key: cord-0718572-oannsrgd
authors: Zhang, Jianlu; Liu, Siqi; Zhu, Bin
title: The fever screening methods in public places during the COVID-19 pandemic
date: 2020-11-17
journal: J Hosp Infect
DOI: 10.1016/j.jhin.2020.11.011
sha: 5df89d6e858428e6ab51a72a556c7fcaad8ff5c8
doc_id: 718572
cord_uid: oannsrgd

nan

The recent letter 'The non-contact handheld cutaneous infra-red thermometer for fever screening during the COVID-19 global emergency' expressed legitimate concern about the accuracy of non-contact handheld infrared thermometer in temperature measurement during the pandemic [1] . The non-contact handheld infrared thermometer was indeed less accurate than tympanic thermometer and other infrared thermal systems in fever detection [2] . In addition to the inadequacy of the equipment itself and the excessive distance between the thermometer and the skin [1] , there is a worrying operator-dependent error exists. Although it is well known that the handheld infrared thermometer is measured on the temples or forehead, a large number of operators are still measuring the forearm to save time and avoid close contact with the measured people. The real temperature of the human body is the core temperature, which is higher and more stable than the shell temperature [3, 4] . The shell temperature, especially the skin temperature of the extremities, is vulnerable to the influence of environmental factors and thermoregulatory responses [4] . Therefore, using thermometers to measure forearm skin for fever detection is a colossal error.

The tympanic infrared thermometer has been shown to correlate with core temperature and is more accurate than infrared skin thermometer [5] . However, it is Therefore, we strongly recommend the use of infrared thermal imaging cameras at the entrance to places with high pedestrian flow. Although thermal imager only measures the shell temperatures, there is evidence that the thermal imager, with faster reaction speed and wider temperature acquisition area that avoids missing the potential hottest point of the body surface such as the inner canthus of the eye [6] , which is more accurate than the handheld infrared thermometer [2, 7] . If a person's temperature is higher than the set point, the alarm of the equipment will alert the staff to take a more accurate temperature review of the person [8] . In addition, the recording function also monitors if an operator has missed a person with suspicious body temperature.

During the COVID-19 global emergency, we propose a graded temperature measurement mode for fever detection: 1) infrared thermal imaging cameras; 2) tympanic thermometers; 3) sterilized thermometers for measuring axillary or rectal temperature. We recommend the use of infrared thermal imaging cameras at the main entrances of hospitals, shopping malls, stations, airports, schools and so on for the preliminary temperature measurements. The tympanic thermometers can be used in clinic rooms, airplanes, long-distance buses, hotels, and classrooms for the review of temperature. The sterilized thermometers for axillary or rectal temperature are more recommended in fever clinics, isolation wards, in-patient wards, and for reexamination of suspected fevers. J o u r n a l P r e -p r o o f

The non-contact handheld cutaneous infrared thermometer for fever screening during the COVID-19 global emergency

Diagnostic accuracy of non-contact infrared thermometers and thermal scanners: A systematic review and meta-analysis

Textbook of Medical Physiology

Effects of core temperature, skin temperature, and inter-beat interval on resting metabolic rate measurements in thermoneutral conditions

Clinical accuracy of tympanic thermometer and noncontact infrared skin thermometer in pediatric practice: an alternative for axillary digital thermometer

Infrared thermal imaging of the inner canthus of the eye as an estimator of body core temperature

Is thermal scanner losing its bite in mass screening of fever due to SARS?

New standards for devices used