Many employers have implemented
protocols to safeguard
employees and customers.
Employees may have their
temperature taken and/or answer questions about potential
symptoms or high-risk behaviors.
These screening practices raise a number of difficult
issues. Do they accurately detect infection? Are some
questions or techniques more accurate? Do they disproportionately
flag some demographic groups, potentially
leading to workplace discrimination?
A recent working paper from the Minneapolis
Fed’s Opportunity & Inclusive
Growth Institute sheds light on these
questions, using results from a nationally
representative survey that asks about
employment status, financial security,
COVID-19 symptoms, health status,
and personal efforts to avoid infection.
The paper’s authors, economists Krista
Ruffini of Georgetown University, Aaron
Sojourner of the University of Minnesota,
and Abigail Wozniak, director of the
Institute, point to drawbacks and benefits
of various forms of screening and
provide guidance on factors employers
should consider when designing workplace
Key considerations for employers
First, workplace screens “will likely
identify many workers as high-risk
on any given day.” Depending on the
screening technique, as many as 7 percent
of workers could be flagged as possibly
How a survey is designed and the number and type of symptoms
that employees are asked about will affect which individuals are
identified as possibly sick. This raises issues of discrimination.
Second, the screening method matters.
How a survey is designed and the
number and type of symptoms that
employees are asked about will affect
which individuals are identified as possibly
sick. This raises issues of discrimination,
since different demographic groups
report symptoms at different rates.
Third, although indirect evidence
suggests that positive screen rates are
higher than actual infection rates, workplace
screens can nonetheless serve “as
an important public health tool.” Positive screens could lead workers to engage in
protective health behaviors that lower
overall disease rates. Moreover, in the
absence of routine medical testing,
screens are likely to be widely used.
KRISTA RUFFINI, Assistant
University McCourt School of
Public Policy (2021); AARON
Professor, Carlson School of
Management, University of
Minnesota; ABIGAIL WOZNIAK,
Director, Opportunity &
Inclusive Growth Institute
Finally, the economists discuss several
points for employers to consider,
including the importance of using methods
that do not inadvertently encourage
misreporting. Also, firms should weight
the choice between screens that provide
higher false negatives with fewer demographic
disparities and those that yield
lower false negatives but more disparities.
Another consideration: The harms
and benefits of particular strategies may
change as local caseloads change.
The COVID Impact Survey
The researchers analyzed data from the
COVID Impact Survey (CIS), a nationally
representative survey conducted
in three waves of roughly 8,000 respondents
each between April and June 2020.
The survey asked individuals about
fever- and COVID-19-related symptoms,
exposure to COVID-19, behaviors
to avoid infection, and labor market
engagement. About half of respondents
provided their current temperature.
From these results, the researchers
develop seven COVID-19 screens,
varying in type and number of symptoms
queried. One screen is a simple
thermometer check of temperatures 99
degrees or higher. Another asks about
COVID-19 symptoms from a 17-item
checklist. Screens differ in detection levels, over time, and for different demographic
One salient finding: “A substantial
share of the workforce would screen
positive under any of the screens,” and
results varied widely among the different
screens. Over half of respondents
said they’d experienced at least one
COVID-19-related symptom that week,
for example, but just 4 percent registered
temperatures of 99 degrees or
higher on a specific day.
Positive rates were fairly level over
time and considerably lower when
screens required two or more symptoms.
These survey results are likely
higher than an actual workplace screen
would find, note the researchers, since
workers may tend to underreport symptoms
fearing loss of jobs (and income)
if they screen positive. Also, many CIS
questions use a week-long look-back
period, while actual screens are for a
Are screens reliable? Do they discriminate?
The wide range of positive results across
the seven screens raises the question
of reliability. After all, the researchers’
data do not include results from a medical
test for COVID-19 infection. Importantly,
no single question or screen
is perfect. And employers should not
rely exclusively on temperature-taking
when screening workers.
Examining whether workplace
screens have disparate demographic
impacts is “crucial,” say the economists.
If a particular screen flags one racial,
ethnic, age, or gender group more often
than another, it may unfairly deprive
those workers of their livelihoods. Yet
if a screen regularly fails to catch infected
workers of a given group, that group
could be exposed to greater probability
The CIS finds that groups do indeed
differ in their rates of measured and
reported symptoms. Women and young
workers are more likely to report elevated
temperature. Non-Hispanic Whites,
women, and young workers are more likely
to report at least two fever symptoms.
Trade-offs and dilemmas
may want to assure
workers that they
won’t lose income
should they be
by a screen.
This paper is the only study to date to
examine U.S. COVID-19 workplace
screening techniques, and its value is
enhanced through the unique information
provided by the nationwide CIS.
It highlights the trade-offs and dilemmas
that employers will face as they
implement workplace screening. Broad
questionnaires will flag high percentages
of employees as potential COVID-19
cases. Requiring more than one reported
symptom for a positive result will permit
more employees to enter the workplace.
But demographic groups report symptoms
at different rates, raising equity
To encourage truthful responses,
employers may want to assure workers
that they won’t lose income should
they be flagged positive by a screen.
And employers should be aware that
screens with higher negative rates have
fewer demographic disparities, and
the converse. Whatever the employer’s
choice, “the design of these screens …
affects how many, and which, workers