Virginia COVID-19 Workplace Safety Standard: Infectious Disease Preparedness and Response Plans

Today, we focus on a mandate applicable to covered employers with hazards or job tasks classified as “very high,” “high,” or “medium” exposure risk to known or suspected sources of the SARS-CoV-2 virus: The requirement that they prepare and implement an infectious disease preparedness and response plan.

Background: The Risk Exposure Levels

The standard divides hazards and job tasks into four risk exposure levels: “very high,” “high,” “medium,” and “lower.”

“Very high” exposure risk hazards or job tasks are those in workplaces with a high potential for employee exposure to known or suspected sources of the SARS-CoV-2 virus (e.g., laboratory samples) or people known or suspected to be infected, including, during specific medical, postmortem, or laboratory procedures, such as:

• Aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures, and exams, or invasive specimen collection) on a patient or person known or suspected to be infected with the SARS-CoV-2 virus;
• Collecting or handling specimens from a patient or person known or suspected to be infected with the SARS-CoV-2 virus (e.g., manipulating cultures from patients known or suspected to be infected with the SARS-CoV-2 virus); and
• Performing an autopsy that involves aerosol-generating procedures on the body of a person known or suspected to be infected with the SARS-CoV-2 virus when the person died.

“High” exposure risk hazards or job tasks are those in workplaces with a high potential for employee exposure inside six feet to known or suspected sources of SARS-CoV-2, or people known or suspected to be infected with the SARS-CoV-2 virus that are not otherwise classified as “very high” exposure risk, including:

• Health care (physical and mental) delivery, care, and support services provided to a patient known or suspected to be infected with the SARS-CoV-2 virus, including field hospitals (e.g., doctors, nurses, cleaners, and other hospital staff who must enter patient rooms or areas);
• Health care (physical and mental) delivery, care, and support services, wellness services, non-medical support services, physical assistance, etc., provided to a patient, resident, or other person known or suspected to be infected with the SARS-CoV-2 virus involving skilled nursing services, outpatient medical services, clinical services, drug treatment programs, medical outreach services, mental health services, home health care, nursing home care, assisted living care, memory care support and services, hospice care, rehabilitation services, primary and specialty medical care, dental care, COVID-19 testing services, blood donation services, contact tracer services, and chiropractic services;
• First responder services provided to a patient, resident, or other person known or suspected to be infected with the SARS-CoV-2 virus;
• Medical transport services (loading, transporting, unloading, etc.) provided to patients known or suspected to be infected with the SARS-CoV-2 virus (e.g., ground or air emergency transport, staff, operators, drivers, pilots, etc.); and
• Mortuary services involved in preparing (e.g., for burial or cremation) the bodies of people who are known or suspected to be infected with the SARS-CoV-2 virus when they died.

“Medium” exposure risk hazards or job tasks are those not otherwise classified as “very high” or “high” exposure risk in workplaces that require more than minimal occupational contact inside six feet with other employees, other people, or the general public who may be infected with SARS-CoV-2, but who are not known or suspected to be infected. Those hazards and job tasks may include operations and services in:

• Poultry, meat, and seafood processing; agricultural and hand labor; commercial transportation of passengers by air, land, and water; on-campus educational settings in schools, colleges, and universities; daycare and afterschool settings; restaurants and bars; grocery stores, convenience stores, and food banks; drug stores and pharmacies; manufacturing settings; indoor and outdoor construction settings; correctional facilities, jails, detentions centers, and juvenile detention centers; work performed in customer premises, such as homes or businesses; retail stores; call centers; package processing settings; veterinary settings; personal care, personal grooming, salon, and spa settings; venues for sports, entertainment, movies, theaters, and other forms of mass gatherings; homeless shelters; fitness, gym, and exercise facilities; airports, and train and bus stations; etc.; and
• Situations not involving exposure to known or suspected sources of SARS-CoV-2: hospitals, other health care (physical and mental) delivery and support services in a non-hospital setting, wellness services, physical assistance, etc.; skilled nursing facilities; outpatient medical facilities; clinics, drug treatment programs, and medical outreach services; non-medical support services; mental health facilities; home health care, nursing homes, assisted living facilities, memory care facilities, and hospice care; rehabilitation centers, doctors’ offices, dentists’ offices, and chiropractors’ offices; and first responders services provided by police, fire, paramedic, and emergency medical services providers, medical transport; contact tracers, etc.

“Lower” exposure risk hazards or job tasks are those not otherwise classified as “very high,” “high,” or “medium” exposure risk that do not require contact inside six feet with people known to be or suspected of being, or who may be infected with SARS-CoV-2. Employees in this category have minimal occupational contact with other employees, other people, or the general public, such as in an office building setting; or are able to achieve minimal occupational contact through the implementation of engineering, administrative, and work practice controls, such as:

• Installation of floor to ceiling physical barriers constructed of impermeable material and not subject to unintentional displacement (such as clear plastic walls at convenience stores behind which only one employee is working at a time);
• Telecommuting;
• Staggered work shifts that allow employees to maintain physical distancing from other employees, other people, and the general public;
• Delivering services remotely by telephone, audio, video, mail, package delivery, curbside pickup, or delivery, etc., that allows employees to maintain physical distancing from other employees, other people, and the public; and
• The mandatory physical distancing of employees from other employees, other people, and the public.

Employee use of face coverings for contact inside six feet of coworkers, customers, or other people is not an acceptable administrative or work practice control to achieve minimal occupational contact. However, when it is necessary for brief contact with others inside the six feet distance a face covering is required.

As we reported yesterday, all covered employers must (1) assess their workplace for hazards and job tasks that can potentially expose employees to the SARS-CoV-2 virus or COVID-19 disease; and (2) classify each job task according to the hazards to which employees are potentially exposed.

Also, under the standard, (1) employers with hazards or job tasks classified as “very high,” and “high,”; and (2) employers that have eleven or more employees and hazards or job tasks classified as “medium,” must develop and implement a written infectious disease preparedness and response plan that applies to employees in the “very high,” “high,” and “medium” risk categories.

The Plan

• Employers must designate a person to be responsible for implementing their plan.
• The plan must:
  • Identify the name(s) or titles(s) of the people responsible for administering it. This person must be knowledgeable in infection control principles and practices as they apply to the employer’s covered facility, service, or operation.
  • Provide for employee involvement in developing and implementing the plan.
  • Consider and address the level(s) of SARS-CoV-2 virus and COVID-19 disease risk associated with the employer’s various workplaces, the hazards to which employees are exposed, and the job tasks that employees perform at those sites. Those considerations must include:
    • Where, how, and to what sources of the SARS-CoV-2 virus or COVID-19 disease might employees be exposed to at work, such as (a) the general public, customers, other employees, patients, and others; (b) people known or suspected to be infected with the SARS-CoV-2 virus or those at particularly high risk of COVID-19 infection (e.g., local, state, national, and international travelers who have visited locations with ongoing COVID-19 community transmission, health care employees who have had unprotected exposures to known or suspected to be infected with SARS-CoV-2 virus people); and (c) situations in which employees work more than one job with different employers and encounter hazards or engage in job tasks that present a “very high,” “high,” or “medium” level of exposure risk.
    • To the extent permitted by law, including HIPAA, employees’ individual risk factors.
    • Engineering, administrative, work practice, and personal protective equipment controls necessary to address those risks.
    • Contingency plans for situations that may arise from disease outbreaks, such as (a) increased employee absenteeism; (b) the need for physical distancing, staggered work shifts, downsizing operations, delivering services remotely, and other exposure-reducing workplace control measures such as elimination/substitution, engineering controls, administrative and work practice controls, and personal protective equipment, e.g., respirators, surgical/medical procedure masks, etc.; (c) options for conducting essential operations with a reduced workforce, including cross-training employees across different jobs in order to continue operations or deliver surge services; and (d) interrupted supply chains or delayed deliveries.
  • Identify basic infection prevention measures to be implemented: (a) promote frequent and thorough hand washing, including by providing employees, customers, visitors, the general public, and other people in the place of employment with a place to wash their hands. If soap and running water are not immediately available, provide hand sanitizers. (b) maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment; and (c) establish policies and procedures for managing and educating visitors to the place of employment.
  • Provide for the prompt identification and isolation of known or suspected to be infected with the SARS-CoV-2 virus employees away from work, including procedures for employees to report when they are experiencing symptoms of COVID-19.
  • Address infectious disease preparedness and response with outside businesses, including subcontractors who enter the workplace, businesses that provide or contract employees to the employer, and others accessing the workplace to comply with the requirements of the standard and the employer’s plan.
  • Identify the mandatory and non-mandatory recommendations in any CDC guidelines or Commonwealth of Virginia guidance documents with which the employer is complying in lieu of the standard.
  •  And, ensure compliance with all mandatory requirements of any applicable Virginia executive order or order of public health emergency related to the SARS-CoV-2 virus or COVID-19 disease.

Employers must develop and implement their infectious disease preparedness and response plans within sixty days after the new standard’s effective date, which Virginia’s Department of Labor and Industry expects will occur during the week of July 27, 2020. Preparing them will take time and effort. So, employers are well-advised to promptly get underway, in consultation with their counsel and safety experts.