Update: March 13, 2020: President Donald Trump declared a national emergency March 13 in the wake of the new coronavirus pandemic. More federal funds and supplies are said to become available. Trump issued an executive order to increase the availability of N95 respirators after March 10 Centers for Disease Control and Prevention (CDC) guidance for healthcare workers and emergency responders drew backlash. The CDC stated that “face masks are an acceptable alternative” due to a shortage of respirators, prompting nurses’ associations to demand more protections.

Dive Brief:

• Hundreds of healthcare workers in the U.S. have been exposed to SARS-CoV-2 and do not have the proper protection, Democratic lawmakers said March 10, introducing a bill to remedy those alleged failings. The COVID-19 Worker Protection Act of 2020 (H.R. 6139) introduced by Committee on Education and Labor Chairman Bobby Scott, D-Va., Rep. Donna Shalala, D-Fla., and 19 House Democrats March 10, calls for the Occupational Safety and Health Administration (OSHA) to issue an "emergency temporary standard" (ETS) for SARS-CoV-2.
• The ETS would require healthcare facilities to implement comprehensive exposure control plans as OSHA currently has no enforceable standard to protect workers from airborne infectious diseases, the lawmakers said in a statement. The Centers for Disease Control and Prevention’s (CDC) existing guidance to protect healthcare workers from SARS-CoV-2 is not binding, according to the lawmakers. They seek to require that OSHA order an ETS within 30 days, followed by a permanent standard.
• The Occupational Safety and Health Act gives the U.S. Department of Labor the authority to issue an ETS if "employees are exposed to grave danger from exposure to substances or agents determined to be toxic or physically harmful or from new hazards, and that such emergency standard is necessary to protect employees from such danger," the act states. "If health care workers are quarantined in large numbers, or get ill or die, or fear coming to work, due to the risks, it’s not just a personnel or workplace problem, it’s a national public health disaster," Scott and Rep. Alma Adams, D-N.C., said in a March 5 letter to Labor Secretary Eugene Scalia. 

Dive Insight:

The CDC announced new guidance March 10 for healthcare workers and emergency responders caring for patients with suspected or confirmed cases of the new coronavirus. Nurses’ associations have called the guidance "‘ineffective."

After analyzing local and regional supplies of personal protective equipment, the CDC said "face masks are an acceptable alternative when the supply chain of respirators cannot meet the demand." Face masks can protect the healthcare provider from splashes and sprays, and specialized masks, known as N95 respirators, filter inspired air and offer respiratory protection, the organization said. It also recommended that available respirators be prioritized for procedures most likely to generate respiratory aerosols that pose the highest exposure risk to healthcare professionals. In some of the areas hardest hit by the new coronavirus, hospitals have started to use emergency supplies, according to HR Dive’s sister publication, Biopharma Dive.

The CDC’s new protocols further weakens COVID-19 guidance for healthcare workers, according to the California Nurses Association/National Nurses Organizing Committee and National Nurses United. 

"These changes include, among other things, rolling back personal protective equipment standards from N-95 respirators to allow simple surgical masks; not requiring suspected or confirmed COVID-19 patients to be placed in negative pressure isolation rooms at all times; and weakening protections for health care workers collecting diagnostic respiratory specimens," the nurses said March 10. The organizations also held a rally in Sacramento March 11 "to protest the ineffective employer and government response to COVID-19 and demand protections now," according to the statement. 

Members of the Illinois Nurses Association said in a statement March 12 that they are "angry at the gross incompetence of the federal government’s handling of COVID-19 pandemic."

"The lack of available face masks and shields, as well as shortages of up to one thousand other items on the Strategic National Stockpile, reveal the federal government’s poor planning and mishandling of this crisis," the association stated. "In addition, there has been a failure to calm panic and ensure that the equipment that is available is used appropriately. Because of this incompetence, nurses and patients may now be at greater risk of contracting COVID-19, as well as other viruses."

In response to the CDC’s latest guidance, Scott said in a statement that there is "no evidence surgical masks are adequate to prevent exposure of frontline health care workers to the virus that causes COVID19". The CDC must prioritize conserving equipment and systematically addressing any shortages as they occur, he said.