Testing for Hypoxemia as Early Indicator of COVID-19

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Preliminary, but compelling data is indicating that hypoxemia (low oxygen levels) is increasingly seen in COVID-19 patients and may be an early indicator of the virus, even when no other symptoms exist. Because oxygen-level testing, for which an inexpensive finger-tip pulse oximeter is used, is objective and noninvasive, TAG recommends the addition of an oxygen-level test be added to Wellness Screening.  

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According to Mayo Clinic: Hypoxemia (or hypoxia) is a below-normal level of oxygen in your blood; is a sign of a problem related to breathing or circulation; and may result in various symptoms, such as shortness of breath. Hypoxemia can be estimated by measuring the oxygen saturation of your blood using a pulse oximeter (a small device that clips to the finger). Normal pulse oximeter readings usually range from 95 to 100 percent. Values under 90% are considered low.

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Pulse Oximeters are readily available from several online sources as well as some retailers. Follow package directions and add to wellness screening as follows:

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1. Ask employee to wash or sanitize hands thoroughly.

2. Disinfect oximeter.

3. Place oximeter on employee fingertip.

4. If reading shows O2 level at or below 90, employer should wait two minutes and retest individual.

5. If employee’s O2 levels are still below 90, employee should be sent home and should contact their health care provider.

6. Low oxygen levels can be normal for some people, so the employee can return to work if the health care provider validates that normalcy for that employee.

7. Disinfect the oximeter before placing on next employee.

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The WHO lists some factors that can interfere with pulse oximeter readings including employee movement (such as shivering), bright light or sunlight shining directly on the probe, and extreme cold or low blood pressure of the employee. Some studies have also demonstrated that fingernail polish colors can impact readings.