the virus in those settings. Further, employees in critical infrastructure sectors including air and seat ports as well as water and communication system, where workers reside in congregate housing, mass testing employees may be necessary.
However, this approach is nuanced by state laws. In Illinois, for instance, employers are allowed to mass test their workers before they return to work, but Texas prohibits it.
Nonetheless, the CDC advises employers to consider different approaches to testing asymptomatic employees. You may choose to test all workers before they return to work, or test them at regular intervals, or only conduct targeted testing of new workers or those returning from a prolonged absence if the risk of workplace transmission of the virus is high.
In fine, the agency recommends that employers adopting this strategy have a plan for continuation of work operations based on test results and for managing cases of false positive results before setting out on mass testing.
Testing Symptomatic Workers
The CDC advises that anyone with COVID-19 symptoms including fever, dry cough, sore throat, body aches, fatigue, and runny nose should get tested and isolated until symptoms resolve or their test comes back negative.
Even for employers adopting the mass testing approach of asymptomatic individuals, this still remains the most relevant testing consideration to curb transmission in workplaces. In the event that daily symptom screening identifies a worker with COVID-19 symptoms, the employee should be immediately isolated from others and tested. Testing may be done in partnership with approved private or state health facilities. If the employee tests positive, the employee should isolate at home.
Now, discontinuing isolation is where the confusion comes for many employers. When should an employee safely return from isolation? According to the CDC, employers do not have to wait for a negative coronavirus test result before an employee can return from home isolation. A symptom-based or a time-based approach may be all that’s needed in many cases.
The CDC recommends that for persons who have COVID-19 symptoms, they can discontinue isolation if at least 10 days have passed since symptom onset at least 24 hours have passed since resolution of fever without using any antipyretic, or other symptoms have resolved.
A test-based criteria may only be needed for workers who never had symptoms and those who are severely immunocompromised.
However, it still depends on state regulations. Some states discourage or prohibit a test-based strategy for discontinuing isolation while others may allow it. Ultimately, employers should check with their local laws and consult with healthcare providers to determine the best strategy for discontinuing isolation.
Testing Workers Exposed to the Virus
This goes without saying. In the event that initial or routine coronavirus testing identifies an infected employee, all co-workers who have been in close contact with the said employee need to get tested.
Close contact has been defined as being within 6 feet of an infected individual for at least 15 minutes. In this context, employees can leverage contact tracing devices to track the infected worker’s contacts or course within the office building in the days before the test.
However, employers should note that there may be a delay between when a worker is exposed to the virus and when they are tested positive, during which many other people could have been exposed to the virus. This means at any single point of detecting a positive test, many infections would have been missed. Furthermore, COVID-19 takes up to 14 days before it becomes detectable using standard test methods, Thus, employees who test negative may be asked to return to work, only to find days later or after subsequent tests that they indeed had the infection. Employers should also factor in the chances of false positive test results, which may potentially diminish a worker’s morale and make overall work unnecessarily less productive.
This reveals the need for employers to incorporate other measures to curb workplace transmission of COVID-19, including regular disinfection and cleaning, regular health checks, and the use of face masks.
First, employers should ensure their testing strategies comply with relevant state and local guidelines, which vary by jurisdiction. Then, when selecting a strategy, employers should consider creating a policy that clearly discloses to employees the circumstances under which they are required to be tested, the specific tests they should take, the purpose of the test, and the reliability of the test. The policy should spell clearly how test results would be handled, the actions associated with negative or positive test results, how the test results will be used, and the consequences of refusal to take the test, and each of these components must comply with relevant state and federal laws.