AHA's Comments on OSHA's COVID-19 Health Care Emergency Temporary Standard

American Hospital Association (AHA) appreciates the opportunity to submit comments on the Occupational Safety and Health Administration’s (OSHA’s) COVID-19 Health Care Emergency Temporary Standard (ETS) interim final rule.

For more than a year, health care workers have battled COVID-19 and worked tirelessly and courageously to care for patients across the country with and without COVID-19. These health care workers’ crucial life-saving roles have never been more evident than during the course of this pandemic. And our organizational leaders, engineers, supply chain managers and others have been there with them, supporting their efforts, seeking supplies of personal protective equipment, re-engineering ventilation systems as needed, sharing updates on the latest clinical care guidance, arranging for staff vaccinations as soon as they became available, and performing countless other tasks to support and protect staff. The safety and protection of all health care workers remains a top priority for the AHA and its members.

The AHA, together with hospitals and health systems, remains similarly committed to following the science-based and sometimes quickly-evolving guidance issued by the Centers for Disease Control and Prevention (CDC). Throughout the course of the pandemic, hospitals have followed these strict, evidence-based protocols to ensure the safety of frontline staff and patients. More recently, hospitals have been actively engaged in efforts to vaccinate their communities, starting with their employees and then expanding beyond their workforce into the local populace. These vaccination efforts are the most promising route to ending the pandemic. As health care workers received top priority in these efforts, the majority are now fully vaccinated, which is the strongest protection against illness, hospitalization and death.

Hospitals, through the diligent efforts of their administrators, infection control officers, hospital engineers and material managers, and other front-line staff, have helped ensure that health care workers are protected and that the latest evidence-based practices and policies are followed. We know that those measures have kept health care workers safe, as evidenced by a recent study1 that found that health care workers were more likely to catch COVID-19 in the community than from the workplace. Maintaining frontline workers’ health and safety is central to a successful response to the pandemic, and no one has a more vested interest in doing so than the nation’s hospitals.

Nevertheless, in promulgating the ETS, OSHA now asserts that COVID-19 poses a grave danger for health care workers and that these regulations are necessary to address the danger. Considering hospitals’ and health systems’ long-standing commitment to adhering to the CDC’s science-based guidance and recommendations and the strong movement towards vaccinating all health care workers, we do not believe that the ETS is necessary. OSHA’s recent decision is particularly puzzling, especially considering that in the spring of 2020, when COVID-19 was still novel and its transmission less understood – when hospitals were overwhelmed with patients with suspect or confirmed COVID-19 infections and experiencing unprecedented shortages of essential supplies necessary to protect health care workers and patients – OSHA declined to deem COVID-19 a grave danger and expressly stated an ETS was not needed.

At this point in time, the AHA does not believe that the ETS provides any additional benefit beyond what hospitals have already been doing, and continue to do, to protect their workforce throughout the pandemic. As such, we urge OSHA to withdraw the ETS interim final rule. If the agency declines to do so, we recommend that the ETS be allowed to expire at the end of the six months and not be published as a final rule.

Below is a summary of our other overarching concerns and comments. Additional detail on each is included in our specific comments.