Recently, Forbes questioned the efficacy of fever screening in Why Fever, Temperature Checks Are Inaccurate Ways to Screen for Coronavirus. In March 2020 there was not a thermometer to be found in retailers. Much like Lysol, toilet tissue, and Tylenol, thermometers became as rare as water in the desert. Untold sums have been expended on thermometers of all descriptions. I have been scanned entering medical facilities and even restaurants, on some occasions more cordially than others.
Back in March, there was a drive to study temperatures. This blog recently noted in Artificial Intelligence Surveillance that some businesses are even measuring temperatures surreptitiously and systematically. I have even heard of businesses that perform daily temperature checks on all arriving employees. This requires equipment and competent staff to use it. The Forbes author suggests many of us may lack the skills to effectively use electronics and the periodically flashing time on my appliances may indeed support his contention.
That is not to say that temperature testing is necessarily legally advisable. The American Civil Liberties Union has questioned both efficacy and legality. The main focus of the legality perspective centers on the right to privacy. Your right to privacy is discussed in Griswold v. Connecticut, 381 US 479 (1965). That case is discussed in both Artificial Intelligence Surveillance and The Rush to Repeal Our Rights. After that was published, I actually had an educated individual ask me what people's rights have to do with workers' compensation. That was an interesting and somewhat disappointing conversation.
On the question of rights, I have frequently warned legal studies students to remember the power of fear. When we are scared, we look to the government for safety and protection. It is then that we may be individually or collectively inclined to forego our rights in exchange for protection. There are those who see the passage of the Patriot Act following September 11 from that perspective. The government declaring a curfew, limiting access to some location, or otherwise limiting us may simultaneously protect us and yet infringe on our rights. Some see various reactions to SARS-CoV-2 and COVID-19 in this same contrast.
Returning to the recent Forbes piece Why Fever, the author suggests that fever "may help determine whether you want more cowbell" a reference to Will Farrell and Christopher Walken, not to Mississippi State University (dinka, dinka, dinka, dinka). However, he posits, "A fever is not a great way to tell if you have a Covid-19 coronavirus infection."
The author proceeds to explain that medical studies now support that one may have COVID-19 and not display an increased body temperature. The July 6 "study published on July 6 in the Proceedings of the National Academy of Sciences (PNAS)" concluded that most people contract the virus from someone who had no symptoms whatsoever at that time (including fever). Studies on patients who exhibit COVID-19 symptoms support that significant numbers of them do not report fever in their symptom constellation. Thus, the absence of fever is not necessarily demonstrative of the absence of disease. A "normal" body temperature upon entering the restaurant or workplace does not assure anyone that you do not carry SARS-CoV02 or that you will not infect those around you.
The "false" positive potential is as troubling. The Forbes author notes that fever or increased body temperature may very well be demonstrated for a variety of non-SARS-CoV-2 reasons. In fact "A wide range of different things can cause a fever besides cowbell deficiency." These include a variety of maladies, both viral and otherwise, medications, exposures, and beyond. Science Daily even contends that mere stress can escalate body temperature. And, of course, exercise can do so also as an acquaintance recently found after a brisk pace from the parking lot to the hospital emergency room (after parking and finding entrance after entrance locked and inaccessible). Thus, the presence of increased body temperature could be inappropriately relied upon to produce a false positive (fever = presence of COVID-19).
Yet another caution Forbes proposes is the ease with which fever can be concealed temporarily. The author notes the effects of "fever-reducing medication like Tylenol," which might be taken for a variety of non-COVID reasons. This use "could mask any fever that you may have." In January, the British Broadcasting Corporation reported on a traveler from Wuhan China who boasted on social media regarding her use of medication to avoid officials inhibiting her exit from China or entrance to France. Thus, the use of medication might be fever-altering through happenstance (innocent use for some non-COVID purpose) or intent.
These points are worthy of consideration as is the author's suggestion that there remains some potential for user error with temperature scanning devices. Admittedly, the author concedes, that temperature scanning may in fact screen some potential risk individuals. However, the probabilities and possibilities suggest that we should perhaps not feel so protected or so safe because our present location includes such scanning, or because our own temperature is "normal." There is the benefit that someone is doing something, and there is potential that it may result in some success.
But, it is far from pervasive success or certainty. In the end, answering the question in this post's title, there is some measure of diagnostic potential, but apparently more placebo than not. Or, at least, more "supportive" than "conclusive." There is merit in this testing as part of a broader approach to premises safety, but it is no be-all or end-all. Similarly, social distancing, masks, hand washing, and disinfectant may each alone also not be the be-all or end-all, but each nonetheless has merit and improves our individual odds despite not rendering us absolutely or indubitably safe.
In the end, short of a vaccine, perhaps there is no "end all" effort we can undertake. More likely, success against this pandemic will include many little efforts that each produce some small benefit and that combined help us either avoid exposure or resist infection. And, along the way, we seem to be gradually learning more about it and perhaps ourselves.
