LWHA COVID-19 Screening Tool for the Workplace

Active screening is paused at this time. Please proceed with the usual sick call process.  COVID related questions refer to the Decision Tool.

LWHA COVID-19 Screening Tool for the Workplace

This self screening tool is for use by employees and physicians entering the facility. All patients, visitors, contractors and vendors must go through in-person screening at the designated entrances of the hospital.

  • REQUIRED SCREENING QUESTIONS
  • Are you currently experiencing any of these symptoms?

    1. Fever (temperature of 37.8°C/100.0°F or greater) and/or chills
    2. Cough (that is new or worsening (e.g. continuous, more than usual if chronic cough) including croup (barking cough, making a whistling noise when breathing)
      • Not related to other known causes or conditions for which current symptoms do not represent a flare-up/exacerbation related to infection (e.g., chronic obstructive pulmonary disease)
    3. Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheeze, that is worse than usual if chronically short of breath
      • Not related to other known causes or conditions (e.g., chronic heart failure, asthma, chronic obstructive pulmonary disease)
    4. Decrease or loss of smell or taste
      • Not related to other known causes or conditions (e.g., nasal polyps, allergies, neurological disorders)

  • Are you experiencing ONE OR MORE of the following symptoms:

    1. Extreme fatigue, lethargy, or malaise (general feeling of being unwell, lack of energy, extreme tiredness) that is unusual or unexplained
      • Not related to other known causes or conditions (e.g., depression, insomnia, thyroid dysfunction, anemia, malignancy, receiving a COVID-19 or flu vaccine in the past 48 hours)
    2. Muscle aches or joint pain that are unexplained, unusual, or long-lasting
      • Not related to other known causes or conditions (e.g., fibromyalgia, receiving a COVID19 or flu vaccine in the past 48 hours)
    3. Nausea, vomiting and/or diarrhea
      • Not related to other known causes or conditions (e.g. transient vomiting due to anxiety in children, chronic vestibular dysfunction, irritable bowel syndrome, inflammatory bowel disease, side effect of medication)
    4. Sore throat (painful swallowing or difficulty swallowing)
      • Not related to other known causes or conditions (e.g., post nasal drip, gastroesophageal reflux)
    5. Rhinorrhea or nasal congestion (runny nose or stuffy nose)
      • Not related to other known causes or conditions (e.g., returning inside from the cold, chronic sinusitis unchanged from baseline, seasonal allergies)
    6. Headache that is new and persistent, unusual, unexplained, or long-lasting
      • Not related to other known causes or conditions (e.g., tension-type headaches, chronic migraines, receiving a COVID-19 or flu vaccine in the last 48 hours)

  • Do any of the following apply?

    1. You live with someone who is currently isolating because of a positive COVID-19 test.
    2. You live with someone who is currently isolating because of COVID-19 symptoms
    3. You live with someone who is waiting for COVID-19 test results
    If public health has advised you that you do not need to self-isolate, select “No.”
  • This field is for validation purposes and should be left unchanged.
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