By Paul Nicolaus
July 13, 2021 | Employers are testing for COVID-19 at noticeably higher levels in 2021 compared to late 2020, according to findings from a global business survey conducted by Arizona State University's College of Health Solutions and the World Economic Forum, along with support from the Rockefeller Foundation.
Responses came from over 1,100 companies spanning more than 20 industry sectors and over 30 countries. About 75% of those responses came from businesses with 250 or more employees, and 95% of responses came from companies based in the U.S. and U.K.
A report released in April details the results of the survey, which was conducted during the month of March. According to those findings, 68% of employers perform COVID-19 testing for at least some of their workforce. A previous fall 2020 survey, by comparison, found that fewer than 20% of companies were testing any of their employees.
The notion that fewer than 1 in 5 employers were testing in the fall didn’t necessarily come as a surprise, Mara G. Aspinall, professor of practice at Arizona State University’s College of Health Solutions, told Diagnostics World. At that time, tests were difficult to obtain, people didn’t know how to use them, and they were expensive.
By early 2021, however, the landscape had changed and nearly 7 in 10 employers were testing at least some of their workforce. “That is extraordinary,” she said of the jump in testing, and is the area where the most dramatic changes in employer behavior occurred based on their findings.
She and coauthor Nathaniel Wade, a senior director of strategic initiatives at ASU’s College of Health Solutions, attributed the significant growth in testing to various factors. The availability of testing supplies and testing service providers has improved, for example, and there are more companies and labs with EUAs. In addition, all the competition has driven the cost of testing down.
Perhaps most importantly, however, confidence levels among employers have grown along with knowledge about how a testing program can be implemented while minimizing disruption, they noted in the report.
Survey Findings Overview
Of the survey respondents conducting viral testing, over 7 in 10 are doing so at least once a week, with 43% testing once a week and 29% doing so daily. However, some companies indicated they are testing less frequently, such as once a month (13%), twice a month (6%), only when symptomatic (7%), or one time only (1%).
In choosing a testing provider, the quality of the tests stood out as the most important deciding factor, followed by availability and turnaround time. Just 3% of companies who have committed to testing indicated that price was the most critical factor.
Looking ahead, many employers indicated they intend to keep up with or pick up their levels of testing. For example, of those using viral testing, 44% indicated they plan to maintain, and 42% indicated they plan to increase their levels of testing. Similarly, those using antibody testing noted plans to maintain (38%) or increase (48%) testing. By comparison, only about 1 in 10 employers said they planned to make reductions moving forward.
The most common testing sites reported were health testing laboratories, followed by employers' facilities and local/regional hospitals. Other locations used for testing employees included retail pharmacies, academic or university sites, and homes.
The spring 2021 survey responses also shed light on why some have chosen not to test thus far. The top answer pertained to the expense involved. Other notable concerns relate to employee privacy, testing accuracy, liability, and testing availability, among others.
About one-third of the companies that have gone without testing indicated they are uncertain about future testing plans. Another third or so said they do not intend to test their employees.
In addition to testing insights, the report included data on the impact of the coronavirus pandemic on workplace practices such as contract tracing, vaccination, employee wellbeing, pandemic response and preparedness, financial impact, and the future of work.
The underlying aim of the survey series is to see how workplace settings and employers are changing over time, so they were intentionally phased out. Another key thought is that both employers and policymakers need information to make informed decisions about back-to-workplace matters.
Accordingly, the Commons features an interactive data dashboard that allows access to anonymized information from the phase 2 (spring 2021) and phase 1 (fall 2020) surveys. Results from the third survey are expected to be available by the end of September.
"Our goal is to democratize knowledge," said Wade, "and to put things in a publicly available space for people to go to and for them to learn over time and to be involved in that. So we really wanted to form a community where people can engage and learn."
Another goal is to make it possible for employers to share their practices with others in their industry sector, enabling them to learn from each other. "We hope to have a lot more case studies between now and September available online from different companies," he told Diagnostics World.
Additional Diagnostics Commons Efforts
The COVID-19 Workplace Commons from the College of Health Solutions at Arizona State University is designed to tackle the COVID-19 pandemic with information about testing, diagnostics technologies, and strategies for how employers can keep employees safe as the economy reopens.
It is just one branch of the COVID-19 Diagnostics Commons, an initiative first announced about a year ago and envisioned as an interactive hub for the global community to access the latest information about testing options and share knowledge and best practices.
Another feature of the Diagnostics Commons is the COVID-19 Testing Commons, a regularly updated repository containing information about COVID-19 tests on the market and in the pipeline. Intended to help leaders and decision-makers find the tests that most closely match their needs, users can search this tool using various parameters, such as test type, technology, regulatory status, or country of origin.
Beyond the interactive online dashboards for workplace practices and test information, the Diagnostics Commons set out to assist employers and policymakers in “scaling and updating their use of testing strategies as the pandemic continues to evolve” in the form of resources such as webinars.
Before the pandemic, getting together and talking was a common way of sharing knowledge, said Aspinall, but “the pandemic took that away, particularly at the beginning.” So this initiative is about taking back control and “putting power in people’s hands to make educated decisions.”
Early on, there were very few tests, she explained, and there was a desire to know more about those tests that had emerged. As things progressed, though, the explosion of tests that followed sparked an array of questions. How do they work? Which ones are the most effective? Which ones return results quickly?
The Testing Commons was created to simplify the process of determining what tests are available and how they work—and to help users see which ones have been authorized and which ones have been revoked. It became a national and international database of tests both on the market and under development.
“There are three factors here: vaccination, mitigation, confirmation,” Aspinall explained. Vaccination is obvious. Mitigation includes elements such as masks, appropriate distancing, ventilation, and washing hands. And then there’s confirmation.
“The only way you can confirm that the mitigation and vaccination are working is through the confirmation the testing brings,” she said. At this stage of the pandemic, people are attempting to find an appropriate balance between testing and vaccinations.
Recent Trends, Future Efforts
When asked if she has picked up on any workplace testing trends since the release of the April report, Aspinall said she has noticed that employers are getting bolder in recent months, with many indicating they want to see a return to the office setting.
It’s an observation that seems to go hand in hand with the most recent data available. Whereas nearly two-thirds of employers surveyed plan to allow their employees to work from home full time through 2021, more than two-thirds believe workers should be in the office setting at least 20 hours a week. “So it's not as if everyone’s going to stay home forever,” she said.
The result is that “testing is going to happen more frequently,” she predicted. In many cases, this means empowering employees by sending tests that can be handled at home or by giving employees tests in the morning and allowing them to conduct the testing independently. “I think there will be more personal responsibility for tests,” she added.
In the upcoming survey, Aspinall said there’s an interest in getting into some of the subtleties of testing, like how employers are implementing their programs. Another notable aspect is a new category of surveillance testing. “There will be a variety of additional surveillance mechanisms that don't interrupt privacy but are done at a high level,” she explained. “I think that will be one of the key pieces of this next stage of the pandemic.”
Her hunch is that surveillance techniques will be used to pinpoint where testing needs to take place. For instance, if air quality monitoring indicates a potential issue in a particular department, it could be strongly suggested that all employees in that specific department get tested. It’s going to be less about controlling the entire pandemic, she added, and more about controlling outbreaks and taking steps to prevent spread.
As they look ahead to the future of the Workplace Commons, Wade and Aspinall highlighted the Connect to Test tool, developed in collaboration with When To Test and Project N95. It is intended to help businesses and organizations make informed decisions while determining the right COVID-19 tests for their needs.
“It's not theoretical anymore,” Aspinall said. Businesses can buy COVID tests right then and there through a nonprofit.
She also highlighted efforts to tackle the array of testing-related questions that continue to come up. Do antigen tests work? What is the best time to PCR? What kind of testing should we use? “We want a single repository of the data on how well these tests work,” Aspinall said of the Evidence Commons, which is currently in beta testing.
Paul Nicolaus is a freelance writer specializing in science, nature, and health. Learn more at www.nicolauswriting.com.