Effectiveness of Workplace Screening Programs for Reducing the Spread of COVID-19 in Healthcare Settings

AHS’ COVID-19 Scientific Advisory Group (SAG) recently investigated the latest evidence from around the world pertaining to a key topic: effectiveness of workplace screening programs for reducing the spread of COVID-19 in healthcare settings.

In late March 2020, AHS implemented a ‘fit-for-work’ screening process to reduce transmission/infection of COVID-19 in healthcare settings, to augment use of PPE, and to support public health measures. Two general screening methods have been used in Alberta: in person using a paper form and an online self-reported form. There was very little evidence about the effectiveness of either, though in-person screening has been shown to detect ill individuals and prevent them from entering health facilities. There are downsides to each method, the former being resource intensive and manual, and the latter being subject to lower sensitivity due to compliance and disclosure challenges. The effectiveness of temperature screening was unclear, and if used, it should only be implemented in combination with symptoms screening.

Recommendations

1. Given the current low prevalence of COVID-19, it was recommended to use an online platform to perform screens electronically and offer access to diagnostic testing as appropriate. In-person assessments should be reconsidered if prevalence rises.
2. The current fitness to work tool, using the standard symptom list, should continue to be used. Healthcare workers should also be made aware of the general Alberta population recommendations to self-monitor for the AHS expanded symptom list and to guide need for testing.
3. Institutional policies and communications should be aligned to promote a “Healthy Worker” culture. This may include flexible sick leave pay policies, alternate call schedules, flexible work assignments, protecting HCW privacy in case of illness, and an awareness campaign to reduce the stigma around staying home while symptomatic
4. Staff screening programs should be evaluated and reassessed based on program data and on current prevalence of COVID-19 in the community/referral region.

It was noted that the threshold for increasing or decreasing the intensity of the HCW and visitor screening programs should be determined based on epidemiological evidence and expert consensus.

To see the complete list of Rapid Response Reports, please check the COVID-19 Scientific Advisory Group website. New reports and updates appear here on a daily basis.