The next step is a temperature check. If an employee has a high temperature, the company can conduct a COVID-19 test right on the spot. Employers have access to a dashboard of real-time results, Shulman said, of who can come in, who should stay home and immediate alerts about temperatures.
“All of this data is housed in a separate, secure, HIPAA-compliant medical records system,” he said, warning that companies should be careful with who can see employees’ medical information. “HR really should be the only one who has access to that information.”
The last, and most complicated, component is the COVID-19 testing. Shulman explained that there are PCR tests, antigen tests and antibody tests, which can be done both at “point of care” or at a lab. The PCR test, which uses the long nasal swab, is the “gold standard,” said Shulman, who noted that it’s the best test to see if someone is infected at the moment with COVID-19.
The PCR sample can be tested at either a lab or point of care. For the lab option, Shulman said it’s important for employers to ask what the turnaround time is and to get guarantees.
“A lot of the large labs are taking days, some are 12 days for results,” he said. “At that point, it’s pointless.”
Shulman said one great option is called “pooling,” which is when a lab takes multiple PCR samples and tests them at the same time. He said it’s a good choice for employers who want to do a large number of tests, and tends to be significantly less expensive.
He noted that New York City is opening its own lab specifically to do pooling. With point of care for PCR samples, Shulman said there are three or four tests that are cleared under Emergency Use Authorization by the Food and Drug Administration (FDA). The only roadblock is that only two or three samples can be done per hour for a piece of equipment.
“The logistics don’t necessarily work,” he said.
Another COVID-19 test is the rapid antigen test, which looks for the protein of the virus. That test has between an 84 and 87 percent sensitivity, which is much lower than the PCR test. As a result, there is a higher rate of false-negatives, Shulman said. The MobileHealth CEO said the antigen test is the recommended test for initial screenings of asymptomatic healthy people.
“It’s not perfect, but do not let perfect be the enemy of the good,” he said. “Eighty-seven percent is much better than zero percent.” If someone has a positive antigen test, Shulman noted, that’s when they do a second PCR test with a “true result.” The last COVID-19 test is the antibody test, which Shulman said was “really popular for about two days.” “It’s great if you want to satisfy your own curiosity,” he said. “But from an organizational perspective, I don’t see anybody wanting antibody testing.”
Even if someone has antibodies, he said, it’s still unclear how long that immunity is good for. Shulman added that he anticipates antibody testing will be part of their testing menu sometime down the road. “That’ll be after a vaccine,” he said.