Due to the current climate of having a shortage of skilled staff, this would result in a stand down for specific staff members. For small to medium business, this is not sustainable position, as many cannot afford to keep on staff that are not fulfilling their job description and doing the job they were hired for. — TracyRichardson
I am also seeing situations where we are somewhat playing chicken with determining how Covid risks will be managed in the long term, especially considering what part the vaccination plays in the wider scheme - to a point where effective planning is being sidelined until someone blinks and calls for the site to be "vaccination only" (even though both sides know that going vaccinated only is not really a viable option as it will have significant impacts on the sites being able to actually be staffed and operated).
In my mind (for whatever reason) some of the industry guidelines have been coopted as just another vehicle for the drive for increased vaccination rates rather than providing good industry specific guidelines for managing risks of an infectious disease in a workplace - specifically spending too much of their effort on justifying the implementation of a "vaccination only" policy rather than management of the risk of Covid spreading through their industry member's workplaces.
Regarding daily (or similar) RA testing - at the estimate low end of $10 per test and checking every day it is going to cost more than an additional $2,500 for testing each year per unvaccinated worker. But what is the effective risk reduction?
Some back of a napkin math...
Looking to other countries for an estimate on the average number of workers we should expect to become infected on any given day it would be reasonable to estimate <0.1% (USA - 0.032%, UK - 0.065%, Aus - 0.054%, Ireland - 0.093% -
calculated from the rolling 7 day new cases)).
The US CDC are reporting that >80% new infections are in unvaccinated people (
here)
RA test are expected to return a false positive for every 4 tests out of 1000 (
MoH guide)
From the expected daily infection rate and the skew of infections being more in unvaccinated people we expect that (roughly) 0.08% of the unvaccinated workers will become infected in any given day, and likewise 0.02% of vaccinated workers. Lets assume a workplace with 100 workers and 90% vaccination rate, so we will have 90 vaccinated workers and 10 unvaccinated.
For the case where we are only testing unvaccinated workers - on average each day we would expect that:
0.008 (10 x 0.08%) will return a positive test because they are actually infected,
but 0.040 ((10 - 0.008) x 0.4%) will luck out and return a false positive,
with the remaining 9.952 returning negative results,
(and 90 workers not tested as they have been vaccinated).
But that doesn't make much intuitive sense so lets look at it from a perspective of how often should we expect a positive test on average. Which is we should expect a positive test approximately every 21 days (so roughly one per month), except that is any positive so includes the false positives too. We would expect an actual positive result from an infected worker only every 125 days (or roughly twice a year).
But now consider if we test everyone on site each day - this ends up with:
0.026 (10 x 0.08% + 90 x 0.02%) will return a positive test because they are actually infected,
but 0.400 ((100-0.026) x 0.4%) will luck out and return a false positive,
with the remaining 99.574 returning negative results.
or positive test approximately every 2.3 days and an actual positive result from an infected worker every 38 days.
This also highlights the need to not focus on the unvaccinated, as while they may be more likely to become infectious this is outweighed by the fact that there are many more vaccinated people that still can (even though they are less likely to be on an individual level). In the case above if you only tested unvaccinated workers you would potentially miss catching 2 or 3 additional actual infections early compared with if you were testing everyone... although you would also be needed to deal with a false negative every few days which will be a significant burden on the operations (especially following the MoH guide for RA Testing linked above).
All the above is to say that some significant consideration on the actual effectiveness for how you will use RA testing is needed. One example where the benefits will likely be worth the effort/impact is for a response to a positive Covid case in the workforce - to augment the health monitoring of casual contacts who can continue to work while monitoring for Covid symptoms