There were 1,136 participants in the 2020 subset of this surveillance system with a variety of positions such as engineer, manager, production worker, human resource officer, janitorial staff, and more. This suggests that adequately sampling from multiple socioeconomic demographics was included in this analysis. At this time, other studies are unable to be identified that consider this parameter of fully paid time off within this setting. This parameter uniquely allows for positive reward to the employee to then encourage prevention activities. Additionally, rewarding the employee with incentivized leave allows for a more complete dataset to be obtained. Therefore, in combination with the surveillance system that responds to clusters of cases, this practice is worth continuing because it helps to prevent morbidity to the employee population.
This surveillance system was limited by a variety of factors: most notably, recall bias. The data obtained from this system came from employees who chose to self-report, and only employees who self-reported were included in the dataset. Within these reported test results, it was theorized that employees who tested positive were more likely to report results than those who tested negative given the financial incentive. However, it cannot be claimed that it incentivized them to honestly and fully self-report. It is possible that some employees overreported symptoms to receive extra paid time off. There was no time off awarded to those who reported negative test results. In contrast, employees may have simply forgotten to report non-positive results or felt it was unnecessary. This would have caused positive results to hold a larger proportion of total test results than truly accurate. In other words, it is thought the positivity rate of the population was skewed higher than true. However, this cannot be tested to verify.
Another limitation may exist with the assumptions. This study assumes that CDC guidelines were followed to nearly the full extent on-site and were not followed off-site. Employees who contracted COVID-19 on-site were strictly monitored to ensure they followed guidelines at work. In contrast, employees who contracted COVID-19 off-site could not be monitored to ensure they were following guidelines, so it was assumed they did not follow them. However, it is likely a portion of employees chose to continue to follow guidelines off-site and still contracted COVID-19.
The use of masks and social distancing as protective measures are common but still highly debated through news and social media. This report provides more independent information that citizens, health officials, and other professionals can use to make informed decisions on the topic of masks and prevention controls. Thus, the results from this surveillance system can be viewed to support an effective prevention strategy that may directly reduce morbidity in the setting applied. It can be said with confidence that on-site employees had a lower risk of COVID-19 transmission. The enforcement of the CDC’s guideline on-site and the potential absence off-site demonstrated the guideline’s effectiveness. Employees were incentivized to stay home by being offered full paid time off. As a result, the risk for employees contracting COVID-19 was lower on-site as opposed to off-site. From the results of this study, it can be concluded that financially incentivized reporting and CDC’s guidelines are effective in combination to prevent communicable disease spread within a medical device development and manufacturing setting.