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What Employers Need to Know About Federal COVID-19 Vaccine Mandates

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In an effort to combat the COVID-19 virus and its subsequent variants, the Biden administration has instituted three important mandates that employers should be aware of as they may impact their business. First, the Emergency Temporary Standard (ETS), issued by the Occupational Health and Safety Administration (OSHA), requires that all employers with 100+ employees mandate vaccination or weekly testing. The second mandate involves federal workers and contractors and requires them to obtain a vaccination without any option for weekly testing. The final mandate was issued by the Centers for Medicare and Medicaid Services (CMS), and requires vaccination of all healthcare workers at CMS-covered facilities.

OSHA’s Emergency Temporary Standard

The mandate that has the most wide-ranging impact is Occupational Health and Safety Administration’s (OSHA) Emergency Temporary Standard (ETS) that calls for employers with 100 or more employees to either require employees to obtain a COVID-19 vaccination or to prove compliance with a weekly-testing program. This ETS is expected to affect over 80 million employees. 

On December 17, the Sixth Circuit Court of Appeals lifted the stay placed on OSHA’s ETS issued by the Fifth Circuit in November. The court held that OSHA does have statutory authority to mandate national vaccines and/or testing for employers with more than 100 employees. Specifically, it outlined that because COVID-19 is a virus that causes bodily harm, OSHA was well within its administrative authority to regulate the health and safety of employees. 

Since the Sixth Circuit’s decision to dissolve the stay, OSHA announced that it will not be issuing citations for noncompliance with the ETS requirements until January 10 and the testing requirements will not be enforced until February 9 with the caveat that the employer must make good faith efforts to come into compliance as soon as possible.

After this ruling by the Sixth Circuit, eight groups challenged the OSHA vaccine mandate and filed emergency applications with the U.S. Supreme Court asking it to stay the mandate again until the case can be heard in the highest court. On December 20, the Supreme Court requested a response from the federal government by December 30. And, on December 22, in an almost unprecedented move, the Supreme Court ordered oral argument on these emergency applications, which will take place on January 7.

Despite the fact that the validity of the ETS is now squarely before the Supreme Court, employers should still operate as if the ETS will go into immediate effect. OSHA has implemented new deadlines to reflect the current status of the ETS.

By January 10, employers should:

  • Track employee vaccination status
  • Create a database detailing vaccination information for each employee
  • Require unvaccinated employees to wear a mask
  • Provide paid time off for employees to get vaccinated and recover

As of February 9, 2022, employers must also require unvaccinated employees must start testing for COVID weekly. Self-administered or self-read tests would not comply. Employers must observe or use a proctor and have employees tested on site, or at a recognized testing facility.

The Mandate for Federal Employees and Contractors

The second mandate stems from President Biden’s executive order that requires most federal employees or contractors to get vaccinated. This mandate does not have a testing option.

On December 7, the U.S. District Court for the Southern Section of Georgia granted a preliminary injunction to temporarily halt the enforcement of the Biden’s administration’s vaccine mandate for federal contractors.The court found that the administration had overstepped the bounds of it authority under the Federal Property and Administrative Services Act 40 U.S.C. 101 et. seq. The injunction effectively prohibits enforcement of the federal contractor vaccine mandate in all 50 states and any territory of the United States. However, on December 17, the Eleventh Circuit, denied the government’s motion to stay. This effectively upheld the injunction. The court found that the government had failed to show that it “would be irreparably harmed absent a stay.”

The CMS Mandate

The third mandate is an interim file rule of the Centers for Medicare and Medicaid Services (CMS), which requires vaccination of all healthcare workers at CMS-covered facilities throughout the United States. The CMS mandate is currently enjoined by court order in 25 states and continues in full effect in 25 other states. After the ruling by the Fifth Circuit in November, however, CMS suspended implementation and enforcement of the mandate pending resolution of the challenges before the Supreme Court.

Preparing for the Next Stage of the COVID-19 Pandemic at RIMS Content Roundtable

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In last week’s “RIMS Content Roundtable: COVID-19 Vaccines and Distribution,” a group of RIMS members gathered for an exclusive Q&A with Dr. Adrian Hyzler, chief medical officer at Healix International, who focused on progress with COVID-19 vaccination efforts and moving toward a “next phase” of the pandemic.

“Where we’re headed is: this pandemic will end—all pandemics end—but it doesn’t end all of a sudden, it goes out with a whimper…it sort of just seeps away at different rates around the world,” Hyzler said, noting the rates of vaccination and controls implemented country by country will curb the coronavirus at different paces. “But it’s now going to be an endemic disease, meaning it’s something we live with. We’re not going to get rid of this disease.”

He believes recognition among public health experts that COVID-19 will become endemic rather than be eradicated prompts new conversations about expectations and preparations around the world.

“The new dialogue is: what is the acceptable level of COVID and what is the acceptable level of deaths from COVID? Because COVID is a respiratory disease and people die of respiratory diseases every year, especially in winter. That’s something we live with,” Hyzler said. “We’re going to have to get to a point where there are going to be people who die from COVID every year, but they’re not going to overrun hospitals, and they’re not going to affect care of other diseases.”

Getting to the stage of “a disease we live with” requires mass vaccination, and he stressed the importance of the widespread effort to encourage people to get COVID vaccines as soon as possible. Scientists are not yet sure what percentage of the population will need to be fully vaccinated to control the pandemic sufficiently and, he said, “that’s vaccinated across the whole population evenly, and that’s not the case—we know there are communities where they are vaccine-hesitant, we know there are religious groups that are not as confident about the vaccine, and they tend to cluster, so those are always ready for outbreaks.”

Rather than discuss the sometimes controversial or scientifically debatable concept of “herd immunity,” Hyzler encouraged thinking about “community immunity.”

“‘Community immunity’ is good because it’s more about what we can do for each other,” he explained. “Getting vaccinated, for a 28-year-old, is not necessarily about that person, it’s about what it can do for the community—the older people, the people who have preexisting conditions that make them vulnerable.”

This kind of community orientation and widespread adherence to best practices will be critical in getting to any next phase of the pandemic, and to staying there. Reflecting on his experience of the acute lockdowns implemented in the U.K., for example, Hyzler stressed the lessons learned about the impact of mass adherence to mitigation and prevention measures. “Even with the variant that’s come out here that is very transmissible and has become common in the States, we’ve shown that non-pharmaceutical interventions—which are masks, distancing, isolation, hygiene—they work,” he said.

Many of these non-pharmaceutical interventions will not be going away any time soon—indeed, they may be just as critical moving forward. Hyzler predicted, “I think, into next year, we may still be wearing masks in many situations and there may be a great move to more things outdoors, since we know how much safer that is, and I think we’ll have learned a lot of things from this… Hopefully we’ll also be more ready for something that will happen again.”

As the world moves toward mass vaccination to help curb COVID-19, companies should be preparing for the next stage of the pandemic and creating detailed plans for safely returning to work. To that end, Hyzler noted some large private companies have publicly offered resources to help other enterprises protect employees and operations amid the pandemic and prepare for a return to workplaces.

For example, Ford has published two versions of a “Return to Work Playbook,” one for manufacturing and another for non-manufacturing companies. According to Ford, in addition to providing these documents to employees, “the company is also providing a copy to its suppliers, business partners and relevant third parties to ensure they are all aware of its health and safety practices when they are on site at Ford facilities or are interacting with Ford personnel.” Companies outside of Ford’s supply chain can also benefit, however.

“Add in some CDC advice, and look at what people [around you] are doing, because there are little things you can do that are very specific to your area or your workforce,” Hyzler recommended. “Then, take the information [from the playbook] that’s useful and mold it into a mini version of a playbook, if you’re a smaller company.”

In addition to the Ford playbooks Hyzler mentioned, check out these publicly available resources from the private and public sectors that may offer help in managing COVID-19 risks and creating a return-to-work plan for your enterprise:

Ford’s Return to Work Manufacturing Playbook [PDF]
Ford’s Return to Work Non-Manufacturing Playbook [PDF]
IBM’s Return to Workplace Playbook [PDF]
Kaiser Permanente’s COVID-19 Return to Work Playbook
CDC’s Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19)
CDC’s “Daily Activities” Guide for Returning to Work
OSHA’s Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace

Participants in the roundtable event were able to debrief with fellow risk professionals in breakout rooms, sharing impressions from the session and experience addressing related risks within their own organizations. For more opportunities to discuss return-to-work plans, vaccine considerations and other COVID-related risks with other risk professionals, all RIMS members can continue the conversation on Opis, the society’s community engagement and networking platform. Among almost 200 education sessions, the upcoming RIMS Live 2021 virtual conference will also offer dozens of COVID-related education and networking events from April 19 to 30, and registration is now open. To hear more insights directly from Dr. Hyzler, you can check out his appearances on the RIMScast podcast.

Work-From-Home Risks: The Toll of Bad Ergonomics

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The early days of COVID-19 saw employees camped at home, using kitchen tables, beds, sofas and whatever else they could use as makeshift workstations. The compounding stress of prolonged sub-optimal work conditions in a residential environment is taking a significant toll on the workforce’s physical health and mental wellbeing.

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Unless organizations intervene to address this situation, the problem is likely going to snowball into a very expensive oversight.
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Ergonomics aims to increase efficiency and productivity, and reduce discomfort. If left uncorrected, however, an un-ergonomic desk-chair-monitor-keyboard combination can lead to numerous manifestations of so-called “sitting disease,” such as repetitive strain injuries (RSIs), fatigue, vision complications, metabolic syndrome (weight gain and diabetes), circulatory issues in the legs, and musculoskeletal disorders (MSD) like chronic back, neck and shoulder pains.

The appalling work-from-home conditions for millions of employees in the United States may also soon be a nightmare for HR when it faces massive payouts for occupational injuries and MSD complications. The productivity losses that will ensue may also impact organizational performance as a whole.

Minimizing Workstation-Related Health Risks During Quarantine

Here is a snapshot of typical company costs for treatment of MSD-related complaints, in terms of direct and indirect workers’ compensation. In some regions, the average claim amounts for these kinds of injuries can be two to four times larger. Multiply these numbers by the number of potentially affected employees, and the math begins to look pretty grim:

• Wrist/Carpal tunnel injury: $7,600 average cost

• Tennis Elbow: $9,100 average cost

• Shoulder/Rotator Cuff injury: $14,800 average cost

• Neck injury: $21,000 average cost

To address these issues, employers can improve work conditions at home by offering ergonomic solutions. Ergonomic workstation equipment, such as sit-to-stand desks and proper standing mats, monitor arms, keyboard trays, active chairs and other flexible accessories help mitigate the most common health risks associated with desk jobs, such as back and neck pain, eye strain, wrist and carpal tunnel injury, and sitting disease. Here is a breakdown of the most common injuries and the office equipment that may address each:

Back and Neck Pain is caused by a lack of movement while holding the body in a fixed (often awkward) position, forcing discs to bulge and exert pressure on the spinal nerve. One solution is ergonomic sit-stand desks and desk converters, which allow employees to work while standing. This stretches out the spine, relieving pressures that accumulate in the back and neck areas.

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More time spent standing also reduces risks of heart disease and high blood sugar while boosting the body’s metabolic rate for weight loss, increased energy and improved mood.

Eye Strain is caused by having a computer monitor placed too close or too far away from the face, making the eyes work harder to focus or forcing the body to lean forward and strain the neck and eyes. One solution is an ergonomic monitor arm, which allows the user to move the screen forward or back and up and down to keep the center of the screen comfortably located between 15 and 20 degrees below horizontal eye level.

Wrist and Carpal Tunnel Injury is caused by long hours of keyboard use, resulting in painful fluid build-up, pressure on the median nerve, as well as awkward positioning of the hand and wrist while typing. A vertical mouse, which places the hand in an upright position, or an ergronomic keyboard tray can prevent this injury.

Sitting Disease and physical inactivity can lead to health consequences such as obesity, increased blood pressure, high blood sugar, accumulation of belly fat and abnormal cholesterol levels. Switching from sitting to standing to walking throughout the day is the most prudent regimen. Using a treadmill desk can help mitigate the debilitating consequences of sitting disease while potentially giving the body more oxygen, increased focus and enhanced mental acuity.

The human body was not designed to sit for many hours at a time doing repetitive work. Before the industrial revolution, people spent only three hours per day sitting. COVID-19 has effectively made an already known health risk many times worse by restricting employees indoors and forcing them to work off beds, sofas and kitchen tables.

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The onus is now on employers to get proactive about employee health and productivity while lowering healthcare costs.

Hurricane Laura Leaves Destruction—and Pandemic-Related Recovery Challenges

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Hurricane Laura made landfall in the United States at 1 a.m. on Thursday, hitting Louisiana and Texas as a Category 4 storm with maximum sustained winds of 150 miles per hour and what National Hurricane Center officials called “unsurvivable” storm surge. In such ferocious wind, thousands of homes and businesses were damaged or completely destroyed, hundreds of thousands were left without power and, as of Thursday evening, at least four people had been killed.

While forecasters initially expected the storm to lose intensity before reaching land, it rapidly intensified this week, becoming one of only 10 hurricanes to make landfall in the continental U.S. with winds over 150 mph since modern recordkeeping began in 1851. After windspeeds nearly doubled on Wednesday, officials in Texas and Louisiana ordered several hundred thousand people in the storm’s path to evacuate, but many were either unable to leave or chose not to. Increasingly severe storms in the area in recent years may have left some feeling prepared or resigned to ride out the storm.

Others faced difficulties related to the pandemic. As Risk Management recently reported, many experts have expressed concern that the COVID-19 pandemic could significantly complicate hurricane season this year, increasing the risk to individuals and businesses and making disaster recovery more difficult. Ahead of Laura, NPR reported that emergency shelters had a hard time safely accommodating evacuees without overcrowding and had to direct many to hotels. Pandemic-related job losses may have ruled that option out for some. Mayor Nic Hunter of Lake Charles, which was particularly devastated in the storm, told NPR that he “suspects the coronavirus pandemic and economic hardship are leading many people to take pause.” The outlet also reported that experts are concerned that mass evacuations from the hurricane could lead to new outbreaks in the region.

Now, the recovery process will undoubtedly be impacted by the pandemic as well.

“The global health crisis is going to have a major impact on recovery from any major storm, including Hurricane Laura—the stress of natural disaster becomes more intense when it unfolds against the backdrop of a highly contagious viral outbreak,” John Dickson, president and CEO of flood insurance provider Aon Edge, told Risk Management in the wake of the storm on Thursday.

For example, he said, “If you think back to hurricanes like Katrina (which hit about 15 years ago almost to date) and create a mental image, you see the community banding together to respond in close physical proximity. Similar images emerged from last year’s prolonged flooding along the Missouri River. In those and other events, assembly lines formed to fill and deploy sandbags—a task impossible to do six feet apart.”

Dickson noted that technology increasingly used by insurers (also known as risktech) would be more important than ever in responding to natural disasters this year as emergency response must be balanced with safe social distancing practices.

“Smart phones and basic technology can help homeowners achieve the recommended preparation steps and stay safe during a storm,” he advised. “For example, taking pictures and videos with date and time stamps could minimize the need for on-site inspections and physical proximity to claims adjusters.”

For insurance professionals, he noted, “The insurance industry is thinking through very tactical steps to ensure policies and procedures are in place to protect those who are on the frontlines when a hurricane hits. Drone technology offers the opportunity to take photos remotely, and computer models help better quantify risk and manage work forces.”

For more insight and actionable guidance on risk management for hurricanes and other natural catastrophes, including disaster preparedness, recovery and insurance, check out the following pieces from Risk Management:

Before Disaster Strikes: How to Prepare for Natural Catastrophes
How does an organization ensure it is prepared to minimize losses and recover quickly following a natural disaster? Long before a disaster strikes and property damage occurs, the best response plans begin with careful negotiation and placement of well-defined property coverage. Read more

Key Considerations for Disaster Planning
Meticulous disaster response planning has never been more critical. When developing a plan, it is important to involve key stakeholders and review every step that your business, your network and your vendors must take if a natural catastrophe impedes operations. A strong plan should address these key questions. Read more

Weathering Hurricane Season During the Pandemic
Pandemic-related social distancing guidelines and supply shortages could make it harder for business owners to protect their properties should a storm happen, making it even more important to have an action plan in place. These key considerations can help businesses owners mitigate potential storm risks amid COVID-19. Read more

Understanding Post-Storm Business Interruption Coverage
Whether in the impacted area or beyond, businesses suffering from supply chain disruptions after hurricanes and other storms should look to their property insurance policies for contingent business interruption coverage. Read more

Natural Disaster Planning During COVID-19
As the COVID-19 pandemic continues, government authorities and disaster-response entities are over-extended and may not be able to provide assistance as readily this year. It is more important than ever that companies make backup plans and assess the potential impact of shortfalls in their disaster response protocols. Read more

The Human Element of Disaster Recovery
Crisis and disaster recovery plans offer a critical advantage when catastrophe strikes, helping mitigate the impact on facilities, information systems and equipment. Just as important, however, is considering how a disaster can affect the company’s workforce. Read more

Ensuring Insurance Recovery After a Hurricane Loss
These seven tips can help policyholders resolve disaster insurance claims in the wake of hurricanes and other natural catastrophes. Read more