Testing for COVID is not the panacea for determining the optimal time for workplace reintegration
Until there is a proven vaccine, businesses need to lead the way in adopting new processes and technologies to safeguard their employees
Although the country is aching to regain normalcy and jumpstart the economy, opinions greatly differ as to the rate and methodology of this reintegration. In some areas furloughed workers are protesting actively the economy’s shutdown and demand terminating quarantine restriction, while other opinions parallel those of Speaker Pelosi and Gov. Cuomo who calling for more testing and documentation of major decreases in case burdens prior to any decisions being made about opening society back up. To wait for everyone to be tested and then retested periodically is largely impractical.
Testing for Covid-19 presence is certainly important to those who test positive for the disease but for everyone else the test has little value. About 1% of the US population or 370k have been tested for Covid-19 (as of 4/17). However, using a negative test as a work clearance vehicle asserts a major proportion of the 130 million workforce members would need testing.
That scenario does not even account for the false-negative rate of the test which has been as high as 30%. Retesting would also be necessary as someone could plausibly contract Covid-19 one week after going back to work. In fact, the amount of comprehensive testing required to identify all potential disease bearers or carriers in the US is extraordinary, with estimates being three or four times the number of tests being currently done on a daily basis.
"herd immunity theory"
The “herd immunity theory” employing antibody testing to gauge mass immunity to a disease contends that the number of Covid-19 cases will eventually become minimal if a large percentage of the population (most say at least 30%) develop antibodies that confer immunity to Covid-19. For this theory to work, the presence of antibodies needs to imply that the individual is immune to subsequent disease (which is unproven for Covid-19). Unfortunately, the herd immunity theory as a near-term solution for the Covid-19 epidemic in the US has lost much of its luster as studies have found that only a very small proportion of the population possess antibodies to Covid-19. In fact, these three separate population studies from Wuhan, Iceland, and Santa Clara found that the antibody presence in the general populations of these respective countries is notably less than 5%. Therefore, over 95% of the population may have never been infected and are at risk of infection with Covid-19 upon reintroduction into the workplace.
Until there is a vaccine, only zealous contact tracing with strict isolation of all suspected exposures and infections will prevent further spread of disease. Software giants Apple and Google are planning Bluetooth technology for determining location of potential contacts. While this technology is conceptually impressive, multiple issues have been brought up including privacy, accuracy, and the timeliness of the contact tracing.
Businesses Need To Take Control
Even if there were delays in reintegration and high numbers of tested individuals, isolated cases will occur and could cripple companies. To combat this likely scenario beforehand, businesses need to take matters into their own hands and formulate plans for work reentry since the workplace will become the major venue for disease spread. Taking temperatures at the entryway of every office building in America with mandates for masks and social distancing in the workplace will not be enough. Instead, a comprehensive strategy to monitor employee health, contacts and (eventually) travel with methodical documentation and aggressive isolation will be necessary to prevent individual workplace cases into full-fledged outbreaks. Employees will recognize these practices are for their own safety as many of the quarantined employees will not yet have the disease. Human resource departments and executive management should take advantage of the innovative tools appearing in the marketplace that provide automated new technologies with interpretable dashboards specifically designed to trace Covid-19 disease to best manage their employees.
Importantly, with their employers providing this safety net of scrutiny and caution, employees will feel safer in the workplace and become more productive. Beyond feeling more assured of their own safety, they will feel comfortable knowing that they will be less likely to transmit an illness to their domestic contacts. The largest beneficiaries of this aggressive containment strategy will be the most vulnerable and health-challenged members of society such as the elderly and those with preexisting medical conditions. These individuals would be the ones who would predictably fare the worst if they were to contract Covid-19.
Safety in the workplace will minimize further catastrophic damage to the economy and loss of life.A sound monitoring strategy will prevent business disruptions due to loss of talent, injury to clients, office closures and, based on the staggering number of coronavirus-based lawsuits already reported, litigation.Safety in the workplace will minimize further catastrophic damage to the economy and loss of life.A sound monitoring strategy will prevent business disruptions due to loss of talent, injury to clients, office closures and, based on the staggering number of coronavirus-based lawsuits already reported, litigation.
The American workplace can eventually lead the world in the process of business resumption but the time for harnessing proactive solutions is now.
Soumi Eachempati, MD, FACS, FCCM, retired professor of surgery and public health and co-Founder of Chelsea Health Solutions