An article released on News 24 yesterday 21st May 2020 stating the protocols and guidelines with regards to children returning to school, ie all schools must only have one entrance and exit etc…
The screening control guidelines have been set as follows:
• Staff must be on duty to ensure learners adhere to social distancing norms
• Learners and teachers must have their temperatures checked and if normal proceed to a screening point
• The screening point will have prepopulated registers – containing name surname grade physical address learners cell phone number next of kin contact no, temperature and response to the screening questions
• Officials managing the screening point will then screen the learner and record the temperature and response onto the register
• If the screening questions indicate there are no risks and the temperature is below 38 Deg C the learner proceeds to enter the building
If the screening or the temperature indicates a risk the learner or teacher must be accommodated in an isolation room / area until the next of kin arrive. The next of kin must be advised to immediately seek medical advice
Screenings to be completed 3 x per day
The inherent issue with the above process is that person(s) completing screening processes or taking relevant temperatures need to understand and be informed in the correct methods of doing this.
We need to firstly understand that we are not taking Body temperatures but Skin temperatures, and the best place to complete this is from the inner canthus of the eye (Tear Duct) as is the hottest part of the body, and is as per ISO Screening Standards.
or on the temporal artery on the forehead. Ie Between the eyes where the unibrow would meet or just above on the forehead
The reason why we take from these two areas are that they are normally the hottest areas of the body and research has ascertained that there is a direct correlation between the canthus of the eye (Skin) and body temperature.
95% of schools will be utilizing non contactless IR Thermometers to complete temperatures of pupils, There are other technologies we will get into later sessions using thermal cameras with pre set algorithms that can do this automatically, however expensive, and many schools just cannot afford the technology, however most IR Thermometers range is between 32 deg – 42.5 deg C/ most IR Thermometers also have a surface and body setting – first ensure you are correctly set for body.
To ensure that correct readings are attained bearing in mind that the statutory alarm or threshold has been set by government at 38 deg C and hence most IR thermometers alarm setting has been set at 38 deg C– however the all testing must be completed in a constant environment of between 23 – 27 deg C, with us going into winter this cannot and will not be achieved in the mornings where our ambient temperatures can drop as low as +- -3 deg C and hence a vital floor in setting the fever threshold at 38Deg
Understanding that there is a direct relationship between skin temperatures and ambient temperatures necessary adjustments need to be assessed. Many people using IR thermometers have already asked the question why in the mornings are we getting “LO” on our thermometers – the answer is simply that the Skin temperature has dropped below what the thermometer can read, as well as people possibly not understanding where readings can and should be taken from.
Therefore in the mornings many of you taking temperatures will often get a “lo” reading or temperatures between 32.5 – 33.8 deg and this is purely due to the ambient temperature effecting the skin temperature. The problem that very few people realise is that the alarm threshold or Fever Temperature needs to be dropped in accordance with the average skin temperatures, this in the mornings when temperatures are attained at between 32.5 and 33.9 an average needs to be established which in the above case is 33.2 deg, add a differential of 1.5deg C and your fever threshold is now 34.7 and not 38 deg
The problem is with taking temperatures more so in the morning is that should a child or teacher have a fever or mild fever, due to the setting of the fever threshold at 38 deg, these teachers or children would still gain entry to schools as the ambient temperature has decreased there skin temperatures below the “alarm threshold” of 38 deg.
Therefore schools need to be pro active in setting up a prior to each screening / temperature session as three have been dictated during the course of a school day and understanding that we are taking Skin temperature and not Body temperatures and the anomalies that can occur. Even set up class projects so Kids can also understand.
For example in a scenario where most children or teachers are in an outside environment in the morning and there skin temperatures all adjust within those parameters, and we understand that the average temperature taken is 33 deg C and the alarm threshold set 1.5 deg above the average at 34.5 deg C and then a person arrives from an air conditioned vehicle and the temperature is 36.5 deg C and is higher than that of the alarm threshold set at 34.5 deg C, one cannot simply say that that person now has a temperature, that person has to be given 5 – 10 minutes within the confines of the environment you are testing in for their skin temperature to adjust accordingly and a second test completed, on the second test completed then that person can continue to the screening station to complete the required documentation.
In the adverse effect where the skin temperature does not drop after allowing that person to remain within the confines of the ambient temperature and remain at 36.5 deg we decern that that person could well now have an EST (Elevated Skin Temperature) and now requires a medical thermometer to again check that they in fact do or don’t have a relevant fever or EBT (Elevated Body Temperature) On checking with a medical thermometer by medical personal then again that person will either be allowed or not allowed to proceed dependent on the medical practitioner completing the reading of the temperature and the screening process.
Remember that having a fever or EST or EBT does not necessarily mean that you have Covid 19 or the Corona Virus – only further testing will and can determine that, however people do need to be informed in the correct methods of screening as with government setting the parameter at 38 deg C is incorrect and persons will gain entry to facilities with fevers if the correct procedures are not changed or adhered to. Also bear in mind that there are other factors that can also influence body temp and skin temperature apart from the environment – some of these include – sweat, exertion, ethnicity, Gender, Menstruation, underlying illnesses etc
Correct Process: (Note these are sample guidelines and can be adjusted for each institution)
The above allows us to determine a sample population to get a reference temperature allowing us to determine the alarm threshold temperature (Variance can be adjusted to 2 deg and is dependent on each institution) Therefore the alarm threshold is a value of 35.3 deg and not 38 deg. This should be completed prior to each screening session thus ensuring you adjust the alarm temperature in accordance with reference temperatures.
Click here to download the population sample document