A federal rule that could have helped protect health-care workers from coronavirus has been stuck in regulatory limbo since the start of the Trump administration.
An Occupational Safety and Health Administration rule in the works since 2010 was designed to ensure that employers have in place comprehensive programs to protect health-care workers against infectious diseases. Without such standards, compliance with Centers for Disease Control and Prevention guidelines on infection control can’t be easily enforced.
Although OSHA has a rule protecting workers from blood-borne pathogens (and says some provisions of that standard could help limit the spread of pathogens by other means), it has no overarching standard for diseases not spread via blood.
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With the start of the current administration, the rule was removed from OSHA’s active rule-making agenda and relegated to a list of “long-term actions” with no date for moving forward. “Putting it on the long-term agenda essentially means you’re not going to do it,” said Dr. David Michaels, head of OSHA from 2009 to January 2017 and now a professor at the George Washington University School of Public Health.
OSHA, which has joined the CDC in offering guidance for employers on responding to the coronavirus outbreak, did not respond to requests for comment.
The World Health Organization has said that protecting health-care workers must be a top priority in confronting the coronavirus. “If we don’t protect the first-line health-care workers, it will be very difficult to control the epidemic or treat people affected by it,” Michaels said. The importance of appropriate safety protocols was underscored this week as a report emerged that Department of Health and Human Services workers interacted with people quarantined for possible coronavirus exposure without proper equipment or training.
Even before the coronavirus outbreak, some lawmakers expressed concern that OSHA was not prioritizing the infectious-disease standard. At a House Education and Labor Committee hearing in May 2019, Rep. Bobby Scott, the Virginia Democrat who chairs the committee, said OSHA was “relegating to the back burner standards to protect health-care workers from exposure to infectious diseases such as Ebola, pandemic flu and MRSA.”
OSHA’s draft infectious-diseases standard was developed partly in response to the H1N1 flu pandemic in 2009.
As coronavirus concerns grew in January, Scott and Rep. Alma Adams, a Democrat from North Carolina who chairs the subcommittee on workforce protections, wrote Labor Secretary Eugene Scalia urging action on the infectious-diseases standard. The lawmakers were “very concerned that OSHA’s Infectious Diseases standard continues to languish on the agency’s ‘Long-Term Actions’ ” list, they wrote. OSHA should be prepared to issue a temporary emergency rule to help protect workers and a compliance directive to guide OSHA inspectors on enforcement of safe working conditions in health-care workplaces, the letter said.
A committee spokesperson said Friday that the committee had not received a response to the letter. The Department of Labor did not respond to a request for comment.
The pace of the regulatory process has been “frustrating for folks working on the front lines,” said Gerard Brogan, a registered nurse and director of nursing practice at the California Nurses Association and the umbrella trade union National Nurses United. “Regulations matter, and we’re disappointed and frankly appalled that this would be put down as a long-term issue,” he said. Pandemics are “not a question of if,” he said. “It’s a question of when.”
In a recent survey of nearly 5,000 members, National Nurses United found that only 9% said their facility had a plan to isolate patients with possible coronavirus infections; 46% said they had access to N95 respirators; and 31% said their facility had sufficient stock of personal protective equipment such as gloves, gowns and eye protection.
Eleanor Laise reports for MarketWatch and Barron’s Group from Washington.