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Comprehensive Guide to Fever Screenings

Why Fever Screening?

Infectious diseases travel quickly. We’ve experienced this rapid spread with the Coronavirus Disease 2019, SARS, H1N1, Ebola, and others. A virus can begin in a localized area and reach the other side of the planet in a matter of weeks. In many of these viruses, including a novel coronavirus, a fever is the first indication that something is wrong. This fever often shows before a doctor’s visit happens to diagnose the illness.

Testing is limited, so scanning for symptoms is the most efficient way to flag a potentially infected individual. Fever screening is the first line of defense for many airports and hospitals, allowing them to flag febrile or potentially febrile individuals for further testing and/or quarantining.

How to Tell if You Have a Fever

Using a medical thermometer, whether oral, rectal, or in-ear, is the only way to definitively confirm a fever. However, using a medical thermometer to take temperatures in a crowd is not always plausible. Taking one person’s temperature at a time using a thermometer is time-consuming, and studies have shown self-reports to be inaccurate. This is where many airports and other high-volume locations are turning to more efficient solutions for measuring skin temperatures.

Locations That Can Benefit from Fever Screening

There is a wide range of locations that can take advantage of the usefulness of fever screening, especially during a pandemic like COVID-19, where the virus is extremely contagious and hard to contain:

  • Airports
  • Hospitals and other healthcare settings
  • Schools
  • Offices 
  • Factories
  • Cruise ships 
  • Transportation hubs, stations, and terminals
  • Theaters 
  • Sports arenas
  • Many more

Why Quick Temperature Screens Matter

When there are large crowds in the time of pandemics, it’s critical to have a quick and efficient method for scanning temperatures. This was illustrated as complications arose surrounding fever screens in airports during COVID-19. In March 2020, as passengers arrived in major airports across the United States after President Trump’s European travel ban, long lines and delays ensued. These health screenings involved paper questionnaires filled out using shared pens and short interviews with health workers, according to passengers at Boston’s Logan Airport, WGBH reported.

Passengers stood in close proximity, often shoulder-to-shoulder, for hours as they waited their turns for screening. This scene was counterintuitive to the CDC’s recommendations of 6 feet of social distancing. Many passengers said these health checks did not include temperature screens.

These tests were not sufficient and could have easily allowed carriers of COVID-19 to enter cities and spread the virus with others in the airports as they were kept in such close quarters. If quicker, passive methods of health and fever screenings were put in place, passengers would have been able to move through the process much more quickly and safely.

Common Fever Screen Questions Asked Regarding COVID-19

What does COVID-19 stand for?

According to the Centers for Disease Control and Prevention: “The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as ‘2019 novel coronavirus’ or ‘2019-nCoV.’

What are the symptoms of the coronavirus disease?

According to the World Health Organization, the most common symptoms of COVID-19 are:

  • Fever
  • Tiredness
  • Dry cough

Some patients may have:

  • Aches and pains
  • Nasal congestion
  • Runny nose
  • Sore throat
  • Diarrhea

WHO states that these symptoms are usually mild and begin gradually, though some people may be asymptomatic carriers of the virus. This means they’re infected but do not feel unwell. Fortunately, about 80% of people with COVID-19 recover without special treatment, though about 1 in 6 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness.

How long should I stay home in isolation if I have the coronavirus-2019 disease?

You can find steps for caring for yourself and self-quarantine on the CDC website here. As well as providing self-care regime suggestions, they also advise on what to do whether or not you will be tested for the virus. If you have COVID-19, follow the CDC guidance for isolation and care.

Infrared Skin Temperature Detection Systems

Infrared cameras and other devices are able to scan skin temperatures and detect elevated temperatures with pinpoint accuracy. It is important to note that while these temperature measurements are accurate, they may not tell the whole story. For example, someone with a fever could trigger the camera’s alert for an elevated temperature, but so might someone who was just sitting outside in the sun. Specialized infrared devices measure surface temperatures — not internal temperatures.

A common issue with infrared temperature screenings is a lack of education or proper technique from the screeners. When using a handheld infrared non-contact thermometer, many users point the device at the subject’s forehead. However, this is not the best way to take a skin temperature screening. The best way to get an accurate reading is by scanning the inner canthus of the eye. This is the hottest part of the human face. Improper temperature measurements can produce widely varying results. Watch this demonstration on proper use on Rossen Reports.

Infrared devices can be highly useful in situations where public fever screenings must take place, but it’s important to remember that they are to be used in an adjunctive capacity, not independently. If an infrared device notices an elevated skin temperature, a medical thermometer should follow to complete the fever screen and confirm whether or not the individual has a fever.

It’s best to conduct skin temperature screenings one at a time. This is what is recommended by the ISO 13154 standard. This may be more time-consuming, but it is worth taking the extra time and precautions when public health is in question.  

Infrared Temperature Screening Devices

In a Forbes article, ICI founder and CEO Gary Strahan was interviewed on fever screening devices. In the article, Strahan describes temperature systems, the meaning of fever screening for pandemic situations, and typical price ranges for systems approved by the FDA.

Infrared Cameras Inc's (ICI) CEO, Gary Strahan, at the 4C Conference 2019 showcasing the latest infrared technology, our ICI IR-Pad 640.

Thermal imaging products for temperature monitoring include handheld devices, mountable cameras, and systems that are permanently mounted. These devices are useful in a range of medical applications, from screening temperatures to medical imaging. They are small, lightweight, easily portable, and provide real-time radiometric data streamed directly to any computer or tablet via USB.

ICI also offers medical-use devices, including non-contact thermometers and handheld skin temperature measuring infrared cameras. Handheld cameras can be operated one-handedly and are often budget friendlier. You can find Infrared Cameras Inc’s medical-use devices for temperature monitoring and imaging in the product list here.

It’s important to remember that these systems are intended to be used adjunctively and not as a standalone device when it comes to thermal screening. Thermal cameras cannot detect if someone has a fever or virus, but they can flag someone who MIGHT have these conditions. Further testing is required to confirm.

Importance of Infrared Camera Quality

From company to company, pricing and sensitivity can vary widely on these products. Cost is a strong reflector of accuracy. Cheap infrared cameras will not provide the level of accuracy needed for testing skin temperatures during serious outbreaks such as the Coronavirus disease 2019. When human health is at stake, accuracy can’t be neglected.

Where to Find Training for Temperature Screening Thermographs

While these infrared skin temperature tests are used to evaluate large groups of people measured one at a time, it’s of the utmost importance that those using the device are trained in how to use thermographic cameras for that specific use.

level 1 thermography training class at the infrared training institute

Anyone using a thermal camera for temperature measurement has a responsibility to learn how to properly use the device. ISO/TR 13154:2017 covers the deployment, implementation, and operational guidelines for identifying febrile humans using screening thermographs. When working with people, education on proper thermal regulations and usage is absolutely critical. 

Infrared Cameras Inc offers thermography training courses in Beaumont, Texas through its sister company Infrared Training Institute. ITI provides thermography certification training courses, on-site training, application courses, camera operator training, and more. Visit the website for upcoming training dates.