Is Body Temperature Mass Screening a Reliable and Safe Option for Preventing COVID-19 Spread?

Abstract

With the ongoing coronavirus disease 2019 (COVID-19) pandemic continuing across the world, mass screening of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection is a cornerstone of strategies aimed at limiting viral spread within the community. Although mass screening of body temperature with handheld, non-contact infrared thermometers and thermal imagine scanners is now widespread in a kaleidoscope of social and healthcare settings for purpose of detecting febrile individuals bearing SARS-CoV-2 infection, this strategy carries some notable drawbacks, which will be highlighted and discussed in this article. These caveats include the high rate of asymptomatic SARS-CoV-2 infections, the challenging definition of “normal” body temperature, variation of measured values according to the body district, the use of antipyretics, device inaccuracy, impact of environmental temperature, along with the low specificity of this symptom for screening COVID-19 in patients with other febrile conditions. Some pragmatic suggestions will also be endorsed for increasing accuracy and precision of mass screening of body temperature. These encompass the assessment of body temperature (possibly twice) with validated devices, which shall be regularly monitored over time and used following manufacturer’s instructions, the definition of a range of “normal” body temperatures in the local population, patients interrogation on their usual body temperature, standardization of measurement to one body district, allowance of sufficient environmental acclimatization before body temperature check, integration with contact history and other clinical information, as well as exclusion of other possible causes of increased body temperature.