Less than 24 hours after inauguration, President Biden issued an executive order tasking the Occupational Safety and Health Administration (OSHA) to consider the necessity of an emergency COVID-19 standard; to issue revised guidance to employers on workplace safety during the COVID-19 pandemic; and require OSHA to review its current enforcement efforts.

An Anticipated Federal OSHA Emergency COVID-19 Standard

On January 29, 2021, Federal OSHA issued “Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace”. This guidance focuses on workplace COVID-19 prevention programs and lists sixteen (16) elements of an effective plan: (1) Assignment of a workplace coordinator; (2) Identification of where and how workers might be exposed to COVID-19 at work; (3) Identification of a combination of measures that will limit the spread of COVID-19 in the workplace, in line with the principles of the hierarchy of controls; (4) Consideration of protections for workers at higher risk for severe illness through supportive policies and practices; (5) Establishment of a system for communicating effectively with workers and in a language they understand; (6) Educate and train workers on your COVID-19 policies and procedures using accessible formats and in a language they understand; (7) Instruct workers who are infected or potentially infected to stay home and isolate or quarantine; (8) Minimize the negative impact of quarantine and isolation on workers; (9) Isolating workers who show symptoms at work; (10) Performing enhanced cleaning and disinfection after people with suspected or confirmed COVID-19 have been in the facility; (11) Providing guidance on screening and testing; (12) Recording and reporting COVID-19 infections and deaths; (13) Implementing protections from retaliation and setting up an anonymous process for workers to voice concerns about COVID-19-related hazards; (14) Making a COVID-19 vaccine or vaccination series available at no cost to all eligible employees; (15) Not distinguishing between workers who are vaccinated and those who are not; (16) Other applicable OSHA Standards.

Further, employers can look to state standards that have been developed and implemented under California’s COVID-19 Prevention Emergency Temporary Standard, Michigan’s MIOSHA Emergency Rules for COVID-19, Oregon’s Temporary Rule Addressing Temporary Workplace Risks, and Virginia’s “Final Permanent Standard” for Infectious Disease Prevention of the SARS-CoV-2 Virus That Causes COVID-19 to recognize a direction that Federal OSHA may take regarding the requirements of a Federal Emergency Standard. We recommend employers become familiar with and understand the state standard examples to prepare their workplace safety policies and plans regarding COVID-19 for adherence to guidance in advance of an anticipated Federal Emergency Permanent Standard following an initial Emergency Temporary Standard. Virginia’s SARS-CoV-2 “Final Permanent Standard” separates itself from the other state standards with identification of exposure risk hazards within workplaces and job tasks as “very high”, “high”, “medium” and “lower”. The four levels recognize the level of possibility that an employee could be exposed to the hazards associated with SARS-CoV-2 virus and the COVID-19 disease. Among the requirements, the high-risk and medium-risk worksites must implement a written infectious disease preparedness and response plan.

In preparation Employers may wish to evaluate and validate their policies on:

• Disinfection of Common Areas: The CDC recommends employers clean dirty surfaces with soap and water prior to disinfection and to routinely disinfect frequently touched surfaces at least daily. The State of Virginia states that areas where multiple shifts are employed must be cleaned and disinfected no less than once every 12 hours.
• COVID-19 Prevention Program: Establish and implement an effective and understandable written COVID-19 Prevention Program. If one already exists, an audit of the current infectious disease preparedness and response plans may be needed.
• COVID-19 Preventative Measures: Implement COVID-19 Preventative Measures and Guidance, namely physical distancing, face coverings, engineering and administrative preventative controls, handwashing and sanitizing facilities, use of personal protective equipment (PPE) other than masking, and ventilation testing, verification, validation and modifications, as needed.
• Reporting and Recordkeeping: Report COVID-19 cases and retain COVID-19 related records in a confidential manner as consistent with OSHA accident reporting and medical records regulations.
• Management of Outbreaks –  20 or more confirmed COVID cases: Under the State of California – Cal OSHA Prevention Emergency Standard a workplace outbreak is defined as three or more cases in the same workplace within a 14-day period and defines a “major” outbreak as 20 or more COVID-19 cases within a 30-day period in the same workplace. If a major outbreak occurs, employers must comply with certain requirements until no new COVID-19 cases have been detected in the workplace for a 14-day period (provide COVID-19 testing at least twice a week; exclusion of workers who have COVID-19 or experienced a COVID-19 exposure; ongoing COVID-19 case investigations; COVID-19 hazard assessment and corrections; and ongoing COVID-19 notification obligations). Virginia’s SARS-CoV-2 “Final Permanent Standard” requires employers to notify their local health department if two or more workers are discovered to be infected over a two-week span; but it is left up to the state health department to decide what manner of testing is needed.
• Management of COVID-19 Infections and Outbreaks: Under the State of California’s Cal OSHA Prevention Emergency Temporary Standard, employers shall provide COVID-19 testing to all employees at a workplace or worksite where an outbreak (as defined above) has been confirmed with follow-up testing 1 week later. This testing is to be at no cost to the employees and shall be offered during employee work hours. If considered necessary by Cal OSHA, and/or recommended by the health department, or to manage an ongoing outbreak, follow on testing will be at no charge to employees.
• Worker Isolations: Isolate and delay return of workers to the workplace who are known to have COVID-19 or who have had a COVID-19 exposure and apply set criteria for allowing workers to return.
• COVID-19 Case Investigation: Promptly investigate potential and confirmed COVID-19 outbreaks and cases to determine if workplace related factors contributed and take immediate action to address any identified COVID-19 related hazards.
• COVID-19 Training: Train and notify supervisors and employees on workplace safety policies and new guidance, as needed.

RHP Risk Management’s skilled and knowledgeable professionals support and partner with clients to provide resources to workers, customers, and the general public about the evolving spread of the coronavirus.

Preparing Workplaces for Re-Entry provides a framework that follows the hierarchy of controls used by occupational health and safety (OHS) science professionals when designing and implementing controls for workplace hazards. The hierarchy of controls lays out options for controlling and or mitigating hazards that range from elimination, engineering, administrative controls and lastly PPE.

Presentation of a hierarchy of controls in an individual workplace can be seen through Pandemic Infectious Disease Plan: Returning to a New Normal, in which RHP Risk Management experts provide guidance and steps for employers in their development of a Pandemic Infectious Disease Plan that fits their specific industry and worksite. Some elements of such a plan are universal as can be seen in the standards above, a comprehensive infectious disease plan should, at minimum, include the purpose of the plan and definitions; designated point of contact and infectious disease workplace coordinator; definition and determination of essential personnel; remote work policies; training requirements; infectious control measures including health certification, engineering controls, administration controls, personal protective equipment (PPE), physical distancing, and personal hygiene requirements.

Employers should audit their workplaces to evaluate, test and validate preventative control measures that can be made through their building’s engineering systems. In the study, Go With the Flow: Ventilation and the spread of SARS-CoV-2 (COVID-19), researchers found that large infectious aerosol particles (i.e., 5 to 15 micrometers) remain airborne for several minutes and smaller particles (i.e., less than 5 micrometers) remain airborne longer, for many minutes to hours. In the absence of air currents, aerosolized particles disperse slowly and over a longer period of time.

The CDC recommends considering the following ventilation engineering controls to reduce transmission by:

• Improve ventilation in buildings based on local environmental conditions (temperature/humidity) and ongoing community transmission in the area by increasing the percentage of outdoor air and consider use of natural ventilation to increase outdoor air dilution of indoor air.
• Increase total airflow supply to occupied spaces, if possible; disable demand-control ventilation (DCV) controls that reduce air supply based on temperature or occupancy.
• Improve central air filtration.
• Consider running the HVAC system at maximum outside airflow for 2 hours before and after occupied times, in accordance with industry standards.
• Generate clean-to-less-clean air movements by re-evaluating the positioning of supply and exhaust air diffusers and/or dampers and adjusting zone supply and exhaust flow rates to establish measurable differentials. Have staff work in “clean” ventilation zones that do not include higher-risk areas such as visitor reception or exercise facilities (if open). Remember to consider air movement changes and flow blockage if you are using barriers such as plexiglass or new wall construction or dividers.
• Consider adding portable high-efficiency particulate air (HEPA) fan/filtration systems to help enhance air cleaning.
• Ensure exhaust fans in restroom facilities are functional and operating at full capacity when the building is occupied.
• Consider the use of ultraviolet germicidal irradiation (UVGI) as a supplemental technique to inactivate potential airborne virus in the upper-room air of common occupied spaces, in accordance with industry guidelines.

Ventilation System Testing and Validation – Modifications to ventilation systems, such as the installation of more restrictive filters or changes to damper settings, can have an impact on overall system efficiency. It is important to demonstrate that changes made yield the intended effect of improved ventilation and reduced risk of indoor aerosol transmission. Ventilation system testing and validation has numerous benefits including reducing the risk of an outbreak within a facility which could lead to a costly shutdown, increasing employee confidence that returning to work is safe, improving productivity and maximizing profitability by optimizing operations and building occupancy within current pandemic restrictions, reducing the risk of workers’ comp claims from workplace exposure, and documenting implementation of best practices and defensible processes.

RHP experts provide specific guidance and recommendations for ventilation considerations in commercial buildings and schools, see Current Best Practices: Important Re-opening Considerations for Schools, Campuses, and Commercial Buildings. Effective solutions to manage occupancy and combat disease transmission is not limited to a single control mechanism or practice, instead multiple control measures should be implemented to add layers of protection such as physical distancing, cloth masks, personal hygiene, and engineering and administrative controls that work together to reduce risk.

At RHP Risk Management, we help our clients navigate the uncertainties associated with environmental and occupational hazards and risks. Our staff of public health professionals are experienced and trained in recognizing, anticipating, and controlling hazards. For more information on RHP’s services and contact information, please visit www.rhprisk.com.