OSHA Issues New Rules on COVID-19 Safety for Healthcare Workers


Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The US Occupational Safety and Health Administration (OSHA) issued its long-awaited Emergency Temporary Standard (ETS) for COVID-19 today, surprising many by including only healthcare workers in the new emergency workplace safety rules.

“The ETS is an overdue step toward protecting healthcare workers, especially those working in long-term care facilities and home healthcare who are at greatly increased risk of infection,” said George Washington professor and former Obama administration Assistant Secretary of Labor David Michaels, PhD, MPH. “OSHA’s failure to issue a COVID-specific standard in other high-risk industries, like meat and poultry processing, corrections, homeless shelters, and retail establishments is disappointing. If exposure is not controlled in these workplaces, they will continue to be important drivers of infections.”

With the new regulations in place, about 10.3 million healthcare workers at hospitals, nursing homes, and assisted living facilities, as well as emergency responders and home healthcare workers, should be guaranteed protection standards that replace former guidance.

The new protections include supplying personal protective equipment and ensuring proper usage (eg, mandatory seal checks on respirators); screening everyone who enters the facility for COVID-19; ensuring proper ventilation; and establishing physical distancing requirements (6 feet) for unvaccinated workers. It also requires employers to give workers time off for vaccination. An anti-retaliation clause could shield workers who complain about unsafe conditions.

“The science tells us that healthcare workers, particularly those who come into regular contact with the virus, are most at risk at this point in the pandemic,” Labor Secretary Marty Walsh said on a press call. “So following an extensive review of the science and data, OSHA determined that a healthcare-specific safety requirement will make the biggest impact.”

But questions remain, said James Brudney, JD, a professor at Fordham Law School in New York City and former chief counsel of the US Senate Subcommittee on Labor. The standard doesn’t amplify or address existing rules regarding a right to refuse unsafe work, for example, so employees may still feel they are risking their jobs to complain, despite the anti-retaliation clause.

And although vaccinated employees don’t have to adhere to the same distancing and masking standards in many instances, the standard doesn’t spell out how employers should determine their workers’ vaccination status — instead leaving that determination to employers through their own policies and procedures. (California’s state OSHA office rules specify the mechanism for documentation of vaccination.)

The Trump administration did not issue an ETS, saying OSHA’s general duty clause sufficed. President Joe Biden took the opposite approach, calling for an investigation into an ETS on his first day in office. But the process took months longer than promised.

“I know it’s been a long time coming,” Walsh acknowledged. “Our healthcare workers from the very beginning have been put at risk.

While healthcare unions had asked for mandated safety standards sooner, National Nurses United (NNU), the country’s largest labor union for registered nurses, still welcomed the rules.

“An ETS is a major step toward requiring accountability for hospitals who consistently put their budget goals and profits over our health and safety,” Zenei Triunfo-Cortez, RN, one of NNU’s three presidents, said in a statement Wednesday anticipating the publication of the rules.

The rules do not apply to retail pharmacies, ambulatory care settings that screen non-employees for COVID-19, or certain other settings in which all employees are vaccinated and people with suspected or confirmed COVID-19 cannot enter.

The agency said it will work with states that have already issued local regulations, including two states that issued temporary standards of their own, Virginia and California.

Employers will have 2 weeks to comply with most of the regulations after they’re published in the Federal Register. The standards will expire in 6 months but could then become permanent, as Virginia’s did in January.

Sheila Eldred is a freelance health journalist in Minneapolis. Find her on Twitter @MilepostMedia .

Do you have information on how your hospital or health network is responding to PPE shortages, gag orders, or other related issues? Has anyone you know faced disciplinary measures for speaking out? Write to us: news@medscape.net .





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