COVID swap being inserted into vial But dogged by issues of cost, access, logistics andemployee privacy, tests aren't part of most back-to-workplans.(Photo: Shutterstock)

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(Bloomberg) –From nursing homes in New York and a landfill inUtah to Disney World and the Las Vegas Strip, employers arewrestling with workplace safety in the age of Covid-19 and makingfraught calculations about how to safeguard both their businessesand their employees. Mass testing, a critical tool to stem thevirus's spread, would appear an obvious solution.

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But dogged by issues of cost — diagnostic tests start at around$100 each — access, logistics and employee privacy, tests aren'tpart of most back-to-work plans. As health-care companies that workwith employers in this capacity are fond of saying, there's nosilver bullet.

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Another major deterrent is that Covid-19 tests only measure thatpoint in time, notes Lauren Vela, senior director for the PacificBusiness Group on Health, which represents large employers likeMicrosoft Corp. and Walmart Inc. If a worker is infected shortlyafter being tested, it wouldn't show up but everyone would befalsely reassured by the negative result.

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Related: Insurers not required to pay for mandatory employerCOVID-19 tests, HHS says

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Testing is "not really available, feasible or easy, and it's nota solution you can do for every employee, every day," Velasaid.

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So instead employers are favoring lower-cost,easier-to-implement interventions like temperature checks andsymptom screening while also stocking up on masks, hand sanitizerand cleaning wipes. While those measures help, asymptomaticindividuals could still transmit the virus.

Return to work graph

Health-care startup Buoy Health has been working with employerson Covid workplace issues. Only a few are taking an on-site testingapproach.

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"The cost of the test at scale is pretty prohibitive," ChiefExecutive Officer Andrew Le said.

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

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Performers sing, dance and hand things to each other, noted KateShindle, president of the Actors' Equity Association, the unionthat represents cast members at Broadway shows and Disney's Floridaresorts.

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"There's lot of people who can do their work when they'rewearing a mask and gloves. Our people can't do that," Shindle saidin an interview. "It's just very important to our membership, whootherwise is overwhelmingly eager to get back to work."

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In a June 24 letter to its unions in California, Disney said itdoesn't think testing is a good idea, citing a high rate of falsenegatives 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 andsanitization.

'Not in control'

Intermountain Regional Landfill in Utah, located about an hour'sdrive from Salt Lake City, has made a different calculation. Casesin the state have surged in recent weeks and an employee recentlyhad to stay home for three days because of a potential exposurethrough a family member who ended up testing negative.

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That was "not only cumbersome and a loss of productivity, butreally frustrating to know we're not in control of it," said ChiefFinancial Officer Adam Campbell.

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Intermountain processes over four million pounds of waste a dayand operations are easily disrupted even if only a few workers gotsick. In the worst-case scenario, should infection hit all 15employees and force a total work suspension, the business wouldface estimated losses of about $20,000 a day.

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

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"We could be testing for years at a high level and never eventouch 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, which ananalysis by the Foundation for Research on Equal Opportunity foundaccount for 45% of virus deaths in the U.S., testing employees ismandatory for many. But the bill quickly adds up.

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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 leastsix sick employees, but Russ is still waiting to see how to coverthe $100,000 tab. The lab that processed the tests will try billingemployees' insurance, though Russ said he doesn't expect them tocover repeat testing.

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Keene Valley Neighborhood House, an assisted living facility inupstate New York, has had success billing insurance, according toexecutive director Richard Rothstein. But employers are ultimatelylikely to bear these costs themselves through higher premiums.

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Employers, many of whom are already facing massive losses fromshutdowns, often find the cost doesn't make sense. Antigen testing,which screens for active infections and provides rapid and cheapresults, has promise but is only beginning to come to market.

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Although antibody tests, which screen for past infections andare easier for labs to scale up, seemed like a solution, it isn'tclear what sort of immunity antibodies grant. And after the Centersfor Disease Control and Prevention said antibody tests shouldn't beused in deciding to send people back to work, the Equal EmploymentOpportunity Commission issued a statement telling employers theycan't require the tests. Diagnostic tests for current infectionsare permitted.

Cost and privacy shart

South of Los Angeles, EB Design builds decorative interiors forhotels and high-end restaurants, a group that was "basicallydecimated" during shutdowns, owner Eric Beneker said. He decided totest his 20 employees biweekly to ensure their safety, but couldn'tfind information or resources on how to do it.

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The company ended up booking appointments through facilities setup by local governments. It's been time-consuming, though, as therewere few open slots and long turnaround times. And they had tomislead the sites to get in because individuals have to besymptomatic to get tested.

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"Is it the honest thing to do?" Beneker said. "Probably not, butwe don't have any other choice, and we're not given any otherchoice."

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In May, two employees tested positive and EB Design closed down.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 outneither had Covid-19. Could the company field that kind of billregularly? "Hell no," Beneker said.

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"The problem is we're so far down the road here with reopeningof the economy," he said. "While we're trying, and we're doing ourbest, we're not getting the tools" needed to help.

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Logistical challenges abound — results often take days or over aweek to come in, supplies continue to be limited — but privacyissues often weigh as heavily.

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Suffolk Construction partners with Buoy Health on its workplacesafety plan. A testing facility is available as needed, but thebuilder isn't implementing mass screenings, Executive VicePresident Alex Hall said, citing privacy concerns and the limitedusefulness of the results.

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"We get it. There's an element of Big Brother around thissituation anyway," Hall said. "We want to be mindful of how peopleare feeling."

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

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Managers, unions and other business leaders created a programwith a hospital to test workers at the convention center. But itisn't mandatory, according to Bethany Khan, a spokesperson for theCulinary Workers Union Local 226, which represents casinoemployees.

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While Caesars Entertainment Corp. has made testing mandatoryafter a worker died from the virus in June, others haven't. Khansaid the union is pushing for regular testing and on Monday, itsued Harrah's hotel, operated by Caesars, and MGM ResortsInternational's Bellagio for not adequately protecting workers.

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MGM said it's working with health-care professionals to developsafety protocols, including mandatory testing for anyone withsymptoms or exposure, as well as free ones for anyone who wants atest. "Nothing is more important to us than the safety of everyoneinside of our properties," the company said.

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

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"It was three months that we did social distancing, that we didlockdown in Las Vegas," Sixto Zermeno said. "I go back to work,three days later I'm sick on the fourth day."

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