Temperature testing may be insufficient to detect hidden coronavirus cases and safely reopen workplaces, as new Victorian data reveals only one in five people infected with COVID-19 have a fever.
As Melbourne braces to reopen the economy and workers emerge from isolation, public health and infectious disease experts say more creative solutions are needed to prevent widespread outbreaks before a vaccine becomes available.
Blake Hedley, who runs Hedley Perrett Real Estate, has implemented a range of measures to stop coronavirus outbreaks at his workplaceCredit:Eddie Jim
Coughs, sore throats and runny noses are the most common symptoms being detected in Victorians who test positive to coronavirus, data compiled by the state's public health team shows.
While fever is often thought to be a distinctive feature of the virus, only about 20 per cent of people found to have coronavirus in recent weeks had a high temperature.
"It really does then raise questions about validity of temperature screenings,” Melbourne infectious diseases physician Michelle Ananda-Rajah, said.
Thermal screening and temperature checks have been widely rolled out at workplaces, airports and hospitals across the city to detect cases, but Professor Ananda-Rajah is concerned that using fever as a screening tool for COVID-19 may provide a false sense of security.
“If you’ve got people coming to work and they are getting their temperatures checked, well, if only one in five have a fever, it also means that four out of five could be infectious and don’t have fever," she said.
"In other words, temperature screening is not going to be a particularly sensitive tool to pick up these infected people.”
Public health expert Professor Caroline Miller said temperature screening was among the more costly infection control measures, but it didn't garner the same results as cheaper options such as strong contact tracing, good hygiene and social distancing.
"When really we haven't seen evidence coming forward that's it's a good tool in picking up positive cases," Professor Miller, director of the health policy centre at the South Australian Health and Medical Research Centre, said.
Professor Michelle Ananda-Rajah, infectious diseases specialist.Credit:Eddie Jim
For this reason, Professor Ananda-Rajah believes there needs to be far greater emphasis on commonsense measures such as opening windows and doors in workplaces.
"It is such a simple thing, but it can massively improve ventilation," she said.
"We need start thinking about some really imaginative solutions. Why couldn’t children be taught outside for example? Why can't we set up tents? It would be safer for teachers and children."
Eating lunch inside, in a kitchen or tearoom, was also advised against.
"People should be outdoors as much as possible," she said. "Nobody should be eating inside."
Indoor staff meetings are a thing of the past at Hedley Perrett Real Estate on St Kilda Road. Director Blake Hedley has ditched the board room for the park in a bid to prevent transmission of the virus among workers.
"Rather than sitting around in close quarters, we've decided to hold team meetings in the park across the road," Mr Hedley said. "Or grab a coffee and go for socially distanced walk to catch up."
Mr Hedley has also looked overseas for inspiration on how to protect his team of 20 staff during the pandemic.
While they're encouraged to work from home if they can, staff also use an app to check how many people have logged into the office, to ensure social distance measures are upheld.
"We use the technology to make sure the occupancy in the office never gets too high," he said.
Physical house inspections are banned until the end of next month, and are instead conducted via live videos on Zoom, where owners will take potential buyers on a virtual tours as real estate agents narrate.
"Basically, everything we do has had to be tweaked," Mr Hedley said.
Professor Ananda-Rajah suspects the widespread use of face masks could be one reason why Victorians infected with the pathogen in recent months are becoming less ill, and therefore, less likely to run a fever.
“I suspect, and this is just theory, it’s related to mask use," Professor Ananda-Rajah said.
“It is an observation that has been reported anecdotally in other countries too. The fact we are all in masks now means that we are probably acquiring a lower dose of the virus and that may actually be having an effect on the inflammatory reaction to the virus."
Commentary by a group of leading US infectious disease physicians, published on Tuesday in the New England Journal of Medicine, also suggests masks expose the wearer to just enough of the virus to spark a protective immune response.
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