The American Hospital Association (AHA) wants the Biden administration to withdraw a COVID-19 emergency protection standard because it believes hospitals are already doing enough to protect front-line workers.
At the same time, the American Nurses Association (ANA) wants the standard to be even stronger, asking for vaccine mandates to be included in the Occupational Health and Safety Administration (OSHA) temporary standard, which requires employers to provide certain protections such as vital equipment like N95 masks.
The stark difference in views on the standard, which was open for comment until Aug. 20, comes as nurse unions and advocacy groups have charged that hospitals have not done enough to protect workers while facilities say they are following the latest policies and redoubled efforts to shield workers from the virus.
The AHA said in comments (PDF) that hospitals have installed the latest evidence-based measures from the Centers for Disease Control and Prevention (CDC) to keep front-line workers protected.
“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 healthcare workers, we do not believe the [standard] is necessary,” the comments said.
The AHA also noted that OSHA declined to deem COVID-19 a grave danger, and a standard was needed back in the spring of 2020 when the first surge of the virus was overwhelming facilities.
The AHA wanted OSHA to get rid of the standard altogether but, if the agency doesn’t heed that advice, then to at least give hospitals at least another six months to comply with the requirements.
“Hospitals and health systems are struggling under the weight of the COVID-19 pandemic’s fourth wave and have told us that although they remain committed to following the CDC’s guidance, they need more time to fully implement the [emergency standard’s] many new requirements,” the comments said.
The AHA also wants OSHA to update the standard to amend a physical distancing requirement to better account for healthcare worker vaccination status.
“Hospitals believe that the requirement hinders staff education, negatively impacts staff morale and impedes hospital’s exhausted workforce from doing their job efficiently—all when hospitals are already taking many other precautions for the benefit of employee safety,” the comments said.
Other hospital groups are concerned with the short time frame for implementation.
“Compliance with this rule will require some academic medical centers, and their associated health care facilities, to make significant modifications to their hospital policies and procedures, and undertake structural changes to their facilities, such as installing physical barriers,” said the Association of American Medical Colleges in its comments.
But nurses believe the protection standard needs to go even further.
The ANA wrote in comments that OSHA should revise the standard to require employers to install mandatory COVID-19 vaccination programs.
“To underscore the critical importance of COVID-19 immunization to the protection of all healthcare personnel, ANA urges OSHA to amend the [emergency standard] to require healthcare employers to mandate COVID-19 vaccination, subject to reasonable exceptions as outlined by CDC,” the ANA said.
More than 50 hospital systems have already mandated staff to get vaccines, with more likely on the way.
The ANA also praised requirements for providing personal protective equipment (PPE) such as N95 masks and gowns. But it wanted OSHA to clarify certain parts of the standard.
For example, since the onset of the pandemic, several states have required hospitals to keep a certain stock of PPE on hand.
“OSHA should offer guidance clarifying application of the [emergency protection standard] in relation to state and local regulation,” the comments said. “If state provisions are more stringent, the [standard] should be considered a minimum standard.”