Recommendations for screening tools used as part of COVID-19 health surveillance for health workers

Abstract

BACKGROUND : The coronavirus disease 2019 (COVID-19) pandemic has created the need for electronic screening tools for occupational health surveillance in South Africa. This is to ensure that the surveillance systems pick up symptomatic COVID-19 suspected cases early so that testing can be carried out, and cases isolated expeditiously, to facilitate control of transmission. Electronic screening tools are being used as part of the decision-making process to support referral for testing. The screening tools consist of a brief history and questions about selected signs and symptoms. OBJECTIVE : To make recommendations on the choice of signs and symptoms and the numerical score that should be attached to each, in a screening tool. METHODS : A rapid review of open source COVID-19 literature was undertaken to identify commonly reported presenting signs and symptoms of COVID-19 in healthcare workers. RESULTS : The literature reviewed supported the recommendation that each of the six symptoms of cough, fever, sore throat, shortness of breath, fatigue and myalgia be prioritised in a screening tool, and provided a basis for assigning a predictive numerical score. A numerical score can be allocated to each sign or symptom based on its frequency of occurrence in cases diagnosed with COVID-19, and used in conjunction with personal and occupational risk ratings. The higher the cumulative score, the more likely that a healthcare worker has COVID-19 and requires urgent follow-up for appropriate evaluation and testing. CONCLUSION : A screening tool using a scoring system for COVID-19 health surveillance could support persons working in the field of occupational health with decision making on whether to test an employee for COVID-19.