AFT Resolution

INFECTIOUS DISEASE EMERGENCY PREPAREDNESS IS ESSENTIAL FOR HEALTHCARE

WHEREAS, infectious disease specialists have warned governments for years of an impending, serious infectious disease outbreak, and the emergence of the SARS, MERS, H1N1 influenza, Zika and Ebola over the last 17 years reinforced the need to prioritize emergency preparedness for newly emerging infectious disease outbreaks; and

WHEREAS, past and present administrations failed to address the lack of domestic production of personal protective equipment, particularly N95 respirators, ensuring the global supply chain problems we currently face; and

WHEREAS, the Trump administration systematically dismantled the federal government’s ability to effectively respond to any infectious disease outbreak, disbanding global health security taskforces in the National Security Council and the Department of Homeland Security that would have ensured interagency coordination and timely leadership; cutting the Centers for Disease Control and Prevention’s international epidemic prevention programs by 80 percent in 2018, allowing scores of positions within the CDC to remain unfilled; and eliminating programs to study zoonotic disease outbreaks, ensuring a disorganized, inadequate federal response; and

WHEREAS, the United States lacks a functioning state and local public health infrastructure with the capacity to respond to any large-scale infectious disease outbreak or other public health emergency. State and local public health departments have historically been severely underfunded and are highly reliant on the CDC for support and direction; and

WHEREAS, the Trump administration wasted valuable time when the SARS-CoV-2 emerged, downplaying the threat, muzzling CDC and National Institutes of Health leaders, and promoting false cures and incompetent managers instead of following the advice of experts and directing federal resources where needed; and

WHEREAS, the supply of N95 respirators and other personal protective equipment in the Strategic National Stockpile had not been replenished since 2009, resulting in an inadequate supply of unexpired respirators. At the outset of the pandemic, the stockpile contained 12 million N95s, but 3.5 billion were needed. States and hospitals are not required to maintain and restock their own stockpiles; and

WHEREAS, President Trump has refused to deploy the Defense Production Act to require American manufacturers to produce badly needed respirators. Trump delayed centralizing a federal procurement and distribution process for respirators and other personal protective equipment, forcing states and employers to enter a bidding war and artificially inflating the cost of PPE. When Trump finally directed the Federal Emergency Management Agency to coordinate procurement and distribution of PPE, the result was FEMA commandeering PPE legally purchased by states and hospitals; and

WHEREAS, the CDC initially provided infection-control guidance to healthcare employers, recommending N95 or stronger respirators for healthcare workers caring for patients with suspected or confirmed COVID-19, but downgraded this guidance in March in response to lobbying by hospitals and some local health departments over concerns about the supply and supply chains of N95 respirators, saying that SARS-CoV-2 is spread primarily through droplet transmission, ignoring a growing body of evidence that SARS-CoV-2 is an airborne-transmissible virus, and giving cover to employers wanting to avoid providing respiratory protection to healthcare workers; and

WHEREAS, multiple federal agencies under the Trump administration have failed to uphold their mission to protect the public from harm, including the CDC providing weak guidance to healthcare employers and failing to systematically gather data on healthcare-worker infections and death from COVID-19, the Occupational Safety and Health Administration failing to require employers adhere to CDC guidance or OSHA standards in order to protect healthcare workers from a recognized serious and deadly hazard; and the federal government prioritizing decontamination of N95 respirators over production and stockpiling of respirators that were designed to be reused; and

WHEREAS, as a result, an estimated 69,761 healthcare workers are known to have been infected and at least 368 have died. We know this to be a gross undercounting. Many states are not reporting this information, and the federal government is not requiring it

WHEREAS, testing for SARS-COV-2 is the only way to track where and how quickly the virus is spreading in communities and whether or not healthcare workers are getting infected:

RESOLVED, that the American Federation of Teachers calls for a national policy of mass testing and contact tracing of SARS-COV-2. Healthcare workers should be guaranteed access to free, regular testing; and

RESOLVED, that the American Federation of Teachers will work to push the federal government, states and employers to develop regulations and systems to prevent this massive failure to protect healthcare workers and the public at large from an infectious disease or other public health emergency from ever happening again; and

RESOLVED, that the AFT will advocate for OSHA to promulgate a temporary infectious disease standard immediately and a permanent infectious disease standard within 24 months of enactment, and in the interim, for OSHA to enforce existing standards to protect healthcare workers from occupational exposure to COVID-19; and

RESOLVED, that the AFT will advocate for the Centers for Medicare & Medicaid Services and states to strengthen and enforce requirements for hospital and healthcare services emergency preparedness planning, including metrics for determining adequate PPE stockpiles; rules for maintenance of stockpiles; incentives to implement elastomeric or powered air purifying respirators as part of a stockpile; and capacity to develop temporary airborne infection isolation rooms, ventilated headboards, improved general ventilation dilution and other engineering controls; and

RESOLVED, that the AFT will advocate for the Food and Drug Administration to rescind emergency use authorizations for N95 decontamination when respirator supplies and supply chains are restored; and

RESOLVED, that the AFT will advocate for strong investment in public health on the federal and state levels to develop a rigorous system that supports prevention of illness as a public good, re-establishing defunded global infectious disease prevention, and tracking and establishing new and stronger state and local public health funding; and

RESOLVED, that the AFT will support increased funding for OSHA enforcement and whistleblower protection, and increased funding for the National Institute for Occupational Safety and Health for research on respiratory protection, PPE and engineering controls like ventilated headboards, establishing incentives for improved technologies; and

RESOLVED, that because no healthcare worker should have to experience the gross failure to uphold their right to a safe and healthy workplace, and one healthcare worker death from COVID-19 is too many, the AFT will work through collective bargaining to ensure healthcare employers are prepared to protect healthcare workers from occupational exposure to COVID-19 and any other infectious disease outbreak.

(2020)