COVID-19 testing has vexed health officials andpoliticians since March. Federal and state leaders have bickeredover whether supplies of tests are adequate. (Photo:Shutterstock)

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Just a few miles from Disney World, Harris Rosen's hotel empireis mostly closed because of the COVID pandemic.

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One crucial condition for reopening will be testing any of his4,000 employees who show potential signs of having the disease, hesaid.

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Since March, the company has tested more than 500 workers at itsemployee health clinic and its impromptu drive-thru site inOrlando, Florida. Sixteen were confirmed cases of COVID-19.

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Related: Latest sticking point in COVID-19 relieflegislation: Indemnity for employers

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When Rosen Hotels & Resorts, which comprises eight hotelswith nearly 7,000 rooms in the Orlando area, reopens later thisspring or summer, it plans to have employees regularly fill out aquestionnaire about their health and travel history. All employeeswill get their temperature taken when they arrive, and those withfevers above 99°F will not be allowed on the worksite. Rosen isstill working out details of its strategy, but it also plans togive workers with a fever and other COVID-19 symptoms a diagnostictest for the virus.

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The Rosen chain is ahead of many businesses still weighingoptions for reopening. That's partly because since 1991 it hasprovided medical care to workers through its employee healthclinic.

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"Companies are asking what is necessary to reopen businessessafely, and they see testing as one of the key things," saidStephen Ezeji-Okoye, chief medical officer of Crossover Health,which manages worksite health clinics.

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Across the U.S., and across industries, companies have closedtheir worksites for the past month or so, or operated atsignificantly reduced capacity. Meat-processing plants in theMidwest have been closed because tight workspaces helped spuroutbreaks, nursing homes across the country have seen deaths amongstaff members needed to care for ailing residents, and flightattendants report increasing cases of the disease.

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Now, as half of the states begin the delicate task of liftingstay-at-home orders and allowing businesses to reopen, Rosen is oneof many employers being thrust into the debate about how to keepemployees and customers safe.

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Some employers say testing and screening can help reduce diseasetransmissions and workers' fears.

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"Employers are tremendously interested in testing because theywant to make sure their workplaces are as safe as possible," saidDr. Jeff Levin-Scherz, a national co-leader of Willis TowersWatson, a consulting firm. "Testing needs to be a component of away to reduce the risk, but it's not the entire strategy."

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Yet COVID-19 testing has vexed health officials and politicianssince March. Federal and state leaders have bickered over whethersupplies of tests are adequate.

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Rosen Hotels & Resorts, however, says it does not anticipateany problems securing test kits. While there are still parts of thecountry with a paucity of testing, central Florida is not one ofthem. The Orlando area has at least two dozen testing sites, and Gov. Ron DeSantis said duringa meeting at the White House last week, "Our ability to testexceeds the current demand."

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For many companies, however, moving toward a testing program ismuch less certain.

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"It's a difficult time for employers trying their best toprotect employees," said Dr. Mohannad Kusti, corporate medicaldirector of Pittsburgh-based U.S. Steel Corp. The company hopes todecide this month whether to start testing its roughly 18,000employees at locations in Pennsylvania, Indiana, Alabama and otherstates.

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Kusti said testing isn't perfect but could add to the arsenal ofweapons against the virus, which include requiring workers to weargloves and face masks and increasing social distancing whenapplicable.

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The company has hesitated to start testing partly because of alack of tests and concerns over accuracy, he said.

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In Nevada, Wynn Resorts, which owns two large hotels in LasVegas, is partnering with University Medical Center of SouthernNevada to provide free testing to all its Las Vegas employees,either at the workplace or a hospital-designated site.

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"This will ensure that Wynn employees that would like to betested will have access to reliable and accurate COVID-19 testingwell in advance and leading up to the opening of the resort," Wynnsaid in a statement.

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'Uncharted waters'

Employers with on-site health clinics are best positioned totest because they likely have access to the supplies and theproviders needed to administer them, said Mike Thompson, CEO of theNational Alliance of Healthcare Purchaser Coalitions.

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For example, earlier this year Microsoft began a testing programfor workers at its Redmond, Washington, headquarters. Intel Corp.said it is looking into the issue but has not decided how toproceed. Amazon said it is setting up a system of labs to begintesting its workers across the country.

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"Regular testing on a global scale, across all industries, wouldboth help keep people safe and help get the economy back up andrunning," Amazon CEO Jeff Bezos wrote in a recent shareholderletter.

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San Francisco recently partnered with a private genomics testingcompany, Color, to provide COVID-19 testing to any city employees,contractors and other "essential" workers with symptoms of thedisease.

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"The reality is we are all in uncharted waters," said Color CEOOthman Laraki. Employers want to offer testing to help theirworkers and customers they serve feel more secure, he said.

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About one-third of employers surveyed by the Pacific BusinessGroup on Health in April said they are testing employees at or nearthe workplace or considering it.

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Some experts, however, question whether such efforts will make adifference.

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Dr. Jamal Hakim, chief operating officer at Orlando Health, alarge hospital system in the Florida city, said he doesn't seeemployer testing as a panacea. A more effective strategy, hesuggested, would be making sure that employees stay home if theyhave any COVID symptoms, such as fever and dry cough, and that theywash hands often and don't touch their face.

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"Those behavior modifications will dwarf testing in terms ofimportance going forward," Hakim said.

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Part of the challenge with testing is someone newly infected maynot show a positive result for several days. Someone can also getinfected following the test. It also takes at least a day to getresults back, giving the virus more time to spread unchecked.

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New EEOC guidance

Employers are generally not allowed to inquire about workers' medicalconditions. But the Equal Employment Opportunity Commission, thefederal agency that enforces workplace civil rights laws, issuednew rules in April permitting employers to test for COVID-19 asa condition of entering the workplace. The one caveat is thatemployers must test all employees, or, if only certain employeesare selected for testing, the employer must have a reasonablereason for doing so — such as testing employees who exhibitpersistent coughs or other symptoms associated with thedisease.

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Despite the drawbacks of testing, many major employers aremoving forward in an effort to keep workers safe.

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St. Louis-based Watlow, a global manufacturer of thermalproducts with 1,600 U.S. employees, this month began testingworkers who believe they may have been exposed to people withCOVID-19, as well as workers who are traveling to its Mexico plant,to see if they have the virus or previously had it and now haveantibodies for the disease. In addition, the temperatures of allemployees are taken when they arrive for work, and anyone above99.2°F is sent home. Employees wear masks on the job, and barrierswere installed between some workstations to promote socialdistancing.

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As of May 6, Watlow has tested fewer than a dozen people at itsonsite health clinic, said Sheryl Hicks, vice president of humanresources. The company is weighing whether it can or should testeveryone.

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"We are learning as we go," Hicks said. "There is a cost tothese things, but if it gives us more information to keep peoplesafe or provide a safer environment for folks, then that is notnecessarily a bad thing."

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Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

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Read more: 

• Returning to the workplace: Navigating the legalobstacles
• COVID-19 return to work testing: guidance forbrokers and employers
• Return to work: Mitigating the risk of COVID-19 inthe workplace