Trump Team Killed Rule Designed To Protect Health Workers From Pandemic Like COVID-19 "If that rule had gone into effect, then every hospital, every nursing home would essentially have to have a plan," said David Michaels, former Occupational Safety and Health Administration chief.

Trump Team Killed Rule Designed To Protect Health Workers From Pandemic Like COVID-19

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When President Trump took office, his team killed new regulations that would have forced hospitals and nursing homes to prepare for a pandemic like COVID-19. Critics say that decision left health care workers dangerously vulnerable. Tens of thousands of nurses and other care providers have gotten sick. There's a push now for the federal safety rules to be implemented, but the Trump administration is still opposed. NPR's Brian Mann reports.

BRIAN MANN, BYLINE: The federal government has safety rules covering all kinds of workplace hazards, but there are no specific regulations protecting health care workers from deadly airborne pathogens like influenza, tuberculosis or COVID-19. This fact hit home during the last respiratory pandemic.


UNIDENTIFIED REPORTER: ...Quadrupled its estimated H1N1 flu virus death toll to roughly 3,900.

MANN: As H1N1 spread in 2009, federal officials found many hospitals unprepared. Studies found voluntary safety guidelines weren't being followed. There were shortages of personal protective equipment, dozens of health care workers got sick, and at least four nurses died. At the time, David Michaels was head of OSHA, the Occupational Safety and Health Administration.

DAVID MICHAELS: H1N1 made it very clear that OSHA did not have adequate standards for airborne transmission.

MANN: The proposed rules were based on federal regulations for bloodborne diseases created during the HIV/AIDS epidemic that forced hospitals to improve training and safety equipment. Making a new infectious disease standard for respiratory ailments affecting much of the health care industry was time-consuming and complex. Federal records reviewed by NPR show OSHA went step by step through the process for six years. And by early 2016, the new infectious disease rule was ready. The Obama White House added it to a list of regulations scheduled to be implemented in 2017. Then came the presidential election.


PRESIDENT DONALD TRUMP: Earlier this year, we set a target of adding zero new regulatory costs onto the American economy.

MANN: President Trump, speaking here in 2017, made deregulation a big part of his economic agenda. Federal records show Trump's team stripped the airborne infectious disease rule from the agenda two years before COVID-19 hit. Again, David Michaels, the former director of OSHA.

MICHAELS: If the rule had gone into effect, then every hospital, every nursing home would essentially have to have a plan where they made sure to have enough respirators and that they were prepared for this sort of pandemic.

MANN: Instead, hospitals and nursing homes found themselves again without enough protective equipment, only this time on a larger, deadlier scale. Bonnie Castillo heads a union called National Nurses United.

BONNIE CASTILLO: Even just a few months ago, I couldn't have imagined that I would have been on a Zoom call reading out the names of registered nurses who have died on the front lines of a pandemic.

MANN: At least 43,000 nurses, doctors and other frontline medical workers have gotten sick, many of them infected while caring for patients in facilities where personal protective equipment, or PPE, was being rationed. Castillo says the regulations shelved by the Trump administration should be implemented now by Congress as an emergency rule before a second wave of COVID-19 hits.

CASTILLO: Which obviously would mandate that employers have the highest level of PPE, not the lowest.

MANN: Democrats in the House passed a bill in mid-May that would do that, but the measure has so far been blocked by the Republican-controlled Senate. And the rules are still opposed by the White House. The Trump administration hasn't responded to NPR's inquiries. In a briefing call with lawmakers earlier this month, the current head of OSHA, Loren Sweatt, argued there are already enough rules protecting workers. A recording of the call was provided to NPR.


LOREN SWEATT: Well, we have mandatory standards related to personal protective equipment and bloodborne pathogens, sanitation standards. We have existing standards that can address this area.

MANN: Hospitals also oppose the new safety rules. Nancy Foster with the American Hospital Association says voluntary guidelines are adequate.

NANCY FOSTER: They're not regulations, but they are the guidance that we want to follow. They set forth the expectation for infection control. So in a sense, they are just like regulation.

MANN: But the airborne infectious disease standard would have required the health care industry to do far more, stockpiling personal protective equipment to handle surges of sick patients. NPR also found the lack of fixed regulations allowed the Trump administration to relax worker safety guidelines as COVID-19 spread. That meant hospitals could say they were meeting federal guidelines while requiring workers to reuse masks and protective gowns after they'd been exposed to sick patients.

Brian Mann, NPR News.

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