Why are temperature checks still happening despite 'limited' effectiveness?

Go into many businesses and offices these days, from doctor’s appointments to hair salons and restaurants, and there’s a good chance you’ll be asked to have your temperature taken by one of those no-contact infrared thermometers. But how effective are they at preventing the spread of COVID-19?

Temperature checks are used to identify whether a person has a fever — one of the signs of a COVID-19 infection. But it’s possible to be infected with the coronavirus and “have a cough or other symptoms with no fever, or a very low-grade one, especially in the first few days,” according to Johns Hopkins Medicine.

That’s why some experts are questioning relying on temperature scans. “It’s something you can do, and it makes you feel like you’re doing something,” Dr. David Thomas, an infectious disease specialist at Johns Hopkins University School of Medicine, told the New York Times. “But it won’t catch most people who are spreading COVID.”

A woman has her temperature checked before attending The Metropolitan Museum of Art on their first day open since closing due to the coronavirus disease (COVID-19) outbreak in the Manhattan borough of New York City, New York, U.S., August 27, 2020.  REUTERS/Carlo Allegri
A woman has her temperature checked before attending the Metropolitan Museum of Art in New York on its first day open since closing due to the pandemic, Aug. 27. (Reuters/Carlo Allegri)

Recently, the Centers for Disease Control and Prevention noted the limitations of symptom-based screenings and, in turn, has shifted its strategy when it comes to preventing COVID-19 infections during air travel. In a statement issued on Sept. 9, the CDC said: “We now have a better understanding of COVID-19 transmission that indicates symptom-based screening has limited effectiveness because people with COVID-19 may have no symptoms or fever at the time of screening, or only mild symptoms. Transmission of the virus may occur from passengers who have no symptoms or who have not yet developed symptoms of infection.”

Dr. Iahn Gonsenhauser, chief quality and patient safety officer for the Ohio State University Wexner Medical Center, tells Yahoo Life that while touchless thermometers are “established and reliable devices,” it’s “debatable” whether they should still be used before people enter public businesses.

“The impact of this specific intervention is quite limited,” he says. “Most people with fevers are also symptomatic in other ways and are voluntarily quarantining at home. However, the otherwise asymptomatic person with a fever, while rare, does occur, and these people may present an increased risk of COVID or other viral transmission to those around them.”

But Gonsenhauser adds that temperature scanning does serve a purpose. “We know that there is a segment of the population that is defiant about expert recommendations, and they will still venture to public spaces even with a broad array of symptoms,” he says. “While the number of people detected and redirected as a result of this intervention is low, it isn’t zero, and as such, this precaution does reduce transmission risk. As we deal with cold, flu and allergy seasons, fever can be the indicator that distinguishes someone’s typical allergies from something more concerning.”

Neysa Ernst, nurse manager of the Johns Hopkins Biocontainment Unit, tells Yahoo Life, that, for the general public, no-contact thermometers are “fine,” while keeping in mind that temperature checks are really “one step in a screening process.”

“Remember, a temperature check outside of a clinical environment is not a clinical assessment,” she says. “Like any nonclinical assessment, it has limitations.”

Ernst notes that temperature checks “may not be effective for all commercial operations — airports, for instance, are stopping temperature checks and employing other screening tools.” However, the practice does show that a business is taking at least some steps to ensure the safety of its customers and employees.

“Businesses want customers to come back to their establishments [and] customers want safety,” says Ernst. “While it is clear that temperature checks have limitations, customers are looking for businesses that take their safety personally. Temperature checks say, ‘I care about your safety as a customer.’”

So what other safety measures should businesses follow to protect their customers and employees?

“Health care experts may sound like broken records, but ensuring adequate personal distance, requiring the use of masks and making hand hygiene supplies readily available are critical,” says Gonsenhauser.

He says that avoiding the use of waiting rooms and “creating opportunities for remote interactions” are “major risk-reduction strategies.” On the employer side, Gonsenhauser says that businesses should be “supporting their staff to stay home if symptomatic or concerned about exposure.”

Ernst recommends training staff to “turn away customers who come in without a mask” and handle certain situations that can arise in the age of COVID-19: “What should the establishment do if a customer has a high temperature? How are staff trained to respond?” Ernst says.

She also suggests training employees to enforce social distancing. “I am so proud of frontline employees who point out when a customer is too close,” she says. In addition, Ernst urges people to “do your part to avoid a twindemic” — namely, COVID-19 and the flu: “Get a flu shot,” she says.

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