OBJECTIVE: Determine performance characteristics and safety outcomes of two rapid COVID-19 screening methods to inform immediate return to work (RTW) decisions while health care personnel (HCP) await results of pending confirmatory laboratory test. METHODS: This is a retrospective, occupational health quality improvement study comparing screening with rapid SARS-CoV-2 nucleic acid amplification (NAAT) and antigen test. RESULTS: Five hundred thirty-one mildly symptomatic HCP screened over 16 months.• Negative predictive values: 96.7% (95% CI 95.1%-98.3%) for the rapid NAAT, 94.8% (92.8%-96.7%) for the rapid antigen test• Rapid antigen screening estimated to prevent 627 unnecessary lost shifts versus 620 with NAAT screening.• No nosocomial transmission identified and could be excluded in all but 4 cases. CONCLUSIONS: Until more accurate affordable NAAT tests become available, antigen test screening alone addresses simultaneous needs to minimize COVID-19 transmission from symptomatic HCP and maintain an adequate workforce.