Due to complaints related to a lack of personal protective equipment (PPE), insufficient training on appropriate standards and possible coronavirus illness (COVID-19) transmissions in the workplace, the Occupational Safety and Health Administration (OSHA) has issued temporary guidance for its area offices to use in their efforts to enforce the agency’s workplace safety and health mandates. These mandates require employers to take prompt actions to mitigate hazards and protect employees during the COVID-19 pandemic

The new guidance, issued on April 13, 2020, directs OSHA compliance officers to process most complaints from non-healthcare and non-emergency response establishments as “non-formal” and to conduct investigations via phone or fax whenever possible. However, employers should know that after receiving a serious incident report, OSHA area directors will determine whether to conduct an inspection or a rapid response investigation (RRI). RRIs are intended to identify any hazards, provide abatement assistance and confirm abatement, and OSHA generally encourages area directors to recommend them.

This Compliance Bulletin provides a summary of the enforcement guidance provisions that relate specifically to COVID-19 issues.

Action Steps

Employers should use this Compliance Bulletin to become familiar with the procedures and guidelines OSHA will use to enforce workplace safety and health laws during the COVID-19 pandemic. Employers are encouraged to contact their local OSHA area office if they have concerns or need clarification on how to comply with specific OSHA standards.

COVID-19 Inspections

Under the guidance issued on April 13, 2020, OSHA’s area offices will prioritize their resources in coordination with their regional offices to determine whether an on-site inspection of the workplace is necessary. If an on-site inspection is warranted, compliance officers will evaluate the risk of COVID-19 exposure before the inspection takes place. Employers should note that OSHA is encouraging their compliance officers to maximize the use of electronic means of communication (including remote video surveillance, phone interviews, email correspondence, facsimile and email transmittals of documents and video conferences) and to consult with their regional solicitors when appropriate.

If an on-site inspection is warranted, compliance officers will coordinate with their regional office and contact the Office of Occupational Medicine and Nursing (OOMN), as necessary, whenever they identify a workplace with potential for high-risk exposure to COVID-19. The OOMN may serve as a liaison with relevant public health authorities and can facilitate Medical Access Orders (MAOs) to obtain worker medical records from employers and healthcare providers.

COVID-19 inspections will be treated as novel cases. The Directorate of Enforcement Programs (DEP) must be notified of all proposed citations and federal agency notices that relate to a COVID-19 exposure. State Plan designees should report any COVID-19 inspections to their regional offices.

All activity related to enforcement and compliance assistance must be appropriately coded to allow for tracking and program review. This includes COVID-19 activity, which should continue to be coded in the OSHA Information System (OIS) with the specific code: N-16-COVID-19.

Workplace Exposure Risk Levels

To determine the risk of exposure for compliance officers, OSHA has defined three risk categories—high, medium and low. These risk levels stem from the Occupational Risk Pyramid described in the OSHA’s Guidance on Preparing Workplaces for COVID-19.

High Risk of Exposure

Jobs considered to be at high or very high risk of exposure are those that involve known or suspected sources of COVID-19 during specific medical, postmortem or laboratory procedures.

Workplaces considered to have job duties with high risk of exposure to COVID-19 include:

• Hospitals treating suspected or confirmed COVID-19 patients;
• Nursing homes;
• Emergency medical centers;
• Emergency response facilities;
• Settings where home care or hospice care are provided;
• Settings that handle human remains;
• Biomedical laboratories, including clinical laboratories; and
• Medical transport companies.

Aerosol-generating procedures, in particular, present a very high risk of exposure to workers. The aerosol-generating procedures for which engineering controls, administrative controls and personal protective equipment (PPE) are necessary include, but are not limited to: bronchoscopy, sputum induction, nebulizer therapy, endotracheal intubation and extubation, open suctioning of airways, cardiopulmonary resuscitation and autopsies.

Medium Exposure Risk

Medium exposure-risk jobs include those with frequent or close contact with people who may be (but are not known to be) infected with COVID-19. “Close contact” refers to a distance of less than six feet. Workers in this risk group may have frequent contact with travelers returning from international locations with widespread COVID-19 transmission.

In areas where there is ongoing community transmission, workers in this category include, but are not limited to, those who have contact with the general public (such as in schools, high-population-density work environments and some high-volume retail settings).

Low Exposure Risk

Lower exposure risk jobs are those that do not require contact with people known to be, or suspected of being, infected with COVID-19 nor frequent close contact with the general public.

Workers in this category have minimal occupational contact with the public and other co-workers.

Complaints, Referrals and Rapid Response Investigations (RRIs)

Complaints and referrals for any operation alleging potential exposures to COVID-19 will be handled in accordance with established procedures, except that employers will be notified of alleged hazards or violations by telephone, fax, email or letter.

Through their phone or fax communications, area offices will direct employers to publicly available guidance on protective measures, such as OSHA’s COVID-19 webpage. As it deems appropriate, OSHA will forward complaint information to federal partners with concurrent interests.

Fatalities and Imminent Dangers

Fatalities and imminent danger exposures related to COVID-19 will be prioritized for inspections, with particular attention given to health care organizations and first responders.

During the outbreak, formal complaints alleging unprotected exposures to COVID-19 for workers with a high or very high risk of transmission may warrant an on-site inspection. Area offices will prioritize resources and consider all relevant factors, including whether a complainant alleges inadequate PPE due to supply issues, in determining whether to perform a non-formal phone or fax investigation instead of an on-site inspection.

Other Formal Complaints

In general, most other formal complaints alleging COVID-19 exposure will not result in an on-site inspection if employees are engaged in tasks that involve medium or lower risk of exposure. In these cases, area offices will use the non-formal procedures for investigating alleged hazards.

However, employer-reported hospitalizations will be handled using RRIs in most cases.

Finally, employers should keep in mind that workers requesting inspections, complaining of COVID-19 exposure or reporting illnesses may be covered under one or more whistleblower statutes.

Inspection Scope, Scheduling, and Procedures

Inspection activities resulting from COVID-19-related complaints, referrals and employer-reported illnesses will primarily focus on facilities with jobs involving high and very high risk of exposure. OSHA aims to reassure employers that, during on-site inspections, compliance officers will take care to avoid interfering with any ongoing medical services.

Compliance officers will inspect facilities in a manner that minimizes or prevents exposure, such as by avoiding potential exposure to suspected or confirmed COVID-19 patients. It is not generally necessary for compliance officers to enter patient rooms or airborne isolation areas. If compliance officers must enter a vacant, airborne-infection-isolation room (AIIR), sufficient time must lapse to allow for proper clearance of potentially infectious aerosols before they enter. Before entering an occupied AIIR or a recently vacated AIIR that has not been adequately purged, a compliance officer must discuss the issue with his or her area director.

Opening Conferences

To avoid unnecessary exposure, compliance officers may decide to conduct opening conferences over the phone. However, if an on-site opening conference is deemed appropriate, officers will attempt to use a designated, uncontaminated administrative area. If available, officers may also ask to speak to a facility’s infection control director, safety director or the health professional responsible for controlling occupational health hazards. Individuals who are responsible for providing records pertinent to an inspection may also be included in the opening conference or interviewed early in the inspection. These individuals may include, for example, facility administrators, training directors, facilities engineers, nursing directors and human resources personnel.

Program and Document Review

Compliance officers will strive to conduct the following electronically or remotely:

• Determining whether an employer has a written pandemic plan as recommended by the Centers for Disease Control and Prevention (CDC). If an employer’s plan is a part of another emergency preparedness plan, a compliance officer’s review does not need to be expanded to the entire emergency preparedness plan. The evaluation of an employer’s pandemic plan may be based on other written programs and, in a hospital, a review of its infection control plan.
• Reviewing the facility’s procedures for hazard assessment and protocols for PPE use with suspected or confirmed COVID-19 patients.
• Determining whether a workplace has handled specimens or evaluated, cared for, or treated suspected or confirmed COVID-19 patients. This will include a review of laboratory procedures for handling specimens and procedures for decontamination of surfaces.
• Reviewing other relevant information, such as medical records related to worker exposure incidents, OSHA-required recordkeeping and any other pertinent information or documentation deemed appropriate by a compliance officer. This includes determining whether any employees have contracted COVID-19, have been hospitalized as a result of COVID-19, or have been placed on precautionary removal or isolation.
• Reviewing a respiratory protection program and any modified respirator policies related to COVID-19 to assess compliance with respiratory protection standards.
• Reviewing employee training records, including any records of training related to COVID-19 exposure prevention or made in preparation for a pandemic, if available.
• Reviewing employer documentation of provisions made to obtain and provide appropriate and adequate supplies of PPE.
• Determining whether a facility has airborne infection isolation rooms or areas and gathering information about an employer’s use of air pressure monitoring systems and any periodic testing procedures. This also includes reviewing any procedures for assigning patients to those rooms or areas and procedures to limit access to them by employees who are not trained or adequately outfitted with PPE.
• Reviewing an employer’s procedures for transferring patients to other facilities in situations where appropriate isolation rooms or areas are unavailable or inoperable. This includes reviewing procedures for transferring COVID-19 patients from other facilities.
• Establishing the numbers and placements of confirmed and suspected COVID-19 patients under isolation at the time of an inspection.
• Establishing patterns of placements for confirmed and suspected COVID-19 patients in the preceding 30 days.
• Determining and documenting whether an employer has considered or implemented a hierarchy of controls for worker protection. This documentation can be done with photos or design specifications.

Walkaround

Based on information from program and document review and interviews, compliance officers will use professional judgment in determining which areas of a facility will be inspected. Compliance officers will avoid entering patient rooms or treatment areas while high-hazard procedures are being conducted.

Where practical, photographs or videotaping may be used for case documentation. However, compliance officers will take all necessary precautions to assure and protect patient privacy and confidentiality. Throughout their engagement with facilities treating a significant number of COVID-19 patients, compliance officers should take care to avoid interference with the facilities’ provision of ongoing medical services.

Private Interviews

As appropriate to an inspection, compliance officers may conduct private interviews with affected employees in uncontaminated areas. However, interviews will not take place in a room or area where a high-hazard procedure, such as bronchoscopy or sputum induction, is being or recently has been conducted. To the extent possible, compliance officers will practice social distancing during employee interviews. Also, when possible, officers may choose to conduct these interviews over the phone.

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.

The coronavirus (COVID-19) outbreak has impacted businesses across a variety of industries, forcing them to rethink their daily operations to ensure the safety of their employees and the general public. This is no different for construction firms, where multiple contractors and tradespeople on a job site may be working in the same space at any one time. In these instances, just one misstep can lead to the quick spread of COVID-19, jeopardizing the well-being of workers.

To help slow the spread of COVID-19 and safeguard our staff, Morris & Reynolds Insurance has created a standardized action plan for responding to COVID-19. This plan, which is based on Centers for Disease Control and Prevention (CDC) and Occupational Safety and Health Administration (OSHA) guidance, highlights responsibilities of managers and employees, job site safety measures and OSHA recordkeeping considerations. While there may be worksite-specific considerations to keep in mind, this action plan includes general strategies company officials and employees can use to address COVID-19 concerns and remain safe on the job.

Responsibilities

When it comes to ensuring a safe job site during the COVID-19 outbreak, both managers and employees have their role to play. The following is a breakdown of the possible responsibilities for your leadership and staff.

Managers and Supervisors

Your leaders, including managers and supervisors, should familiarize themselves with the details of the action plan. Above all, leadership must be prepared to answer questions from employees and set a good example by adhering to the guidance prescribed in the plan. This involves practicing social distancing and good personal hygiene.

Employees

Employees play a critical role in your COVID-19 prevention efforts. To protect everyone on the worksite, we are suggesting a number of best practices employees can follow:

• Understand the signs and symptoms of COVID-19, and stay home if you are feeling sick—Any employee who is experiencing symptoms of COVID-19 (e.g., fever, cough, shortness of breath, sore throat, runny nose, body aches, chills or fatigue) should stay home. Individuals experiencing such symptoms should also be instructed to consult guidance from the CDC on seeking medical care.
• Practice good hygiene—Employees should clean their hands often, either with an alcohol-based hand sanitizer or soap and water. Hand sanitizers should contain at least 60%-95% alcohol, and employees should wash their hands with soap for at least 20 seconds. In addition, employees should avoid touching their face and cough into their arm.
• Practice social distancing—Social distancing is the practice of deliberately increasing the physical space between people to avoid spreading illness. In terms of COVID-19, social distancing best practices for employees can include:
  • Avoiding gatherings of 10 or more people
  • Keeping at least 6 feet of distance from other people
  • Hosting meetings virtually when possible
  • Working from home when possible
  • Refraining from shaking hands
  • Refraining from sharing tools and personal protective equipment (PPE)

Job Site Protective Measures

In order to keep staff safe and prevent the spread of COVID-19, we recommend the following job site protective measures:

General Safety Policies

• Employees, visitors and contractors who exhibit signs or symptoms of COVID-19 will be asked to leave the worksite.
• Where possible, meetings will be conducted virtually or via telephone. For in-person meetings, participants will be limited to groups of 10, and employees will be asked to remain 6 feet apart. Attendance will be tracked verbally in lieu of using a physical sign-in sheet.
• Employees will be asked to practice social distancing and should keep at least 6 feet of distance from co-workers, contractors and visitors.
• Employees should stagger lunches to limit the number of individuals congregating in break areas. You may divide crews to reduce the number of workers on the job site at any given time.
• Provide access to handwashing stations and alcohol-based hand sanitizers.
• Employees should refrain from sharing tools and equipment. In instances where this is unavoidable, provide alcohol-based wipes and other cleaning materials that employees can use to clean tools and equipment.
• Employees will be asked to avoid using a common water cooler. For increased safety, provide employees with disposable plastic water bottles or instruct them to bring their own.

Workers Entering Occupied Buildings and Homes

• Employees should assess the unique hazards associated with occupied structures before entering them. Employees should ask occupants to keep at least 6 feet of distance from them.
• Employees should sanitize work areas before entering the building, throughout the day and then before leaving for the day. Provide alcohol-based wipes for cleaning purposes.

Job Site Visitors

• Limit visitors to the job site to necessary personnel only.
• Screen visitors to the job site. Supervisors may ask targeted questions to visitors regarding their current health before they enter the job site. If they answer yes to the following questions, supervisors may ask them to go home and not return to the job site until further notice:
  • Have you been in contact with a person who has tested positive or is in the process of being tested for COVID-19?
  • Have you or anyone you’ve been in contact with traveled outside of the United States recently?
  • Has a medical professional told you to self-quarantine?
  • Are you having trouble breathing, or have you had flu-like symptoms within the past 48 hours (e.g., fever, cough, shortness of breath, sore throat, runny nose, body aches, chills or fatigue)?
• Deliveries will be permitted, but should be completed with social distancing best practices in mind.

Personal Protective Equipment and Work Practice Controls

• In addition to standard PPE, like hard hats and hearing protection, provide:
  • Gloves—Employees should wear gloves at all times while at the job site. The types of gloves employees use should be appropriate for the task at hand. If gloves aren’t typically required for a given task, any type of glove would be appropriate, including latex gloves.
  • Eye protection—Employees should wear eye protection at all times while on the job site.
• Employees should use N95 respirators if the task requires it. However, due to the current shortage of N95 respirators, employees are encouraged to reduce the need for masks by:
  • Keeping dust down through the use of engineering and workplace controls. This could involve using water-delivery or dust-collection systems.
  • Limiting their exposure to workplace dust.
  • Practicing good housekeeping to reduce dust on the job site.

Personnel Considerations

To ensure job site safety, commit to working with all personnel as well as third-party vendors and partners to prevent the spread of COVID-19. Specific precautions include:

• For general contractors, require firms/individuals to:
  • Provide the materials and assistance necessary to increase job site hygiene.
  • Train their personnel on COVID-19 awareness and safety procedures.
  • Perform status checks and other meetings virtually to avoid large gatherings.
• For subcontractors, require firms/individuals to:
  • Develop a hygiene plan to supplement policies and procedures created for general contractors.
  • Refrain from in-person meetings when possible.
  • Train their personnel on COVID-19 awareness and safety procedures.
• For project superintendents and project managers, require individuals to:
  • Instruct employees to stay home if they are sick.
  • Ensure handwashing stations are well stocked.
• For safety professionals, require individuals to:
  • Communicate and execute on guidance from the CDC, OSHA, World Health Organization and other government sources.
  • Ensure employees are properly trained on COVID-19, particularly as it relates to preventing the spread of the disease.
  • Review existing policies on workplace hygiene.

Job Site Cleaning and Disinfecting

• The worksite, trailers and break areas must be cleaned at least once per day. This can involve sanitizing doorknobs, keyboards, tools, reusable supplies and equipment. Employees responsible for cleaning will be given the appropriate PPE. Cleaning should be completed using CDC-recommended products, including:
  • Environmental Protection Agency-registered household disinfectants
  • Alcohol solutions with at least 60% alcohol
  • Diluted household bleach solutions (if appropriate for the surface)
• Trash will be collected from the job site regularly. Those collecting trash will be instructed to wear nitrile, latex or vinyl gloves.
• Portable toilets will be sanitized at least twice per week.
• Frequently touched services will be disinfected often.
• Vehicles, equipment and tools will be cleaned at least once per day and before a change in operator or user occurs.
• Hand sanitizer dispensers will be refilled frequently.
• When an employee has tested positive for COVID-19, ensure areas in which the individual worked are cleaned thoroughly.

Job Site Exposure Situations

Create response plans in place for situations where employees exhibit symptoms of or tests positive for COVID-19.

Employee Exhibits Symptoms of COVID-19

In the event an employee shows symptoms of COVID-19, they will be asked to remain at home until they are symptom-free without the use of medications (e.g., fever reducers or cough suppressants) for 24 hours or four to five full days after symptoms improve. If possible, employees will be asked to obtain a doctor’s note before returning to work.

Employee Tests Positive for COVID-19

Employees who test positive for COVID-19 will be instructed to follow the advice of a qualified medical professional and self-quarantine. Specifically, employees who have tested positive should not return to work until they have been symptom-free for seven full days. Employees who have tested positive and been hospitalized should consult their medical care provider to determine when they can return to work. If possible, employees will be asked to obtain a doctor’s note before returning to work.

Employee Comes Into Contact With an Individual Who Has Tested Positive for COVID-19

Employees who have been in close contact with an individual who has tested positive for COVID-19 will be instructed to self-quarantine. Employees should self-quarantine for at least 14 days from the last day they had contact with the person who tested positive for COVID-19. If it was an employee who tested positive, conduct an investigation to determine who may have had close contact with said employee. Those individuals will also be instructed to self-quarantine.

OSHA Recordkeeping and Reporting

Adhere to OSHA-mandated requirements as they relate to recording and reporting certain work-related injuries and illnesses.

Questions

If employees have any questions regarding the content of this action plan, they should be instructed to speak with their supervisor. Furthermore, while the strategies highlighted in this document can protect workers from COVID-19, it’s important to follow CDC guidance at all times. For more information, click here.

As has been the case since 1950, the professional agents and underwriters at Morris & Reynolds Insurance are happy to help you. Whether you have a question about this topic or need help with any form of insurance, please contact us at any time at 305.238.1000.