Author: Carrie Nickel, RN, BSN, MS, COHN-S
The Supreme Court recently blocked the Biden’s administration’s federal COVID-19 vaccine or testing mandate for non-healthcare workplaces. It did uphold the vaccine/testing requirement for medical facilities that accept Medicare or Medicaid payments.
With or without federal mandates, employers are still responsible for maintaining a safe workplace. Per U.S. Secretary of Labor Marty Walsh, the Occupational Safety and Health Administration (OSHA) will do everything in its existing authority to hold businesses accountable for protecting workers under the COVID-19 National Emphasis Program and the General Duty Clause.
With the Omicron variant causing some breakthrough infections, Advocate Aurora’s Occupational Health team members are being asked these questions about COVID-19 testing in the workplace:
Q. Can employers administer COVID-19 tests to employees without a federal mandate?
A. Employers are allowed to test employees to determine if their presence in the workplace pose a health threat to others. According to the American Disabilities Act (ADA), when employers implement mandatory testing of employees, it must be “job related and consistent with business necessity.” The Centers for Disease Control and Prevention (CDC) reaffirms that employers can take screening steps to determine if employees have COVID-19 because employees carrying the virus can pose a direct threat to their coworkers. COVID-19 testing administered by employers is consistent with current CDC guidance and meets the ADA’s “business necessity” standard.
Q. What is the differences between a PCR test, an antigen test and an antibody test?
There are two different types of tests – diagnostic tests and antibody tests.
PCR tests
Diagnostic tests can show if a person has an active coronavirus infection and should be quarantined or isolate themselves from others. A Nucleic Acid Amplification Test, or NAAT, is a type of diagnostic test for the virus that causes COVID-19. Polymerase Chain Reaction (PCR) tests are one of the many methods of a NAAT. PCR test are highly sensitive and specific for diagnosing COVID-19 infection. These tests are typically processed in a laboratory. Some NAATs are called “Point of Care” (POC). They are usually performed in a clinical setting with results available in about 15 - 45 minutes.
Antigen tests
Antigen tests detect specific proteins on the surface of the coronavirus. Antigen tests generally have similar specificity but are less sensitive than most NAATs (PCR). Most can be processed at the point of care or purchased over the counter (OTC) with results available in minutes. They are often used in screening programs to quickly identify those who are likely to be contagious. Because of the performance characteristics of antigen tests, it may be necessary to confirm a negative test in persons with symptoms with a laboratory-based PCR. Positive results of antigen tests do not have to be followed up with a PCR as results indicate high sensitivity.
Antibody tests
Antibody (or serology) tests are used to detect previous COVID-19 infection. The CDC does not recommend using antibody testing to diagnose current infection. Antibody tests look for antibodies made by the immune system in response to a threat, such as a specific virus like COVID-19. Antibodies can take several days or weeks to develop after an infection. Antibodies may stay in the blood for several weeks or longer after recovery.
Q. What should employers consider before starting a workplace testing program?
A. Employers who plan to test employees should have procedures in place for rapid notification of results and establish appropriate measures based on testing results. This includes instructions regarding self-isolation and restrictions on workplace access.
Remember, a positive COVID-19 test result reveals that a person most likely has a current infection and may be able to transmit the virus to others. A negative test result means the person did not have detectable COVID-19 at the time of testing. A negative test does not mean that the person will not acquire the virus later.
Q. How can employers stay current with the changes surrounding COVID-19 testing?
Testing and vaccine recommendations are likely to evolve as new information becomes available. Employers are encouraged to regularly check the CDC’s and their state public health websites for updates. Advocate Aurora Occupational Health physicians can also assist with medical consultations for interpretation of website information.
Q. How should employers handle sending employees home when they test positive for COVID-19 (with or without symptoms), or have had exposure to someone with COVID-19?
If they test positive for COVID-19 or have symptoms, regardless of vaccination status, they should stay home for five days and end isolation after five full days, if they are fever free for 24 hours (without the use of fever-reducing medication) and symptoms are improving. Mask wearing in the workplace should be mandatory until day 10. To calculate isolation, Day 0 is the first day of symptoms or positive viral test. Day one is the first full day after symptoms developed or the positive test was collected.
If employees are exposed to COVID-19 and are up to date on COVID-19 vaccinations and boosters, there is no need to stay home, but they should wear a mask at work for 10 full days (using the same calculation for Day 0 as mentioned above). Even if they don’t develop symptoms, they should get tested at least five days after the last close contact.
If people are exposed and not up-to-date on COVID-19 vaccinations, they should quarantine for at least five days and get tested at least five days after exposure. Then they can return to work, if no symptoms develop, wearing a mask at work until day 10 of post-exposure (using same calculation for Day 0 as above).
COVID-19 guidelines and protocols change quickly and frequently. Please continue to visit the CDC www.cdc.gov/coronavirus and OSHA websites www.osha.gov/coronavirus for the most up-to-date information.
Advocate Aurora Employer Solutions offers a wide range of customizable employee health programs and solutions to help you and your employees live well and work well. Customized solutions could include health benefit plans, COVID-19 resources, Employee Assistance Program (EAP), employer clinics, occupational health, wellness services and more. We'll partner with you to create a personalized program that meets your employees’ needs and goals while aiming to lower your bottom line. Visit employersolutions.aah.org to learn more.
Carrie Nickel, RN, BSN, MS, COHN-S, serves Advocate Aurora Health as Senior Director, Occupational Health
This post is locked to comments.
