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Employers balk at frequent COVID-19 tests for workers. Here’s why

A nurse at a COVID-19 testing site adjusts her goggles
A nurse adjusts her safety goggles while working at a COVID-19 testing site in Texas this spring.
(David J. Phillip / Associated Press)

From nursing homes in New York and a landfill in Utah to Disney World and the Las Vegas Strip, employers are wrestling with workplace safety in the age of COVID-19 and making fraught calculations about how to safeguard their businesses and their employees.

Mass testing, a crucial tool to stem the virus’ spread, seems like an obvious solution.

But because of issues of cost — diagnostic tests start at around $100 each — access, logistics and employee privacy, testing isn’t part of most back-to-work plans. As healthcare companies that work with employers in this capacity are fond of saying, there’s no silver bullet.

Another major deterrent is that COVID-19 tests measure only that point in time, said Lauren Vela, senior director for the Pacific Business Group on Health, which represents large employers such as Microsoft Corp. and Walmart Inc. If a worker is infected shortly after being tested, the test wouldn’t detect it and everyone would be falsely reassured by the negative result.

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Testing is “not really available, feasible or easy, and it’s not a solution you can do for every employee, every day,” Vela said.

So instead employers are favoring lower-cost, easier-to-implement interventions such as temperature checks and symptom screening while also stocking up on masks, hand sanitizer and cleaning wipes. Those measures help, but people without symptoms can still transmit the virus.

Healthcare start-up Buoy Health has been working with employers on coronavirus workplace issues. Only a few opt for on-site testing. “The cost of the test at scale is pretty prohibitive,” said Chief Executive Andrew Le, a physician.

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But at Walt Disney Co. theme parks, actors working the live shows are demanding screenings before they return.

Performers sing, dance and hand things to one another, noted Kate Shindle, president of the Actors’ Equity Assn., the union that represents cast members at Broadway shows and Disney’s Florida resorts.

“There’s lot of people who can do their work when they’re wearing a mask and gloves. Our people can’t do that,” Shindle said in an interview. “It’s just very important to our membership, who otherwise is overwhelmingly eager to get back to work.”

In a June 24 letter to its unions in California, Disney said it doesn’t think testing is a good idea, citing a high rate of false negatives and concerns that it creates “a false sense of security,” among other factors. Instead, it’s focusing on physical distancing, wearing effective face coverings, hand washing and sanitization.

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Disneyland and California Adventure’s reopening is delayed as Disney waits for California coronavirus reopening guidelines. Its Anaheim hotels’ reopening is also delayed.

Intermountain Regional Landfill in Utah, about an hour’s drive from Salt Lake City, has made a different calculation. Case counts in the state have surged in recent weeks and an employee recently had to stay home for three days because of a potential exposure through a family member who ended up testing negative.

That was “not only cumbersome and a loss of productivity, but really frustrating to know we’re not in control of it,” Chief Financial Officer Adam Campbell said.

Intermountain processes more than 4 million pounds of waste a day, and operations are easily disrupted even if only a few workers get sick. In the worst-case scenario, should infection hit all 15 employees and force a total work suspension, the business would face estimated losses of about $20,000 a day.

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So Intermountain decided to test its workforce. It’s working with Atlas ID, a software company that had focused on employment verification systems before the pandemic, to work out how often to test and in which scenarios. It’ll cost about $2,000 a round.

“We could be testing for years ... and never even touch just missing one day’s worth of having to divert our waste,” said Rob Richards, the landfill’s president and general manager.

At nursing homes and assisted living facilities, which an analysis by the Foundation for Research on Equal Opportunity found account for 45% of coronavirus deaths in the U.S., testing employees is mandatory for many. But the cost quickly adds up.

Len Russ owns Bayberry Care Center in New Rochelle, N.Y. His roughly 100 employees were tested twice a week for five weeks, at a cost of $20,000 a week. The screening did identify at least six sick employees, but Russ is waiting to see how to cover the $100,000 tab. The lab that processed the tests will try billing employees’ insurance, though Russ said he doesn’t expect the insurers to cover repeat testing.

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Keene Valley Neighborhood House, an assisted living facility in upstate New York, has had success billing insurance, said executive director Richard Rothstein. Yet employers are ultimately likely to bear these costs themselves through higher premiums.

The U.S. Centers for Disease Control and Prevention said last week that employers may use testing as part of a comprehensive approach to reducing the virus’ spread at work. But employers, many of which are already facing massive losses from shutdowns, often find the cost doesn’t make sense. Antigen testing, which screens for active infections and provides rapid and cheap results, has promise but is only beginning to come to market.

Separately, antibody tests, which screen for past infections and are easier for labs to scale up, seemed like a solution, it isn’t clear what sort of immunity antibodies grant. And after the CDC said antibody tests shouldn’t be used in deciding to send people back to work, the Equal Employment Opportunity Commission issued a statement telling employers they can’t require the tests. Diagnostic tests for current infections are permitted.

EB Design in Paramount builds decorative interiors for hotels and high-end restaurants in the L.A. area. Owner Eric Beneker said he decided to test his 20 employees biweekly to ensure their safety, but he couldn’t find information on how to do it.

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The company ended up booking appointments through facilities set up by local governments; it has encountered few open slots and long turnaround times. And they had to mislead the sites to get in because at that time, people had to be symptomatic to get tested.

“Is it the honest thing to do?” Beneker said. “Probably not, but we don’t have any other choice, and we’re not given any other choice.”

In May, two employees tested positive and EB Design closed. The company paid a private lab to re-test everyone. It cost about $3,000 total, around 10% of the company’s payroll. It turned out neither worker had COVID-19. Could the company foot that kind of bill regularly? “Hell, no,” Beneker said.

“The problem is we’re so far down the road here with reopening of the economy,” he said. “While we’re trying, and we’re doing our best, we’re not getting the tools” needed to help.

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Logistical challenges abound — results often take days or over a week to come in, and supplies continue to be limited — but privacy issues often weigh heavily too.

Suffolk Construction partners with Buoy Health on its workplace safety plan. A testing facility is available as needed, but the builder isn’t implementing mass screenings, Executive Vice President Alex Hall said, citing privacy concerns and the limited usefulness of the results.

“We get it. There’s an element of Big Brother around this situation anyway,” Hall said. “We want to be mindful of how people are feeling.”

The battle is also playing out in Vegas, where cases have surged since casinos began reopening last month.

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Managers, unions and other business leaders created a program with a hospital to test workers at the convention center. But it isn’t mandatory, according to Bethany Khan, a spokesperson for the Culinary Workers Union Local 226, which represents casino employees.

While Caesars Entertainment Corp. has made testing mandatory after a worker died from the virus in June, others haven’t. Khan said the union is pushing for regular testing and on Monday, it sued Harrah’s hotel, operated by Caesars, and MGM Resorts International’s Bellagio, accusing the companies of not adequately protecting workers.

MGM said it’s working with healthcare professionals to develop safety protocols, including mandatory testing for anyone with symptoms or exposure, as well as free tests for anyone who wants one. “Nothing is more important to us than the safety of everyone inside of our properties,” the company said.

At a news conference last week, a bellman at The Signature at MGM Grand hotel spoke about falling ill in June.

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“It was three months that we did social distancing, that we did lockdown in Las Vegas,” Sixto Zermeno said. “I go back to work, three days later I’m sick.”

Court, Palmeri and LaVito write for Bloomberg.


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