GOVERNMENT AND NATIONAL AFFAIRS COMMITTEE
OSHA must renew its COVID-19 Emergency Temporary Standard Regarding Airborne Pathogens Gregory Jasani, MD and Gary Gaddis, MD PhD MAAEM FAAEM FIFEM
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ecently, the Occupational Safety and Health Administration (OSHA) permitted expiration of its “COVID-19 Emergency Temporary Standard (ETS),” concerning mandatory workplace protections from “airborne pathogens” such as the SARS-CoV-2 virus. This ETS was issued on June 28, 2021. Its expiration should be of concern to all health care workers, and it deserves to be reversed. As we will explain, the protections provided by the ETS deserve to be made permanent. This ETS specified new, enforceable regulatory protections for health care workers. Institutions not in compliance could be fined. Before its issuance, federal guidance regarding “airborne pathogens” as issued by the Centers for Disease Control, were non-enforceable suggestions, not enforceable mandates. Of course, the ETS as its name implies, was not issued with the clear intent that it became permanent. As an ETS, it was set to “automatically” expire no later than 12 months after it was introduced. OSHA had the power to make this ETS permanent, but failed to do so. We lament this wasted opportunity. The ETS that OSHA put out was sorely needed given the new realities that COVID has forced upon the health care system. We believe that OSHA must revisit this issue and produce a permanent standard for airborne pathogens, not just to protect us during this pandemic but for the next one as well. Working in health care institutions during the COVID-19 pandemic came with significant risk. Health care workers were three times more likely to be infected with COVID-19 compared to the general public.1 This high infectivity rate was likely exacerbated by PPE shortages during the initial phases of the pandemic. In the early days of the pandemic, there were even alarming news stories of hospitals and other health care organizations that actually forbade their employees from wearing masks and other PPE.2 Obviously, PPE shortages and restrictions were unsafe and unacceptable for those working in health care. For instance, these shortages spurred the development of movements such as “Get Us PPE.”3 Hospitals and other health care organizations mobilized quickly, in most cases, to implement new voluntary standards and practices. With remarkable speed, wearing masks, eye protection, and gowns became ubiquitous in the health care field.
change.4 However, one important aspect lacking in the CDC’s recommendations was enforcement. The CDC can give recommendations, but its recommendations are not enforceable. Further, those recommendations did not carry any penalties for employers who do not follow them. To properly protect health care workers, the federal government needed to do more. Therefore, President Joe Biden, within one day of assuming the Presidency, issued Executive Order 13999, regarding Protecting Worker Health and Safety. Stating that “ensuring the health and safety of workers is a national priority and moral imperative,” the executive order required the federal government to “take swift action to reduce the risk that workers may contract COVID-19 in the workplace.”5 It spelled out actions for various federal agencies to take, including tasking OSHA with determining if an ETS for COVID-19 was indicated. OSHA determined that an ETS was indeed necessary and officially introduced it on June 28, 2021. The ETS placed several requirements on health care employers. It specified multiple requirements that it deemed health care employers must fulfill to best protect their employees against COVID-19. These included the development of a written COVID-19 plan to address steps the workplace will take to combat COVID-19, following
>> The COVID-19 pandemic, for all of the suffering it has caused, has helped advance our understanding of best practices for airborne contagion prevention.”
The Centers for Disease Control (CDC) developed COVID-19 recommendations for health care providers, which stated that providers “should wear well-fitting source control,” undoubtedly helped spur this
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