The Quest program joins similar ones from Laboratory Corp. of America Holdings and health providers like primary-care clinic One Medical, showing how reopening efforts have created a new way for health-care companies to market their services.

Testing could take on an even greater role in the back-to-work push in the U.S., thanks to significantly improved availability of both diagnostic testing and antibody tests that screen for prior infections. Even so, many employers have approached the subject cautiously. Obstacles abound, including the complex logistics of testing a workforce, the cost of a large-scale program, and the privacy concerns raised by employers taking on an unusually invasive role in their workers’ health.

For employers looking to bring in non-essential employees, the approach “varies quite a bit based on who they are, what they do and how urgent they believe it is for their workforce to return physically to work every day,” Quest Chief Executive Steve Rusckowski said in an interview. Location is also a factor, as well as rates of infection in the community and the density of a given environment.

Varying Approaches

All available testing for the new coronavirus has limitations, so approaches will vary. Some employers have opted for diagnostic tests for all employees, with required weekly testing, while others are more inclined to test some of their workforce on a periodic basis, alongside imposing hygienic standards and other precautions like surveillance, Rusckowski said.

For companies with workers in hotspots like New Jersey, for instance, antibody testing, which screen for markers in the blood tied to a past infection and may also indicate some level of immunity, can be a “very valuable tool” to examine the virus’s prevalence in their workforce, Chief Medical Officer Jay Wohlgemuth said in an interview. Antibody tests can be used to develop other parts of a workplace strategy, including how often diagnostic testing — which is considered more reliable — is needed, he said.

“Boy, that’s a tall order to do diagnostic testing with nasal swabs in the entire population. And then to do it on a repeated basis, that’s expensive and that’s burdensome,” Wohlgemuth said.

Moreover, “the reality is, once we test you, that moment of time will determine if you have the virus or not,” Rusckowski said. “After you leave, you can get infected. So you’re always at some exposure.”

Holiday Retirement

An early client of the new Quest program is Holiday Retirement, which manages independent living facilities for seniors in hundreds of communities across the U.S. The Winter Park, Florida-based company is using Quest to perform antibody tests on employees, and aims to offer diagnostic testing as well.

Quest has also had to navigate testing its workforce, offering voluntary antibody tests so its near-35,000 employees continue to work during the pandemic.

Scaling up testing, particularly diagnostic testing, will also hinge on its accessibility. Quest believes at-home sample collection is likely to be key. It requires the patient to take her own swab and mail it in, a capability that Quest is developing and expects the U.S. Food and Drug Administration to authorize in the near term, Wohlgemuth said.

“We’re not asking a symptomatic person to get up and drive in somewhere, which is just a bad idea. And we don’t need protective gear” with at-home sample collection, Wohlgemuth said. “This is what we think will make diagnostic testing available in a way that we can actually meet this return to work need.”

“And maybe this is how we should have been doing it all along, because this is health care that is centered on an individual and not on a doctor or health system,” he said.