Thread by @jimbuctwit

TEMPERATURE CHECKS - and academic and instructive example of how knowledge evolves.

THREAD (short, just a few thoughts).

Here's a STAT News article, to start, but read on for my take.
...statnews.com/2020/07/02/sme…

As businesses & other public venues, & maybe schools, are seeing more human movement within their walls, many owners and admins are trying to provide safe environments.

Some recommend or require masks and physical distancing.
Some limit numbers of people or require appts.
...

And some are checking temps on the way in. WHY?

Early on, months ago, this seemed like an obvious and easy way to screen for illness - specifically coronavirus infection. Fever is a common symptom among COVID-19 patients. Makes sense.

But...

We NOW know MANY infected individuals are asymptomatic (ie, NO FEVER) or pre-symptomatic (ie, NO FEVER), so this screening method will miss MANY infected & contagious individuals.

SO, afebrile (no fever) people, clients, students, etc. should not be considered free of dz.
...

In order to be SAFER, especially in areas of significant community spread, everyone should assume they and everyone else is infected and contagious, and apply all the basic methods to protect self and others: distancing, masking, washing ...

Temp checks are nice, but
...

I'm sorry to report that like so many other aspects of the coronavirus pandemic, temp checks is not the easy answer. Relying solely on a single concept, method, test, whatever, would be naive and shortsighted.

...

I suppose if checking temps is relatively easy, then do it. But do everything else too. DO NOT ASSUME no fever = no infection.

An age-old tenet of good medical practice is not to do a test that won't affect what you will do next in managing your patient. Think about that.