As this report was filed, the Occupational Safety and Health Administration (OSHA) had finalized the COVID-19 draft standard to protect healthcare workers and submitted it to the White House.
On Dec. 8, 2022, OSHA sent the standard to the Office of Management and Budget, with a decision on its fate expected sometime in early 2023.
A polarizing document as an Emergency Temporary Standard (ETS), the final draft version likely will draw similarly mixed reviews. A major point of contention in the hearings and comments that preceded the final draft was whether OSHA should be completely independent or essentially should codify recommendations by the Centers for Disease Control and Prevention (CDC). The Association for Professionals in Infection Control and Epidemiology (APIC) took the latter position, saying the OSHA regulation could end up being “one size fits all.”
“CDC guidance is evidence-based and is updated based on sometimes rapidly changing data,” said Lisa Sturm, MPH, CIC, FAPIC, who testified for APIC. “The frequent changes in guidance from the CDC often look indecisive. But on the contrary, it shows that the CDC is able to update and flex their guidance as new data emerge.”
In its June 1, 2021, version — now expired pending finalization — the ETS required multiple protections, including barriers, social distancing, and upgraded ventilation.
OSHA moved to finalize the ETS, opening it for comment in April 2022, holding a public hearing, and then reopening the docket for final comments in May.1 In doing so, it expressed consideration of less restrictive policies for healthcare workers who have been vaccinated.
“OSHA is considering suggestions that requirements be relaxed for masking, barriers, or physical distancing for vaccinated workers in all areas of healthcare settings, not just where there is no reasonable expectation that someone with suspected or confirmed COVID-19 will be present,” the agency stated.2
In a Dec. 8, 2022, statement that coincided with the submission of the OSHA draft standard, National Nurses United (NNU) called for a permanent standard that would “require employers” to protect nurses and other healthcare workers from occupational exposure to COVID-19.3 “The COVID-19 pandemic is not over,” Deborah Burger, RN, president of NNU, said in the statement. “New, more immune-evasive variants continue to circulate, bivalent booster vaccination rates are extremely low, and few public health measures remain in place. Nurses, other healthcare workers, and their patients remain at risk of COVID exposure, infection, illness, and death because their employers continue to fail to fully protect them.”
The NNU said a December 2022 survey of more than 2,800 nurses in 46 states found that only 66% report wearing a respirator for every encounter with a COVID-positive patient.
Only 34% of nurses report that they are informed of COVID exposures in a timely fashion, even though prompt testing and isolation are essential to preventing transmission.
“Many nurses continue to experience the devastating impacts of long COVID,” Burger said. “This is why we need a permanent standard and why we must continue to maintain multiple measures of infection control, including masking, vaccinations, testing, ventilation, contact tracing and notification, proper isolation, and quarantining.”
- Occupational Safety and Health Administration. COVID-19 Healthcare Rulemaking. https://www.osha.gov/coronavirus/healthcare/rulemaking
- 87 Fed Reg 16426 (March 23, 2022).
- National Nurses United. National Nurses United applauds OSHA for sending Covid-19 permanent standard for health care workers to OMB for review, urges OMB to take prompt action. Published Dec. 8, 2022. https://www.nationalnursesunited.org/press/nnu-applauds-osha-sending-covid-19-permanent-standard-for-health-care-workers-to-omb