This article was written by Owen Kell, Senior IoT Research Associate at Memoori.
While much of Europe has returned to some form of lockdown, and COVID-19 cases continue to rise in North America, the calls for a widespread return to traditional workplaces will continue, particularly for activities that cannot be effectively delivered remotely. While health and safety measures including improved in-building sanitation, social distancing, increased hand washing, and usage of face mask are being widely adopted, the inability to identify and isolate coronavirus infections amongst the workforce has resulted in staff absences and reduced overall economic productivity. Employers are therefore investigating the practicality of deploying rapid COVID-19 diagnostic testing as part of their return-to-work approach.
Testing can take the form of both antigen, or antibody testing. Antigen screening tests for an active viral presence (indicating that the person is currently infected), while antibody tests screen the blood to indicate whether a person has had the disease at some point.
Early on in the pandemic, antibody tests were seen as a potentially viable means of generating “immunity passports” for people who had already contracted and recovered from the virus, as a means of controlling virus spread. However, increasing evidence that it is possible to catch COVID-19 more than once has reduced the overall enthusiasm for an antibody testing based approach for a safe return to work. Antibody tests may also prove less useful for diagnosing current infections because antibodies may not develop for weeks after infection.
PCR tests, (which look for the presence of the covid-19 virus on swabs taken from the throat) remain the gold standard for antigen testing, but this approach is costly (between $40 and $200 per test), and therefore unaffordable for most recurrent use in most organizations. Furthermore, the turnaround time to get the results back (typically between 36 and 72 hours) is also an issue as the swabs need to be sent to a lab for analysis.
Several innovations promising cheap, rapid turnaround testing, are already being touted, with more on the horizon. Some of these rapid tests would be administered at home. Others could be delivered at offices or schools. Manufacturers are developing testing kits costing a fraction of traditional PCR tests, and promise results in as little as 15 minutes, without the need for specialist labs, expensive machines, or expertly trained personnel. One solution of this kind has already gained FDA approval while others are in the pipeline.
Opinions on the effectiveness of rapid testing at enabling a safe return to the workplace vary however, advocates including the former CEO of Google Eric Schmidt see the approach as a key enabler for allowing corporate offices to reopen in earnest:
“There’s plenty of technology that allows for rapid testing, and with rapid testing corporations could open. People could go to work,”
A recently published study in the New England Journal of Medicine, also concludes that low sensitivity tests performed more frequently would be more efficient in isolating contagious individuals while letting the “non-spreader” go back to work.
Rapid testing is not without its limitations however, according to Rebecca Lee Smith, an epidemiologist who helps run the University of Illinois’ testing procedures, rapid tests can be imprecise, reporting both false negatives and positives, and warns that rapid tests aren’t designed to catch asymptomatic cases of the virus, even though asymptomatic people can still spread the disease.
Some major employers are also yet to be convinced. Will Moss, a spokesperson for Intel, says the company doesn’t offer testing, because it doesn’t think the tests are accurate enough. Instead, Intel relies on cleaning its facilities, requiring face masks, and encouraging social distancing where possible. The company directs anyone who wants a test to their own health care provider.
Employers considering a testing-based approach may also face some legal and data protection constraints, local regulations on mandatory testing of employees will vary, and for nations subject to GDPR data protection regulations, employers will also need to comply with the GDPR and the Data Protection Act 2018, due to its sensitivity. Health data has the protected status of ‘special category data’ under data protection law so will need to be carefully protected.
In conclusion, while widespread employee testing may at first glance seem like a reasonable way to ensure employee attendance, improve employee peace of mind and keep the workplace safe, it is not yet the silver bullet. For employers that are able to test frequently, quickly and accurately, this approach may yet prove sound, but ongoing concerns about testing accuracy may limit the effectiveness of such an approach in the short-term. Using inaccurate tests could have major consequences in terms of false results and could ultimately undermine employee confidence in testing altogether, wasting considerable amounts of money and potentially having a detrimental effect on employee health.
That said, R&D activity and related innovation in rapid testing are extremely exciting and the evidence base around efficacy is set to grow quickly, and in combination with increasing hopes of widespread effective vaccination programs in Spring of 2021, a safe return to the workplace may soon become a reality.