86 replies to this topic

[TimG]

I am not sure if my question is related to the topic or not. but I would like to understand if an employee work in a hot area like ovens, does the heat affected the body temperature to read as fever by thermal camera?

Absolutely. My pest control guy was late and he told me why. Several places recently required him to submit to passing a temperature check prior to entering their premises. His typical procedure at these places was to start on the exterior stations then go inside. This is Houston, it's hot. He consistently failed the temperature checks (he claimed low 100s) for entrance, would go out to his truck and sit in the A/C, and come back and pass. He's changing his order of attack to interior-->exterior.

Edited by Charles.C, 22 May 2020 - 05:28 AM.
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[Tresa]

Absolutely. My pest control guy was late and he told me why. Several places recently required him to submit to passing a temperature check prior to entering their premises. His typical procedure at these places was to start on the exterior stations then go inside. This is Houston, it's hot. He consistently failed the temperature checks (he claimed low 100s) for entrance, would go out to his truck and sit in the A/C, and come back and pass. He's changing his order of attack to interior-->exterior.

Thanks a lot for your reply, and great information

Edited by Charles.C, 22 May 2020 - 05:28 AM.
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[Tresa]

Yes body heat can rise significantly while working in a hot area, especially in a dehydrated employee not sweating properly (heat stroke).  Be sure to read any literature supplied by the manufacturer of your device/cameras.  I have no experience with thermal cameras, but if someone naturally rests at 98.5 it should be expected to rise during their shift.

 

https://www.mayoclin...se/art-20048167

Thank you for the link which has a great information. I appreciate it.

Edited by Charles.C, 22 May 2020 - 05:29 AM.
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[Xoinks]

Thanks everyone for the input and good feedback/discussion!  We've established an 'investigation' zone to account for some of the variation.  

 

From the feedback I've gotten from a few different sources (City health department, our HR company, etc.) - they've all noted the infrared are notoriously variable based on the person and the immediate circumstances and said that a second reading if the first is 'unusual' is reasonable.  We have established that if someone's temperature is >100.3 on the infrared it'll be a 'go home' situation.  If someone is in the 'investigational' range (99.5-100.3) and two temps stay in that range (after the person sits and rests for a moment), then we will use an oral thermometer with a disposable probe cover to check them orally.  

 

Bucketloads of fun writing the SOP, I feel a bit like when I first started in Quality 15 years ago and I didn't have a large base of knowledge/practical experience to draw on.  

 

I really appreciate the different perspectives here, it's been great hearing what different places are doing and I am thankful for the sharing of information and practices.  

 

Hope everyone stays healthy. 

Edited by Charles.C, 22 May 2020 - 05:29 AM.
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[Charles.C]

Just as a side-note, what percentage of people who test positive for Covid-19 display no significant temperature rise ?

 

IIRC, the statistic which was found in New York was "substantial".

Edited by Charles.C, 22 May 2020 - 05:29 AM.
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[maylao123]

Hi all,

 

do you guys take body temperature on your employees and visitors upon entrance to prevent COVID-19? If so, what kind of measures? We are taking forehead temperature by infra-thermometer everyday but it seems the temperature is always very low and not accountable (average 35.5 - 36.2 C). Probably due to the weather outside is cold, since verification of Thermometer shows it's accurate. Please advise if any of you have the same the situation and how you handle it. Thanks.

Edited by Charles.C, 22 May 2020 - 04:56 AM.
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[Ryan M.]

You can do some control testing with employees.

 

Take their temperature immediately when they arrive.  Take it again later after they acclimate to the warmer indoors.

 

We are seeing the opposite occur here since it has warmed up.  Whenever an employee has a high reading we let them sit inside with AC, isolated of course, and take their temperature about 5 minutes later.  We see a difference with this.

Edited by Charles.C, 22 May 2020 - 04:56 AM.
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[SQFconsultant]

You are getting a lower temp (as you suspect) because the infrared bounces back surface temperature.

We initially took temps this way, but stopped on the advice of our attorney in the US.

Edited by Charles.C, 22 May 2020 - 04:56 AM.
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[olenazh]

I've been checking temperature for more than a month (from when it was quite cold in Toronto to now, when it's pretty hot) using IR thermometer for babies - and it's been pretty accurate during this period of time. No complaints, continuing using it.

Edited by Charles.C, 22 May 2020 - 04:55 AM.
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[The Food Scientist]

What Ryan said.

 

We have considered buying personal thermometers for everyone as an extra step. For them to self monitor themselves as well.

Edited by Charles.C, 22 May 2020 - 04:55 AM.
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[mgourley]

At some point, preventive measures become overbearing.
Are you in an area that has significant outbreaks?
Do you have a significant populations of employees that have tested positive for the virus?
Are you disinfecting areas where common "touch" happens?

Are you providing appropriate PPE for employees?

Are you enforcing "social distancing" where it is possible?

I simply don't see the upside of taking temperatures if you are already doing all you can do.

 

Marshall

Edited by Charles.C, 22 May 2020 - 04:54 AM.
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[Ryan M.]

Well, I can tell you it has prevented a number of personnel from entering the facility and finding out later they either have COVID or some other illness.  So...for the minimal time it takes there is a lot of upside.

BTW...we have all the other measures in place you listed and we are in an area of "moderately significant" outbreaks.  Albeit, we do not have significant population of employees who have tested positive.

 

If you aren't taking temperatures you aren't doing all you can...

 

 

At some point, preventive measures become overbearing.
Are you in an area that has significant outbreaks?
Do you have a significant populations of employees that have tested positive for the virus?
Are you disinfecting areas where common "touch" happens?

Are you providing appropriate PPE for employees?

Are you enforcing "social distancing" where it is possible?

I simply don't see the upside of taking temperatures if you are already doing all you can do.

 

Marshall

Edited by Charles.C, 22 May 2020 - 04:54 AM.
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[mgourley]

Ryan, point taken, but not everyone has the people/time to lase everyone entering the facility.
We have zero positives, so, as with all things, risk assessments rule.

 

Marshall

Edited by Charles.C, 22 May 2020 - 04:54 AM.
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[sbarzee]

Here is our questionnaire.  Daily Employee Health Screening Questionnaire v3.docx   20.04KB   41 downloads

[sbarzee]

We take forehead temperatures, but they are not as representative of body temperature as oral temperatures. We have oral thermometers as back ups in the event someone tests high and we need to verify. 

[Charles.C]

Here is our questionnaire. Daily Employee Health Screening Questionnaire v3.docx

 

Hi sbarzee,

 

Thks for yr attachment.

 

IMO it contains a lot of useful ideas but has 3 significant defects -

 

(1) Unworkably long/complicated.

(2) Questions need to be rearranged/prioritised.

(3) Inaccuracy, eg 1C omits "dry" eg "2" = 14 days !!

 

Regardless, appreciate yr input.

[kfromNE]

Just as a side-note, what percentage of people who test positive for Covid-19 display no significant temperature rise ?

 

IIRC, the statistic which was found in New York was "substantial".

The number is low. Of all that we are doing - this is one thing I'd like to see go first when we ease on restrictions. However - us processing meat in the Midwest where the numbers have been high, we've been lucky so far. The positive side of being considered a high risk industry - even with the shortage of tests, our employees are getting tested if they need to be.

 

I also read from Mayo or Cleveland Clinic that are body temperatures are naturally lower in the morning. With most of our employees mainly arriving from 5:00 - 6:00 am, we've seen it.

 

As for temperature varying due to being outside - very much so. I've done my own experiments (taking my own temperature indoors then walking outside around the building and taking it again). This is why if needed we take their temperature in their ear. We also have been taking employees temperatures on their wrist using the infrared thermometer. With people needing to walk outside a little ways to get into the building - this has been a lot more accurate than the forehead.

[Charles.C]

The number is low. Of all that we are doing - this is one thing I'd like to see go first when we ease on restrictions. However - us processing meat in the Midwest where the numbers have been high, we've been lucky so far. The positive side of being considered a high risk industry - even with the shortage of tests, our employees are getting tested if they need to be.

 

I also read from Mayo or Cleveland Clinic that are body temperatures are naturally lower in the morning. With most of our employees mainly arriving from 5:00 - 6:00 am, we've seen it.

 

As for temperature varying due to being outside - very much so. I've done my own experiments (taking my own temperature indoors then walking outside around the building and taking it again). This is why if needed we take their temperature in their ear. We also have been taking employees temperatures on their wrist using the infrared thermometer. With people needing to walk outside a little ways to get into the building - this has been a lot more accurate than the forehead.

 

Hi kfromNE,

 

I just googled << how many people with covid-19 show no symptoms ? >> (ie asymptomatic carriers)

 

I was frankly astonished at the info/articles which popped up.

 

Seems that my "substantial" was a major underestimate.

 

Regarding New York, I found this comment -

 

Davidson highlighted the low incidence of fever at hospital presentation as one of the most clinically significant findings from the case series analysis.

Of the 5,700 patients sequentially hospitalized at Northwell Health centers between March 1 and April 4 (median age, 63 years; range, 0-107 years: 39.7% female), just 30.7% were febrile at triage.

Fever is widely considered a first-line benchmark for suspicion of Covid-19, but the observational finding suggests that a high percentage of patients requiring hospitalization may present without this symptom.

“There are many places simply checking for fever, and that’s it,” she said. “We show that not only can you be infected without fever, you can have severe Covid-19 requiring urgent medical care without fever.”

 

https://www.physicia...-with-no-fever/

[TimG]

Yeah, I've read information about the temperature not being a good indicator or overall pretty unreliable. But what's our alternative? Using that daily health screening questionnaire I'd probably have to send myself home for the last 3 weeks. I have pretty bad allergies this time of year which gives me:

A.      Difficulty breathing (not severe)

B.      New or worsening cough

D.    Sore throat (Heck right now it's killing me)

G.    New loss of taste or smell (Although surprisingly I still want to eat! Maybe that's the turning point on this one, If I lose my appetite I should stay home?)

H.    Headache

In the past I've even had a low grade fever (<100F) just from allergies.

 

Like most of the other allergy, sinus infection, or asthma sufferers we are stuck here asking "Is that you 'Rona!?" every time we show some of these very common symptoms.

This is unprecedented and we're all trying to do what's best for our facilities to minimize risk, but until we get reliable testing or something akin to that, a good deal of it is going to be security theater.

[kfromNE]

Yeah, I've read information about the temperature not being a good indicator or overall pretty unreliable. But what's our alternative? Using that daily health screening questionnaire I'd probably have to send myself home for the last 3 weeks. I have pretty bad allergies this time of year which gives me:

A.      Difficulty breathing (not severe)

B.      New or worsening cough

D.    Sore throat (Heck right now it's killing me)

G.    New loss of taste or smell (Although surprisingly I still want to eat! Maybe that's the turning point on this one, If I lose my appetite I should stay home?)

H.    Headache

In the past I've even had a low grade fever (<100F) just from allergies.

 

Like most of the other allergy, sinus infection, or asthma sufferers we are stuck here asking "Is that you 'Rona!?" every time we show some of these very common symptoms.

This is unprecedented and we're all trying to do what's best for our facilities to minimize risk, but until we get reliable testing or something akin to that, a good deal of it is going to be security theater.

Your right, that is what is so crazy about this. I was able to get tested early on since I do have severe allergies (I was negative thankfully). However we had an employee at the facility who I would have bet anything had a sinus infection - classic signs - had been around people who had had recent sinus infections. They went to the doctor and due to where they work - got tested for the virus. It came back positive. The person and us management were dumbfounded. We didn't see it coming. The person didn't have the 'classic' signs.

 

For those of you in the US and able to enjoy the 3 day weekend - enjoy. Because after this week and the weeks I've been having - I need it.

[sbarzee]

Hi Charles C.,

 

I appreciate the feedback. Would you be willing to take a stab at editing the screening questionnaire as you see fit? I welcome any edits that are appropriate. I agree that a 14 day history is not necessary with a daily questionnaire.

 

TimG,

 

You know your own health patterns, but if you don't have a history with allergies and have a sore throat and a new loss of taste or smell. I would ask you to stay home if you don't think it's allergies until your symptoms subsided. We had someone with a sore throat stay home for three days until she felt better. I think that's the kind of game we have to play right now, like it or not.

[sbarzee]

Also, as far as I understand, sneezing is not a symptom of COVID-19, and most of the time neither is a runny nose (except in children), so those symptoms are more related to allergies. This is based on my research from three weeks ago, so it's possible there are new symptoms I'm not aware of.

[Charles.C]

Yeah, I've read information about the temperature not being a good indicator or overall pretty unreliable. But what's our alternative? Using that daily health screening questionnaire I'd probably have to send myself home for the last 3 weeks. I have pretty bad allergies this time of year which gives me:

A.      Difficulty breathing (not severe)

B.      New or worsening cough

D.    Sore throat (Heck right now it's killing me)

G.    New loss of taste or smell (Although surprisingly I still want to eat! Maybe that's the turning point on this one, If I lose my appetite I should stay home?)

H.    Headache

In the past I've even had a low grade fever (<100F) just from allergies.

 

Like most of the other allergy, sinus infection, or asthma sufferers we are stuck here asking "Is that you 'Rona!?" every time we show some of these very common symptoms.

This is unprecedented and we're all trying to do what's best for our facilities to minimize risk, but until we get reliable testing or something akin to that, a good deal of it is going to be security theater.

Hi Tim,

 

Unfortunately decision procedures are (or should be) all about Validation.

 

Based on recent publications I speculate that the asymptomatic level at any given location is anywhere between 0 and 50%.

 

I suggest that one "alternative" (your Post) is to simply assume that any/every worker in the facility may be infected and act accordingly.

 

I enclose 3 inter-related publications which attempt to summarize the current situation -

 

 virus screening.pdf   4.57MB   25 downloads

 unwitting spreaders.pdf   1.84MB   15 downloads

 antibody testing.pdf   1.39MB   14 downloads

 

PS - this item concerning the (US) employer's involvement may also be of some interest -

 

https://www.wilmerha...rs-need-to-know

[Charles.C]

Hi Charles C.,

 

I appreciate the feedback. Would you be willing to take a stab at editing the screening questionnaire as you see fit? I welcome any edits that are appropriate. I agree that a 14 day history is not necessary with a daily questionnaire.

 

Hi sbarzee,

 

Googling << Covid questionnaire(Q) for employee screening >> yields an encyclopedia of (mostly US) examples, typically based on WHO/CDC/FDA's  offerings as discussed elsewhere here.

 

I have browsed through some of the above and selected a few (see QU's) which looked useful to me. Predictably their bases are similar to yr own presentation so you can compare and maybe utilize if interested. There are also 2 example Qs in this parallel thread  -

 

https://www.ifsqn.co...rs/#entry160037

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 COVID, QU1,Employee.pdf   251.99KB   23 downloads

 COVID, QU3,Employee.pdf   248.42KB   19 downloads

 COVID, QU6,Staff,.Checklist and Actions.pdf   141.66KB   30 downloads

 

Comments QU1,3,6

 

(1) First choice (tabular) for Questionnaire = QU1 although a few of the elements are perhaps redundant IMO.

(2) QU3, QU6 are non-tabular, condensed versions of QU1 and suggest some useful consequential actions (also applicable to certain entries in QU1)

(3) Some text may need revision in respect to current local quarantine regulations, etc. I retained the references to 14 days since this is typically associated with viral potency.

 

PS - I also noticed this example (ie Sample 1) with slightly different format which is  perhaps more useful for Visitors.

 

 QU 7 - COVID -19 Health Screening Questionnaire.doc   204KB   22 downloads

[paulam1]

We have a COVID 19 written policy, we have infrared cameras at each time clock upon entrance. We trained all staff to understand the requirements set out by the CDC. We encourage all staff to take temps prior to coming to work as well and stay home if exhibiting any type of symptoms. A handheld infrared thermometer is used as a validation if the infrared detects an above-allowed temperature (100.4°F).
If the temperature is above on 2nd round, the employee is segregated from the work area and sent home, the requirements state they must be free from temperature without using medications for 72 hours before they can return.

All information is documented within HR. There are multiple levels of safety implemented including face masks, shields, increased hand washing, as well as physical barriers. We have staggered lunches and breaks, implemented very intensified hand washing and placed hand sanitizers moderately throughout the facilities. We have floor barriers showing marking for 6 feet distance as well as physical barriers in all break areas.

The biggest concern I am questioning is how this will be seen through audit? All that we can think to do internally is provide a risk assessment, document preventative measures and actions, as well as follow guidelines to the maximum point of protection that is possible.

Edited by Charles.C, 24 May 2020 - 12:33 AM.
formatted slightly