As businesses reopen, workers are navigating a daily pandemic challenge: getting in the door.
Entryways to businesses — from construction sites to home health care providers — no longer require just the swipe of an identity card.
Questionnaires, temperature scans, social-distance monitoring devices, sanitizing sprays and COVID-19 tests are among the bulwarks in place to safeguard Long Island businesses and their employees.
Precautions aside, experts expect a torrent of lawsuits when employees seek to trace infections to their workplace.
Typical entry questions for workers include: Have you tested positive for COVID-19? Have you experienced a cough, fever, difficulty breathing or loss of taste or smell? In the past 14 days, have you been in contact with someone who has symptoms or tested positive?
"Those questions are asked every single day to every employee," said Mark Gatien, owner and vice president of Community Care Home Health Services.
But the questions may be the least of it. The provider of home health workers, personal care assistants and nurses has 35 administrative employees plus more than 300 field personnel reporting to its Smithtown headquarters and passing through a $17,000 "Sanitizing Station" where their temperature is taken and they go through a mist of disinfecting hypochlorous acid solution.
"It's amazing how this pandemic has turned things around," Gatien said.
Hard hats and face masks
At the construction site of The Wel, a 260-unit apartment project in Lindenhurst, about 140 workers arrive in shifts at 6:30, 7 and 7:30 a.m. to maintain social distancing.
"They line up 6 feet apart when they come in," said James L. Coughlan, principal and co-founder of Tritec Real Estate Company Inc., an East Setauket developer.
Richard "Rick" Parente, president of B&R Mechanical Inc., a Bellport electrical contractor, is among those who go through the screening tent at the site.
"You have to sanitize your hands," he said. "You fill out a form that you didn't have COVID or any symptoms."
After each worker's identity is verified, "they take your temperature every single day you walk onto the property," he said.
Masks have joined hard hats and boots in the uniform of the construction trades, Parente said.
Masks are hot and some workers protested, but he said, it's a matter of survival.
"They don't love to wear them," he said, but "this is the protocol that's here until things change and the CDC [Centers for Disease Control and Prevention] tells us differently," he said. "Everybody needs to work and feed their families."
In addition to the conventional screening and precautions at the $110 million project, Tritec has added a high-tech tracking device that attaches to hard hats.
The devices sound an alert when wearers get too close to each other, but also aid in contact tracing. Should a worker come down with COVID-19 symptoms, a manager can get a report on who they encountered during work hours to limit the potential spread.
"If someone does become sick, we can look back at where they were and who they were near," Coughlan said.
These days, even clients have their temperatures taken and their hands sanitized at Red Hots Spa in Roslyn, said co-owner Josephine Noto.
When the 19 workers arrive at the provider of massages, facials, waxing and airbrush tanning, they have their temperatures taken, too. Throughout the day, they wear face masks and shields.
"So far, everybody feels safe," Noto said.
At institutions dealing with at-risk populations, basic screening tools may not be enough. At Gurwin Jewish Nursing and Rehabilitation Center in Commack, the 1,200 employees submit to weekly tests for the COVID-19 virus at a cost of $100 per test.
While some Long Island companies are navigating the employee screening protocols by themselves, others are seeking an experienced hand.
Nicholas Stefanizzi, chief executive of Northwell Direct, a new for-profit arm of Northwell Health, said "a groundswell of companies" have sought advice.
The response was at least in part related to Northwell's high profile in battling the pandemic, he said.
At the time that Northwell Direct was launched in May, he said, its parent had provided care to more COVID-19 patients than any health care system in the country.
The Northwell Direct venture provides an array of services, from flu shots to wellness programs, but COVID-19 services have become its marquee offering.
Virus-related services for businesses include consulting, on-site testing and virtual and telehealth programs.
One service provides guidance for employees who are adrift after being barred from the workplace because they were exposed to the virus.
The employees are advised to call a Northwell contact center. There they can get advice on scheduling a test or, if they test positive, a counselor who will follow their case for two to four weeks.
Stefanizzi said Northwell Direct is in talks with partners to offer its services in markets beyond the metro area and is planning to roll out symptom-tracking apps for smartphones and web browsers.
Northwell's software offering will compete against another Long Island product launched last month by a unit of Melville-based Canon USA Inc.
Canon is marketing Check-In Online, a cloud-based and encrypted questionnaire that employees or outsiders fill out before gaining clearance to access a facility.
Meanwhile, Ronkonkoma-based Soter Technologies LLC has developed a walk-through screening device for workplaces or high-volume sites like arenas, stadiums and mass-transit hubs.
The SymptomSense scanner can rapidly check the temperature, respiration rate and blood oxygen level of hundreds of people an hour, according to chief executive Derek Peterson.
Another Long Island company, Bay Shore-based Advance Convergence Group Inc., is marketing a temperature detection camera being used by RXR Realty in 35 buildings, CEO David Antar said.
Lt. Gen. Paul K. Carlton Jr., former surgeon general of the U.S. Air Force and an adviser to Soter Technologies, said many businesses are navigating in the dark when it comes to screening employees, because the science surrounding COVID-19 is evolving.
"There's so much we don't know," he said.
That knowledge gap suggests that businesses should try to layer multiple indicators when screening employees, to improve the odds of accurately detecting COVID-19, Carlton said.
For instance, if a person is given a questionnaire and is tested for blood-oxygen level, pulse rate, respiratory rate and temperature, the chances of identifying a case of the coronavirus are greater than with just a temperature scan and a questionnaire, he said.
"You might as well flip a coin," he said of two-factor screening. "I don't think there are one or two measurements that are reliable...You have to collate a bunch of things."
The nature of the virus itself makes it elusive. COVID-19 can incubate within a person for as long as 14 days before symptoms appear, according to the CDC website.
That means a pre-symptomatic victim could harbor — and potentially spread — the virus for days.
Once they appear, the symptoms themselves can vary. Fever is the most common, followed by a cough, fatigue, loss of appetite and shortness of breath, according to the CDC.
Natalia Shuman, CEO of Bureau Veritas North America, a hygiene and testing company whose parent is based in Neuilly-sur-Seine, France, acknowledged that not every person with COVID-19 runs a fever. Temperature checks are more reliable when paired with other diagnostic tools, she said.
In New York State, employee screening requirements vary by business and over time.
Restaurants and offices are required to question employees about symptoms and COVID-19 exposure, but temperature scans are not mandatory.
Personal care businesses like spas were required to test employees for COVID-19 every 14 days while the region was in Phase 3 of the state's reopening plan, but that requirement was dropped in Phase 4.
While businesses are mandated to provide screening, new legal, financial and medical issues related to screening and other COVID-19 issues in the workplace are beginning to percolate.
Kevin Law, CEO of the Long Island Association business group, forecast in a June 10 Newsday webinar that courts will be swamped by pandemic-related filings.
"I guarantee there will be a flood of litigation" from employees and customers, he said.
One national poll of 504 employed voters found that more than one-third of Americans living in the Northeast said they would sue their company over COVID-19 exposure, even if the employer followed "every protocol to sanitize the premises, maintain social distancing, require face masks and conduct COVID-19 testing." The poll, conducted in May, was produced by Engagious, Sports and Leisure Research Group and ROKK Solutions.
Last Sunday, President Donald Trump told Fox News that he backs efforts by Senate Republicans to immunize businesses from COVID-19 liability to workers and consumers.
Some states including Arkansas, Louisiana, Kansas, Oklahoma, North Carolina, Wyoming and Utah have passed their own bills shielding businesses from virus-related lawsuits.
Law said that though legislation is being considered in Albany, a bill providing unqualified protection would be a mistake.
"You don't want to provide immunity to businesses that are not taking any steps," he said. "You don't want to give a...get out of jail card to companies that are not interested in complying."
Health care professionals and facilities, however, were granted qualified immunity in all but the most egregious malpractice cases in April when the New York State Legislature passed the Emergency Disaster Treatment Protection Act.
Last week, the Legislature passed a bill that would roll back part of that immunity; Gov. Andrew Cuomo hasn’t said if he will sign it.
Michael Schmidt, labor and employment attorney with Philadelphia-based Cozen O'Connor, said screening practices inevitably will lead to claims by employees.
Among the issues are whether companies are maintaining confidentiality and whether they are screening for issues that go beyond the specifications of the CDC and the state Department of Health.
"You're already seeing hundreds of cases on employment issues around the country," Schmidt said.
Douglas Rowe, employment law partner at Certilman Balin in East Meadow, said any legal claims by employees related to COVID-19 would face challenges related to causation.
"If it could be proven the employee contracted coronavirus in the workplace, there would be coverage of wages and expenses," he said.
Once a vaccine is developed, Rowe said employers could require workers to get inoculated, though they might have to make exceptions for people with disabilities or religious objections.
And at some companies that prized selflessness, a cultural fix is in order, said Janet Lenaghan, professor of management and dean of the Zarb School of Business at Hofstra University.
"Heroic" employees who showed up at work even when they were sick will have to temper their gung-ho spirit, she said, and "employers will need to create a psychological and emotional feeling of safety."
The workplace questions extend into the ethical sphere.
Nancy Berlinger, research scholar at The Hastings Center, a bioethics research institute in upstate Garrison, said getting people back to work requires some forethought.
"The big ethical challenge is how should employers create and support safe work conditions during a continuing health emergency," she said.
For employers, however, the ability to create a secure environment may be limited by testing technology itself.
Dr. Anthony Harris, chief innovation officer and medical director at Anaheim, California-based WorkCare, which is consulting with businesses as they reopen, said its policy calls for administering viral tests to all workers of companies in locations that saw major outbreaks.
Even viral tests for COVID-19, however, are not foolproof, Harris said, in part because of "genetic drift" in which the virus mutates and tests become less accurate.
Conscientious screening may not be guaranteed to halt the spread of COVID-19 in the workplace, but employers still will have to make their best effort, Rowe said.
"All employers can do is try in good faith to keep the workplace as safe as possible," he said. "There's nothing foolproof."
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