Cost, access kick virus tests out of employers’ measures

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 both their businesses and their employees.

Mass testing, a critical tool to stem the virus’s spread, would appear an obvious solution.

But dogged by issues of cost, access, logistics and employee privacy, tests aren’t part of most back-towork plans. As health-care

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, notes Lauren Vela, senior director for the Pacific Business Group on Health, which represents large employers like Microsoft Corp. and Walmart Inc. If a worker is infected shortly after being tested, it wouldn’t show up but everyone would be falsely reassured by the negative result.

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-toimplement interventions such as temperature checks and symptom screening while also stocking up on masks, hand sanitizer and cleaning wipes. While those measures help, asymptomatic individuals could still transmit the virus.

Health-care startup Buoy Health has been working with employers on covid-19 workplace issues. Only a few are taking an on-site testing approach.

“The cost of the test at scale is pretty prohibitive,” Andrew Le, a physician and Buoy’s chief executive officer, said.

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 each other, noted Kate Shindle, president of the Actors’ Equity Association, 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.

‘NOT IN CONTROL’

Intermountain Regional Landfill in Utah, located about an hour’s drive from Salt Lake City, has made a different calculation. Cases 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,” said Chief Financial Officer Adam

Campbell.

Intermountain processes more than 4 million pounds of waste a day, and operations are easily disrupted even if only a few workers got 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.

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 at a high level and never even touch just missing one day’s worth of having to divert our waste,” Rob Richards, the landfill’s president and general manager, said.

INSURANCE HELP?

At nursing homes and assisted living facilities, testing employees is mandatory for many. But the bill quickly adds up.

Len Russ owns Bayberry Care Center in New Rochelle, New York. 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 still 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 them to cover repeated testing.

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

The Centers for Disease Control and Prevention said on Friday that employers may use testing as part of a comprehensive approach to reducing the virus’s spread at work. But employers, many of whom 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.

Although 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.