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The U.S. CDC’s Mask Guidance Ignores the Risks Workers Face Every Day

7 minute read
Jordan Barab was deputy assistant secretary of labor for the Occupational Safety and Health Administration from 2009 to 2017 and senior labor policy advisor to the House of Representatives Committee on Education and Labor from 2019 to 2021. He writes the Confined Space newsletter.
David Michaels, PhD, MPH is a professor at the Milken Institute School of Public Health at George Washington University. He was assistant secretary of labor for OSHA from 2009 to 2017, and is the author of The Triumph of Doubt: Dark Money and the Science of Deception (Oxford University Press, 2020).

The U.S. Centers for Disease Control and Prevention’s (CDC) announcement last week that fully vaccinated people no longer have to wear masks or socially distance came as a great relief to millions of people who have been vaccinated. But it has also led to confusion and chaos in workplaces and other locations where vaccinated and unvaccinated people mix.

Public health agencies like CDC are charged with protecting the health of populations, not just individuals. With its recent masking recommendation, the CDC is forgetting its basic public health mission, holding back our efforts to stop the COVID-19 pandemic, and increasing the danger that workers face.

Workplaces are centers of virus transmission, and those who work in such environments have borne a tragic burden throughout the pandemic. While most white-collar workers have sheltered at home, performing their job tasks on Zoom and other video platforms, workers in health care, transportation, food processing, corrections, retail and other essential jobs have been forced to come to work every day, risking their safety and the safety of their loved ones.

While we may never know the exact number of work-related infections or deaths from COVID-19, we do know that the pandemic has taken a devastating toll on workers across key sectors. Some 90,000 workers at meatpacking plants, food processing facilities, and farms have tested positive for COVID-19 as of May 20, according to the Food & Environment Reporting Network. Major outbreaks across the country have been traced to virus transmission in meat processing, grocery stores, warehouses, farms and factories, where workers are in close proximity to each other or members of the public.

One of the groups hit hardest by the pandemic are workers at long-term care facilities. Through May 9, 578,757 employees working at long-term care facilities had been infected with COVID-19 and 1,911 had died, according to data from the Centers for Medicare & Medicaid Services (CMS).

Not all “essential” workers are equally at risk. Black and Brown workers are overrepresented in workplaces with the highest risk or exposure. This is one of the primary reasons working-age adults from minority communities in the U.S. are so much more likely to be sickened or killed by the virus than white Americans of the same age.

Since the earliest days of the pandemic, worker advocates and public health experts have been asking the Occupational Safety and Health Administration (OSHA) to issue mandatory, enforceable emergency standards to supplement CDC’s voluntary guidance. The Trump Administration refused to allow OSHA to do so. But just two days after being sworn in as President, Joe Biden issued an executive order calling for OSHA to issue such a standard by March 15.

Now, more than two months after President Biden’s deadline, OSHA still has not issued this badly needed regulation and the CDC’s recent announcement is making an already bad situation worse for workers. The CDC said its new guidelines do not apply to health care, corrections, homeless shelters and transportation, but there are many other types of workplaces with similarly dangerous working conditions—like meat or poultry factories and farms —where large numbers of workers have been infected in the recent past and in which outbreaks continue to occur.

In failing to consult with workplace experts before issuing its guidance, the CDC has managed to infuriate both labor unions and employers. The United Food and Commercial Workers union, which represents meat processing and grocery workers, has accused the agency of forcing employees to be the “vaccination police,” putting them in potential danger from anti-mask customers. The Retail Industry Leaders Association, a trade group, said the conflict between CDC’s guidance and state and local orders puts retailers and their employees in “incredibly difficult situations.”

States and localities can maintain public health precautions, but after the CDC’s announcement, most governors have abandoned them. Many have already done so, despite the fact that almost 60% of working age adults (ages 18-64) have not been fully vaccinated. In states where that’s happened, it is now on the honor system whether a worker or customer discloses whether or not they’ve been vaccinated—and how well a worker is protected is essentially up to their employer. Workers employed by Albertsons or Whole Foods, which are maintaining their mask requirements, will be better protected than workers at Walmart or Trader Joe’s, which have lifted theirs.

Employers who want to do the right thing feel handcuffed, their options limited by existing Equal Employment Opportunities Commission (EEOC) regulations that prohibit them from requiring every employee to be vaccinated—employees can refuse if they have a disability or religious-related objection.

Lower-wage, as well as Black and Brown workers are less likely to have been vaccinated than higher-wage and White workers—and for many, the reason is not “vaccine hesitancy,” but structural barriers to getting the shot, like a dearth of transportation options, difficulty in missing work to get a vaccine, health issues, language barriers, fear of having to pay out of pocket for the vaccine and concerns stemming from legal status, particularly for Hispanic workers.

CDC needs to work with OSHA, EEOC, unions, and employer organizations who understand workplaces better than CDC scientists to establish criteria for when it is safe to relax protections in high-risk workplaces—especially in areas where community transmission remains high. OSHA should then be given authority to require workplace outbreak reporting and, when exposure risk is high, and require employers to apply a layered approach to protection, called the “hierarchy of controls,” when exposure risk is high. That approach entails reducing the concentration of the virus in the air through improved ventilation and filtration, masking and distancing.

The CDC has exempted certain high-risk workplaces from its new guidance, telling operators of healthcare facilities, correctional or detention facilities and homeless shelters to continue to provide masking and other precautionary measures for all vaccinated and unvaccinated people: employees and members of the public. The types of workplaces where precautionary measures remain should be expanded to include other industries where workers remain at high risk. Unlike the general public who may spend 20 minutes in a grocery store or on a bus, or an hour in a restaurant, many workers spend 8-12 hours a day at work with frequent or prolonged close contact with each other or the public in poorly ventilated indoor settings or enclosed spaces, like meat processing plants where employees work elbow to elbow; retail stores where workers have hours of contact with the public; and factories and warehouses where large numbers of workers congregate indoors.

Finally, benchmarks need to be established for when it is safe and appropriate to step down mitigation measures as infections decline and vaccinations increase in communities. Measures would remain in workplaces with active outbreaks of COVID-19, in locations where community transmission of COVID-19 is high, or workplaces where not all workers are fully vaccinated.

The CDC made a mistake. Public health agencies need to follow the science for protecting populations, not just individuals. But it is not too late to fix that mistake and get the nation’s pandemic control efforts back on track.

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