Abstract

Background: In the fight against COVID-19, efficient fever screening was essential to curb transmission. Fever served as a cardinal symptom, aiding early and timely identification of fever among healthcare workers (HCWs) was crucial. While non-contact infrared thermometers (NCITs) offered non-invasive screening, existing data gaps were present. This study aimed to assess the NCIT effectiveness in HCW fever screening by comparing results with serology and RT-PCR tests, ascertaining their utility in healthcare settings for COVID-19 detection.

Methods: This prospective observational study was conducted at a dedicated COVID-19 tertiary care hospital with 250 beds in South India. The study population comprised 736 healthcare workers (HCWs) working in the hospital, and the study was carried out between April 2020 and December 2020. Daily fever screening using non-contact infrared thermometers (NCITs) was performed on all HCWs upon their entry to the hospital. Additionally, serological tests were offered to all HCWs starting from November 2020 to assess prior COVID-19 infection exposure. COVID-19 admissions were closely monitored during the study period to identify hospitalized HCWs with symptoms who subsequently tested positive for COVID-19 using RT-PCR.

Results: In this study cohort of 736 HCWs, 44,836 NCIT screenings revealed no fever cases. The serological analysis identified prior COVID-19 exposure in 229 HCWs. McNemar's test (χ² = 26.27, p < 0.05) emphasized discordance between NCIT and serology. ROC analysis yielded an AUC of 0.500, indicating NCIT's challenge in distinguishing febrile cases. Additionally, 68 symptomatic HCWs tested COVID-19 positive through RT-PCR, highlighting the role of complementary diagnostics.

Conclusion: The failure of NCIT to identify fever cases in our study highlights the importance of incorporating supplementary screening methods and comprehensive strategies in future pandemic preparedness.