USA
/The following information has been collected and collated by convergence consulting in collaboration with our in-country Global Alliance Partner. Please let us know if you have additional questions by emailing us at COVID-19@cc-global.com.
1. Does your country’s health authority have guidelines or requirements for when COVID-19 cases are classified work-related and reported as a workplace illness?
Yes, the Occupational Safety and Health Administration (OSHA) has developed a dedicated multi-page website for COVID-19-OSHA compliance-related information and OSHA recommendations. This includes guidance on when COVID-19 cases would be classified as reportable as a workplace illness. According to OSHA: “COVID-19 can be a recordable illness if a worker is infected as a result of performing their work-related duties. However, employers are only responsible for recording cases of COVID-19 if all of the following are true.
“The case is a confirmed case of COVID-19 (see CDC information on persons under investigation and presumptive positive and laboratory-confirmed cases of COVID-19);
“The case is work-related (as defined by 29 CFR 1904.5); and
“The case involves one or more of the general recording criteria set forth in 29 CFR 1904.7 (e.g., medical treatment beyond first aid, days away from work).”
Links:
2. Is there information on the timing of “return to work” and the process for a worker to return, i.e. examination by a physician, or a negative COVID test?
OSHA refers to the Centers for Disease Control (CDC) for guidance about the discontinuation of home isolation for people with COVID-19. Generally, (per OSHA):
“If you have been isolating yourself at home: Your healthcare provider or state, local, tribal, or territorial health department can provide the best information about when you can discontinue isolation and return to essential activities, such as going to work.
“If you have been hospitalized with COVID-19: Follow your healthcare provider's discharge and follow-up instructions, which should include information about when you can return to essential activities, such as going to work.”
So as not to place undue strain on the health care system, OSHA discourages employers from requiring documentation such as a “doctor’s note” for employees returning to work following illness.
CDC, regarding someone who was absent due to illness with COVID-19: “Employees should not return to work until the [CDC] criteria to discontinue home isolation are met, in consultation with healthcare providers and state and local health departments.” The CDC criteria and timelines for discontinuing home isolation vary depending on whether the person was symptomatic or tested positive but asymptomatic, and whether they are immunocompromised.
It is important to note that there is expanded family and medical leave under the Families First Coronavirus Response Act, including allowances for employees to remain at home to care for a sick family member or take care of their children.
DOL COVID-19 and the American Workplace
3. Does your country’s health authority have COVID-19 mitigation guidelines for the public and/or for business? If so, please list them below and how long they will be in place.
On the CDC COVID-19 web page there is a section dedicated to businesses: Businesses and Workplaces – Plan, Prepare, and Respond. CDC conducted a 45- minute Business Sector Call for COVID-19 (with a visual presentation) on May 4, which was recorded and is available on this page for review. There is also a FAQ page for businesses that concisely addresses how to handle in the workplace; suspected or confirmed COVID-19 cases, reducing the spread of COVID-19, healthy business operations, and cleaning and disinfection. It also provides guidance for critical infrastructure workers.
Regarding “critical infrastructure” and “essential businesses”:
The Department of Homeland Security (DHS) developed a list of essential critical infrastructure workers to help state and local officials as they work to protect their communities, while ensuring continuity of functions critical to public health and safety as well as economic and national security. CDC has provided guidance to specify when and how critical infrastructure workers can continue to work following exposure to COVID-19.
DHS considers facilities in the chemical sector, which includes pharmaceuticals, to be critical infrastructure.
State and local officials make the final determinations for their jurisdictions about critical infrastructure workers. Many states use the terms: “essential” and “non-essential” businesses or workers. In general, essential businesses are permitted – and sometimes required – to remain open and continue providing their goods and services, while non-essential businesses are required to remain closed unless they can conduct their business in a manner that prevents the potential for transmission of COVID-19.
Key CDC COVID-19 guidance documents for businesses include:
COVID-19 Travel Recommendations by Country. Currently, CDC recommends that travelers avoid all nonessential travel to all global destinations; also, most foreign nationals who have been in one of the following countries during the previous 14 days will not be allowed to enter the United States: China, Iran, most European countries, including the UK and Ireland.
nterim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19). The interim guidance is intended to help prevent workplace exposures to COVID-19, in non-healthcare settings. (CDC has provided separate guidance for healthcare settings.) This guidance also provides planning considerations for community spread of COVID-19.
Links:
DHS Critical Infrastructure web page
An overview of US government guidelines for COVID-19 and departmental contributions to respond to the pandemic: USA.gov/coronoavirus.
4. Which governmental authority issued these guidelines, and are they voluntary or mandatory?
In general, guidelines issued at the federal level by CDC, the Presidential Coronavirus Task Force, and other federal entities are voluntary. As posted on the CDC web page: “CDC guidance for COVID-19 may be adapted by state and local health departments to respond to rapidly changing local circumstances. For specific locations, always check state and local (county or municipal) health department resources.”
In the United States, it very much matters where you or your facility is located. CDC guidelines are referenced and relied upon by state and local jurisdictions which are adopting the federal guidelines, often with additions or modifications, and making them enforceable, usually through emergency orders, at the state, county, and municipal level.
To quickly access the websites of state health agencies, use the CDC web page “Cases in the U.S.” as a portal: On the map of state cases, the number of cases and deaths will appear as you rollover the state with your cursor. Left click once on the state you are interested in, and the state’s health authority web site will open in a new window. This includes U.S. territories such as Puerto Rico and the U.S. Virgin Islands.
Be aware that you should also check county/municipal web sites, as some states further delegate authority for emergency orders related to COVID-19 to these jurisdictions. Many of the state health authority web pages have a similar page where you can jump to the county health authority of interest.
OSHA has clarified on its website how some workplace measures to prevent or control the spread of the coronavirus fall under requirements of existing OSHA and state standards. OSHA has issued enforcement guidance that provide allowances for certain exceptions during the national emergency around specified issues, such as use of alternate PPE when N-95 respirator masks are not available.
Links:
5. Do these mitigation measures have any consequence, such as, if a person does not abide by these measures must they pay a fine or go to jail?
The emergency orders issued by state, county, and municipal executives generally provide the authority to enforce social distancing or “Safer at Home” orders. The authority and the inclination toward enforcement varies widely from state to state and even among different jurisdictions in the same state.
In some locales where there has been persistent non-compliance with social distancing or restrictions on gatherings, and especially in cities that are “hotspots” of growth in new cases and hospitalizations, local law enforcement has stepped in. This has primarily been to remedy the immediate situation rather than to press charges, though many jurisdictions have the authority to issue fines or jail offenders. In some cases, such as in Maryland, the executive decided to exercise enforcement penalties in order to send a visible message to the public about the need to take seriously the requirements of the emergency executive orders.
6. Has your country adopted any laws or regulations related to COVID-19?
There have been four major pieces of U.S. legislation related to COVID-19:
The Coronavirus Preparedness and Response Supplemental Appropriations Act (PL 116–127, March 18, 2020), referred to as Phase 1. This bill provided $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak focusing on vaccine development. It also waived certain Medicare restrictions and requirements regarding telehealth services during the coronavirus public health emergency.
The Families First Coronavirus Response Act, PL 116–127, March 18, 2020, referred to as Phase 2. Requires certain employers to provide their employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19.
Coronavirus Aid, Relief, and Economic Security Act (CARES Act), PL. 116-136, March 25, 2020. This is the largest of the legislative actions amounting to $2 trillion in funding and is the largest economic stimulus package in U.S. history. Its major provisions are: Health Care, Relief to Businesses and Organizations, Relief to Individuals, and provisions for federal contractors and the U.S. Mail service. It included the $349 billion Paycheck Protection Act, a small business loan program.
The Paycheck Protection Program and Health Care Enhancement Act, PL 116-139, April 24, 2020. This is a $484 billion law that increases funding to the Paycheck Protection Program and also provide more funding for hospitals and testing for COVID-19.
Links: Federal legislation, Presidential proclamations, and regulatory changes related to COVID-19 are tracked and listed on the Gov Info website.
The data presented here is not a complete analysis of all COVID-19 information; however, our in-country Partner will provide updates as and when considered appropriate and as relevant data becomes available. If you have any additional questions, or request for country information, please email us at COVID-19@cc-global.com with additional inquiries.
