Review: ‘Appalling’ U.S. Failure to Secure Frontline Personnel Through Pandemic

Review: ‘Appalling’ U.S. Failure to Secure Frontline Personnel Through Pandemic

— Absence of protections “produced a excellent storm for vulnerable staff,” scientists reported

by Katherine KahnWorkers Author, MedPage Right now

The U.S. regulatory, political, and legal devices failed to reduce hundreds of fatalities amid the nation’s critical employees through the COVID-19 pandemic, in accordance to a scathing investigation.

Frontline staff who experienced to present up to function throughout the early days of the pandemic have been at significant chance for disease and dying, thanks to unmitigated office publicity to SARS-CoV-2, documented David Michaels, PhD, MPH, of the Milken Institute University of General public Heath at George Washington University in Washington, D.C., and colleagues.

“From the outset, frontline staff ended up a component in the spread of SARS-CoV-two, and they and many others had been built ill or died as a outcome of exposures at perform,” they wrote in The BMJin the initially in a collection of content on classes from the COVID pandemic in the U.S.

Since Black, Hispanic, and immigrant staff are used in quite a few crucial industries, this sort of as health care, agricultural creation, and general public transportation, they ended up extra possible to die from COVID than white workers.

“Visualize if there ended up no Zoom, no telework, and the highly paid, politically highly effective executives in finance and large-tech ended up demanded to occur into the business office every working day,” Michaels, who served as the assistant secretary of labor for the Occupational Safety & Wellness Administration (OSHA) from 2009 to 2017 and was the longest serving administrator in OSHA’s historical past, explained to MedPage These days. “I think we would have seen a national clamor for more robust principles to shield staff. Rather, we mainly ignored the exposures that were transpiring in workplaces and the most vulnerable personnel compensated the rate.”

In an accompanying editorialGavin Yamey, MD, MPH, of Duke Worldwide Overall health Institute at Duke University in Durham, North Carolina, and colleagues famous that “ingrained inequalities contributed to devastating pandemic results. The U.S. has greater cash flow inequality and much more constrained worker protections than its friends, and precarious employment was on the increase even right before COVID-19.”

The one.sixteen million Us residents who died from COVID stand for 16% of international fatalities in a country with just 4% of the world’s population, Yamey and colleagues pointed out. About 300,000 kids lost 1 or both equally moms and dads, and a single in 3 People in america know anyone who died from COVID.

A deficiency of employee protections “made a excellent storm for susceptible staff,” Michaels and colleagues wrote, noting that the U.S. is a single of only six nations devoid of a countrywide common paid out sick go away plan and the only state out of 37 in the Organisation for Economic Cooperation and Improvement without having universal health care obtain.

Additionally, some employers set gain ahead of workers’ wellness and protection, and have been encouraged to do so by elected officers, the authors wrote. For example, a Residence Oversight Committee report detailed how the Trump administration pressured the meatpacking field to preserve functioning at total capacity, even with big outbreaks of COVID amongst its employees.

U.S. devices to ensure the health and fitness and basic safety of staff, including OSHA, the CDC, and point out and regional overall health departments, were weak right before 2020, but subsequently unsuccessful through the pandemic, the research authors reported.

“OSHA has historically been structured by Congress and successive administrations as a weak agency, both in phrases of sources and its potential to insist that workplaces be designed harmless,” they wrote. “On a national degree, OSHA has only adequate inspectors to pay a visit to each workplace once every one hundred ninety many years,” they extra, citing a the latest American Federation of Labor-Congress of Industrial Companies Protection and Wellbeing Business report.

OSHA also identified itself at odds with the CDC on how best to secure frontline staff during the pandemic. While OSHA had typical procedures for managing exposure to airborne pathogens, this sort of as strengthening place of work air flow and air quality, the CDC selected to emphasis on droplet and fomite transmission of SARS-CoV-2, with an emphasis on surgical masks, handwashing, and social distancing.

“It is now very clear that the CDC erred in clinging to the droplet dogma,” the authors wrote.

Federal and point out OSHA systems gained “a lot of countless numbers of grievances” from workers who confronted probable retaliation when they voiced problems about SARS-CoV-2 exposures or a lack of private protecting products (PPE), and many workers’ issues are continue to in litigation right now.

“The underlying authorized routine merely did not provide ample protection to employees who facial area significant dangers,” Michaels and workforce wrote. “The outcomes of these failures had been appalling.”

During 2020, penalties assessed to corporations violating OSHA regulations had been incredibly small, they noted. For case in point, OSHA fined Smithfield Packaged Meats Corp. in Sioux Falls, South Dakota just $13,494 for failing to safeguard employees from SARS-CoV-2 an infection, immediately after nearly 1,300 workers contracted the virus and four died. That amount was the optimum authorized by regulation.

Michaels and colleagues made available various action details on how to defend frontline employees likely forward:

  • OSHA really should challenge new expectations on pandemic preparedness and the prevention of place of work exposure to airborne pathogens
  • Each individual employer should really be demanded to create particular options to guard its employees. Pandemic preparedness designs should really guarantee employee accessibility to PPE, vaccines, and other health interventions
  • Common paid out medical depart ought to be proven to let staff to remain household when ill
  • Nearby constructing codes should really be up-to-date to increase HVAC methods and air top quality
  • OSHA must issue a typical that employees be provided in place of work possibility assessment and abatement routines, and be guarded against retaliation for pointing out threats to their wellbeing and basic safety
  • Laws is required that expands OSHA’s capacity to carry out inspections and challenge penalties
  • Greater coordination is necessary among office security and community health and fitness companies

“These insurance policies and plans would be beneficial even in the absence of a pandemic, and we really should not wait for the next pandemic to introduce them,” the authors concluded.

  • author['full_name']

    Katherine Kahn is a staff author at MedPage Right now, covering the infectious health conditions beat. She has been a clinical author for about fifteen several years.


Michaels noted receiving funding from the Health Motion Alliance, as properly as the McElhattan Basis, from which two other co-authors also received funding.

Yamey has obtained funding from the WHO, Invoice & Melinda Gates Basis, and Carnegie Company, amid other people. He served on the COVID-19 vaccine improvement undertaking force hosted by the Environment Bank.

Key Resource


Resource Reference: Michaels D, et al “US workers through the COVID-19 pandemic: uneven dangers, inadequate protections, and predictable repercussions” BMJ 2024 DOI: ten.1136/bmj-2023-076623.

Secondary Source


Resource Reference: Yamey G, et al “Pandemic lessons for the 2024 US presidential election” BMJ 2024 DOI: 10.1136/bmj.q150.

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