If I have antibodies to the COVID-19 virus, or if I recovered from the disease, am I protected? These are the two burning questions workers and employers are asking today. The answer, at least from what we know today is bound to be unsatisfying—we don’t know.
Mounting evidence from Italy and elsewhere raises serious unknowns about positive antibody tests for SARS-CoV-2. Not all people who recover from the virus make high levels of antibodies and in some cases, people make no antibodies at all. Even those who do make the antibodies may not make the right ones, the so-called neutralizing antibodies that inactivate the virus in the test tube. In some studies, only 15% of those who tested positive for SARS-CoV-2 antibodies made these neutralizing antibodies. And even among those with the “right” type of antibody, there is a question over how long protection against a new infection might last, or if there is any real protection at all.
All these questions make it difficult for employers to rely on an antibody test, or even successful convalescence, to determine the risk for infection in the workplace. To be sure, anyone who tests positive for an active infection—whether they are symptomatic or not—should be excluded from the workplace. That much is clear. But even someone who tests negative is not necessarily good to return to work, given how many tests fail to detect people who are actually infected and infectious.
The only safe assumption any of us can make as long as COVID-19 is present in our local populations, is to consider everyone is capable of infecting others and that everyone is susceptible to infection.
That means every business must take precautions to avoiding workplace contagion.
Reasonable precautions are:
Measuring the temperature of everyone reporting to work and every person who enters a workplace. That is especially important for consumer facing businesses, such as shops and restaurants. These temperature checks are not just for staff but should also include any customer who may enter the working space.
Requiring everyone within the workplace to wear masks at all times. Removing a mask in a private office risks contaminating others who enter the space for business or cleaning.
Reducing workplace density by creating staggered shifts, encouraging remote work, spacing work stations, and limiting the number of people in the working space, be they staff members, patrons, delivery persons, or otherwise.
Instituting rigorous cleaning procedures designed to reduces workplace exposure and contamination. Ideally the cleaning process and its execution should monitored by an independent agency.
Enforcing the rules to ensure compliance. It is unlikely that all workplaces will agree to institute the necessary precautions. The ability to stay open and to remain in business must depend on compliance. That means local, state and federal guidelines for reopening must be clear. It also means that all workplaces be subject to on the spot inspections. Those who don’t follow the guidelines should face the consequences and should be shut down immediately. Workers and employers should be allowed to file anonymous complaints against companies that are not following health and safety guidelines.
These working conditions will not last forever. Eventually the pandemic will pass, and medicine will triumph. But until then, the only way to counter the disease, reopen our businesses, and resume our vibrant economy is vigilance by all.