Which temperature screening method is right for your company?

For many, having your temperature taken reminds you of being sick at home from school. You're sitting in front of the TV with endless cartoons and mom’s chicken noodle soup. Today, it means something very different. It’s becoming a new way of life. As businesses reopen across the country, the CDC has recommended that employers use temperature screening to help slow the spread of COVID-19. Their guidelines specify to measure the employee’s temperature before they start work or enter the facility. Because of this, businesses are implementing temperature screenings to protect their employees, including using handheld thermometers and thermal cameras. But which method makes more sense for your business? What are the pros and cons of each method? In this blog, we’ll look at the benefits and limitations of both temperature screening methods. Read on to see which may prove to be more cost-effective for your company.

Why temperature screening?

First, let’s dive into why temperature screening has become so important. Fevers are one of the few detectable symptoms of COVID-19. In a recent survey, the CDC discovered 80% of people infected with COVID-19 had a fever. This makes temperature screening one measure that businesses can take to identify people who may be infected and slow the spread of the virus. But temperature screening alone isn’t the answer. It should be one part of a more comprehensive plan to keep your employees and visitors safe. Other key protocols to safeguard your team include contact tracing, social distancing, and employee screening.

The two methods of temperature screening

There are two methods to screen for temperature: handheld thermometers and thermal cameras.

1. Handheld thermometers are small devices that use infrared to measure someone’s body temperature. These thermometers need an operator to hold the device and point it at the person’s forehead from a distance of one to four feet.
2. Thermal cameras, also called thermal imaging systems, are devices that measure someone’s body temperature by detecting their face and looking at the tear ducts of the eyes. This is from a camera positioned 6-15 feet away. Thermal cameras do not need an operator, except to set up the device away from reflective backgrounds and out of direct sunlight.

How thermal imaging systems work

Handheld thermometers are straightforward to use and only require a device and someone to screen temperatures. Thermal cameras are more complex. They consist of more components that must be set up in the entryway of a building. This includes:

• An infrared camera that detects body temperature
• A visual camera that guides the infrared camera to identify the face and eyes
• A heat source reference point (HSRP) that holds a constant temperature for accuracy
• A computer system that contains the software and sends alerts when applicable
• And other small components to help the system function

This may seem more convoluted than handheld thermometers, but most systems are ‘plug and play’ to set up and frictionless to use after that.Although thermal cameras differ across the industry, here’s how most work: a person walks through an entryway and looks at the camera. Each person must walk through one-by-one. The thermal camera calculates a person’s temperature relative to the HSRP by measuring the tear ducts as well as the entire face. After the system measures their temperature, an audible or visual alert indicates whether they have a high or normal temperature. If elevated, the system can send another alert to the right people on your team. This exact method varies based on the thermal imaging system you use, but this is how Athena works. Thermal imaging systems work well because they’re highly accurate. The HSRP acts as a ‘true North’ to help get the most precise measurement. While a basic handheld thermometer has an accuracy of ± 3.5 °F, a thermal imaging system with an HSRP has an accuracy of ± 0.55 °F. This makes it significantly more reliable than a handheld device. Both methods of temperature screening can be effective, but what are the advantages and disadvantages of each?

The pros and cons of handheld thermometers

Handheld thermometers are popular for a reason: they’re inexpensive and fairly accurate if used properly. Most range in price from $20-$80 on the cheaper end, to $100-$1,000 for more expensive name brands. The benefits of using handheld thermometers according to the FDA include:

• They quickly measure and display a person’s temperature
• They can quickly retake a person’s temperature if needed
• They’re easy to use, clean, and disinfect

But using handheld thermometers comes with limitations. And the drawbacks can be consequential. They’re often unreliable, not because of the device itself, but because of the operator misusing it. The New York Times published an article on handheld thermometers in which specialists claim that most operators hold them too far from or too close to the subject. This results in temperature measurements that are either too hot or too cold. They also put the person who is taking the temperature at risk of infection because they need to stand one to four feet from the subject. That doesn’t meet the CDC’s social distancing guidelines of at least six feet. The FDA claims that this close contact can present a risk of spreading the disease. Handheld thermometers can be inefficient. They require someone on staff to measure temperatures one-at-a-time and clean the equipment after each use. This can create a bottleneck for employees as they enter the building and go to work. Finally, while handheld thermometers may seem inexpensive, they come with some hidden costs. If your company wants to bring in healthcare workers or use an employee to screen for temperatures, the cost increases. Not only do you have to pay for their time, but you should also provide personal protective equipment (PPE) for each person to ensure their safety.We’ve calculated the yearly expense of using handheld thermometers based on information gathered at Memorial Hermann Hospital in Houston. Here's the breakdown:

• Staff salary for four operators: $156k
• Disinfectant and cleaning labor: $40k
• PPE: $30k
• Total: $226k

It’s important to note that we based this cost analysis on a single entry location, open for 24 hours/day. Given this information, when does it make sense to use handheld devices? Small companies with up to 15 employees on-site would be the ideal size to use handheld thermometers. They could create efficient entry processes and limit any bottlenecks as employees enter the building. Plus, if they can avoid hiring someone new by training a current employee to take temperatures instead, they could save even more.

The pros and cons of thermal cameras

If your company plans to have more than 15 employees onsite, thermal cameras may be more cost-efficient for you. Thermal cameras are being used in increasing numbers due to their accuracy, ease, and cost savings. Across the industry, prices range from $5k for moveable kiosks to $30k for more automated and high-end systems. The FDA lists the following benefits of thermal cameras:

• They don’t require an operator to be physically close to the person being evaluated
• They can measure surface skin temperature faster than the typical forehead thermometer
• When used correctly, they provide more accurate temperature measurements

Like handheld devices, thermal cameras have their own set of limitations. The FDA’s limitations for thermal cameras include:

• They are not as effective when used to take the temperature of multiple people at the same time and should not be used for “mass fever screening”
• They only work effectively when the system is set up properly, in the correct location

So, which method is right for your company?

As the Co-founder and CEO of Athena, a company that specializes in thermal imaging systems, I may be a little biased. But I promise to give you my most objective answer. It all depends on the size of your company and how many people you intend to have return to the office full-time. If you expect more than 15 employees on-site and can afford the initial investment, then thermal cameras likely make sense for you. Your initial investment will vary depending on which thermal imaging system you choose. You'll want to look for a system that meets the following criteria:

• Includes all the required components
• Doesn't need an operator
• Can integrate with your existing employee registration and visitor management system
• Can send alerts in real-time when someone poses a risk to entering your space

Systems that meet these criteria range from $20k - $30k. While this is not an insignificant amount, it is far lower than the costs that come with handheld thermometers that we listed previously. Greg Haralson, the CEO of Memorial Hermann Hospital that we used in our calculations above, stated that switching to thermal cameras “has been a real game-changer.” They switched methods because they wanted to minimize contact and meet social distancing guidelines. It wasn't long until they realized that they were also able to save money while keeping their employees and visitors safe. Now Memorial Hermann is looking to expand the approach system-wide for every public entrance that it has at all of its hospitals.

Conclusion

No matter which method you go with, it's important to know that detecting a fever doesn’t mean you’re detecting COVID-19. A person who has an elevated temperature should go for further testing. Also, temperature screening is ineffective if the person is asymptomatic or not yet showing symptoms. Despite this, we need to screen temperatures because we know it’s a measure we can take now that can help. It’s not a silver bullet, it should be one part of your company’s return to office plan. In addition to industry best practices, there’s plenty of technology that can help you keep your workplace safe during COVID-19.

Learn more about how you can use temperature screening at your workplace with Athena’s seamless integration with Envoy.