May 01, 2020
As employers refine their approaches to safely return employees to the workplace, the Association welcomed medical experts from two member companies to discuss how diagnostic and antibody tests work and how quickly testing will expand. (A members-only summary of the call is forthcoming.) Despite the national push to expand testing, it is clear that testing will only serve as a complement to temperature screenings and workplace controls for the foreseeable future.
COVID testing by the numbers: U.S. testing facilities conducted 1.3 million diagnostic tests within the past week, but news reports indicate that many testing labs are underutilized because of inadequate coordination of testing capacity among public, private, and academic facilities. However, with 130.5 million U.S. workers (prior to the crisis) and 328 million residents, it will take new technology and expert coordination before widespread and regular testing can occur.
White House Testing Blueprint: In a Rose Garden press conference earlier in the week, President Trump unveiled a Blueprint for Testing, which puts the states in charge of managing testing, supported by the federal government. The federal government will assist states in developing robust diagnostic testing plans, encourage states to use the monitoring systems currently used for the flu, and assist in the development of targeted testing to determine asymptomatic individuals. The White House has promised that testing will expand to 8 million tests per month by the end of May. The blueprint promises a CDC-developed nationwide program of community protection teams to assist with contact tracing.
Diagnostic vs. antibody tests: On the Association call, the experts explained that diagnostic tests detect the presence of COVID-19 in the body approximately 3 to 5 days after contracting the virus. Some diagnostic tests require sending a swab into a lab, with results available within a couple of days, while others can be done at the point of care, and results can be determined within 30 minutes. Antibody testing consists of a blood test to screen for the presence of virus antibodies. Diagnostic testing is currently more reliable but the experts agreed that the accuracy of both types of tests is rapidly improving.
Testing generally requires doctor and employee approval: Under current legal and regulatory requirements in most states, a test cannot be performed unless a doctor orders it, which can slow down the testing process. Many third-party providers often have a doctor on staff who can authorize and conduct the tests. Under privacy rules, a test cannot be performed unless an employee agrees to the test, which can be a condition of employment.
Who to test and how often? The experts agreed that because tests and testing apparatus are not yet widely available, it would not currently be feasible for most employers to test all employees every couple of days. Instead, they recommended employers use a combination of targeted testing (in part determined by the local prevalence of the virus, symptom tracking, and workplace controls) as the best approach currently to ensure employee safety.