“In response to the [pandemic] devastation, President Biden issued an executive order that directed the Department of Labor to consider whether any emergency temporary standards were necessary to keep workers safe from the hazard created by COVID-19,” OSHA stated in announcing the action.1 “On Monday, April 26, OSHA sent draft standards to the Office of Management and Budget’s Office of Information and Regulatory Affairs for review after working with its science-agency partners, economic agencies, and others in the U.S. government to get the proposed emergency standard right.”

OSHA further stated that $100 million in additional funding granted under the American Rescue Plan of 2021 will be used, in part, to hire more than 160 new critical personnel, including compliance safety and health inspectors.

“The health and safety movement has been fighting for mandatory COVID rules in the workplace since this pandemic started,” said Jessica Martinez, co-executive director of the National Council for Occupational Safety and Health. “There is no public agency that is tracking the number of workers who have died from workplace exposure to COVID.”

Martinez urged rapid implementation of the measure in a recent national commemoration for workers. “We are hopeful that it is comprehensive and provides sufficient protections,” she said. “At the very minimum, we are aware that the standard mandates that employers must have a [COVID-19] prevention program in place that allows for workers to provide input.”

Lost Battles and Beyond

Broadly speaking, infection preventionists traditionally have preferred Centers for Disease Control and Prevention (CDC) voluntary guidelines rather than rigid OSHA regulations. Perhaps the most memorable example was when the Association for Professionals in Infection Control and Epidemiology (APIC) got into a prolonged battle with OSHA over a proposed tuberculosis (TB) standard about two decades ago. After outbreaks in the 1990s, TB was in a national decline that has continued in the United States. Thus, APIC argued the respiratory fit-testing and other regulations for a plummeting disease was a wasteful use of healthcare resources. It appeared APIC’s arguments had won the day, but OSHA pulled a now infamous 11th hour move by adding some of the controversial TB provisions into its existing respiratory protections standard on New Year’s Eve 2003.

“The TB standard was not as scientifically driven as we would have liked,” says Ann Marie Pettis, RN, BSN, CIC, current president of APIC. “Hopefully, this one will be. The problem, though, in my mind is that so much of the science still isn’t worked out for [COVID-19]. If [the standard] comes out and it is all evidence-based — and it gives support to the fact that the powers that be need to make sure that the [2020] PPE [personal protective equipment] supply debacle doesn’t happen again — I would agree with that.”

An argument still could be made against mandates seen as draconian, as more and more workers are vaccinated. Even if they are not vaccinated, some have argued workers are at more risk in the community than in the controlled healthcare environment. However, OSHA has considerable political momentum, not the least of which is President Biden’s working-class roots. The Biden Administration certainly could argue that a standard now would protect workers in the next pandemic.

Then there are the personal stories from workers who lost coworkers. Pascaline Muhindura, RN, a critical care nurse at a hospital in Kansas City, MO, and a member of National Nurses United (NNU), spoke at the national commemoration for workers.

“I am here today to remember my colleagues and all the nurses and frontline workers who have lost their lives because our employers did not give us the protections we needed for the COVID pandemic,” she said. “In January 2020, nurses urged our employers to prepare for COVID. They didn’t.”

Muhindura blames the lack of readily available N95 respirators for a COVID-19 exposure from a patient, which led to the fatal infection of her coworker, Celia Yap Banago, in April 2020. “Despite Celia’s death, the hospital continues to ration N95s,” she says. “Management is still forcing us to unsafely reuse the same N95 for our entire shift.”

Nurses need mandatory rules, not voluntary guidelines, she said.

REFERENCE

  1. Occupational Safety and Health Administration. U.S. Department of Labor observes 2021 Workers Memorial Day as agencies look ahead to stronger worker safety, health protections. April 28, 2021. https://www.osha.gov/news/newsreleases/national/04282021