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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

OSHA Finalizing COVID-19 Rule in Healthcare Settings

By Gary Evans, Medical Writer

The Occupational Safety and Health Administration (OSHA) has reopened comments and slated a public hearing for April 27, 2022, as it moves to finalize its Emergency Temporary Standard (ETS) to protect healthcare workers from COVID-19.

The ETS originally was issued on June 21, 2021, with OSHA requiring multiple protections, including barriers, social distancing, and upgraded ventilation. With most healthcare workers now vaccinated and revised guidelines by the Centers for Disease Control and Prevention (CDC), OSHA is considering relaxing some of the requirements.

”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 said in a Federal Register notice.

The deadline for submitting comments is April 22, 2022. Comments and associated documents for this rulemaking (Docket Number OSHA-2020-0004) should be submitted electronically, OSHA said.

The virtual hearing will begin on April 27, 2022, and, if necessary, will continue on subsequent days.

With CDC guidelines changing, the ETS is no longer in alignment with some provisions, including isolation and return to work requirements. “OSHA is considering whether it is appropriate to align its final rule with some or all of the CDC recommendations that have changed between the close of the original comment period for this rule and the close of this comment period,” the agency stated. “OSHA seeks comment on this approach.”

Noting that some healthcare employers found the ETS provisions overly prescriptive, OSHA “is considering restating various provisions as broader requirements without the level of detail included in the Healthcare ETS and providing a ‘safe harbor’ enforcement policy for employers who are in compliance with CDC guidance applicable during the period at issue.”

OSHA also seeks comment on linking regulatory requirements to measures of local risk, such as the CDC has done for healthcare settings and in guidance for prevention measures in the community.

“OSHA is considering specifying that this final standard would apply not only to COVID-19, but also to subsequent related strains of the virus that are transmitted through aerosols and pose similar risks and health effects,” the agency stated.

This point has been made by critics as well, saying a standard applicable to other respiratory viruses would have more utility and staying power than measures strictly for COVID-19.

Acknowledging the previous comment period for the ETS closed before Delta and Omicron variants appeared, OSHA asked for new studies or data on “the rate of infection, long COVID, hospitalization, and death among healthcare workers compared to those rates among the general adult population.”

OSHA requested more information on several other key indicators, which are paraphrased as follows:

  • The average number of days healthcare workers have been out with COVID-19 infection or quarantine.
  • The percentage of healthcare workers who have taken sick days due to COVID-19 infection.
  • The health effects of breakthrough infections in fully vaccinated employees, including hospitalizations, long COVID, and mortality.
  • The percentage of healthcare workers who — due to age or compromised immunity — are at elevated risk of severe COVID-19

For more on this story, see the next issue of Hospital Employee Health.

Gary Evans, BA, MA, has written numerous articles on infectious disease threats to both patients and healthcare workers. These include stories on HIV, SARS, SARS-CoV-2, pandemic influenza, MERS, and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.