How the US failed to protect its frontline workers from COVID-19


The COVID-19 pandemic has exposed the weaknesses of the US regulatory system in ensuring the safety and health of its frontline workers. An analysis published in the British Medical Journal reveals how the lack of adequate laws and regulations, coupled with the economic and racial inequalities, led to thousands of preventable deaths among the workers who kept the society functioning.

The disproportionate impact of COVID-19 on frontline workers

Frontline workers are those who provide essential services that cannot be done remotely, such as health care, food production, transportation, retail, and education. According to the analysis, these workers faced a higher risk of exposure to the virus, as well as a higher risk of severe outcomes, such as hospitalization and death. The analysis estimates that more than 100,000 frontline workers died from COVID-19 in the US, accounting for about 20% of the total deaths.

The impact of COVID-19 on frontline workers was not evenly distributed across the population. The analysis shows that low-wage workers, who are more likely to be Black and Hispanic, were disproportionately affected by the pandemic. These workers often had less access to personal protective equipment (PPE), testing, paid sick leave, health insurance, and social support. They also faced more barriers to accessing health care and vaccination. The analysis notes that the COVID-19 mortality rate among Black and Hispanic workers was twice as high as that of white workers.

The inadequate response of the US regulatory agencies

The analysis criticizes the US regulatory agencies, such as the Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control and Prevention (CDC), for failing to protect frontline workers during the pandemic. The authors argue that these agencies did not issue or enforce mandatory standards for workplace safety, did not provide clear and consistent guidance, and did not collect or report data on workplace outbreaks. The analysis states that the US regulatory system was “unprepared, under-resourced, and outmatched by the scale and urgency of the crisis.”

frontline workers during the pandemic

The analysis also points out the political interference and pressure that undermined the scientific integrity and credibility of the regulatory agencies. The authors cite examples of how the Trump administration downplayed the severity of the pandemic, delayed the declaration of a national emergency, dismissed the recommendations of public health experts, and promoted unproven treatments and misinformation. The analysis claims that the political interference “hampered the ability of the regulatory agencies to act independently and effectively.”

The need for systemic reforms to protect worker health

The analysis concludes that the US needs to learn from the lessons of the pandemic and implement systemic reforms to protect worker health in the future. The authors propose several recommendations, such as:

  • Establishing a permanent infectious disease standard for workplaces that requires employers to provide adequate PPE, ventilation, physical distancing, testing, and vaccination for workers.
  • Strengthening the enforcement and oversight of the regulatory agencies, and ensuring their scientific independence and transparency.
  • Expanding the coverage and benefits of the occupational health and safety system, and ensuring the participation and representation of workers and unions.
  • Addressing the social determinants of health, such as income, education, housing, and health care, that affect the vulnerability and resilience of workers.
  • Promoting a culture of prevention and precaution, rather than reaction and denial, in the face of emerging health threats.

The authors urge the Biden administration and the Congress to take swift and bold actions to implement these reforms, and to “honor the sacrifices of the frontline workers by making their health and safety a national priority.”


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