In the 2020’s pandemic environment, reducing or eliminating workforce exposure to and spread of COVID-19 is part of the employer's responsibility to provide a safe workplace. As employers plan to reopen their businesses or bring employees back on-site, they must plan for safety. Part of that planning may include offering or requiring COVID-19 testing. Understanding the types of COVID-19 tests and how to use them is key.
About COVID Testing
While the Centers for Disease Control (CDC) encourages employers to follow federal, state and local health officials and laws regarding testing, it offers considerations for employers when developing plans to reduce virus transmission in their work force operations.
The CDC recommends providing clear information to employees about testing, including the type of test, the reliability and limitations of testing, how the test will be administered, and how to understand results.
The CDC has identified five categories of people that qualify for COVID-19 testing:
- Individuals with symptoms of the virus when health checks like symptom or temperature screening identify sick employees should be separated from the workforce and referred to isolation and testing.
- Asymptomatic individuals with recent exposure to the virus should be separated and referred to quarantine and testing.
- Asymptomatic individuals without recent exposure to the virus for the purpose of proactive identification in special settings such as workplaces where social distancing is difficult, businesses far from medical facilities, businesses in critical services sectors, and workplaces that house employees for work such as fishing vessels, offshore oil rigs, etc.
- Individuals who have tested positive and recovered from the illness to determine if isolation can be discontinued.
- Testing for public health surveillance of the virus to determine and/or monitor hotspots.
Types of COVID Tests
The different types of COVID-19 tests are molecular tests, antigen tests, and antibody tests. The molecular and antigen tests are diagnostic tests for current infection and infectiousness and are done with nasal or throat swabs. Molecular tests are highly accurate, with results taking a day to a week. Results can be affected by accidental contamination of samples, temperature at which samples are kept before analysis, and swabs not getting virus particles in nose or throat.
The antigen tests are usually accurate on positive results but have a higher rate of missing active infections. Negative results may need confirmation with a molecular test if active symptoms are present.
The antibody test is a blood test to determine previous infection and possible immunity, and may show false results. The FDA says antibody tests shouldn’t be used to diagnose an active infection as they only detect antibodies, not the virus.
The Food and Drug Administration (FDA) reports that newer tests recently available or becoming available include rapid, point-of-care tests that are analyzed immediately where they are administered instead of sent out to a lab, at-home collection tests available by prescription, and saliva tests for patients to spit into a tube instead of getting the more invasive a nasal or throat swab.
The Society for Human Resource Management (SHRM) explains that the Equal Employment Opportunity Commission (EEOC) says that employers can screen employees for COVID-19 because of the direct threat to others that the virus poses. The EEOC recommends that employers follow the updated pandemic guidance of authorities including the FDA and CDC, while paying attention to the following considerations.
- Screening and testing for COVID-19 must be done in a nondiscriminatory way, which probably means employers must require testing of all employees.
- Test results are confidential medical records and should be handled as such.
- Employers should plan for how to handle employee refusal of testing.
- Wage and hour laws may require paying employees for time spent on testing.
- COVID-19 testing implementation should include considerations of test accuracy, how and when employees who test positive may return to the workplace, and what actions to take when there is an employee who tests positive.