a brilliant application of the drive-through and pick-up model of the food industry to medical examinations, which is characteristic of the so-called "K-epidemic response." As many countries shut down their borders to control the inflow of infected people, multinational corporations faced management challenges. They could not move their employees from one country to another, especially from their headquarters to foreign branches. Solving this problem was a top priority for a nation like the ROK due to its high economic dependency on trade. The Korean government and domestic corporations pursued diplomatic solutions. They came up with an idea to convince their major trade partners. They assured them that their employees would be tested for COVID-19 and only personnel certified as healthy would be sent.
For this purpose, we have implemented COVID-19 testing for workers who need the certification. However, our hospital, like all others in the ROK, is overcrowded with patients, raising the risk of hospital-based transmissions. To curb the chances of infection, we visit workers in their workplaces and test them onsite. All workers are examined by physicians and asked about symptoms, disease history, and, most importantly, COVID-19 exposure risks (Fig. 1) . Sample collections for COVID-19 laboratory tests are done by physicians in a separate facility outside the main building complexes because of concerns about droplet or aerosol generation.
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Onsite mass workplace testing for COVID-19
https://aoemj.org As of June 11, 2020, 2,620 workers had been tested with reverse transcription polymerase chain reaction (RT-PCR), and none of them was found to be positive ( Table 1) . We have issued certifications for overseas dispatches, enabling workers to perform their tasks abroad without unnecessary quarantine periods (Fig. 2) .
Due to the unprecedented COVID-19 pandemic, regular health examinations for workers in the ROK have been pending for several months. We were able to resume the scheduled examinations recently as the spread of COVID-19 in the ROK has slowed. However, many things have changed: all examinees are now required to wear masks, temperature checking is mandatory, and pulmonary function tests are prohibited. Even with these precautionary measures, there is no guarantee that we can retain our system.
The most important reason for this uncertainty is that the current system does not consider the effects of transmissible disease outbreaks on the regular health examination system of Korean workers. Alongside onsite COVID-19 examinations, we believe the following issues must be discussed further. Third, we need to focus on the fact that onsite COVID-19 testing can serve as job fitness evaluations. Workers found to be COVID-19 negative could get a certification to work overseas, which means he or she is healthy and fit for the job. As decisions about the job fitness of candidates are made based on their regular health examinations in relation to occupational hazards, we believe the same concept can be applied to COVID-19 tests. There is social and clinical evidence on the benefits of adding testing for infectious diseases like COVID-19 to the current system.
In addition, the fact that the Korean Medical Service Act prevents physicians from practicing outside approved areas, such as hospitals, should be borne in mind [4] . In fact, the legal grounds for onsite COVID-19 testing is weak, although the Korean Medical Service Act allows physicians to practice outside hospitals when it is officially sanctioned by authorities in public interest, which could be the case with the current regular health examination system for workers. We reported our onsite COVID-19 examinations to local authorities and gained approval, but it was temporary. If we are to promote onsite COVID-19 tests for the public good, we believe that we must include it in the current system.
To the best of our knowledge, onsite mass workplace testing for COVID-19 is not practiced elsewhere. Its social benefits are indisputable. To overcome these challenging times, we should promote what we do best and incorporate testing for COVID-19 in the system as quickly and widely as possible. In addition, we need to improve the present health examination system for workers to cope with infectious diseases more efficiently.