Implementing a COVID-19 testing laboratory at your workplace

The fight against COVID-19 is taking a new turn. There are now more testing solutions today than just a few months ago. Due to the high demand for many services, goods and commodities, a large number of companies and businesses must keep their worksite fully operational while ensuring the health and safety of their employees, contractors, and clients. 

Many companies are now opting to use the newly available and approved RT-PCR testing solutions at their facilities, which shows their commitment and seriousness about the health and safety of their employees, contractors and clients. These solutions offer on-site actionable results much faster than a traditional lab-based test while helping Public Health with positive contact tracing more efficiently.    

As a decision-maker in a company, you understand that testing is the best way to show your colleagues and business partners that you are serious about their safety and keeping a virus-free work environment. Now that you decided to implement testing into the business, what are the next steps in navigating this implementation?

If you are looking at actualizing a testing program or protocol in your business, you most likely already have a screening and cleaning strategy in place. But you want to be more proactive about potential positive case detection than relying only on cleaning and screening methods.

You probably did some research on RT-PCR units and now you are convinced that it would be the best option for testing. You know it effectively and efficiently tests the people that need to come on your premises, get results quickly and be able to react accordingly.

The most crucial part of the implementation process needs to happen before the mobile device is at your site.  If  not done previously, you will now have to establish your relations with your regional Public Health office and develop your testing strategy.

It is critical to inform Public Health about your testing plans because they control COVID testing across all the Canadian provinces. Before buying an RT-PCR machine, make sure that they approve your use the device on your premises since it is outside a recognized medical lab facility. 

You now realize that you must have a proper site to perform testing. The RT-PCR mobile device is small enough to be operated in a very small environment, but it must be clean. The setting should have lots of lighting and be free of clutter. Counters should also be non-porous for easy disinfection. Proper cleaning protocols must be implemented wherever the mobile device is to be used. We will post a blog specifically dedicated to cleaning and disinfecting.

Our testing device is licenced by Health Canada as a Class IV medical device. As such, it must be operated by a licenced lab technician who is trained in handling sample processing to avoid contamination, vial labelling and organization of collected samples, and have experience performing the types of sensitive manipulations involved in executing this test.

Your lab technician will be quite busy preparing the samples, interpreting the results, recording data and maintaining the lab. Also, someone has to give the results back to the donors, which implies time on the phone or computer. It is helpful to enlist a nurse to assist with these duties, as well as to collect the swab samples.

At this point, you have figured out the logistics, and you are happy about the way it looks on paper. You now must think about the most crucial part of your screening program: the testing strategy.

The testing strategy will determine the workload on your lab team, and most importantly, impact your productivity. These are some questions that you will need to answer to have a clear idea of your testing protocol:

  • Who will you test?
  • Which criteria will you use to determine who will be tested?
  • What is the frequency of testing?
  • Is this frequency the same for all people being tested?
  • Do people have to wait to have their results before proceeding to their workspace?
  • If they do have to wait, where will they wait?
  • Will you include contractors in our program?
  • What do we do if we have a positive case?
  • Where will the testing facility be located?
  • If you have a multi-location site, will a fixed testing unit be suitable, or will you need a mobile unit?
  • How will the testing strategy fit into my overall pandemic fighting strategy?
  • At which level do we get Public Health involved in the process?
  • Who will communicate with Public Health?  What are their communication expectations?

Your testing strategy will also determine your budget allocation. The mobile devices have a limited sample processing capacity.  Your testing strategy will dictate the number of devices and personnel you need to meet your testing targets. 

You will also have to prepare to source disposable lab consumables that you will need, based on the number of tests you will perform. These include throat or nasal swabs, viral transfer media, PPE (disposable gloves, masks, etc.), and cleaning agents.

Once you have answered most of these questions, you will then have to figure out a time frame to setup and implement the testing program. With this time frame you will also have to develop a cadence for the frequency of testing andre-testing individuals. This is important because over the first 4 days of infection before typical symptom on-set, the probability of false-negative results in an infected person are very high. On day 1 of the infection the probability of a false-negative is 100%, whereas on day 4 the probability decrease to 67%. Therefore, it is important to create a morefrequent testing strategy for workers who think they may have come into contact with someone who is ill, or for shift workers who spend extended periods of time on-and off-sites, like a mining or oil-drilling site. (Source: Annals of Internal Medicine available at: https://www.acpjournals.org/doi/10.7326/M20-1495)

Setting up and implementing these protocols is not, for most businesses, a simple task.  It will require a dedicated person, preferably with some knowledge of this type of process, to lead the implementation and guide the senior management in their corporate decisions.  At this stage, you have different options. You can DIY or outsource your program to a third party that will manage the entire testing process for you.

Finally, you will have to communicate the enhanced screening process you are putting in place with your employees and stakeholders. It is important to communicate this as soon as possible to ensure they understand that you are implementing a process to create a virus-free workplace.

 All the stakeholders and the senior leadership team must understand that the testing process involving an RT-PCR mobile unit is just one more tool in your screening process to ensure a virus-free environment.  Having an RT-PCR device at your site does not mean that you can let your guard down on the other important pieces of the screening and cleaning/disinfecting strategy that you have in place.

A Virus-Free Environment

As mentioned earlier, this is not an easy process to put in place. However, it is very rewarding to see all the pieces of your screening and cleaning/disinfecting strategy working together seamlessly to prevent positive cases at your workplace.

How do we know it is so rewarding?  Because we have helped many companies achieve their goal of implementing a world-class screening process, and we see how rewarding it has been for them to give their employees a safe environment to work in and peace of mind.

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