LHSFNA GUIDANCE FOR CONDUCTING WORKPLACE COVID-19 SCREENINGS AND ASSESSMENTS

Employers should consider implementing a screening and assessment program for employees, visitors and vendors before allowing them to access the workplace. This program could utilize screenings, assessments or both options. This document provides employers with guidance on conducting those screenings and assessments. Return to work scenarios for individual employees who are exposed to COVID-19, experience COVID-19 symptoms or are advised by their healthcare provider or a local public health official to self-quarantine or self-isolate are also provided.

Please contact the Laborers’ Health & Safety Fund of North America (LHSFNA) at 202-628-5465 for specific questions or concerns not addressed below. The LHSFNA can develop a screening and/or assessment program tailored to the specific needs and circumstances of your workplace.

Screening Method: Visual Scan and Temperature Check

Screening employees, visitors and vendors for COVID-19 through temperature checks and visual scans is one strategy employers can implement in an effort to protect the work environment.

There are several steps employers can take to protect the employee conducting temperature screenings. The most protective methods incorporate social distancing (maintaining a distance of six feet from others) or physical barriers to eliminate or minimize the screener’s potential exposure due to close contact during screening.

If social distancing or barrier controls cannot be implemented during screening, personal protective equipment (PPE) can be used when the screener is within six feet of an employee. However, reliance on PPE alone is a less effective control and is more difficult to implement given PPE shortages and training requirements.

Temperature screening is a time-intensive process. Depending on the space available and layout of the workplace, multiple screening stations may be necessary.

Steps to Perform a Visual Scan and Temperature Check

1. Before screening begins, the screener should wash their hands with soap and water for at least 20 seconds or, if soap and water are not available, use hand sanitizer with at least 60 percent alcohol.
2. Screener puts on the following PPE:
   • A gown
   • A single pair of disposable gloves
   • Eye protection (goggles or disposable face shield that fully covers the front and sides of the face)
   • Respiratory protection such as a NIOSH-approved N95 or higher-level respirator or facemask (if a respirator is not available)
3. The screener makes a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue, and confirms the employee is not experiencing coughing or shortness of breath.
4. Conduct temperature screening using the protocols described under these three scenarios:
   1. Distancing Scenario
      • An employee, visitor or vendor would be informed in advance to take their own temperature prior to coming into the workplace.
      • The screener stands at least six feet away from the employee and asks them to confirm their temperature is less than 100.4°F.
   2. Barrier Scenario
      • During screening, the screener stands behind a physical barrier, such as a glass or plastic window or partition, that can protect the screener’s face and mucous membranes from respiratory droplets that may be produced when an employee sneezes, coughs or talks.
      • To check the person’s temperature, reach around the partition or through the window. Make sure the screener’s face stays behind the barrier at all times.
      • When using a thermometer that requires physical contact with an employee use a clean pair of gloves for each employee and ensure that the thermometer is thoroughly cleaned between each screening. Follow these directions: Remove and discard gloves, wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60 percent alcohol.
      • If disposable or non-contact thermometers are used and the screener does not have physical contact with an employee, changing gloves before the next screening is not required. If non-contact thermometers are used, clean and disinfect them according to manufacturer’s instructions and facility policies.
      • If at any point the screener does have physical contact with an employee, changing gloves before the next screening is required. Follow the glove removal and handwashing instructions above.
   3. PPE Only Scenario
      • When using a thermometer that requires physical contact with an employee, use a clean pair of gloves for each employee and ensure that the thermometer is thoroughly cleaned between each screening. Follow these directions: Remove and discard gloves, wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60 percent alcohol.
      • If disposable or non-contact thermometers are used and the screener does not have physical contact with an employee, changing gloves before the next screening is not required. If non-contact thermometers are used, clean and disinfect them according to manufacturer’s instructions and facility policies.
      • If at any point the screener does have physical contact with an employee, changing gloves before the next screening is required. Follow these directions: Remove and discard gloves, wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60 percent alcohol.
5. At the end of the screener’s shift, remove and discard all PPE into a trash can, wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60 percent alcohol.

Screening Results

Employees, visitors and vendors with a temperature of 100.4°F or greater should immediately be separated from other people in the workplace, sent home and advised to contact their healthcare provider.

Assessment Method: Exposure and Symptoms

Assessing employees, visitors and vendors is another strategy employers can implement in an effort to protect the work environment. Two possible options for assessing exposure to COVID-19 or symptoms of the virus are a questionnaire and self-certification.

The questionnaire can be given in-person or online. An in-person questionnaire is more time-intensive for the employer and requires protections and distancing measures be in place between the screener and the employee. Please refer to the Distancing, Barrier or PPE Only Scenarios above for more information. The online questionnaire method, implemented through a platform such as Google forms, may also be time-intensive, but removes concerns about in-person interactions.

Assessment Results: No to All Questions

An employee, visitor or vendor responding “no” to all three questions should be granted access to the workplace and proceed with their normal workday.

Assessment Results: Yes to Exposure Question

An employee, visitor or vendor responding “yes” to exposure but “no” to symptoms should self-quarantine for 14 days. According to the CDC, self-quarantine is appropriate when a person feels healthy but recently had close contact for a prolonged period of time (10 minutes or longer) with a person with COVID-19. A person in self-quarantine should do the following:

• Stay home for 14 days
• Practice social distancing
• Check their temperature twice a day
• Self-monitor for COVID-19 symptoms
• Contact their healthcare provider if symptoms develop

Discontinuing Self-Quarantine

While in self-quarantine, the employee may or may not develop symptoms. If the employee does not develop symptoms, they should contact their employer about returning to work after 14 days in self-quarantine. If the employee does develop symptoms, they should begin self-isolation (see details below) and contact their healthcare provider.

Assessment Results: Yes to Symptoms Question

An employee, visitor or vendor responding “yes” to symptoms should be isolated from other people in the workplace and, if they’re an employee, their supervisor should be notified. Prior to the symptomatic person leaving the premises, employers should determine which employees may have been exposed to the virus and need to take additional precautions; this process is known as contact tracing. According to the CDC:

Most workplaces should follow public health recommendations for community-related exposure. This guidance indicates that employees who had close contact (within six feet) for a prolonged period of time (10 minutes or longer) with the symptomatic person during the period from 48 hours before symptom onset until the symptomatic person meets the criteria to discontinue home isolation should self-quarantine, selfmonitor for symptoms and practice social distancing for 14 days.

The symptomatic person should be sent home, advised to self-isolate and contact their healthcare provider. According to the CDC, self-isolation is appropriate when someone has been diagnosed with COVID-19, is waiting for diagnostic test results or has symptoms. A person in self-isolation should do the following:

• Stay in a specific “sick room” or area and away from other people or pets; if possible, use a separate bathroom
• Stay home except to get medical care
• Monitor symptoms and stay in contact with their healthcare provider
• Follow care instructions from their healthcare provider and local or state health department

The employee may or may not be able to receive a COVID-19 diagnostic test from their healthcare provider or health department. Decisions about testing are at the discretion of state and local health departments and/or individual healthcare providers.

Discontinuing Self-Isolation

According to the CDC*, there are two ways to discontinue self-isolation: a test and based on symptoms. These methods are for people with COVID-19 who have symptoms and were directed to care for themselves at home. The test-based approach is contingent on the availability of ample testing supplies and laboratory capacity as well as convenient access to testing.

Conditions indicating recovery with the test-based approach:

• No longer have a fever (without the use of medicine that reduces fever) AND
• Other symptoms have improved AND
• Two negative test results in a row, 24 hours apart

Conditions indicating recovery with the symptom-based approach:

• No fever for at least 3 days (72 hours) – without the use of medicine that reduces fever AND
• Other symptoms have improved AND
• At least 10 days have passed since symptoms first appeared

*CDC guidance for COVID-19 may be adapted by state and local health departments to respond to rapidly changing local circumstances.

After an employee meets the criteria to discontinue home isolation, they should contact their employer about returning to work.

Assessment Results: Yes to Self-Isolate or Self-Quarantine Question

An employee who responds “yes” to being advised to self-isolate or self-quarantine by their healthcare provider or a local public health official should return to their self-isolation or self-quarantine immediately. They should also contact their healthcare provider or local public health official and inform them of breaking self-quarantine or self-isolation, then follow their recommendations on how to proceed.

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