[House Hearing, 117 Congress] [From the U.S. Government Publishing Office] CLEARING THE AIR: SCIENCE-BASED STRATEGIES TO PROTECT WORKERS FROM COVID 19 INFECTIONS ======================================================================= HEARING BEFORE THE SUBCOMMITTEE ON WORKFORCE PROTECTIONS OF THE COMMITTEE ON EDUCATION AND LABOR U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED SEVENTEENTH CONGRESS FIRST SESSION __________ HEARING HELD IN WASHINGTON, DC, MARCH 11, 2021 __________ Serial No. 117-1 __________ Printed for the use of the Committee on Education and Labor [GRAPHIC NOT AVAILABLE IN TIFF FORMAT] Available via: edlabor.house.gov or www.govinfo.gov __________ U.S. GOVERNMENT PUBLISHING OFFICE 43-839 PDF WASHINGTON : 2022 ----------------------------------------------------------------------------------- COMMITTEE ON EDUCATION AND LABOR ROBERT C. ``BOBBY'' SCOTT, Virginia, Chairman RAUL M. GRIJALVA, Arizona VIRGINIA FOXX, North Carolina, JOE COURTNEY, Connecticut Ranking Member GREGORIO KILILI CAMACHO SABLAN, JOE WILSON, South Carolina Northern Mariana Islands GLENN THOMPSON, Pennsylvania FREDERICA S. WILSON, Florida TIM WALBERG, Michigan SUZANNE BONAMICI, Oregon GLENN GROTHMAN, Wisconsin MARK TAKANO, California ELISE M. STEFANIK, New York ALMA S. ADAMS, North Carolina RICK W. ALLEN, Georgia MARK De SAULNIER, California JIM BANKS, Indiana DONALD NORCROSS, New Jersey JAMES COMER, Kentucky PRAMILA JAYAPAL, Washington RUSS FULCHER, Idaho JOSEPH D. MORELLE, New York FRED KELLER, Pennsylvania SUSAN WILD, Pennsylvania GREGORY F. MURPHY, North Carolina LUCY Mc BATH, Georgia MARIANNETTE MILLER-MEEKS, Iowa JAHANA HAYES, Connecticut BURGESS OWENS, Utah ANDY LEVIN, Michigan BOB GOOD, Virginia ILHAN OMAR, Minnesota LISA C. Mc CLAIN, Michigan HALEY M. STEVENS, Michigan DIANA HARSHBARGER, Tennessee TERESA LEGER FERNANDEZ, New Mexico MARY E. MILLER, Illinois MONDAIRE JONES, New York VICTORIA SPARTZ, Indiana KATHY E. MANNING, North Carolina SCOTT FITZGERALD, Wisconsin FRANK J. MRVAN, Indiana MADISON CAWTHORN, North Carolina JAMAAL BOWMAN, New York, Vice-Chair MICHELLE STEEL, California MARK POCAN, Wisconsin Vacancy JOAQUIN CASTRO, Texas Vacancy MIKIE SHERRILL, New Jersey JOHN A. YARMUTH, Kentucky ADRIANO ESPAILLAT, New York KWEISI MFUME, Maryland Veronique Pluviose, Staff Director Cyrus Artz, Minority Staff Director ------ SUBCOMMITTEE ON WORKFORCE PROTECTIONS ALMA S. ADAMS, North Carolina, Chairwoman MARK TAKANO, California FRED KELLER, Pennsylvania, DONALD NORCROSS,New Jersey Ranking Member PRAMILA JAYAPAL, Washington ELISE M. STEFANIK, New York ILHAN OMAR, Minnesota MARIANNETTE MILLER-MEEKS, Iowa HALEY M. STEVENS, Michigan BURGESS OWENS, Utah MONDAIRE JONES, New York BOB GOOD, Virginia JOHN A. YARMUTH, Kentucky MADISON CAWTHORN, North Carolina ROBERT C. ``BOBBY'' SCOTT, Virginia MICHELLE STEEL, California VIRGINIA FOXX, North Carolina (ex officio) C O N T E N T S ---------- Page Hearing held on March 11, 2021................................... 1 Statement of Members: Adams, Hon. Alma S., Chairwoman, Subcommittee on Workforce Protections................................................ 1 Prepared statement of.................................... 5 Keller, Hon. Fred, Ranking Member, Subcommittee on Workforce Protections................................................ 6 Prepared statement of.................................... 8 Statement of Witnesses: Marr, Linsey Ph.D., Professor of Civil and Environmental Engineering, Virginia Polytechnical Institute and State University, Blacksburg, VA................................. 10 Prepared statement of.................................... 12 Michaels, David, Ph.D., Professor of Occupational and Environmental Medicine, The George Washington University, Former Assistant Secretary of OSHA, Washington, DC.......................... 76 Prepared statement of.................................... 78 Muhindura, Pascaline, RN, COVID Progressive Care Unit, Research Medical Center, on behalf of National Nurses United, Kansas City, MO................................................... 24 Prepared statement of.................................... 26 Rath, Manesh, Partner, Keller and Heckman LLP, Washington, DC 68 Prepared statement of.................................... 70 Additional Submissions: Chairwoman Adams: Letter dated March 1, 2021............................... 124 Mr. Keller: Prepared statement from American Hospital Association.... 128 Prepared statement from Construction Industry Safety Coalition.............................................. 131 Prepared statement from National Retail Federation....... 142 Questions submitted for the record by: Chairwoman Adams Omar, Hon. Ilhan, a Representative in Congress from the State of Minnesota Responses to questions submitted for the record by: Dr. Marr................................................. 147 Ms. Muhindura............................................ 150 Dr. Michaels............................................. 156 CLEARING THE AIR: SCIENCE-BASED STRATEGIES TO PROTECT WORKERS FROM COVID-19 INFECTIONS ---------- Thursday, March 11, 2021 House of Representatives, Subcommittee on Workforce Protections, Committee on Education and Labor, Washington, DC. The subcommittee met, pursuant to notice, at 10:47 a.m., via Zoom, Hon. Alma S. Adams (Chairwoman of the subcommittee) presiding. Present: Representatives Adams, Takano, Norcross, Jaypal, Omar, Stevens, Jones, Yarmuth, Scott, Foxx, Stefanik, Keller, Miller-Meeks, Good, Cawthorn, Steel. Staff present: Tylease Alli, Chief Clerk; Jordan Barab, Senior Labor Policy Advisor; Ilana Brunner, General Counsel; Sheila Havenner, Director of Information Technology; Eli Hovland, Policy Associate; Ariel Jona, Policy Associate; Andre Lindsay, Policy Associate; Richard Miller, Director of Labor Policy; Max Moore, Staff Assistant; Mariah Mowbray, Clerk/ Special Assistant to the Staff Director; Kayla Pennebecker, Staff Assistant; Veronique Pluviose, Staff Director; Theresa Thompson, Professional Staff; Cyrus Artz, Minority Staff Director; Gabriel Bisson, Minority Staff Assistant; Courtney Butcher, Minority Director of Member Services and Coalitions; Rob Green, Minority Director of Workforce Policy; Georgie Littlefair, Minority Legislative Assistant; John Martin, Minority Workforce Policy Counsel; Hannah Matesic, Minority Director of Operations; Audra McGeorge, Minority Communications Director; Carlton Norwood, Minority Press Secretary. Ms. Adams. The Subcommittee on Workforce Protections will come to order. Welcome everyone. I note that a quorum is present. The subcommittee is meeting today to hear testimony on, ``Clearing the Air: Science-Based Strategies to Protect Workers from COVID-19 Infections.'' I note for the subcommittee that Mr. Courtney of Connecticut is permitted to participate in today's hearing with the understanding that his questions will come only after all Members of the subcommittee on both sides of the aisle were present, and have had an opportunity to question the witnesses. This is an entirely remote hearing. All microphones will be kept muted as a general rule to avoid unnecessary background noise. Members and witnesses will be responsible for unmuting themselves when they are recognized to speak, or when they wish to seek recognition. I also ask that Members please identify themselves before they speak. Members should keep their cameras on while in the proceeding. Members shall be considered present in the proceeding when they are visible on camera, and they shall be considered not present when they are not visible on camera. The only exception to this is if they are experiencing technical difficulty and inform Committee Staff of such difficulty. If any Member experiences technical difficulties during the hearing, you should stay connected on the platform, make sure you are muted, and use your phone to immediately call the Committee's IT Director whose number was provided in advance. Should the Chair experience technical difficulty, or need to step away to vote on the floor, Mr. Scott of Virginia, as a Member of this subcommittee, or another Majority Member of the subcommittee if he's not available is hereby authorized to assume the gavel in the Chair's absence. This is an entirely remote meeting. And as such the Committee's hearing room is officially closed. Members who choose to sit with their individual devices in the hearing room must wear headphones to avoid feedback, echoes and distortion resulting from more than one person on the software platform sitting in the same room. Members are also expected to adhere to social distancing, and safe healthcare guidelines including the use of masks, hand sanitizer and wiping down their areas, both before and after their presence I the hearing room. In order to ensure that the Committee's five-minute rule is adhered to, staff will be keeping track of time using the Committee's field timer. The field timer will appear on its own thumbnail picture and will be named 001_timer. There will be no one minute remaining warning. The field timer will sound its audio alarm when time is up. Members and witnesses are asked to wrap up promptly when their time has expired. And while a roll call is not necessary to establish a quorum in official proceedings conducted remotely or with remote participation, the Committee has made it a practice whenever there is an official proceeding with remote participation for the clerk to call the roll to help make clear who is present at the start of the proceeding. Members should say their name before announcing they are present. This helps the Clerk, and also helps those watching the platform and the livestream who may experience a few seconds delay. At this time I ask the clerk to please call the roll. The Clerk. Chairman Adams? Ms. Adams. Present. The Clerk. Mr. Takano? Mr. Takano. Present. The Clerk. Mr. Norcross? Mr. Norcross. Present. The Clerk. Ms. Jayapal? Ms. Jayapal. Present. The Clerk. Miss Omar? Ms. Omar. Present. The Clerk. Ms. Stevens? [No response.] The Clerk. Mr. Jones? Mr. Jones. Present. The Clerk. Mr. Yarmuth? Mr. Yarmuth. Present. The Clerk. Mr. Scott? [No response.] The Clerk. Mr. Keller? Mr. Keller. Present. The Clerk. Miss Stefanik sorry? Ms. Stefanik. Present. The Clerk. Ms. Miller-Meeks? [No response.] The Clerk. Mr. Owens? [No response.] The Clerk. Mr. Good? Mr. Good. Present. The Clerk. Mr. Cawthorn? Mr. Cawthorn. Present. The Clerk. Mrs. Steel? [No response.] The Clerk. Chairwoman Adams, that concludes the roll call. Ms. Adams. Thank you, thank you for that. Pursuant to Committee Rule 8(c), opening Statements are limited to the Chair and the Ranking Member. This allows us to hear form our witnesses sooner and provides all Members with adequate time to ask their questions. I'll recognize myself now for the purpose of making an opening Statement. I want to welcome everyone to the first hearing of the Work Force Protection Subcommittee and the 117th Congress. Today we will discuss the imperative to protect worker's health and safety. The COVID-19 pandemic has posed one of the most significant threats to worker's health and safety in a century. Across the country tens of thousands of workers have been infected by COVID-19 on the job, and many thousands have died. Meat packing workers, healthcare workers, transportation workers, correctional workers, and other frontline workers are all struggling with the severe physical and emotional trauma of the pandemic. And while some of us have the luxury of working from home, these workers who are disproportionately low-income and people of color are risking their lives to keep our communities afloat. And one of our witnesses today, Pascaline Muhindura is a nurse at a hospital in Kansas City. Her coworker Celia Yap- Banago died of COVID-19 due to unsafe working conditions. Miss Yap-Banago's family is watching today's hearing. I want to express our condolences for your loss and appreciation for the critical work for which Miss Yap-Banago gave her life. These tragic losses are even more heartbreaking considering that until recently the Occupational Safety and Health Administration, or OSHA, was missing in action, and opportunities to save lives were lost. Under the Trump administration the Federal agency charged with protecting workers refused to issue new enforceable safety standards leaving workers vulnerable to workplace infections. The agency made it harder to keep track of workplace illnesses and industries. The political appointees at OSHA failed to leverage the agency's resources to adequately inspect worksites, and allow multi-billion dollar corporations to get off with meager penalties, while ignoring worker deaths that were likely linked to COVID-19. And during a hearing last year OSHA's acting Assistant Secretary even refused to acknowledge that COVID-19 possesses or poses a grave danger for workers. OSHA's inspectors and staff have worked hard to keep workplaces safe given the resources they have. But the Trump administration's political leadership abandoned OSHA's mission, and left workers with little to no help from their government. As a recent report from the Department of Labor's Inspector General found, worker complaints have skyrocketed during the pandemic, but OSHA inspections have fallen dramatically over the past year. The report also calls on OSHA to consider issuing an emergency temporary standard. A recent Wall Street Journal investigation revealed a litany of major workplace COVID outbreaks, OSHA complaints, and insufficient responses from Federal OSHA or State OSHA plans. The main argument for inaction Federal OSHA had no COVID- related standards. The Journal identified more than 1,000 worker deaths from COVID-19 that were likely linked to workplace transmission of the virus, but had never been investigated by OSHA. Employers had failed to report many of these fatalities to OSHA. So today our witnesses would help us assess how the Biden administration can recover from these failures and keep workers safe and healthy moving forward. First OSHA must swiftly issue a strong emergency temporary standard, or ETS to protect workers against COVID-19 infections. For more than a year Chairman Scott and I urged the previous administration to issue an ETS, but OSHA refused. Thankfully, the Biden administration has moved quickly to restore OSHA's purpose by directly OSHA to consider issuing an ETS. And I'm hopeful that we will see this ETS soon, but we must do far more to protect workers. And as our witnesses will share, we must better protect workers from the airborne transmission of COVID-19. We now know the virus spreads not just through large droplets that quickly dissipate, but through microscopic particles that can travel long distances and for long periods. This has major implications for protecting workers who are frequently in close contact with others. Yet the Centers for Disease Control and Prevention has not updated its workplace guidance to reflect this clear scientific evidence, which is essential to shape a strong OSHA standard. We also need a plan to get vaccines to all of the essential workers who have risked their lives to keep our economy going. Americans across the country are thankfully starting to get vaccinated, but we still have no national strategy to ensure that in addition to emergency responders and healthcare workers, grocery store clerks, meat processing workers, teachers, transportation workers, corrections officers and others are not left behind. We must also take clear steps to track workplace COVID-19 infections. Shockingly, the Federal Government has no system for monitoring the number of workers who have gotten sick, or where they are employed. The previous administrative effectively gutted requirements for employers to report COVID- 19 related worker hospitalizations. And so we cannot hope to learn from the lessons of this pandemic without the data to understand how to protect workers in the future. Any discussion about protecting healthcare workers must also address the disproportionately high rates of violence that healthcare and social service workers face on the job. Today we will discuss legislation introduced by Representative Courtney that requires OSHA to promptly issue a workplace violence prevention standard to protect healthcare and social service workers. Finally, in order for OSHA to identify and address the most dangerous workplaces, it must be able to collect accurate injury and illness data. Today our witnesses will also discuss legislation introduced by Representative Takano that would allow OSHA to more effectively enforce its injury and illness recordkeeping requirements. National emergencies, such as this pandemic, are the exact reason why OSHA was first established, yet for far, far, too long OSHA's leadership was asleep at the wheel costing the lives of workers. Now we have the opportunity to restore OSHA's mission and protect workers health and safety at a time when they need it most. Today's hearing is an important first step toward that goal. I'd now like to recognize the distinguished Ranking Member for the purpose of making an opening Statement. [The statement of Chairwoman Adams follows:] Statement of Hon. Alma S. Adams, Chairwoman, Subcommittee on Workforce Protections I want to welcome everyone to the first hearing of the Workforce Protections Subcommittee in the 117th Congress. Today, we will discuss the imperative to protect workers' health and safety. The COVID-19 pandemic has posed one of the most significant threats to workers' health and safety in a century. Across the country, tens of thousands of workers have been infected by COVID-19 on the job and many thousands have died. Meatpacking workers, health care workers, transportation workers, correctional workers, and other frontline workers are all struggling with the severe physical and emotional trauma of the pandemic. While some of us have the luxury of working from home, these workers-who are disproportionally low-income and people of color-are risking their lives to keep our communities afloat. One of our witnesses today, Pascaline Muhindura, is a nurse at a hospital in Kansas City. Her coworker, Celia Yap-Banago, died of COVID- 19 due to unsafe working conditions. Ms. Yap-Banago's family is watching today's hearing. I want to express our condolences for your loss and appreciation for the critical work for which Ms. Yap-Banago gave her life. These tragic losses are even more heartbreaking considering that, until recently, the Occupational Safety and Health Administration, or OSHA, was missing in action. Under the Trump Administration, the Federal agency charged with protecting workers refused to issue new enforceable safety standards, leaving workers vulnerable to workplace infections. The agency made it harder to keep track of workplace illnesses and injuries. The political appointees at OSHA failed to leverage the agency's resources to adequately inspect worksites, and allowed multi-billion- dollar corporations to get off with meager penalties while ignoring worker deaths that were likely linked to COVID-19. And, during a hearing last year, OSHA's Acting Assistant Secretary even refused to acknowledge that COVID-19 poses a ``grave danger'' for workers. Now, OSHA's inspectors and staff have worked hard to keep workplaces safe given the resources they have. But the Trump Administration's political leadership abandoned OSHA's mission and left workers with little to no help from their government. As a recent report from OSHA's Inspector General found, worker complaints have skyrocketed during the pandemic, but OSHA inspections have fallen dramatically over the past year. The report also called on OSHA to consider issuing an Emergency Temporary Standard. A recent Wall St. Journal investigation revealed a litany of major workplace COVID outbreaks, OSHA complaints, and insufficient responses from Federal OSHA or State OSHA plans. The main argument for inaction: Federal OSHA had no COVID-related standards. The Journal identified more than 1,000 worker deaths from COVID-19 that were likely linked to workplace transmission of the virus but had never been investigated by OSHA. Employers had failed to report many of these fatalities to OSHA. Today, our expert witnesses will help us assess how the Biden Administration can recover from these failures and keep workers safe and healthy moving forward. First, OSHA must swiftly issue a strong Emergency Temporary Standard, or ETS, to protect workers against COVID-19 infections. For more than a year, Chairman Scott and I urged the previous Administration to issue an ETS, but OSHA refused. Thankfully, the Biden Administration has moved quickly to restore OSHA's purpose by directing OSHA to consider issuing an ETS. I am hopeful we will see this ETS soon, but we must do far more to fully protect workers. As our witnesses will share, we must better protect workers from the airborne transmission of COVID-19. We now know the virus spreads not just through large droplets that quickly dissipate, but through microscopic particles that can travel long distances and for long periods. This has major implications for protecting workers who are frequently in close contact with others. Yet, the Centers for Disease Control and Prevention has not updated its workplace guidance to reflect this clear scientific evidence, which is also needed to shape a strong OSHA standard. We also need a plan to get vaccines to all the essential workers who have risked their lives to keep our economy going. Americans across the country are thankfully starting to get vaccinated. But we still have no national strategy to ensure that-in addition to emergency responders and health care workers-grocery store clerks, meat processing workers, teachers, transportation workers, corrections officers and others are not left behind. We must also take clear steps to keep track of workplace infections. Shockingly, the Federal Government has no system for monitoring the number of workers who have gotten sick or where they are employed. The previous administration even effectively gutted requirements for employers to report COVID-19-related worker hospitalizations. We cannot hope to learn from the lessons of this pandemic without the data to understand how to protect workers in the future. Any discussion about protecting health care workers must also address the disproportionally high rates of violence that health care and social services workers face on the job. Today, we will discuss legislation introduced by Representative Courtney that requires OSHA to quickly issue a workplace violence prevention standard to protect health care and social service workers. Finally, in order for OSHA to identify and address the most dangerous workplaces, it must be able to collect accurate injurity and illness data. Today, our witnesses will also discuss legislation, introduced by Representative Takano, that would allow OSHA to effectively enforce its injury and illness recordkeeping requirements. National emergencies, such as this pandemic, are the exact reason why OSHA was first established. Yet, for far too long, OSHA's leadership was asleep at the wheel, costing the lives of workers. Now, we have the opportunity to restore OSHA's mission and protect workers' health and safety at a time when they need it most. Today's hearing is an important first step toward that goal. I now yield to the Ranking Member, Mr. Keller, for his opening Statement. ______ Mr. Keller. Thank you Madam Chair. I'm disappointed that today's hearing is being held in a completely virtual format. As I can show you in today's Washington Post, the people working in the House chamber show up every day and do their jobs, and I think we should be here in our committee's hearing room. I'm currently in committee hearing room and it can comfortably accommodate the 16 Members of this subcommittee. This hearing should be in person, and we can participate and do this work safely. After all, the subject to today's hearing is science-based strategies to protect workers, and Members of the subcommittee should have the opportunity to set a positive example by conducting this hearing in person while adhering to the most current workplace safety guidelines. Over the last year the pandemic has created unprecedented challenges for all Americans, especially workers and job creators. The top priority for employers throughout this crisis has been, and will continue to be preventing the spread of COVID-19 in the workplace to ensure the health and safety of workers and customers. Thankfully, a year to the date after the World Health Organization declared COVID-19 a pandemic, America now is equipped with much greater and thorough scientific knowledge of the virus and innovative employers have developed effective procedures and policies to keep workplaces as safe as possible. Over the past year business centers have worked around the clock to operate safely under the evolving State and local mandates. CDC and OSHA guidelines, and industry-recognized best practices to protect their workers. The vast majority of businesses, regardless of size and location have invested significant resources to implement comprehensive and effective safety precautions specific to their workplaces. And now thanks to the successful efforts of Operation Warp Speed, essential workers have been prioritized for vaccination, and President Biden has Stated that the U.S. should have enough vaccine doses for every eligible adult in the United States by the end of May. We are not out of the woods yet, but America is on the path to recovery, both in terms of health of our citizens and our economy. Under the Trump administration the Federal Government collaborated with businesses across the country, updating them as new information arose on the newest guidelines and procedures to keep workers and customers safe. This dialog allowed businesses the flexibility to create health and safety plans that fit their specific workplace, creating an efficient path forward for businesses. My Democrat colleagues have said almost from day one of this pandemic that it is necessary for OSHA to issue an emergency temporary standard, or ETS. A rigid, one-size-fits-all regulation specific to COVID-19 that would apply to every workplace throughout the country. Not one ETS has been issued since 1983 because of legal challenges and lack of due process for affected stakeholders. In 2021 an ETS would do far more harm than good to workers, employers and the American economy by denying businesses the opportunity to respond quickly to new scientific findings and industry-specific needs. Not all workplaces are the same, yet democrats are eager to impose rigid and inflexible mandates on businesses. This inflexible lagging method to keep workers safe will only hinder our economy recovery, and make it more difficult for employers to ensure safety in their respective workplaces. If OSHA had enacted an ETS a year ago as committee democrats demanded it, it would be woefully inadequate in protecting workers today. Issuing an ETS is not a science-based approach, and is instead yet another example of overbearing government policy that will do nothing but constrict employers from safely running their businesses. Four States across the country have adopted State-wide emergency temporary COVID-19 regulations. In California we're already seeing its negative effects. Since issued in November, the regulations have conflicted at various points with CDC guidance for workplaces, causing massive confusion for employees and their employers. Additionally, the California emergency rule places many new significant burdens on employers and job creators related to workplace testing, paid leave, and required reporting to public health authorities. This is no way to help an already suffering economy. More mandates from Washington, including an OSHA ETS would not only add burdens and regulations on employers that stifle creatively and ultimately hold them back. Instead, the Federal Government should be focusing on ensuring adequate vaccine supply and distribution to vaccinate all workers and providing timely public health guidance to our employers as this Nation works toward economic prosperity. I'd like to thank all of our witnesses for joining us today and I look forward to hearing your testimony. Thank you and I yield back. [The statement of Ranking Member Keller follows:] Statement of Hon. Fred Keller, Ranking Member, Subcommittee on Workforce Protections Thank you, Madam Chair. I am disappointed that today's hearing is being held in a completely virtual format. The Committee's hearing room that I am currently sitting in can comfortably accommodate the 16 Members of the subcommittee. This hearing should be in a hybrid format, so Members who want to participate in person can do so safely. After all, the subject of today's hearing is ``Science-Based Strategies to Protect Workers'' and Members of this subcommittee should have the opportunity to set a positive example by conducting this hearing in person while adhering to the most current workplace safety guidelines. Over the last year, the pandemic has created unprecedented challenges for all Americans, especially workers and job creators. The top priority for employers throughout this crisis has been, and will continue to be, preventing the spread of COVID-19 in the workplace to ensure the health and safety of workers and customers. Thankfully, a year to the date after the World Health Organization declared COVID-19 a pandemic, America is now equipped with much greater and thorough scientific knowledge of the virus, and innovative employers have developed effective procedures and policies to keep workplaces as safe as possible. Over the past year, business owners have worked around the clock to operate safely under evolving State and local mandates, CDC and OSHA guidelines, and industry-recognized best practices to protect their workers. The vast majority of businesses, regardless of size and location, have invested significant resources to implement comprehensive and effective safety precautions specific to their workplaces. And now, thanks to the successful efforts of Operation Warp Speed, essential workers have been prioritized for vaccination, and President Biden has Stated that the U.S. should have enough vaccine doses for every eligible adult in the United States by the end of May. We are not out of the woods yet, but America is on the path to recovery, both in terms of the health of our citizens and our economy. Under the Trump administration, the Federal Government collaborated with businesses across the country, updating them as new information arose on the newest guidelines and procedures to keep workers and customers safe. This dialog allowed businesses the flexibility to create health and safety plans that fit their specific workplace, creating an efficient path forward for businesses. But my Democrat colleagues have said almost from day one of the pandemic that it is necessary for OSHA to issue an Emergency Temporary Standard, or ETS-a rigid, one-size-fits-all regulation specific to COVID-19 that would apply to every workplace throughout the country. Not one ETS has been issued since 1983 because of legal challenges and a lack of due process for affected stakeholders. In 2021, an ETS will do far more harm than good for workers, employers, and the American economy by denying businesses the opportunity to respond quickly to new scientific findings and industry-specific needs. Not all workplaces are the same, yet Democrats are eager to impose rigid and inflexible mandates on businesses. This inflexible, lagging method to keep workers 'safe' will only hinder our economic recovery and make it more difficult for employers to ensure safety in their respective workplaces. If OSHA enacted an ETS a year ago, as Committee Democrats demanded, it would be woefully inadequate in protecting workers today. Issuing an ETS is not a science-based approach and is instead yet another example of overbearing government policy that will do nothing but constrict employers from safely running their businesses. Four States across the country have adopted State-wide emergency temporary COVID-19 regulations. In California, we're already seeing its negative effects. Since issued in November, the regulations have conflicted at various points with CDC guidance for workplaces, causing massive confusion for employers. Additionally, the California emergency rule places many new and significant burdens on employers related to workplace testing, paid leave, and required reporting to public health authorities. This is no way to help an already suffering economy. More mandates from Washington, including an OSHA ETS, will only add burdensome regulations on employers that stifle creativity and, ultimately, hold them back. Instead, the Federal Government should be focused on ensuring adequate vaccine supply and distribution to vaccinate essential workers and providing timely public health guidance to our employers as this Nation works toward economic prosperity. I'd like to thank all our witnesses for joining us today and I look forward to hearing your testimony. ______ Ms. Adams. Thank you to the Ranking Member. Without objection all of the Members who wish to insert written Statements into the record may do so by submitting them to the Committee Clerk electronically in Microsoft Word by 5 p.m. March 25, 2021. I'd now like to introduce our witnesses. Our first witness will be Dr. Linsey Marr. Dr. Marr is the Charles P. Lunsford Professor of Civil and Environmental Engineering at Virginia Tech. She's one of a small number of researchers in the world who study viruses in the air. She holds a BS in engineering science from Harvard and a Ph.D. in civil and environmental engineering from US Berkeley, and she completed her post- doctoral training at MIT. Our next witness will be Miss Pascaline Muhindura. Miss Muhindura is a registered nurse in Kansas City, Missouri. She works in a critical care unit. And since March 2020 she's been caring for COVID patients. She's a member of the National Nurses United and serves as a nurse representative and a member of the Professional Practice Committee for her union. Following Ms. Muhindura will be Mr. Manesh Rath. Mr. Rath is a partner with Keller and Heckman in Washington, DC. He represents employers in a wide range of matters related to occupational safety and health, law, litigation, wage and hour and class action litigation and association law. Our final witness will be Dr. David Michaels. Dr. Michaels is an epidemiologist and Professor of Environmental and Occupational Health at George Washington University. He served as Assistant Secretary of Labor for the Occupational Safety and Health Administration from 2009 to 2017, and he was a member of the Biden Harris transition COVID-19 Advisory Board. To our witnesses we appreciate you for participating today. We look forward to your testimony, and let me remind you that we've read your written Statements, and they will appear in full in the hearing record, pursuant to Committee Rule 8(d) and the committee practice, each of you is asked to limit your oral presentation to a five-minute summary of your written Statement. I also want to remind the witnesses that pursuant to Title 18 of U.S. Code Section 1001 it is illegally to knowingly and willfully falsify any Statement, representation, writing, documents, or material fact presented to Congress or otherwise concealed, or cover up a material fact. So before you begin your testimony please remember to unmute your microphone. During your testimony staff will be keeping track of time, and a timer will sound when time is up. Please be attentive to the time. Wrap up when your time is over and re-mute your microphone. If you experience technical difficulties during your testimony or later, in the hearing you should stay connected on the platform and make sure you are muted. Use your phone to immediately call the committee's IT director whose number was provided in advance. So we will let the witnesses make their presentations before we move to Member questions. When answering a question please remember to unmute your microphone. I want to recognize first Dr. Linsey Marr. Dr. Marr. STATEMENT OF DR. LINSEY MARR, Ph.D., PROFESSOR OF CIVIL AND ENVIRONMENTAL ENGINEERING, VIRGINIA POLYTECHNICAL INSTITUTE AND STATE UNIVERSITY, BLACKSBURG, VA Dr. Marr. Thank you. Chairwoman Adams, Ranking Member Keller, and Members of the subcommittee my name is Linsey Marr, and I am a Professor of Civil and Environmental Engineering at Virginia Tech. I have studied airborne transmission of viruses for the past 12 years, and have published more than 30 scientific papers on the topic. I co-authored the recent letter to the Biden administration and the CDC calling for immediate action to address inhalation exposure of SARS-CoV-2 to prevent COVID-19 infections and deaths. Today I will address four major points. One, how COVID- 19 is transmitted mainly by breathing in aerosol particles carrying the virus. Two, how best to protect workers and the public through the use of appropriate face coverings and other controls. Three, what updates are needed to CDC's guidance. And four, what needs to be done to protect workers and the public from becoming infected. There are three possible ways for the virus to be transmitted. You can touch an object that has been contaminated with the virus and transfer it to your eyes, nose, or mouth, or you could be hit by large respiratory droplets that fly out of a sick person's mouth and land directly in your eyes, nose or mouth. Or finally, you can breathe in small aerosol particles from the air that float around for an extended period of time like cigarette smoke. There is now overwhelming evidence that inhalation of tiny virus-containing aerosols is the main route of transmission for COVID-19. When people breathe, talk, sing, laugh, cough or sneeze, they release far more aerosols than large droplets as shown in this diagram. These aerosols shown in red are most concentrated close to the sick person, and they don't fall quickly to the ground like the large droplets which are shown in blue. The aerosols remain floating in the air and follow air currents for more than six feet like cigarette smoke, filling a room and building up over time if the space does not have good ventilation, as also shown in the diagram. When people are talking in close proximity, it is much more likely that they will breathe in each other's respiratory aerosols than shower each other with large droplets of spittle. Workers require special consideration because they may spend 8 to 12 hours in a poorly ventilated environment where they cannot avoid sharing the air with other people, much longer than a customer who briefly passes through the space. If ventilation if inadequate, or workers do not wear a good mask or respirator, they could breathe in enough viruses from the air to become sick with COVID-19. The most effective way to protect workers is to control the source of infection. Unfortunately, workers may be exposed to members of the public who are unmasked, especially in restaurants and some businesses. The next priority is to use engineering controls such as ventilation, to dilute the virus in the air. Respirators and masks are considered the final line of defense. Because SARS- CoV-2 is transmitted mainly by aerosols, the appropriate PPE for workers at elevated risk is a high-performance mask or a respirator. Unfortunately, most CDC guidance has not yet been updated or strengthened to address and limit inhalation exposure to aerosols. To use a technical term, it is as clear as mud. Their webpages downplay aerosols and airborne transmission, a position that is exactly opposite the best scientific evidence. Their guidance continues to put workers and the public at serious risk of infection, and undermines the effectiveness of an OSHA standard. I coauthored a letter calling for CDC to update and strengthen its guidelines to fully address transmission via inhalation of aerosols at both close distances and farther away. We also urge OSHA to issue an emergency standard on COVID- 19 that requires implementation of control measures including ventilation and respiratory protection against aerosols for all healthcare workers and other workers at high risk, including those in meat packing, corrections and public transit. It is clear from the evidence and our experience over the last year that only strong CDC guidance and OSHA standards that are based on the best available science will enable us to safely reopen workplaces and schools while ending this pandemic and better preparing us for the next one. Thank you. [The prepared Statement of Dr. Marr follows:] Prepared Statement of Linsey Marr [GRAPHICS NOT AVAILABLE IN TIFF FORMAT] Ms. Adams. Thank you very much Dr. Marr. We'll now hear from Miss Pascaline Muhindura. You're recognized ma'am. STATEMENT OF MS. PASCALINE MUHINDURA, REGISTERED NURSE, COVID PROGRESSIVE CARE UNIT, RESEARCH MEDICAL CENTER, KANSAS CITY, MO, ON BEHALF OF NATIONAL NURSES UNITED MS. Muhindura. Good morning. And thank you Chairwoman Adams, Ranking Member Keller, and Members of the subcommittee for giving me the opportunity to testify today. I'm a critical care nurse at Research Medical Center, an HCA healthcare facility in Kansas City, Missouri. And I'm a proud union member of National Nurses United. I will make three main points today. First, my employer has failed to protect us. Second, the CDC and OSHA have failed to protect us. And third, the CDC and OSHA must take immediate steps to ensure that nurses and other workers get the protections we need. For more than a year I have been caring for patients in a COVID unit in my hospital. Every single nurse and healthcare worker in my unit has contracted COVID because we were not given the protections we need. My colleague Celia lost her life. As Dr. Marr outlined SARS-CoV-2 is transmitted through the inhalation of aerosol particles. That means that nurses and other frontline workers must be given respiratory protection. At minimum, we need N95 respirators which are only safe for a single use. Power aired purifying respirators and elastomeric respirators are more protective, and are safely reusable. In January 2020, nurses urge our employer to prepare for COVID. They didn't. When the pandemic started in March none of the COVID nurses had been fit tested for N95's. Management had not implemented our recommendation from January. On March 21 management collected all of the PPE in the hospital, locked it up, and began rationing N95's. The next day a patient was transferred from the emergency department to the cardiac telemetry unit. The nurses on the unit recognized the patient had signs of COVID and the asked management for N95's. Management refused. The patient later tested positive, and as a result of her exposure to this patient, my colleague Celia Yap-Banago contracted COVID and lost her life. Despite Celia's death, the hospital continues to ration N95's. Management is still forcing us to unsafely reuse the same N95 for an entire shift, and is recommending that we use surgical masks with COVID patients. To be clear, nurses on my unit are still caring for COVID patients without adequate protection. This isn't just happening in my hospital. In NNU's February 2021 survey of nurses across the country, more than 81 percent report that they still have to reuse at least one type of single use PPE. As union nurses, my colleagues and I have been fighting these dangerous policies every step of the way. As registered nurses we know that as long as our safety is compromised, our patients are also at risk. In all of our conversations with management they have told us the same thing. They're following CDC guidelines. The CDC guidelines are not based on science. To this day the CDC does not recognize aerosol transmission of COVID. The guidelines allow healthcare employers to give nurses surgical masks, instead of respirators, and to reuse N95's. Management withholds PPE and they used CDC guidelines as their justification for putting our lives at risk. My union filed a complaint with OSHA last spring about the circumstances that led to Celia's death. OSHA found clear evidence Celia and other nurses have been exposed to COVID because of our employer's failure to provide PPE. But OSHA could not cite my employer because the CDC guidelines are weak, and because OSHA doesn't have a standard on infectious disease. As union nurses, with our practice rooted in science, we have clear recommendations for what we need to be able to care for our patients safely. First, we need the CDC to update its COVID guidelines to be based on scientific evidence, especially regarding aerosol transmission. The CDC needs to revoke the crisis standard on optimization of PPE which are based on supply consideration, not science. Second, we need a thorough OSHA standard that requires our employers to protect our health and safety at work. If these recommendations had been implemented 1 year ago, my colleague Celia, along with thousands of other healthcare workers would be alive today. We need immediate action so that nurses and our patients get the protections we need. [The prepared Statement of Ms. Muhindura follows.] Prepared Statement of Pascaline Muhindura [GRAPHICS NOT AVAILABLE IN TIFF FORMAT] Ms. Adams. Thank you very much. Ok thank you. I'm going to go vote now on the floor and Mr. Scott will you please assume the gavel? Mr. Scott.[Presiding] I will thank you. Our next witness is Mr. Rath. STATEMENT OF MANESH RATH, PARTNER, KELLER AND HECKMAN LLP, WASHINGTON, D.C. Mr. Rath. Thank you very much. Good morning Chair Adams, Mr. Scott. Thank you Ranking Member Keller and Members of this subcommittee. I'm grateful for the opportunity to speak before this subcommittee on this issue today, Clearing the Air Science Based Strategies to Protect Workers from COVID-19 Infections. I'm Manesh Rath. I'm a partner at the law firm Keller and Heckman LLP, here in Washington, DC. I work with employers to develop effective improvements in workplace safety and health. In my testimony today I'm expressing only my own understanding of an experience in the field of occupational safety and health law and administrative law, and I'm not here as a representative of any other entity. Today I will address some of the efforts that I have seen employers undertake in response to COVID-19 during the pandemic this past year, and some of the conclusions that employers have drawn from their experiences. During this pandemic, employers with whom I have worked have engaged in a continuous cycle of evaluation and improvement as scientific and healthcare understanding about COVID-19 has evolved. Employers have implemented fundamentally for interventions, and some simple interventions have endured because they work, for example universal use of face masks, hand washing, disinfecting frequently touched surfaces, and distancing where achievable, and installation of temporary barriers which distancing is not achievable. We have also seen creative solutions that only the private sector could have developed, and could not have emanated from government. For example, employers have deployed private transportation networks for workers to isolate them from public transportation exposures. One, a manufacturer with whom we've worked, fabricated cooling booths, equipping those booths with air-conditioning to allow manufacturing workers to take periodic maskless, heat stress breaks. We've seen employer deploy temporary portable adjunct space for additional meeting and brake rooms. Several employers we've worked with have increased their janitorial staff substantially. A couple of employers I've worked with have even engaged their own epidemiologists in order to respond more rapidly than could be seen from OSHA or the Centers for Disease Control and Prevention to adapt to changing science about COVID-19. In addition, we've seen employers that have willingly tried interventions that have had diminishing value. For example, employers early in the pandemic quarantined inventory for 24 hours if the inventory may have been exposed to positive workers, positive cases. We now see that that's been used less and less frequently, and even the CDC has recently opined in October 2020 that contaminated surfaces comprise an uncommon transmission vector. In another example, every employer I've worked with implements symptom screening and temperature check at the beginning of every shift for every employee, and yet we now see evolving science demonstrate that asymptomatic and pre- symptomatic cases comprise a significant fraction of transmission spread. The many changes we've seen at the CDC have also taught us the importance of a flexible guidance-based approach to COVID- 19 in the workplace. For example, on April 6, 2020 the CDC recommended avoiding all non-essential travel, even intra-city. Within 48 hours the CDC revoked that guidance, and again updated it in February 2021. We've seen on February 10, 2021 the CDC released an updated mask recommendation recommending both a disposable mask, and on top of that a cloth mask. So even a year after the onset of the pandemic the CDC's guidance has been updated on something as simple as masks based on data-driven science. If OSHA had implemented any of these recommendations in an emergency temporary standard a year ago, those requirements would have been quickly antiquated by science, dismissed by the public, and a discredit to the agency. In its wisdom, OSHA chose instead to issue guidance documents, and indeed in a one- month period issued 13 guidance documents, some of which were industry specific, all of which could be rapidly revised to meet the changing conditions and science of the pandemic. As with the examples I have discussed, employers have already demonstrated the ability to quickly adapt and implement new interventions faster than government can develop policy. For the same reason, agency guidance that can be rapidly updated, is better suited to our evolving understanding of COVID-19 than emergency regulations could be. Thank you for the opportunity to appear before you, and I look forward to addressing any questions you may have. [The prepared Statement of Mr. Rath follows:] Prepared Statement of Manesh Rath [GRAPHICS NOT AVAILABLE IN TIFF FORMAT] Mr. Scott. Thank you. Dr. Michaels. STATEMENT OF DR. DAVID MICHAELS, Ph.D., PROFESSOR OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, THE GEORGE WASHINGTON UNIVERSITY, FORMER ASSISTANT SECRETARY OF OSHA, WASHINGTON, DC Dr. Michaels. Thank you Chairman Scott, Ranking Member Foxx, Ranking Member Keller, Members of the subcommittee for inviting me to testify today. My name is David Michaels. I'm an Epidemiologist and Professor at the Milken Institute School of Public Health at the George Washington University. From 2009 to January 2017 I served as assistant Secretary of Labor for the Occupational Safety and Health Administration, OSHA. I was also a member of the Biden Harris Transition COVID- 19 Advisory Board. Workers are at the core of this pandemic. Millions work 8 or more hours a day in close proximity to coworkers or members of the public in poorly ventilated settings with inadequate protection performing the activities necessary to maintain the economy and social functioning. They can't avoid exposure to the virus which has sickened or killed an enormously large number of them. These workers bring the virus home to their families and communities, helping drive the disproportionate and tragic impact COVID-19 has had on communities of color. This is the crisis for which Congress enacted the Occupational Safety and Health Act 50 years ago, but OSHA was missing in action during the Trump administration. It failed to take the steps necessary to require employers to protect workers from the virus. It did few inspections, and it issued miniscule fines. At one meat factory for example, where hundreds of workers were sickened and six died, OSHA issued a $15,000.00 penalty, not even a slap on the wrist for a multi-billion dollar corporation. Fortunately, the Biden administration has committed to reinvigorating OSHA. The agency is expected to soon issue an emergency temporary standard that will require employers to assess the risks of exposure in their workplaces, and take steps appropriate to each workplace to limit it. President Biden has famously promised that his administration will ``follow the science''. To do so as Dr. Marr has just testified, the CDC must update its guidance, acknowledge the danger of inhaling infectious particles, and advise employers to take appropriate measures, and OSHA's forthcoming standard must reflect the newest science on COVID transmission and worker protection. There is still much to be done. After thousands of cases, and hundreds of deaths, workers in meat and poultry plants are still forced to work shoulder to shoulder instead of being provided improved ventilation, filtration, and adequate distancing. Many meat and poultry firms hang plastic sheathing between workers who are standing on cutting lines elbow to elbow even though that sheathing is ineffective in stopping exposure. And astonishingly, we have seen some Governors and all mask and density mandates, these ill-advised actions will likely conflict with OSHA's forthcoming regulation, and is expected to require employers whose workers come in close contact with other workers or customers or the public, to mandate facial covering for all people in the workplace. The nation also needs to do more to ensure that front line workers are prioritized for vaccinations. Unfortunately, many States have no plan to do so, or they're conducting insufficient outreach to help those workers get vaccinated. Needed is a national plan for increasing vaccinations among these workers, especially those who are more difficult to reach because of language or cultural barriers, or the nature of their jobs. And despite the huge impact on this Nation's workers, there are a few, if any, sources of complete accurate data on the impact of the virus on workers in any industry or occupation. There's no centralized effort to compile a census of workers who have been affected or died of the disease. Now this is truly a lost opportunity because there are enormous lessons to be learned about preventing transmission in future pandemics. The Federal Government needs to make concerted efforts to collect these data. While it may be too late to conduct a census of deaths, other types of studies could be launched that would help understand the actual toll of the pandemic on the Nation's workers and how to prevent future pandemics. Now while hospitals have hailed nurses and other medical staff as heroes, these workers remain vulnerable to workplace assaults. I strongly support the Workplace Violence Prevention for Healthcare and Social Services Workers Act, H.R. 1195 and grateful to Representative Joseph Courtney who reintroduced the bill last month with bipartisan support. In addition, the accurate reporting of workplace injuries and illnesses by employers is vital to help OSHA target the most hazardous workplaces. I strongly support H.R. 1180, the Accurate Workplace Injury and Illness Record Restoration Act, which Representative Mark Takano introduced to restore OHSA's ability to cite employers who systematically fail to record workplace injuries and illnesses. Thank you for this opportunity to testify. I look forward to your questions. [The prepared Statement of Dr. Michaels follows:] Prepared Statement of David Michaels [GRAPHICS NOT AVAILABLE IN TIFF FORMAT] Mr. Scott. Thank you. Now we'll have Member questions and I'll begin with myself. I recognize myself for five minutes. Dr. Michaels we heard a comment about the problem of incorporating guidance in an ETS, and if the guidance changed, the ETS changes. How complicated and confusing, would that be if at all? Dr. Michaels. Thank you for that question Chairman Scott, and thank you for your work in this area. You know that's a caricature of an OSHA standard, and it's totally wrong. The key part of the emergency temporary standard as I understand it, what we might expect to see is essentially telling employers, look. Assess what's going on in your workplace. Do a hazard assessment, and then look at the guidance that comes out of CDC. Look at what we understand about how workplace transmission takes place, and take steps accordingly. Now I very much agree with Mr. Rath that we don't need to be doing you know major disinfection. And that really turned out not to be effective, and it's really I believe that if CDC changes their guidance on that, you know, employers will do much less of that. So right now the problem is CDC guidelines are out of date, and whatever the OSHA standard is, it's going to say use that CDC standard. And when CDC standard's change, workers get better protection because CDC has improved their thinking about how to protect workers. Mr. Scott. Thank you. And Dr. Michaels are you familiar with the Virginia ETS and now permanent standard? Dr. Michaels. I am. Virginia was the first State to issue an ETS, and the first State to issue a permanent standard to protect workers from airborne infectious diseases. Mr. Scott. And how effective is that standard, and how burdensome is it? Dr. Michaels. Well I believe it's very effective. Look, you know as you've heard from Mr. Rath, some employers do the right thing without being required to, but many employers don't. And that's why Virginia issued the standard. I think it's been very effective in making sure that those employers who wouldn't normally have made those steps to protect workers are now doing so. They know they have to provide social distancing. They have to provide masks in workplace. And they've also given information to the Virginia government that's really important. There's a requirement to notify the Virginia State Health Department when cases are found and when there's a cluster at a workplace, Virginia OSHA is told, so they can actually go out and do some inspections. Mr. Scott. Now did you follow the regulatory adoption of that standard. Dr. Michaels. Yes I did. The Virginia Board included representatives workers of workers, of employers in the public, voted on it and it was passed by a large majority. Mr. Scott. Did that include the employer representatives? Dr. Michaels. Yes it did. Mr. Scott. Thank you. You were at OSHA before. Can you tell us the importance of accurately recording data so that under Mr. Takano's bill, what difference does accurate recording of data--what difference does that make? Dr. Michaels. Oh. That is such an important question. You know OSHA requires most employers to keep track of injuries and illnesses, and that information is really important for that employer, for the workers in that workplace, because recording injuries and illnesses accurately and completely provides a roadmap to prevent future injuries from occurring. Unfortunately, we've gotten into a situation where there really is no enforceable requirement for employers to record data accurately, and the result of that is many of these OSHA logs are incomplete, and so it's hard to actually figure out the best way to prevent future injuries. Mr. Scott. And finally, Mr. Courtney's bill on violence prevention essentially requires employers to have a plan to deal with violence. Can you tell us what those plans look like and how effective they are? Dr. Michaels. Well again, every employer will make a different plan. You know this idea that there's a one-size- fits-all OSHA requirement, each employer if it's a psychiatric hospital, it would like one way. If it's an emergency room it would look another way, but it would say this is what we're going to do to make sure workers are protected, so they can do their jobs, they can take care of their patients. That plan might say for example, in certain situations you can't have a worker by themselves with a patient with a known psychiatric violent problem where every room has to have an emergency button that could be pushed to bring a security guard when necessary. So each one would be different, but each would be appropriate, and that would certainly make healthcare much more less stressful, less dangerous for the workers, and better for all of us who essentially see those healthcare professionals and need their help. Mr. Scott. Thank you very much. My time has expired. Mr. Keller you're recognized for five minutes. Mr. Keller. Thank you. Mr. Rath since the COVID-19 pandemic was declared and became a threat to the U.S. workplaces in early 2020, the scientific understanding of the virus has dramatically changed, and continues to do so. Can you explain how the public health guidance for preventing the spread of COVID-19 in the workplace from CDC and OSHA has evolved since the early days of the virus, and how employers have responded to adopt the necessary precautions over time. Mr. Rath. Thank you for your question Ranking Member Keller. This is a good question. What we've seen over the past year at the employer level is that they have spent an enormous amount of energy rightly so, trying to stay up to date with changes in our science, and our healthcare understanding of COVID-19, and its transmission at the workplace. Some of those developing standards or guidance's that have come from the CDC have been helpful and at some point they were rolling out changes multiple times a week and employers were doing their best to keep up with those changes, and contemplate and implement changes in the workplace accordingly, including the questions of what are the symptoms? That list was rapidly developing in the early months. We saw the list expand, we bifurcated into higher and lower levels of specificity and then be compressed into a singular list again, how long people should be quarantined, or isolated if they were positive or came in close contact with a positive case. And employers have done an excellent job that I've worked with in trying to implement well-intentioned policies to keep up with that science. That science has been changing, and it continues to change, and as I mentioned earlier just a month ago the CDC revised its view on mask wearing to State its recommendation that two masks be worn--a disposable mask underneath a cloth mask. These are data-driven changes from the Centers for Disease Control, and employers have continued to very rapidly, make changes in the workplace accordingly. Far more rapidly we've seen employers make changes, and then later on we've seen the Centers for Disease Control, or OSHA-issued guidance for example, two employers I've worked with have engaged their own epidemiologists, and have looked directly to scientific studies, bypassing, much more rapidly bypassing, the implementation of a change of policy at the Centers for Disease Control and Prevention, and far more rapidly still than guidance could be issued by OSHA. Once OSHA issues an emergency temporary standard it has one chance to do so, and then that is immutable and intransigent against successive evolutions in science. And so that has been a success story with the employers with whom I've worked. Mr. Keller. So, some of the employers have taken it upon themselves to make sure when they've investigated and found a better way to do things, they've been ahead of OSHA and CDC in some cases? Mr. Rath. In several instances that's correct. They've looked directly to the scientific journals and scientific studies as soon as they've been published, evaluated those studies and made changes quickly, and then you've seen those changes manifest themselves in CDC guidance, and then far later still sometimes through OSHA guidance. Mr. Keller. Thank you. And another question Mr. Rath, Ranking Member Foxx and I sent a letter to acting Secretary of Labor Al Stewart asking the department to consider the impact that a one-size-fits-all OSHA regulation could have on small businesses. Can you explain the customary process in which OSHA fulfills its small business feedback related to regulatory initiatives? Mr. Rath. That's an excellent question Ranking Member Keller, thank you for asking it. Under traditional rulemaking there is a step in the rulemaking process where the agency has to solicit the input of small businesses, small business representative entities, and it has to also separately, evaluate the impact of a regulation on small businesses. That in addition to scientific data. Scientific data cannot write a regulation. It has to be alloyed with this small business impact consideration as well as technical and economic feasibility considerations. All rules have to go through these processes. And if you go through an emergency temporary standard, that would exclude the small business stakeholders from being able to contribute comments as to how it would impact small businesses. Mr. Keller. So an emergency temporary standard would bypass America's small businesses which are the backbone of our economy? Mr. Rath. That's correct. It would go straight to developing a rule without small business input. Mr. Keller. Thank you. And how important do you think it is to solicit the feedback from small businesses before an emergency temporary standard related to COVID-19 is contemplated? Mr. Rath. Small businesses are a special case because they comprise the largest fraction of the work force, and safety and health in small businesses is therefore just as important or more so, than the large employers that comprise a much lesser fraction of the total work force. Mr. Keller. Thank you. And I just want to make the point. I worked in a factory and my experience was that employers do value and appreciate the people that come to work every day. And for us not to consider all of America's small business, they're innovators, our neighbors, the people that make our communities so great. I think it would be a huge mistake by our government to discount and not hear their voices, so thank you and I yield back. Mr. Scott. Thank you. The gentlemen's time has expired. Mr. Takano are you there? [No response.] Mr. Scott. Mr. Norcross? [No response.] Mr. Scott. Ms. Jayapal? Ms. Jayapal. Thank you Mr. Chairman. Mr. Scott. Ms. Jayapal you're recognized for five minutes. Ms. Jayapal. Thank you Mr. Chairman. Estimates from the CDC put the total number of COVID cases at over 28 million, and over half a million people have died. I think we have a real duty in Congress to learn what we can from the stories of people, particularly the workers that have suffered the worst of the pandemic, and to confront the stories they tell us about inequalities that are tearing our society apart. I think we have to learn what we can to turn the tide against this virus, and to ensure that our country leaves future generations better prepared. Dr. Michaels, is it true that the Federal Government has no comprehensive system to track worker deaths or infections from COVID-19? Dr. Michaels. Representative Jayapal. Unfortunately, that is correct. Essentially the Federal Government leaves it up to the States to even classify cases and deaths being work- related, not even work-related, but to collect information about industry and occupation. And the States have inadequate resources, and have not been able to do that. There really has been no effort made to have an overall number. I'll give you an example. We know that you know hundreds of thousands, 400,000 healthcare workers have reported to become infected. But we have actually the status of their healthcare workers are less than 20 percent of all cases. So the number could be far, far higher. And while the number is important, more important is understanding why people were exposed. What happens to them after they're exposed? What happens to their communities? And while there have been some studies being done, there really aren't that many, and the feds have not stepped up to the plate to do this. Ms. Jayapal. Thank you. I think it is incredibly important for all those reasons for us to have that national strategy, and to do the research that you're talking about. It seems like we could start by paying attention to the COVID-19 related whistleblower complaints from workers who face retaliation when exercising their workplace health and safety rights. In your opinion has OSHA's response to whistleblower complaints been adequate, and if not, what do you recommend that the subcommittee or Congress do about it? Dr. Michaels. You know this is a complicated question in that I mean there's no question that OSHA's response has not been adequate. OSHA received thousands of complaints of whistleblowers during the last year of workers who have complained that they've been retaliated against for raising concerns. OSHA has attempted to close some of those cases, and they've been overwhelmed. In addition to I think the lack of commitment of the previous administration, the whistleblower protection provisions of the OSHA law are miserably weak, and there were many hearings on this. I certainly testified in front of Congress several times. A whistleblower who is retaliated against for calling OSHA for example, has only 30 days to apply for--to complain to OSHA, and OSHA has limited availability to get them back to work. They have to go to court if the employer doesn't agree. So I think the thing that we should be thinking about is how to improve the protections of workers so they can raise concerns about their health and safety, or their coworkers, and really get the protection that they need to have. Ms. Jayapal. Thank you. Let me stay on this topic of whistleblowers for a second. Miss Muhindura thank you so much for your service on the front lines, taking care of people every day, and in such difficult circumstances. We are truly grateful to you and nurses across the country. In your experience, what does it mean for black, brown, and immigrant workers when whistleblower complaints don't receive an adequate response? Ms. Muhindura. Congresswoman Jayapal thank you so much for the question. There's a large percentage of brown and black immigrant workers who are on the frontline. And so when employers do not give us the protection that we need it is upsetting, it makes us feel that we're disposable. In addition to having the CDC and OSHA abandon us, it was extremely disappointing, and it adds to the anxiety and the traumatic experience that we are already experiencing because of COVID. Ms. Jayapal. And do you have statistics on the disparities that you want to put before us and enter into the record beyond what you said in your testimony? Ms. Muhindura. I do not. Ms. Jayapal. Thank you. I've looked at some of the data on this, and it seems to me that this is you know these disparities are shameful. We have a real obligation to address them, and I think the lack of reliable data on workplace infections, because we don't have this national strategy and these things in place, the research that Dr. Michaels was talking about, it puts all workers at risk, and particularly those who are black, brown, immigrant, who lack the other workplace protections that are really essential. So I look forward to working with all of my colleagues to ensure that the CDC and OSHA adopt the latest scientific means to stop the spread of COVID-19 at work, and I thank you Mr. Chairman and yield back. Mr. Scott. Thank you. I see that the Chair has returned. Madam Chair the Ranking Member is the next to be recognized, Dr. Foxx, so if you could recognize her then you'll be given a list from there on. Ms. Adams. Thank you very much Mr. Scott. I want to recognize the gentlelady from North Carolina, Dr. Foxx. Ms. Foxx. Thank you Madam Chairman and thank you Mr. Scott. Mr. Rath if the Federal Government adds additional mandates on employers related to COVID-19 without considering the real- world feasibility of such a decree, what impact would this have on keeping workplaces safe during the pandemic? Mr. Rath. Thank you Ms. Foxx for this question. It's a good question. Two things emerge to mind immediately. The first is that if an emergency temporary standard was the vehicle by which OSHA decided to regulate the subject, the science which has continued to evolve will evolve over the top of that emergency standard, and it will quickly become outdated, and the agency will have little means by which to update it. Whereas, by contrast guidance documents can be updated quickly and iteratively any number of times to meet changes in our scientific understanding. The second thing I'd say is that the stakeholders have expertise. They have developed an acquired experience and learning about what works and what doesn't, and their input would yield a substantially better set of policies by the agency and at the workplace than an emergency temporary standard which excludes and disenfranchises the expertise of employers, scientists, the healthcare community and employee representative groups. Ms. Foxx. Thank you Mr. Rath. Another question. Ranking Member Keller and I sent a letter to acting Secretary of Labor Al Stewart on February 25th inquiring about the steps the agency's has taken to determine whether an OSHA emergency temporary standard is necessary to protect workers from COVID- 19, and encouraging the agency to solicit feedback from businesses and workers before they made that determination. I'm a strong proponent of evidence-based policymaking. In your view would feedback from employers and workers who have been on the front lines of keeping workplaces safe over the last year, be helpful to the Labor Department in making this determination? Mr. Rath. Thank you for that question Representative Foxx. That is an excellent question, and the answer is yes, clearly employees and employers have acquired a substantial amount of valuable experience and knowledge, not only as to what works in terms of interventions, but what hasn't worked, and what hasn't been effective. And as well, the scientific community and the healthcare community should be provided the opportunity to comment and that is the value of traditional rulemaking. It is a part of administrative law that we've recognized for between 80 and 90 years, and shouldn't be lightly dispensed with during the pandemic. Ms. Foxx. A followup. What impact would new and complex regulatory requirements from OSHA which would override the guidance issued by the CDC and State public health agencies have on the universal adoption of basic health measures in preventing the spread of COVID-19 in the workplace? Mr. Rath. Thank you for that question. I'll limit myself to my experience, which is strictly as an attorney representing employers in the field of occupational safety and health law. And I would suggest that employers who have carefully examined the experience that they're witnessing at the workplace, have been better able to identify the kinds of interventions that work and don't work. And that their consultation with epidemiologists and healthcare, members of healthcare industry, has fashioned better policies and practices of workplace at the workplaces that I've been able to collaborate with employers. Ms. Foxx. Well it's my experience that employers want very much to protect their employees. They care for their employees. In many cases they're like families to them. And unfortunately, our friends on the other side of the aisle don't see things that way. One more followup. Over the last year employers have made significant efforts and investments to adopt health and safety precautions to protect their workers and prevent the spread of COVID in the workplace. You eluded to this, but what have been some of the most innovative measures adopted by employers, and how effective have they been in ensuring safe workplaces? Mr. Rath. Thank you for that question Representative Foxx. We've worked with employers who as I said before have engaged their own epidemiologists on engagement so that they can stay up to date with current science. We've worked with employers who have rolled in temporary adjunct space so that they could have additional space for breaks. One employer has manufactured separate cooling stations so that manufacturing workers on the plant floor could take mask less breaks. I'll add to what we've discussed before. When we talked to an employer who has developed their own testing capacity, so that they can engage in more rapid testing on a regular basis of their work staff to keep the work force going, healthy, safe, and the business running. Ms. Foxx. Thank you Mr. Rath and again, I know employers want to keep their employees safe and healthy. And that's the attitude we should have. How can we help them do better with what they know to do, but they're smart people and they'll do it. Thank you Madam Chairman I yield back. Ms. Adams. Thank you very much. I want to recognize myself now for five minutes. Mr. Rath let me just cut right to the heart of the issue. Do you think that COVID-19 presents a grave danger to workers? Can you give me a yes or no? Mr. Rath. Thank you for that question Miss Chair. Yes. There's no question that COVID-19 presents a health and safety risk to the work force. It is also a community risk. Ms. Adams. Thank you. Mr. Rath. And employers have a substantial role in it, but not of course the only role in a community spread environment. Ms. Adams. All right let me move on. I've got five questions. Thank you. Dr. Michaels, do you think COVID-19 presents a grave danger to workers? A yes or no? Dr. Michaels. Yes. Ms. Adams. OK. Miss Muhindura what about you? Do you think COVID-19 presents a grave danger to workers? Yes or no? Ms. Muhindura. Totally yes. Ms. Adams. Thank you. Dr. Marr can you describe some of the overwhelming evidence that inhalation of virus containing aerosols is the main route of transmission for COVID-19? Dr. Marr. Dr. Adams thank you for the question. Yes. The first piece of evidence is super spreading events. We've heard of these. The choir practice where 53 out of 61 attendees became sick and two of them died. Gym classes where 55 out of 81 people became sick, even though they were six feet apart. Inhalation of aerosols in shared air is the best explanation for these types of events which can also happen in workplaces, as clearly not everyone has spent 15 minutes close to the infected person. There's also we know transmission by people who are infected, but who do not yet have symptoms, asymptomatic or pre-symptomatic. They're not coughing. They can transmit anyway because the virus is released in aerosols that come out when we just breathe and talk. We see substantial indoor transmission, almost no outdoor transmission. That means that's because these aerosols are rapidly diluted in outdoor area. In a study that traced over 7,000 cases of disease there was only one instance of transmission that occurred outdoors, and then there have been many scientific studies where we look at, collect virus samples, or air samples in hospitals. We know the various survives for many hours in the air. I could go on, but I don't want to take up all of your time. Ms. Adams. Thank you very much. Thank you. Miss Muhindura you testified that you and every nurse on your unit became infected with COVID-19. Can you describe your experience? Ms. Muhindura. Yes. When I tested positive for COVID, it was a terrifying experience. I was very anxious. I was lucky to have relatively mild symptoms, but my anxiety came from the fact that I had been caring for extremely sick patients that had been infected with COVID. So that was always in the back of my mind what would happen if I got that sick. I was also angry because I knew I got sick because I wasn't protected at work. And to make matters worse it was the week of Thanksgiving and I missed my daughter's birthday because of that because I was under quarantine, so yes. Ms. Adams. So OSHA refused to cite your hospital despite obviously preventable hazards that led to the death of a nurse, and their excuse was that there was no OSHA standard. Instead they sent your hospital voluntary recommendations in a hazard alert letter that told your employer that you may voluntarily provide this area office with progress reports on your efforts to address COVID-19 hazards in your workplace. So what effect did this hazard alert letter have on improving conditions in your workplace? Ms. Muhindura. Thank you so much for the question. I believe the hazard letter was sent sometime in February of this year, and fortunately, I'm part of the National Nurses United, and I feel like most of the measures that have been implemented, were implemented because of the advocacy that we had been doing since last March. And I don't particularly see a lot of changes that have come out of the hazard letter. Ms. Adams. So if your management, your hospital would have taken safety more seriously if there had been an enforceable OSHA standard, do you think that they would have taken it more seriously, you think? Ms. Muhindura. Yes. I definitely think after reading the OSHA response it was clear that OSHA could not site my employer because OSHA doesn't have a standard. So as long as OSHA doesn't have a standard, our employers were not being held accountable for putting the employees at risk. So I definitely think an OSHA standard would enforce that. Ms. Adams. Thank you very much. Thank you for your testimony. I'm going to recognize Miss Stefanik from New York. You're recognized ma'am. Oh she's not here. Mrs. Miller-Meeks of Iowa you're recognized. Ms. Miller-Meeks. I'm trying to unmute. There we go. Ms. Adams. OK. Ms. Miller-Meeks. I was trying to unmute myself. Thank you so much Chair Adams and Ranking Member Foxx. So you know I'm a physician, former nurse, so Miss Muhindura, thank you very much for your activities as a nurse. Also former Director of the Iowa Department of Public Health. So it is new information to me that there is vast aerosolization of COVID-19, and I think that's why it's not on the CDC site, so with all due respect to the science, and in addition to which I don't think on the CDC site there's also recommendations for improving your immune system such as Vitamin C, Vitamin D and Zinc, which I have actually started taking myself at the beginning of the pandemic. We certainly know, and I think was asked about COVID-19 and representing a risk to workers, and workers are not in isolation. Workers live within a community, so the only place where COVID-19 is contracted is certainly not at the workplace which leads to my question. Dr. Michaels, a yes or no question. Have you visited a meat processing facility during the pandemic? Dr. Michaels. Not during the pandemic. Previously I have. I haven't left my house much during the pandemic. Ms. Miller-Meeks. Thank you for that. I have not been able to visit the meat processing facilities in Iowa in my congressional district or in my Senate district, but working with our public health departments, our county public health departments, and our meat processing facilities very early in the pandemic, we went through changing shift work, adding additional shifts, separating workers, putting up barriers, temperature checking on infants, separate dining facilities, altering the rotation for when people could dine, separating utensils not to have any reusable utensils, or grabbing utensils out of a common container. And also even limiting, not putting salt and pepper shakers there so people could not contract COVID-19 through that. So it seems to me that because this is a public health issue in our communities, not just a workplace safety issue, it's hard to determine. And I have worked in fact with my local health departments on testing and contact tracing, that it's difficult to determine where an individual contracted COVID-19. So Mr. Rath what is OSHA's current policy on recording of COVID-19 cases on employer, and on employer injury and illness logs, and what are the challenges in trying to determine where an individual contracted COVID-19? Mr. Rath. Thank you for that question. Employers are required by OSHA to record work related injuries and illnesses, and this includes illnesses through COVID-19. So there is a requirement to record COVID-19 cases in the injury and illness record keeping form. There is a problem for employers. As you note this is a community spread phenomenon and so employers are challenged. And they struggle, even with the best of intentions it's difficult to know which cases are contracted in the workplace and which ones come from community spread. This is a disease that is inherently idiopathic in its etiology. And the presumption of work relatedness is certainly a starting point, but knowing that employees in 75 percent of their work week are outside of the workplace makes it difficult to know which cases are work related, and which cases are non- work related. Therefore the data, given all the confounding factors, is of necessarily limited value, but it is important to make those record entries nevertheless, to see if the data will yield something of any benefit. Ms. Miller-Meeks. Thank you. And again Mr. Rath, now that vaccines are available, and when we're looking at where an individual contracted COVID-19 and perhaps they're looking to their workplace for workman's compensation. If an individual refuses a vaccine should that play into if COVID-19 was contracted, and you can't prove where it was contracted from, how do you think that that interplay will occur if an employee does refuse or decline vaccination, especially if offered at the workplace. Mr. Rath. Thank you for that question. The question you're asking essentially goes to the intersection between occupational and safety health law, as well as several other areas of workplace law. For example, an employee may have declined a vaccination out of a generally held, or sincerely held religious belief, and there may be a medical opinion for that particular employee that's an underlying condition which would qualify for coverage under the Americans With Disabilities Act, may motivate the employee not to take a vaccination. And so employers have to find opportunities to understand whether or not they need to accommodate those particular circumstances before rendering a workplace decision on merely the mere fact of a declination for a vaccination. Ms. Miller-Meeks. Thank you Chair Adams. I yield back my time. Ms. Adams. Thank you very much. The gentleman from California, Mr. Takano you are recognized. Mr. Takano. I'm trying to unmute myself Madam Chair. Thank you. Thank you Madam Chair. I'd like to hone in on Mr. Michaels, Dr. Michaels question that Chairman Scott began to ask you. Can you tell me what the Volks rule is, what the Volks rule was? Dr. Michaels. Yes. The Volks rule was a regulation that we put out when I was running OSHA that essentially said that employers have to maintain a complete and accurate log for five years, actually five and a half years after the injury occurred. It was in response to a court decision that said that the previous rule that OSHA had was not well-written. They need to be essentially fixed. OSHA long has had the policy that employers must keep track of injuries for five years. That means its on their premises, so they can use it, workers can see it, and OSHA inspectors can see it. The Volks rule was overturned by Congress in a congressional review act, and so essentially OSHA has no ability to issue a fine against the employer if they find an injury was not on the log if 6 months after the injury occurred. Mr. Takano. Thank you Mr. Volk--thank you Dr. Michaels. This rule also would have required them to record illnesses as well, is that right? Dr. Michaels. Absolutely. Mr. Takano. OK. And I want to be clear this was overturned by a congressional review act in 2017 by the republican controlled Congress and signed by President Trump. Dr. Michaels. Yes that's correct. Mr. Takano. So tell me why this rule was so important. Dr. Michaels. Well you know we've seen that employers realize if they're never going to get caught by OSHA, there's no reason to record the injuries and illnesses. Now some employers always want to do the right thing and have very accurate records because they know that helps them prevent the injuries and illnesses in the future. But not all employers are like that, and many take the low road and try to avoid that. In addition we have a regulation that says that employers have to provide OSHA with summary data, and that is going to be made public. And so they don't want people to know if things are really bad at their work place, they don't want people to know that. And so this is the opportunity to essentially to lie about that. So it's really a problem. Mr. Takano. Mr. Rath do you agree that it's important for employers to keep records? I think you in your response to Dr. Miller-Meeks you said you know it's not necessarily determinative that an illness occurred at the workplace, but it's important to have that data. You would agree with that? Mr. Rath. Yes and that's a good question. Thank you. There are four constituents that would want that data, employers who want to define a story, a pattern from the data, employees who have a right to know. Government should want to see the data, should have access to the data if it wants to see it, and researchers should also have access to that data. This is important, but the question at stake is whether or not an omission or an error from more than 180 days ago constitutes a continuing violation. It does not. It is well accepted, and that's what Congress said 40 years ago when they had enacted the OSH Act that it was a discreet moment of violation and not a continual violation. Mr. Takano. Well it's still important necessarily, you would concede that it's important to keep these records. Employees have a right to know whether illnesses are occurring at workplace. Health officials need to know whether it's a pattern for a number of reasons. Dr. Michaels as you know I have legislation which I've introduced, H.R. 1180, the Accurate Workplace Injury and Illness Record Restoration Act, which would restore OSHA's ability to cite employers who systematically fail to record workplace injuries and illnesses. Do you think this is an important tool for OSHA to have in order to be able to provide safety for workers in the workplace? Dr. Michaels. There is no question. It is a vital tool, and that's why I'm a strong supporter of H.R. 1180. You know OSHA citations for recordkeeping violations have dropped by more than 50 percent in recent years. And that means data isn't accurate. No one really knows what's going on in workplaces, and we can't prevent injuries and illnesses if we don't know what's going on. Mr. Takano. Well thank you. Very quickly Dr. Marr. Why is it that you think, do you have an opinion about why the CDC hasn't taken a firm stand on aerosol or particle transmission of COVID-19 standards? Dr. Marr. Thank you that's a great question. On March 5, 2020 over a year ago I tweeted out let's talk about airborne transmission of SARS-CoV-2 and other viruses and explained how it works. There is a reluctance though among the medical community to acknowledge this because I think you can't see aerosols, so they're harder to understand. There's been a long-standing bias against transmission of viruses through the air. There's also a concern in hospitals because the word airborne has a special meaning. And then last early in the pandemic there were concerns about limited supplies of N95's and so that drove some of the messaging. Mr. Takano. I wish I could ask some more questions, but I yield back Madam Chair. Thank you. Ms. Adams. Thank you Mr. Takano. I want to recognize the gentleman from Utah, from Virginia I'm sorry, Mr. Good from Virginia. You're recognized sir. Mr. Good. Thank you Madam Chair. It's great to be with all of you this morning and I appreciate this opportunity to talk with our witnesses. And my questions are going to be directed to Mr. Rath. Mr. Rath with the House Oversight Committee reporting that over 13,000 regulatory guidance documents have been issued just since 2008, I would hope that we could all agree that a high threshold should be reached before we subject businesses to more regulations that are difficult and costly to comply with, and that are disruptive to their essential operations. Furthermore, since the communication regarding the effectiveness of mask mandates has been inconsistent at best, it even seems to contradict decades of pre-COVID lockdown studies, we should be cautious to say the least about continuing, let alone increasing related regulations, restrictions and mandates on citizens and businesses. We know that masks can help with large droplets, but there's conflicting reports regarding whether they truly help with small aerosol droplets such as those which transmit the viruses. And it seems that we're unable to prevent those small aerosol droplets from circulating in a normal course of life which is needed for all of us to survive and prosper. Most of us were already practicing social distancing in the workplace, and frequently washing our hands pre-COVID, and now we're even more aware of course of that importance with the COVID virus, and those with other health factors, or working in higher risk professions need to take greater precautions. Furthermore, we have seen reports that some 70 percent of COVID infections actually take place among family members, or those living together at home, while only 1 percent of infections have come from people visiting a public place such as a bar or restaurant. Now that said Mr. Rath, are you aware of any documented cases of anyone contracting or transmitting the virus while visiting a business without a mask? Mr. Rath. Well that's a good question Congressman, I have not had access in my capacity as an occupational safety and health law attorney to understand that level of data. And I think that that data may be properly the sphere of public health agencies, or of the employer themselves. But I will say that when employers that I've worked with look at the questions of which interventions to interpose, they look for opportunities to achieve the greatest gains in safety and health the most quickly in order to preserve the greatest number of employees health and lives, and that has been something that every employer I've worked with has been sincerely committed to, and that's the question that they debate every day when it comes to universal adoption of masks, universal adoption of hand-washing and distancing, where distancing is not possible the installation of barriers, et cetera. Mr. Good. Well thank you, and again your answer was that you were not aware of any case--any documented case, of someone contracting or transmitting the virus while visiting a business without a mask. How about are you aware of any documented case of anyone contracting or transmitting the virus to or from a coworker because of the failure of one or both to wear a mask? Mr. Rath. Well Representative, that's a very good question and again as an occupational safety and health attorney I don't have the access to that kind of data. What we do work with employers on is how to make sure that that kind of transmission happens as infrequently as possible or not at all. Mr. Good. Are you aware of any documented case of a customer contracting or transmitting the virus to or from an employee because of a failure of one or both to wear a mask? Mr. Rath. That's a good question. That question the understanding of how a customer and worker might transmit the disease is inherently unknowable because of the high degree of--high number of confounding factors such as the conduct behavior and exposures of both parties outside of their brief interchange. Mr. Good. How about if we take that a little bit broader rather than going individually. Can you point to any conclusive data, or scientific evidence showing higher COVID virus contraction or transmission rates based on whether customers or employees were required to wear masks in general. Can we point to any data, any evidence of that? Mr. Rath. I would not have in my role any access to that kind of data. But we do know that the employers we've worked with without any exception, have embraced and stringently adopted a universal mask requirement in order to preserve the health of their work force. Mr. Good. Well we understand that people might embrace that, or people might choose to apply that, but take it even broader. Can you point to any conclusive comparison data regarding the virus transmission rates for companies or organizations, counties within a State, States themselves, or even countries. So conclusive comparison data regarding the virus transmission rates for again, for a company or organization, for a county within a State, for a State itself, or a country, based on the degree of mask restrictions, mandates or compliance? Mr. Rath. I personally am not aware of any such data. Mr. Good. So each of these questions that I've asked you have been answered in the negative that we don't have any data that we can point to, any documentation that we can point to, to justify mandates, regulations, restrictions being forced upon companies and organizations. And so I thank you for your answer, and I yield the balance of my time. Ms. Adams. Thank you very much. I want to recognize Mr. Jones from New York. Mr. Jones. Well thank you Madam Chair, and thank you to the witnesses for their testimony today. I am struck by some of the issues you have highlighted. As you know New York was the epicenter of the COVID-19 pandemic last spring in my district, which covers parts of Westchester and all of Rockland County was hit especially hard during that extremely difficult time. Even today Rockland County has the highest rate of COVID-19 infection of any county in the entire State of New York. Mr. Rath, I'm going to start with you. You testified about the great things some employers are doing to protect their workers, but we've heard testimony today that many other employers have been ignoring measures to protect their workers. Isn't it obvious that national standards would ensure more employers protect their workers? Mr. Rath. That's a very good question Representative Jones. Thank you for the question. The problem with a universal national standard is that as we've already seen in the past year, science quickly evolves, and rules over standard making the intransigent standard unable to adopt or adapt to our newfound science, or healthcare understanding of the disease. And for that reason guidance is a more effective policy instrument. Mr. Jones. Mr. Rath, but couldn't there be a rule or a standard that allows for new scientific information to be uncovered and to adapt accordingly? Mr. Rath. That's a great question. Unfortunately, we see OSHA has issued public Statements numerous times complaining that the standards that it passed in the 1970's and the 1980's have become outdated, and that the rulemaking process to revise that is not only time-consuming and resource-consuming, but it won't be implemented quickly enough to make the difference that employers can make, and that agencies like CDC and OSHA can make through guidance. Mr. Jones. I'm reclaiming my time. Thank you so much. You said in your testimony that an emergency temporary standard is not a suitable vehicle for government intervention in the pandemic, and that employers will prevail against the spread of Coronavirus. But respectively sir, I think we see how the thoughts and prayers approach plays out in for example the gun violence context, where the government literally does nothing to address that epidemic, thankfully, by the way today House democrats are doing something about gun violence. But also your approach to addressing COVID-19 in the workplace is in line with the previous administration's position. The Trump administration downplayed the danger COVID- 19 posed to workers and the general public. The administration even failed to protect its own staff. We know that from September to January as many as 48 White House staff and associates tested positive for Coronavirus, including top officials in the President's inner circle, all of this while the President told Americans to drink breach. And so today marks one year since the World Health Organization declared a global pandemic. Nearly 550,000 people have died in this country since then, many of them essential workers on the frontlines and their family members. Unfortunately, we don't know how many of those who died contracted COVID-19 in the workplace. I'll grant you that. But as we've heard in this hearing there have been outbreaks in workplaces across many industries, and workplaces like at JBS and Smithfield Foods meat packing facilities. And we've seen companies take retaliatory actions against workers who raise safety concerns around COVID-19. In my home State of New York, we saw an incident in which an employee at an Amazon fulfillment center was fired for demanding better protections. That's the previous administration's record on workplace safety in the pandemic. And most Americans understand we need that to change. We need OSHA to issue an enforceable standard to ensue people can be safe at work because the problem sir, with voluntary guidelines is that there are too few volunteers. And so with my time remaining I'll ask Miss Muhindura you know my district has around 20,000 nurses, many of whom have had to deal with the trauma of the COVID-19 pandemic as you have described it. Can you briefly tell me about the nurses you work with. Who are these people? Ms. Muhindura. Yes Congressman Jones. Thank you so much for the question. I work in level one trauma which is obviously the highest traumas around the Kansas City area. And I have the privilege of working with some of the most amazing nurses that I have ever met. Some of the strongest people I have ever met, physically and emotionally, but we have all been affected by this, by taking care of these patients because it's taken a tremendous toll on us. Mr. Jones. Thank you. You all deserve recognition for your incredible work on the frontlines, and Madam Chair I yield back. Ms. Adams. [Silence.] Mr. Cawthorn. Madam Chair I believe I'm next up in the line. Do you mind if I go ahead and start? Dr. Adams I believe you're muted. Ms. Adams. Am I unmuted now? Mr. Cawthorn. Yes ma'am. Ms. Adams. OK. I apologize. I'm having some technical difficulties. Mr. Cawthorn go ahead, you're recognized sir. Mr. Cawthorn. Thank you very much ma'am. So to all the witnesses I genuinely appreciate all of you coming on. Mr. Rath I really thank you for everything that you've done, and also I've been--my life has been saved more times by nurses than it has by doctors, so I genuinely appreciate all the nurses that are on and representing. Mr. Rath I've got a question for you. In your testimony you State that if OSHA had adopted strict standards on any of these issues in an emergency temporary standard a year ago, that these requirements would have quickly become antiquated by science, dismissed by the public, and that it would discredit the agency as you said. So that's the end of the quote, but you know we've hard a lot about science regarding preventing COVID-19 transmission. Chairwoman Adams in an eloquent opening Statement she said we can't properly respond to this pandemic unless we truly understand all of the data. And so I'm wondering in your view what is the appropriate role of science in informing regulatory policy? More specifically, how do statutes such as the Administrative Procedural Act, you know, which governs the procedure--the process by which Federal agencies develop and issue regulations allow for related input when regulations are proposed. As we know science changes very often. Mr. Rath. Thank you for that question Representative Cawthorn. The process of developing a rule at OSHA should start with sound data and the best available evidence. But that is merely the starting point. All OSHA regulations have to start with the best available evidence and be alloyed with traditional rulemaking principles such as technical feasibility, economic feasibility, the impact on small businesses, consideration of flexible options in rulemaking, and then finally the experience and acquired wisdom of the stakeholder community, employee representatives, employers. The scientific community and the healthcare community all can play a part in hammering out a better and more workable, and more effective standard at the end of the process that starts with science. Mr. Cawthorn. Mr. Rath thank you for that answer. But just to get a little more detail, is there a way that OSHA can be utilizing the information that's on the ground? You know I always, the reason why I love State government so much more than the Federal Government is you know it's closer to where the actual information is. And I believe the information, the decisions are coming from where the information lies. I think that it works better for every single industry that OSHA touches. Is that something that's possible to have OSHA receiving that input, you know, and the new scientific guidelines, and then to be flexible with it? Mr. Rath. Yes. There's no question that OSHA has used guidance's over the past year and issued a number of helpful Statements for the employer community that have adopted the evolving science. They refer specifically to the Centers for Disease Control and Prevention Guidance, which has been even more frequently updated. And by that method employers have looked to the CDC's guidance to figure out what the best practices in their unique workplaces should be. Mr. Cawthorn. Fantastic. Well Mr. Rath thank you very much and all the witnesses. I do appreciate it. With that Madam Chair I yield back. Ms. Adams. Thank you very much. I want to recognize Miss Stevens from Michigan. You're recognized five minutes ma'am. Ms. Stevens. Thank you Madam Chair and thank you to our witnesses for this critical hearing and part of why I'm so delighted to be on this subcommittee under the great leadership of Chair Adams. You might have seen last year, actually almost a year ago, it might have been 53 weeks ago, 53 or 54 weeks ago, I did a letter to the agencies asking for an interagency task force to report the real time, scientific guidelines as we were getting them right, with a novel virus to be communicated through the you know, the Secretary of HHS, the communications to our employers and employees right. A year ago this week. I'm with my chief of staff. This is the last time we were all fully in the office, and I said I have got to call the grocery stores, because all of a sudden they're an essential workplace, you know, they're like our general stores. Do they have what they need? So just commending the work around the enforceable standards, an interagency approach. Part of what today's hearing is doing is not only coming up with strategies to protect essential workers from COVID-19, but it's also helping us think through what we do the next time a novel Coronavirus hits. So Dr. Marr, you know, we've seen oh brother, you know some States recently lift their mask requirements all right. And last week, you know, the Retail Industry Leaders Association, you know they released a press Statement opposing the lifting of mask mandates stating that relaxing common sense, non- intrusive, safety protocols like wearing masks is a mistake. We see some friction with the private sector in some of these States that are lifting the mask mandates a little bit prematurely. But Dr. Marr just for the record, can you share who is going to be most impacted by the removal of these requirements at this stage that we're at in the pandemic if you don't mind please? Dr. Marr. Absolutely. There is no question that mask mandates work or universal masking works. This has been shown in many scientific studies. It's hard to point to individual cases, but we can analyze population level data and showing that there is a decrease in the rate of number of cases with mask, greater masking. The real victims of lifting of these mandates are the people who are going to contract COVID-19, some of whom will die, and because of the lifting of this, we're going to have more cases and more deaths than we would otherwise, besides bringing tragedy to the families of those who died, this also places an additional burden on our already exhausted healthcare workers. Ms. Stevens. Yes. And so would you say this has an effect on the safety of workers who are in frequent contact with the public for 8 or more hours a day? I just recently had a grocery store worker share with me you know they're in contact with somewhere between 500 and 1,000 customers on a daily basis. Do you have anymore information on the safety of workers who are in contact with the public for eight or more hours a day? Dr. Marr. Sure. These individual interactions are brief in time, so they may not fall under the 15 minute rule for contact tracing, but they add up. And so over that 8 to 12 hour workday, the grocery store worker can be in contact. And we know with aerosols you don't need to be close to that person. So masks are effective as source control reducing the amount of virus that people release into the air. They may not know that they're sick. If people are not wearing masks that could happen, and workers could be exposed. I'm worried about the workers who will now be exposed to much greater amounts of virus in the air than before if they lift the mask--if the mask mandate is lifted. Ms. Stevens. Right, right, right, because it's with our droplets. OK. So noted for the record. And you know Dr. Michael's we were hearing from Mr. Rath his testimony casting doubt on whether the OSHA ETS would reduce the number of work- related illnesses and deaths. I know we've kind of been covering this in this testimony here in this hearing, and all of you are fabulous by the way, Pascaline you're just shining today. We're glad to have you and your fabulous background here as well. But Dr. Michaels, do you think that an ETS would have a benefit of reducing infections during the 180 day efficacy period? Can we just say it again for the record. Dr. Michaels. Of course. You know this idea of going through the long OSHA administrative procedure makes no sense in an emergency. We need to do this now. We need to do it you know, six months ago. But it will clearly make a difference because while not all employers are as exemplary as Mr. Rath's clients, it will impact millions of employers and reduce exposure to many millions of workers and will save lives. Ms. Stevens. Thank you. And I yield back Madam Chair. Ms. Adams. Thank you very much. Is Miss Steel of California, a young lady from California you're recognized. Ms. Steel. Thank you Chairwoman Adams and all the witnesses today. Independently owned small businesses, including retail and restaurants are the backbone of our local communities. There are more than 22,000 small employer businesses in Orange County in California. These businesses employ more than 183,000 people and generate almost 10 billion dollars in payroll for our community. These business owners and employees that are working hard to prevent the spread of COVID-19 and trying their best to keep their employees safe and employed. But prolonged lockdowns have led to almost 50 percent of small businesses throughout the State of California at risk of closing, or never reopening. We need to work in collaboration with local businesses and hear their stories, not rush to implement one-size-fits-all OSHA regulations that could halt the safe re-openings that are already in process. We need to empower our communities and help businesses thrive while also keeping customers and employees safe. That is why I have worked on the Fresh Air for Business Act to empower businesses to modernize their ventilation systems in order to reduce the transmission of airborne diseases including COVID- 19. Having set that Mr. Rath, thank you very much for coming out today. You mentioned how businesses in southern California were impacted when Cal OSHA hastily approved an emergency plan where stakeholders were preventing from weighing in and making the standard more workable or effective. We have both seen how local California business owners have been affected by Cal OSHA compliance. So should the Federal Government rush misguided actions that could have long-lasting, unintended consequences to employers and employees, just rush burdensome standards? Mr. Rath. Thank you for that question Representative Steel. Had California taken into account the feedback from the stakeholder community, employees and employers, they would have avoided unnecessary mistakes. For example, the California Emergency Temporary Standard imposes upon employers the duties that are traditionally associated with public health agencies like contract tracing, continuous testing, and paid leave, housing, transportation. These kinds of mistakes could have been avoided. And since then the California OSHA has issued three revisions to its frequently asked questions, several press releases, fact sheets, to try and clarify ambiguities or Statements that they have made in their original emergency temporary standard that they quickly came to regret as having been poorly thought out. Ms. Steel. So in your opinion, what does government have to do when we have you know, some emergency situations such as COVID-19. Mr. Rath. Well I think it's important to solicit the input from those with real experience, employee groups, employees, employee representative groups like the ones that Ms. Muhindura is a member of. The scientific community like Dr. Marr, and of course the agencies have a particular role to play as well. But collectively, that input will fashion a better set of policies than an agency unilaterally driving policy by self. Ms. Steel. So you think that it's going to be really helpful that you know, you prepare for this kind of pandemic, hopefully not in the future, but prepare those professional people just grouped together, and just to all get ready for the next pandemic or COVID-19, something like that coming in. Mr. Rath. I think that there has been a tremendous amount of experience and knowledge and wisdom acquired in the workplace community that can contribute to being better prepared for the next pandemic should one ever develop. Ms. Steel. I really appreciate it. Madam Chair I yield back. Ms. Adams. Thank you very much. I think if all committee Members have asked their questions, I believe they have, I want to now recognize Mr. Courtney of Connecticut. Mr. Courtney. Thank you Chairwoman Adams, and thank you for again bringing H.R. 1195 onto this agenda again as Dr. Michaels indicated, this is the bill that we passed in the House last year by a rather healthy bipartisan majority, 251 votes in favor, again that dealt with what was then described as an epidemic by the CEO of the Mayo Clinic, namely Workplace Violence for Healthcare Workers and Social Workers. Just a month ago we had another terrible tragic incident that took place in Buffalo, Minnesota where a disgruntled patient showed up at Alliance Health Clinic, shot dead one of the healthcare employees and three others were critically injured. Again, with no sort of early warning systems or measures in place, which OSHA had developed as voluntary guidelines for many, many years. But again, because we don't have a national standard, are just not being implemented. Ms. Muhindura again, thank you for your testimony today. Again, your organization has been a staunch advocate for workplace violence protections. And I was wondering if you could take a moment to talk about this other epidemic that again people who are going to work every day in the caring professions face. Ms. Muhindura. Yes, thank you so much Congressman Courtney for the question. As nurses we've faced workplace violence for many years. Luckily, I'm part of a union that has fought very hard for the nurses and we have gained a lot of protection simply because of the advocacy that we can get through our union. We have such things as panic buttons in our hospitals we can push if we have a violent intruder, or just a patient that becomes violent suddenly, and security is able to respond quickly. But unfortunately, not everyone has these protections throughout the country. I used to work for a hospital that was not part of a union, and they had no such protections. And to add to that it feels like violence has gotten worse in the past year. You see an increase in anxiety and agitation in patients with COVID related to the strict isolation. So I feel like we could definitely use some more protection. Mr. Courtney. Thank you for that because again there is some narrative well you know, because patient volume may have gone down because of elective procedures that you know, the workplace violence issue has diminished, but in fact we've seen surveys that unfortunately, it continues unabated just like the incident that I just mentioned. Dr. Michaels you know last year or 2 years ago when we debated this bill, you know we were assured, and I think in good faith by opponents of the bill that the Trump administration was moving forward with a rulemaking process. And unfortunately, every single initial hearing was postponed four consecutive times. We are absolutely at ground zero in terms of any movements within the agency. Again Mr. Rath to his credited, note that OSHA moves slowly. And unfortunately, we're talking about life or death issues in terms of protecting people in healthcare institutions and social work. Again I wonder if you could just sort of talk about that, about whether you know given the gravity of this issue of workplace violence, as well as the pandemic, you know, whether or not you know we can just rely on the normal rulemaking process to do anything in a remotely timely fashion. Dr. Michaels. Well these are exactly the right points Representative Courtney. OSHA takes 10 years or more to issue a standard. One of the last things I did when I was running OSHA was accept a petition from the National Nurses United, and from other unions telling OSHA, asking OSHA to move forward on this because the problem was so severe. The stories we heard were heartbreaking. We cried at meetings when you heard what happened to healthcare workers and social service workers. But without Congress setting a deadline, it will take at least ten years for OSHA to get this thing out. That's the normal route. I mean we've already lost years and years because really nothing happened during the Trump administration. They said that it was going to move forward but it didn't. And for your bill which gives OSHA 42 months to get it done, would be a huge step forward and really make a difference. It would make the lives better of nurses and others who provide this important work, but also it would make healthcare and social services better because people can't work if they're under threat of assault. Everybody I talk to that works in an emergency room says yes, it impacts you when you're always looking around to make sure no one is going to hit you. I mean this is just simple common sense, and OSHA standard would not be one-size-fits-all. It would say figure out how to address the problem in your community, in your workplace, and that's what we really badly need. Mr. Courtney. Thank you. And thank you to all the witnesses. I yield back. Ms. Adams. Thank you Mr. Courtney. I want to remind my colleagues that pursuant to committee practice, materials for submission for the hearing record must be submitted to the Committee Clerk within 14 days following the last day of the hearing, so by the end of business, the close of business on March 25, 2021. Preferrable in Microsoft Word format. The material submitted must address the subject matter of the hearing. Only a Member of the subcommittee, or an invited witness may submit materials for inclusion in the hearing record. Documents are limited to 50 pages each, and documents longer than 50 pages will be incorporated into the record via an internet link that you must provide to the Committee Clerk within the required timeframe, but please recognize that in the future that link may no longer work. Pursuant to House rules and regulations, items for the record should be submitted to the Clerk electronically by emailing submissions to [email protected]. Member offices are encouraged to submit materials to the inbox before the hearing or during the hearing at the time the Member makes the request. Now I want to again thank the witnesses for their participation today. Members of the subcommittee may have some additional questions for you, and we ask the witnesses to please respond to those questions in writing. The hearing record will be held open for 14 days in order to receive those responses. I remind my colleagues that pursuant to committee practice, witness questions for the hearing record must be submitted to the Majority Committee Staff, or Committee Clerk within 7 days. The questions submitted must address the subject matter of the hearing. I want to recognize now the distinguished Ranking Member for his closing Statement. Mr. Keller. Thank you Madam Chair. I ask unanimous consent to place into the record a Statement from the American Hospital Association and letters from the Construction Industry Safety Coalition and the National Retail Federation raising concerns with the potential OSHA emergency temporary standard on COVID- 19. Ms. Adams. For. Mr. Keller. Thank you. The American economy is diverse, and it would be naive for us to believe that broad mandates handed down from Washington, DC could ever accurately represent every workplace throughout the country. If we want to have a conversation about that, about what is best for our businesses and workers, then it only makes sense for them to be brought into the fold as part of the discussion. I suspect the last thing Main Street America needs right now is more bureaucratic red tape and barriers dictating how to properly keep their workplaces and teams safe. I appreciate the majority calling this hearing and look forward to engaging with my colleagues on the other side of the aisle about how we can work together on smart policies that properly consider the realities of America's workplaces. Thank you and I yield back. Ms. Adams. Thank you very much. I now recognize myself for the purpose of making my closing Statement. What we heard today is that our Nation's workers need and deserve updated CDC guidance and a strong OSHA emergency temporary standard that reflect the best science. This committee has flagged the importance of considering airborne transmission of the virus in a March 1, 2021 letter to the administration. I ask unanimous consent to enter the letter into the record. So ordered. We have only recently emerged from a year of national crisis where OSHA, the only Federal agency with the authority to enforce safe working conditions left workers on their own. This was not just disappointing, this was a tragedy for tens of thousands of workers in this country, and their families who were infected by COVID-19, and the thousands who died preventable deaths because they lacked adequate protections on the job. Swift action to protect workers is exactly how the architects of the Occupational Safety and Health Act envision OSHA's response during a work-related crisis. The Act tells OSHA that it shall issue an emergency temporary standard if it determines workers are exposed to a grave danger, or from new hazards and that a standard is necessary to protect workers from that hazard. Now I think it's clear that COVID-19 meets these two legal conditions. We welcome the Biden administration's clearly Stated intention to act on that emergency authority. We also urge the administration to focus its efforts on a national strategy to ensure that vaccination of essential workers is prioritized, not only in principle, but that every effort is made to ensure that needles enter their arms as soon as possible. Furthermore, in order to learn the lessons of this pandemic and ensure the safety of workers in the next pandemic, all relevant agencies of the Federal Government need to put their heads together to develop a way to quantify the impact of COVID-19 on this Nation's work force. And finally OSHA cannot effectively carry out its mission without resources. The number of inspectors is recovering from a record low. The number of safety and health complaints has piled up, and the backlog of whistleblower claims is daunting. The American Rescue Plan Act, H.R. 1319 passed by Congress yesterday sent to President Biden for his signature provides 200 million dollars to the Department of Labor for worker protection activities related to COVID-19. Not less than half that amount, 100 million is directed to OSHA to meet this moment. I'd like to thank all of my colleagues in the House and Senate for making that happen. And I want to thank the witnesses again for their testimony. If there's no further business without objection the subcommittee stands adjourned. [GRAPHICS NOT AVAILABLE IN TIFF FORMAT] [Whereupon, at 12:48 p.m., the subcommittee was adjourned.] [all]