As detailed in this Bloomberg Law article, the federal Occupational Safety and Health Administration (OSHA) has issued fines for 85 businesses nationally for safety violations related to COVID-19. Among the latest targets are 23 health care facilities (hospitals, nursing homes, and rehabilitation centers) largely in New York and New Jersey. Nursing homes have been especially hard-hit by the pandemic and experienced shortages of needed PPE, and a recent AARP analysis indicated that nearly half of U.S. nursing homes have had COVID-19 infections among staff. OSHA is charged with enforcing federal workplace safety laws, including employers’ duty to provide a workplace free of known hazards; however, many worker advocates have criticized OSHA’s response to the pandemic, arguing that the agency’s fines have been too low to ensure compliance.
Hospital Surge in Rural Areas
The pandemic is surging in areas previously largely spared, leading to record numbers of hospitalizations in more rural areas across the Midwest and Mountain West. As explained in this Associated Press article and this New York Times article, while the total number of hospitalizations is less than earlier peaks concentrated in New York City and other urban areas, the new hot spots are largely in areas with smaller hospital systems, meaning fewer available beds, fewer staff, and potentially fewer available medical resources generally. The more extensive national spread also limits the ability to facilitate temporary surge capacity by pulling staff from other areas of the countries. While not yet critical, such circumstances increase the chances that facilities could be forced to ration scarce resources.
Japan’s Success in LTCFs
This forthcoming paper by Estevez-Abe and Ide explores the surprisingly low incidence of viral transmission in Japan’s long-term care facilities. Although Japan has a high population density and a very aged society overall, the authors point to factors including an earlier lockdown of LTCFs, implementation of established infection control protocols, allocation of public authorities exclusively to LTCF oversight, and effective public communication as contributing to a comparatively low death toll and low incidence rate in LTCFs, which have been among the hardest hit facilities internationally due to the high vulnerability of their populations.