The Maitre D’ Will Take Your Temperature Now

From NY Times

In recent weeks, a new cadre of gatekeepers armed with thermometer guns has appeared at the entrances of hospitals, office buildings and manufacturing plants to screen out feverish individuals who may carry the coronavirus.

Employees at some companies must report their temperature on apps to get clearance to come in. And when indoor dining resumes at restaurants in New York City later this month, temperature checks will be done at the door.

Since the beginning of the pandemic, the practice of checking for fever has become more and more commonplace, causing a surge in sales of infrared contact-free thermometers and body temperature scanners even as the scientific evidence indicating they are of little value has solidified.

Gov. Andrew Cuomo of New York last week called for checking patrons' temperatures as one of several ground rules for resuming indoor dining in restaurants, along with strict limits on the number of tables and a mask mandate for diners when they are not seated. Restaurants also will be required to obtain contact information from one guest at each table.

There is ample reason for concern. Coronavirus outbreaks — like one in East Lansing, Michigan, this summer that infected 187 people — have been traced to superspreading gatherings at bars and restaurants. And a new study by the Centers for Disease Control and Prevention found that one difference between people who contracted the virus and those who did not is that infected individuals were twice as likely to have eaten at a restaurant in the two weeks preceding their illness. The study, however, did not distinguish between outdoor dining and indoor seating, which most experts consider more hazardous.

But while health officials have endorsed masks and social distancing as effective measures for curbing the spread of the coronavirus, some experts scoff at fever checks. Taking temperatures at entry points is nothing more than theater, they say, a gesture that is unlikely to screen out many infected individuals, and one that offers little more than the illusion of safety.

Cuomo has allowed businesses to demand that patrons undergo temperature checks and to deny admission to those who refuse or have a fever, and he is requiring restaurants in New York City that resume indoor dining to check customers' temperatures. The CDC defines a fever as a temperature of 100.4 degrees Fahrenheit or higher; some reports have questioned the accuracy of thermometer guns, however.

While temperature checks may identify people who are seriously ill, those are the people who probably won’t be socializing much or going out for meals. And a growing body of evidence suggests that many of those who are driving transmission are so-called silent carriers — people who have been infected but feel fine and don’t have a fever or any other symptoms.

Earlier this week, the CDC — which in May told employers to consider checking workers daily for symptoms like fever but appeared to reverse itself in July — said it would stop requiring airport health screenings beginning Sept. 14 for international passengers from China, Iran, Brazil and other countries because the checks can’t identify silent carriers.

“We now have a better understanding of COVID-19 transmission that indicates symptom-based screening has limited effectiveness because people with COVID-19 may have no symptoms or fever at the time of screening, or only mild symptoms,” the CDC said in a statement.

Temperature checks are akin to “getting the oil checked before you go on a long car trip,” said Dr. David Thomas, an infectious disease specialist at Johns Hopkins University School of Medicine. "It makes you feel better, but it’s not going to keep you from wrecking the car or prevent the tires from falling off. It’s not going to make your trip any safer.

“It’s something you can do, and it makes you feel like you’re doing something,” he said. “But it won’t catch most people who are spreading COVID.”

Most people who spike a fever feel lousy and presumably would cancel their dinner plans, said Dr. Thomas McGinn, Northwell Health’s senior vice president and deputy physician in chief. Temperature checks might pick up a few individuals who are unaware of their fever, he said.

The bottom line, officials from the federal health agency said, is that screening employees for COVID-19, including using temperatures checks, before they return to work is “an optional strategy businesses can consider implementing depending on their local situation.”

Peter Kuhn, a professor of biological science, medicine and engineering at the University of Southern California, said his studies suggested that fever is often a first symptom of the coronavirus. And while temperature checks may be useful, he said they should be used in conjunction with a comprehensive package of safety measures that include requiring masks and social distancing and ensuring good ventilation and access to a flow of fresh air.

“Temperature checks are one part of that, but they are only one part,”

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