COVID-19 Testing and Vaccinations: What Should Businesses Do Next to Keep Moving Forward?

Soumi Eachempati, MD, FACS, FCCM, Co-Founder and CEO of Chelsea Health Solutions and CLEARED4

Soumi Eachempati, MD, FACS, FCCM, Co-Founder and CEO of Chelsea Health Solutions and CLEARED4

As COVID-19 vaccines make their way into communities across the U.S., despair is gradually giving way to hope as we have become tantalized by a glimmer of light at the end of a year-long tunnel. However, we are still currently embroiled in the throes of the pandemic, with the number of infections and deaths still setting record numbers. Now and into the foreseeable future, business leaders are tasked with the enormous responsibility of protecting both their people and the viability of their companies.

How they are doing this varies widely. While most businesses have implemented some level of symptom monitoring and tracing — activities that can be standardized and streamlined with the support of specialized HIPAA-compliant software platforms — those that have incorporated a company-sponsored testing component appear to be containing the virus particularly well.

 These proactive weekly testing regimens strategically prioritize individuals. Some target irreplaceable employees who are less inclined to work from home and may have the highest number of work contacts in their daily interactions. Others target high-level executives, and some groups are testing everyone who works on-site. Private employers are largely thought to be within their rights to request the testing of any employee for workplace safety. Even without a company mandate, employees are likely to participate if the testing is convenient, free and relatively noninvasive (e.g., using anterior nasal swabs rather than deep nasopharyngeal techniques).

 Meanwhile, many companies that did not initially embrace the value of testing have been influenced by some triggering event to adopt this useful practice. For example, a retail store that was not testing felt pressed to do so when one worker began having symptoms. Uncovering positive results in several employees and recognizing the potential threat to clientele as well as staff members, the store owner began a standardized testing program.

What can you learn from these companies? Unless your employees work exclusively off-site, employer-provided testing and tracking is a course worthy of consideration — with vaccine verification and tracking following close behind.

Testing to Mitigate the Risks of COVID-19

Symptom monitoring and diligent recordkeeping are essential to lessening the risk of a COVID-19 outbreak, and company-wide or selective testing should be considered based on the prevalence of COVID-19 in the community, the risk to workers and the potential damage to the organization.

 Here are some considerations as you embark on a testing program:

Ensure you have reliable expertise. Creating an effective testing program requires a partnership with a provider that specializes in testing and can report results reliably and quickly. Companies that allow their employees to choose an external provider — e.g., a local pharmacy — often find it’s difficult to manage these test results. You should expect your testing partner to provide expert advice about how often you need to test to ensure you capture all COVID-19 cases, which type of test is right for your needs (the highly accurate polymerase chain reaction, or PCR, test or the antigen, or rapid, test), and what action is appropriate once test results are in (quarantining, further testing, tracing, etc.).

 The value of the test requires timely management of the results, which is difficult to achieve when tests are administered externally. Putting the onus of tracking test results on the employee may result in disease spread if the individual experiences difficulty or a delay in obtaining those results. With centralized control and electronic tracking, the company administrator may be far more expedient in managing positive results, and tracing and quarantining in real time.

Understanding the accuracy and limitations of the actual test cannot be overstated. As the White House learned, testing can provide a false sense of security that can result in disaster. 

 A note on privacy: While employers are not permitted to ask employees questions about their general health issues — e.g., Do you have a heart condition? — most states and federal guidelines regarding COVID-19 actually mandate that employers query employees regarding COVID-19 symptoms. Further, with employee assent and the proper approach, employees will often understand the crucial nature of COVID-19 testing during the pandemic and the value of capturing this information on your company’s HR platform.

Understand your budgetary options. Testing may, on the surface, seem to be an expensive undertaking. However, as so many businesses are learning, a negative experience may enlighten the company that this process may be a worthwhile investment in the health and welfare of their most valuable resource: their employees. Notably, there are ways to contain costs. Specialized software can make testing and tracking processes more efficient, while reducing administrative burden. 

A large proportion of the testing costs result naturally from the number of tests needed. Pooled testing can lower these costs in certain circumstances where the disease prevalence is manageable.

How does pooled testing work? Say you have a team of five people. Each gets a nasal swab test, but instead of running five single tests, the testing company runs all five samples together. If the sample is negative for the virus, then you know all five of those people are negative, and you learned that much less expensively than if you had run five tests. If the sample tests positive, however, then separate tests need to be run to isolate the person or persons who are positive (a process called disambiguation).

Given the costs of any potential second round of testing, you should be thoughtful in considering pooled testing. While it is certainly an economical alternative for businesses in low-risk areas, if your county has COVID-19 positivity of 10 percent or higher, you will likely end up paying more than you would have going with single testing. Also, any employee who reports symptoms should automatically be tested individually as pooled testing is designed for those who are less likely to harbor the disease.

The Next Phase of the Pandemic: Verifying Vaccinations to Bring Your Team Back

While the percentage of Americans who plan to get vaccinated continues to increase, some are still hesitant to trust a vaccine that is so new. But just as testing mandates have become widespread, we could expect to see similar trends for vaccination mandates. According to the U.S. Equal Employment Opportunity Commission, employers may have the authority to require employees to get vaccinated for the COVID-19 virus, provided their policies comply with the Americans with Disabilities Act, Title VII of the Civil Rights Act of 1964 and other workplace laws.

Building a partnership with a company specializing in vaccine verification is advisable. As you allow employees to reenter the workplace, it is vital to workplace safety to understand who has been vaccinated and, for the two-shot vaccines, whether they have received one or both shots. Unfortunately, relying on an individual to report this information accurately may be inherently flawed. Automated software processes that verify this process are more reliable for documentation accuracy as well as promoting workplace safety.

It’s also important to understand that a vaccination is not an all-clear to resume business-as-usual behaviors. Though vaccinated individuals will perhaps move around their workplace and the world more comfortably, for now public guidance still requires they wear masks and be periodically monitored for symptoms. Vaccinated individuals are not likely to experience symptoms themselves; however, they are thought to be able to carry low levels of the virus and spread the disease to other individuals.

While the pandemic continues to challenge us all, business leaders have tools at their disposal to control its spread and protect their people. Thoughtful implementation of these solutions may help you strengthen your company and look toward ongoing success.

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