COVID-19, Emergency Preparedness and Response, Injuries and Illness

Healthcare Emergency COVID-19 Rule Effective Immediately

The Occupational Safety and Health Administration’s (OSHA) emergency temporary standard (ETS), which applies only to employers of healthcare and healthcare support services employees who potentially are exposed to COVID-19, became effective June 21 (86 FR 32376). Covered employers must comply with most provisions of the ETS by July 6 and with the physical barriers, ventilation, and training requirements by July 21.

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Besides physical barriers, ventilation, and training requirements, the healthcare ETS contains requirements for a COVID-19 plan; patient screening and management; standard and transmission-based (infection control) precautions; personal protective equipment; specific precautions for aerosol-generating procedures, such as intubation; physical distancing; cleaning and disinfection; employee health screening and medical surveillance; and employer support for vaccination, including paid leave. The ETS also contains recordkeeping requirements and antiretaliation provisions.

Employers also must provide all required protections at no cost to employees. The ETS contains a “Mini Respiratory Protection Program” requirement, allowing the reuse of disposable respirators that are undamaged and unsoiled. The respiratory protection program does not require medical evaluation; however, an employer may not provide a respirator to an employee who has previously been determined to be medically unfit to wear a respirator. The mini-program also contains a training requirement.

On June 10, OSHA released text of the ETS—the same day it released updated guidance for all employers. The agency’s updated guidelines ease some precautions for fully vaccinated workers, which is in line with recent public health recommendations from the Centers for Disease Control and Prevention (CDC), and encourage employers to protect their unvaccinated workers. The CDC considers persons to be fully vaccinated 2 weeks after their second dose of the 2-dose Moderna and Pfizer vaccines or 2 weeks after their dose of the single-dose Johnson & Johnson vaccine.

Despite a push to get at least 1 shot into 70 percent of American adults by July 4, many employers will still have a workforce of mixed-vaccination status.

The healthcare ETS applies in workplaces providing health care or healthcare support services, including emergency medical services, home health care, and skilled nursing homes, and requires employers to conduct a hazard assessment and develop a written plan to mitigate virus spread. It includes a requirement to identify and manage those who may have COVID-19 before they enter a facility and implement standard and transmission-based precautions to prevent the spread of the disease.

The ETS also requires physical distances of 6 feet between an employee and any other person (coworker, patient, visitor). This may require the reconfiguration of shared workstations or the installation of physical barriers.

The ETS applies to a handful of industries because most employees in health care perform duties that put them at an elevated risk of exposure to SARS-CoV-2 (the virus that causes COVID-19), according to the agency. Employees at risk include those in health care providing direct patient care (doctors, nurses, and emergency medical technicians) and those providing support services (food service, housekeeping, janitorial, and laundry services).

The American Industrial Hygiene Association (AIHA) and the National Safety Council (NSC) both expressed support for the rule.

The AIHA urged OSHA and the White House to issue an ETS and a permanent standard for other industries. The NSC encouraged employers to take a risk-based approach by maintaining precautions with a partially vaccinated workforce and take the lead in vaccine promotion and uptake efforts.

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