COVID-19 has been declared a global pandemic by the World Health Organization (WHO). Preventing the spread of the SARS-Cov-2 virus, which is a facilitator of the disease, requires the implementation of workplace protection measures for frontline health care workers. The COVID-19 Health Care Worker Protection Act of 2020 (H.R.6139) is an important bill that would protect and enhance the safety of care providers who are caring for coronavirus patients. The Act aims at directing the Secretary of Labor through Occupational Safety and Health Administration (OSHA) to issue an emergency temporary standard (ETS) to certain employers. The ETS should force the employers to develop and implement a rigorous plan addressing the control of infectious diseases, such as COVID-19. The bill aimed at protecting employees in the health care sector, as well as other workers at elevated risks, from exposure to coronavirus. The bill was introduced in Congress on March 9, 2020, by Robert ‘Bobby’ Scott, the Representative for Virginia’s 3rd Congressional district (GovTrack.us., 2020). The current status of the bill is still ‘introduced.’ The bill was referred to the Committees on Education and Labor, Ways and Means, and Energy and Commerce for a period to be determined by the speaker.
Substantive Background Regarding the Issues Addressed in the Act
Globally, there have been many cases of infected healthcare workers, with some succumbing to the disease. Since it is the professional duty of care providers to protect their patients, taking care of healthcare workers is paramount to ensuring sustainability and efficiency of the healthcare system (GovTrack.us., 2020). In the United States, hundreds of health care providers have been placed in quarantine or infected as a result of their contact with the disease. Central to the Act, OSHA is required to issue an ETS protecting health care workers from COVID-19.
The bill acknowledges that COVID-19, which is a highly infectious disease, presents a great danger to health care workers who are often the first line of defense against the pandemic. Inadequate precautions surrounding the disease infection control protocols have detrimental impacts on care providers, patients, and the public at large. Currently, there exists only one OSHA standard that enforces the protection of health care workers from infectious diseases (National Employment Law Project, 2020). However, the standard only applies to blood-borne pathogens (Emanuel et al., 2020). The standard was implemented to protect care providers from work-related risks emanating from diseases contracted through blood, such as Hepatitis and HIV.
Hundreds of health care workers have been quarantined or infected by the disease. Consequently, various workers’ unions noted that numerous facilities are not prepared to safely protect their staff (National Safety Council, 2020). Additionally, the guidelines issued by the Centers for Disease Control and Prevention on health care workers’ protection are not fully comprehensive in protecting the workers (GovTrack.us., 2020). Similarly, OSHA lacks an enforceable standard that can protect care providers from contagious airborne diseases. As a result, health care workers are at an elevated risk of being exposed to COVID-19 at a time when they are most needed to take care of patients (Black et al., 2020). The crisis in the health care system could worsen if a large number of health care workers are isolated, fall ill, die, or develop work-related fear or anxiety (McMichael, 2020). OSHA is the only federal agency mandated with the responsibility of enforcing safe working conditions for workers. Ensuring that OSHA develops and issues an emergency temporary standard (ETS) surrounding infectious disease exposure control plans is, therefore, vital to protecting health care workers, consequently promoting health care provision and care.
Pro and Cons of the Legislation
A major advantage of the legislation is that it calls for the issuance of an emergency temporary standard on infectious disease control plans. Public health system stakeholders such as nurses and physicians are therefore expected to benefit immediately from the legislation. Section 6(c) of the OSH Act gives authority to OSHA to issue an ETS without having to go through the normal rule-making process, which is often lengthy (National Safety Council, 2020 a). Similarly, OSHA can promulgate an ETS without the need for supplying an opportunity or notice for public hearings or comments. Without having to follow the lengthy process required for normal laws and rules, the Act is able to ensure that a swift response to the novel-coronavirus disease (Burdorf, Porru & Rugulies, 2020). Upon publishing in the federal register, the ETS immediately becomes effective.
Another advantage of the Act emanates from durations surrounding an ETS implementation. According to the provisions of Section 6(c) (2) of the OSH Act, an ETS is effective until superseded by the permanent standards. The permanent standard should follow the normal rulemaking process as per provisions of the OSH Act (National Safety Council, 2020 b). OSHA is required to promulgate a permanent standard within six months upon enactment of an ETS. The fact that the ETS remains in force until a permanent standard is enacted ensures that the OSHA’s guidelines remain in force without interruptions, thus positively impacting the county’s ability to fight COVID-19 (Estrada, 2020). The legislation, therefore, solves the problem of health care workers’ protection from contagious infectious diseases two-fold; providing a quick temporary ETS and offering a great opportunity to adopt permanent measures.
The legislation offers to protect health care workers both in the public and private sectors. There have been concerns about the mental health of healthcare workers being affected negatively by COVID-19 due to the lack of proper protective standards and protocols in hospitals (Greenberg et al., 2020). The legislation will therefore be helpful in addressing the problem, hence promoting nurses’ mental health. Currently, only 21 states have state OSHA plans that address public employers. For the others, OSHA standards and regulations often cover private employers only. A great advantage of the COVID-19 Health Care Worker Protection Act of 2020 is that the ETS standards will apply to public employers that receive Medicare. Expanding the standards to public facilities ensures that the scope of protected health care workers, who are at high risk, is greatly expanded.
The main disadvantage of the legislation accrues from the lengthy legislative process in congress. For instance, the bill is still in the introduction stage despite that it was introduced into Congress in March 2020. The long process derails the process of protecting health care workers during the period of COVID-19 when such protection is crucial. Another disadvantage relates to the slow nature of adopting required amendments to the Act. According to the provisions of the legislation, amendments by sub-section (a) of the Act shall apply beginning on the date that is one (1) month after ETS has been promulgated. It is, therefore, difficult to implement swift amendments to the Act that seeks to address pressing pertinent issues concerning health care workers’ protection and welfare.
The regulatory burden that will befall hospitals as they struggle to meet the almost impossible standards is a major setback of the bill. Inadequate supply of key personal protective equipment (PPE), surgical masks, and N95 masks make the protective standards set out in the bill very hard to meet (Rowan & Laffey, 2020). Currently, hospitals have already established comprehensive infection control programs. Further, health care facilities invest significant resources to evaluate and improve these programs. Burdening the hospitals with other OSHA standards will have detrimental effects on hospitals’ financial resources. In order to participate in Medicaid and Medicare programs, hospitals must meet some specific infection control standards. Not meeting the standards set out by OSHA may result in hospitals being denied participation in such programs, thus reducing their inpatient capacity. Inability to meet the standards spelled out by OSHA may also result in hefty fines.
Stakeholders Benefiting from the Bill
The legislation will have a significant impact on key public health stakeholders. While some of the stakeholders will benefit from the bill, others will not. Key stakeholders expected to benefit from the legislation include healthcare workers such as nurses, physicians, and cleaning crews. The protection measures proposed by the legislation would ensure that health care workers are protected from contagious infections such as COVID-19, thus improving their welfare. On the other hand, healthcare facilities will not benefit from the legislation. Rather, hospitals will now be required to put in place more stringent measures that protect health care workers from COVID-19. These measures will require resources, hence forcing care facilities to spend more, further increasing operational costs.
Position Statement on the Legislation
As a DNP, I strongly support the swift passage of the COVID-19 Health Care Worker Protection Act of 2020. Congress should protect the frontline health care workers from COVID-19 exposure by mandating the Secretary of Labor, through OSHA, to issue ETS that implements an infectious disease standard control plan (Ranney, Griffeth, & Jha, 2020). Despite that numerous agencies issue guidelines on health care workers’ protection, as well as best practices during the pandemic, employers are not forced to implement safety precautions. OSHA’s mission is to assure healthful and safe working conditions for working populations. To ensure that its mission is achieved, the agency must step in to enforce infectious disease control plans and protocols.
As the country, and the world at large, fights what may be termed as the greatest health care crisis in the recent past, it is in the public interest that government agencies, such as OSHA, be at the forefront in protecting health care workers. Such workers are central to a strong health care system (World Health Organization, 2020). Without proper protection from care providers, the health care system is doomed. As Rep. Shalala argued, the best defense to any form of crisis is making sure that there exists proper infrastructure to handle it. Infrastructure not only entails laboratories and hospital facilities but also includes health care staff that is in the frontline offering care to COVID-19 patients. Due to their constant interactions with patients, the risks of health care workers are elevated greatly. Health care workers also play a crucial role in coordinating COVID-19 response. The COVID-19 Health Care Worker Protection Act of 2020 will ensure that health care workers are kept safe in the face of a rapidly evolving public health emergency.
The COVID-19 Health Care Worker Protection Act of 2020 is an extremely important bill that seeks to protect and enhance the safety of health care workers amid the COVID-19 pandemic. The Act aims at directing the Secretary of Labor, through Occupational Safety and Health Administration (OSHA), to issue an emergency temporary standard (ETS) to certain employers. The ETS should prompt the employers to develop and implement a rigorous plan addressing the control of infectious diseases, such as COVID-19. Having been introduced in Congress by Rep. Robert Scott on March 9, 2020, the bill is still in the ‘introduced’ stage. The legislation solves the problem of health care workers’ protection from contagious infectious diseases by providing a quick temporary ETS and offering a great opportunity to adopt permanent measures. As a DNP, I strongly support the swift passage of the COVID-19 Health Care Worker Protection Act of 2020 as it contributes to a safe working environment for health care workers, thus protecting the entire health care system strain.
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