Should we be screening employees for COVID-19 symptoms? What is the best way to do that?

Screening employees is an optional strategy that employers may use. Screening and health checks are not a replacement for other protective measures such as social distancing. Employees should not enter the workplace if experiencing any symptoms of COVID-19 or a fever equal to or higher than 100.4 F, are waiting for testing results, or have been diagnosed with COVID-19 and are not yet cleared to discontinue isolation.

Screening employees is an optional strategy that employers may use. Performing screening or health checks will not be completely effective because asymptomatic individuals or individuals with mild non-specific symptoms may not realize they are infected and may pass through screening. Screening and health checks are not a replacement for other protective measures such as social distancing.

Consider encouraging individuals planning to enter the workplace to self-screen prior to coming onsite and not to attempt to enter the workplace if any of the following are present:

  • Symptoms of COVID-19
  • Fever equal to or higher than 100.4oF*
  • Are under evaluation for COVID-19 (for example, waiting for the results of a viral test to confirm infection)
  • Have been diagnosed with COVID-19 and not yet cleared to discontinue isolation

*A lower temperature threshold (e.g., 100.0oF) may be used, especially in healthcare settings.

Content of screening questions

If you decide to actively screen employees for symptoms rather than relying on self-screening, consider which symptoms to include in your assessment. Although there are many different symptoms that may be associated with COVID-19, you may not want to treat every employee with a single non-specific symptom (e.g., a headache) as a suspect case of COVID-19 and send them home until they meet criteria for discontinuation of isolation.

Consider focusing the screening questions on “new” or “unexpected” symptoms (e.g., a chronic cough would not be a positive screen). Consider including these symptoms:

  • Fever or feeling feverish (chills, sweating)
  • New cough
  • Difficulty breathing
  • Sore throat
  • Muscle aches or body aches
  • Vomiting or diarrhea
  • New loss of taste or smell

Protection of screeners

There are several methods that employers can use to protect the employee conducting the screening. The most protective methods incorporate social distancing (maintaining a distance of 6 feet from others), or physical barriers to eliminate or minimize the screener’s exposures due to close contact with a person who has symptoms during screening. Examples to consider that incorporate these types of controls for temperature screening include:

  • Reliance on Social Distancing: Ask employees to take their own temperature either before coming to the workplace or upon arrival at the workplace. Upon their arrival, stand at least 6 feet away from the employee and:
    • Ask the employee to confirm that their temperature is less than 100.4o F (38.0o C) and confirm that they are not experiencing coughing or shortness of breath.
    • Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue.
    • Screening staff do not need to wear personal protective equipment (PPE) if they can maintain a distance of 6 feet.
  • Reliance on Barrier/Partition Controls: 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 the employee sneezes, coughs, or talks. Upon arrival, the screener should wash 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% alcohol. Then:
    • Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue.
    • Conduct temperature and symptom screening using this protocol:
      • Put on disposable gloves.
      • Check the employee’s temperature, reaching around the partition or through the window. Make sure the screener’s face stays behind the barrier at all times during the screening.
      • If performing a temperature check on multiple individuals, make sure that you use a clean pair of gloves for each employee and that the thermometer has been thoroughly cleaned in between each check. If disposable or non-contact thermometers are used and you did not have physical contact with an individual, you do not need to change gloves before the next check. If non-contact thermometers are used, clean and disinfect them according to manufacturer’s instructions and facility policies.
    • Remove and discard PPE (gloves), and wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
    If social distance or barrier controls cannot be implemented during screening, PPE can be used when the screener is within 6 feet of an employee during screening. However, reliance on PPE alone is a less effective control and more difficult to implement given PPE shortages and training requirements.
    • Reliance on Personal Protective Equipment (PPE): Upon arrival, the screener should wash their hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol, put on a face mask, eye protection (goggles or disposable face shield that fully covers the front and sides of the face), and a single pair of disposable gloves. A gown could be considered if extensive contact with an employee is anticipated. Then:
      • Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue, and confirm that the employee is not experiencing coughing or shortness of breath.
      • Take the employee’s temperature.
        • If performing a temperature check on multiple individuals, make sure that you use a clean pair of gloves for each employee and that the thermometer has been thoroughly cleaned in between each check. If disposable or non-contact thermometers are used and you did not have physical contact with an individual, you do not need to change gloves before the next check. If non-contact thermometers are used, you should clean and disinfect them according to manufacturer’s instructions and facility policies.
      • After each screening or after several screenings, where you did not have physical contact with an individual, remove and discard PPE and wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol.

From the CDC's General Business Frequently Asked Questions