Thursday, May 7, 2020

New story in Health from Time: Some Employers May Require Employees Get Tested for COVID-19 Before Coming Back to Work



Just a few miles from Disney World near Orlando, Fla., Harris Rosen’s hotel empire is mostly closed because of the COVID-19 pandemic. One crucial condition for reopening, Rosen says, will be testing any of his company’s 4,000 employees who show potential signs of having the disease.

Since March, Rosen Hotels & Resorts, which comprises eight hotels with nearly 7,000 rooms, has tested more than 500 such workers at its employee health clinic and its impromptu drive-thru testing site near Orlando. Sixteen were confirmed cases of COVID-19. When the hotel chain reopens later this spring or summer, it plans to have employees regularly fill out a questionnaire about their health and travel history. All employees will get their temperature taken when they arrive and those with fevers above 99°F will not be allowed on the worksite. Rosen is still working out details of its strategy, but it also plans to give workers with a fever and other COVID-19 symptoms a diagnostic test for the virus.

Across the U.S., and across industries, companies have closed their worksites for the past month or so, or operated at significantly reduced capacity. Meat-processing plants in the Midwest have been closed because tight workspaces helped spur outbreaks, nursing homes across the country have seen deaths among staff members needed to care for ailing residents, and flight attendants report increasing cases of the disease.

Now, as half of the states begin the delicate task of lifting stay-at-home orders and allowing businesses to reopen, Rosen is one of many employers being thrust into the debate about how to keep employees and customers safe.

Some employers say testing and screening can help reduce disease transmissions and workers’ fears. COVID-19 testing has vexed health officials and politicians since March. Federal and state leaders have bickered over whether supply of tests are adequate. Rosen Hotels & Resorts, however, says it does not anticipate any problems securing test kits. A big reason why it’s quickly been able to start testing is because Rosen has been providing health services to its workers for nearly 30 years though a large worksite clinic.

While there are still parts of the country with a paucity of testing, central Florida is not one of them. The Orlando area has at least two dozen testing sites and Florida Governor Ron DeSantis said during a meeting at the White House this week with President Donald Trump, “Our ability to test exceeds the current demand.”

Amid much uncertainty, many companies say they are working to devise their testing strategies. For example, Pittsburgh-based U.S. Steel Corp. is still trying to decide whether to start testing its roughly 18,000 employees at locations in multiple states across the country. “It’s a difficult time for employers trying their best to protect employees,” says Dr. Mohannad Kusti, the company’s corporate medical director. Kusti says testing isn’t perfect—the company has hesitated to start testing partly due to lack of tests and concerns over accuracy, he says—but could add to the arsenal of weapons against the virus. That includes requiring workers to wear gloves and face masks and increasing social distancing when applicable.

Employers with on-site health clinics, like Rosen and U.S. Steel, are best positioned to test because they likely have access to the supplies and the providers needed to administer them, says Mike Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions. For example, earlier this year Microsoft began a testing program for workers at its Redmond, Wash., headquarters. Silicon Valley-based Intel Corp. says it is looking into the issue but has not decided how to proceed. Amazon, based in Seattle, Wash., says it is setting up a system of labs to begin testing its workers across the country.

“Regular testing on a global scale, across all industries, would both help keep people safe and help get the economy back up and running,” Amazon CEO Jeff Bezos wrote in a recent shareholder letter.

Employers are generally not allowed to inquire about workers’ medical conditions. But the Equal Employment Opportunity Commission, the federal agency that enforces workplace civil rights laws, issued new rules in April permitting employers to test for COVID-19 as a condition of entering the workplace. The one caveat is that employers must either test all employees, or, if only certain employees are selected for testing, the employer must have a reasonable reason for doing so—such as testing employees who exhibit persistent coughs or other symptoms associated with the disease.

About one-third of employers surveyed in April by the San Francisco-based non-profit Pacific Business Group on Health said they are testing employees at or near the workplace or considering it.

Some experts, however, question whether such efforts will make a difference.

Dr. Jamal Hakim, chief operating officer at Orlando Health, a network of hospitals in the Florida city, says a more effective strategy would be making sure that employees stay home if they have any COVID-19 symptoms, and that those employees without symptoms wash their hands often and don’t touch their face when at work or out in public. “Those behavior modifications will dwarf testing in terms of importance going forward,” Hakim says.

One challenge with testing is someone newly infected may not show a positive result on a test for several days. People can obviously also get infected following a test. It also takes at least a day to get results back, giving the virus 24 hours to spread unchecked.

Despite the drawbacks of testing, many major employers are moving forward in an effort to keep workers safe. St. Louis-based Watlow, a global manufacturer of thermal products with 1,600 U.S. employees, this month began testing workers who believe they may have been exposed to people with COVID-19 as well as workers who are travelling to its Mexico plant to see if they currently have the virus or previously had it and now have antibodies for the disease. In addition, the temperatures of all employees are taken when they arrive for work and anyone above 99.2°F is sent home. Employees wear masks on the job and barriers were installed between some work stations to promote social distancing.

As of May 6, Waslow has tested fewer than a dozen people at its onsite health clinic, says Sheryl Hicks, vice president of human resources. The company is weighing whether it can or should test everyone.

“We are learning as we go,” Hicks said. “There is a cost to these things, but if it gives us more information to keep people safe or provide a safer environment for folks then that is not necessarily a bad thing.”


Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

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