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[Evidence summary]: Is there evidence that temperature checks for healthcare workers (HCWs) reduce the transmission of COVID-19 in healthcare settings?

dc.contributor.authorNational Health Library & Knowledge Service (NHLKS)
dc.contributor.authorMorgan, Margaret
dc.contributor.authorRyan, Pauline
dc.contributor.authorLeen, Brendan
dc.contributor.authorMalone, Conor
dc.date.accessioned2020-07-22T09:55:38Z
dc.date.available2020-07-22T09:55:38Z
dc.date.issued2020-07-14
dc.identifier.urihttp://hdl.handle.net/10147/627876
dc.descriptionIn a recent clinical evidence assessment, ECRI1 concluded that the weight of evidence does not favour screening programmes using temperature screening devices alone or in combination with a questionnaire, concluding that such programmes are ineffective in detecting infected persons. Under best-case scenarios, simulation studies suggest such screening will miss more than half of infected individuals1. Real-world data show detection rates around 19%20. Absence of fever at the time of testing, inconsistent technique by operators, environmental temperatures, false answers to questionnaires and use of fever-reducing drugs are all cited as factors mitigating the effectiveness of mass temperature screening. Based on conservative assumptions on sensitivity, Quilty et al18 found that 46% of infected travellers passing through mass temperature screening at airports will enter undetected. ECRI concludes that using such an approach to reduce infection risk from visitors and HCWs entering healthcare facilities could provide a false sense of safety. The WHO4 includes temperature screening of employees among a range of measures to prevent transmission of SARS-CoV-2 infection; however, the ECDC6 notes that it is improbable that exit or entry screening will detect a sufficient number of cases to make the screening procedures effective or efficient in preventing disease transmission. Similarly, the HSE3 has advised against mass temperature screening for the following reasons:  It has not proved to be effective in past outbreaks: eg SARS.  It has unintended consequences.  People with fever may attempt to conceal high temperatures by taking anti-pyretic drugs: ie paracetamol.  Temperature screening can give a false sense of security, eg showing a negative result simply because the temperature has been suppressed. Chow et al11 note that screening only for fever, cough, shortness of breath or sore throat might have missed 17% of symptomatic HCWs at the time of illness onset; expanding criteria to include myalgias and chills may still have missed 10%. The data indicate that HCWs worked for several days while symptomatic, and according to a growing body of evidence may transmit SARS-CoV-2 to vulnerable patients and other HCWs. Interventions to prevent transmission from HCWs include expanding symptom-based screening criteria, furloughing symptomatic HCWs, facilitating testing of symptomatic HCWs, and creating sick leave policies that are non-punitive, flexible, and consistent with public health guidance. Although data regarding the effectiveness of mass screening programmes remain equivocal, surveillance may be particularly important in the containment phase of the pandemic in order to help reduce potential healthcare-associated transmission and sustain good staff morale. An integrated surveillance strategy and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs in one study from Singapore16. In summary:  Fever is absent in 52% of confirmed cases.  IR thermometers may not give an accurate reading.  Normal temperature readings may give a false sense of security and may diminish the effects of other important interventions.  Data from previous similar outbreaks show little evidence of benefit from mass temperature screening.en_US
dc.language.isoenen_US
dc.publisherHealth Service Executiveen_US
dc.subjectCORONAVIRUSen_US
dc.subjectCOVID-19en_US
dc.subjectINFECTION PREVENTION AND CONTROLen_US
dc.subjectTEMPERATUREen_US
dc.subjectHEALTHCARE WORKERSen_US
dc.title[Evidence summary]: Is there evidence that temperature checks for healthcare workers (HCWs) reduce the transmission of COVID-19 in healthcare settings?en_US
dc.title.alternativev1.0en_US
dc.typeOtheren_US
dc.contributor.departmentHealth Service Executiveen_US
refterms.dateFOA2020-07-22T09:55:46Z


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