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(c) 2020 Jon L Gelman, All Rights Reserved.

Sunday, May 3, 2020

Is the workers' compensation system ready for the COVID-19 [coronavirus] virus? Live Updates

It seems that every decade a new pandemic emerges on the world scene and complacency continues to exist in the workers’ compensation arena to meet the emerging challenges of infectious disease.

Initially, China reported  that 16 healthcare workers have already been infected with coronavirus. That country is notorious about underreporting serious health issues. China has imposed severe travel and commercial restrictions for over 33 million residents in infected communities. The 

The rapidly spreading 2019-nCoV [coronavirus] virus is emerging rapidly around the globe and confirmed cases have been reported in the United States and Canada. The president of the World Health Organization [WHO] has declared the coronavirus a global health emergency [Public Health Emergency of International Concern] and more recently a Global Pandemic.The UN World Health Organization formally named the virus COVID-19. The WHO completed a mission to China and published a report including the pattern of disease progress for COVID-19 in China and also made a list of recommendations for preparation and action.

The workers’ compensation system in the US needs to be ready for the challenge on the horizon. Is the system ready to compensate workers who should take time off from work for undiagnosed 2019-nCoV even if a mandatory quarantine has not been issued? If transportation has been restricted because of symptoms should workers’ be provided benefits if they have been exposed to a co-worker or family member who presents with symptoms even if not a confirmed case? Will the workers’ compensation be efficient enough to respond to undiagnosed 2019-nCoV even before a co-worker has been confirmed infected to avoid the potential of the further spread of disease

In 2007 the US CDC published a document on pre-planning for a pandemic that addressed social distancing. It focussed community mitigation guidelines. "This document provides interim planning guidance for State, territorial, tribal, and local communities that focuses on several measures other than vaccination and drug treatment that might be useful during an influenza pandemic to reduce its harm. Communities, individuals and families, employers, schools, and other organizations will be asked to plan for the use of these interventions to help limit the spread of a pandemic, prevent disease and death, lessen the impact on the economy, and keep society functioning. This interim guidance introduces a Pandemic Severity Index to characterize the severity of a pandemic, provides planning recommendations for specific interventions that communities may use for a given level of pandemic severity, and suggests when these measures should be started and how long they should be used." Community Mitigation Guidance, CDC, 2007.
The 2009 influenza pandemic (flu) had created a new framework of acts and regulations to respond the World Health Organization’s (WHO) phase 6 pandemic alert. Governmentally imposed employment disruptions resulting from regulatory work disruptions to prevent the spread of disease maybe massive. While workers’ compensation was envisioned as a summary and remedial social insurance program, the challenges facing the workers’ compensation system to deliver benefits as promised may be seriously burdened. 

In the past there was a massive global reaction to the 2009 influenza pandemic. On April 25, 2009, the WHO director-General Dr. Margaret Chen declared the H1N1 virus outbreak as a “Public Health Emergency of International Concern.” The international declaration indicated that a coordinated international response was potentially necessary to prevent curtail the spread of the disease that was perceived as a public health risk. Recommendations to restrict both trade and travel may follow. The current President of the WHO has hesitated about declaring a world health emergency even though the 2019-nCoV [coronavirus] virus has already spread across the globe. This delay compounds issues of credibility that China's past actions have established.

Even future virus strains are being tracked now. Nextstrain provides real-time tracking of pathogen evolution. Nextstrain is an open-source project to harness the scientific and public health potential of pathogen genome data. It provides a continually-updated view of publicly available data alongside powerful analytic and visualization tools for use by the community.

The United States had structured its response on both a State and Federal level to the 2009 influenza alert. The Public Health Service Act (PHS) permitted the Secretary of Health and Human Service (HHS) to access a special emergency fund, allows or the use of unapproved medical treatments and tests, and allows waiver of certain reimbursement of Medicare and Medicaid expenses, and waived penalties and sanctions for violation of the HIPAA Privacy Rule requirements. Additionally, the President was permitted to issue an emergency declaration under The Stafford Act to co-ordinate emergency relief under State and Federal programs, ie. use and distribution of anti-viral medications.

The US National Biodefense Science Board on January 31, 2020 issued a Declaration that the 2019 Novel Coronavirus (2019-nCoV) presents a Public Health Emergency for the United States. This action triggers widespread Federal authority under several laws including Public Law 113-5 (March 13, 2013) 127 Stat. 161. ‘‘Pandemic and All-Hazards Preparedness Reauthorization Act of 2013’’[PAHPRA]. See also,  Pandemic and All-Hazards Preparedness Act of 2006 (PAHPA), Public Readiness and Emergency Preparedness Act of 2005 (PREP Act), Project BioShield Act of 2004, Health Security and Bioterrorism Preparedness and Response Act of 2002 (Bioterrorism Act), Defense Production Act of 1050, 64 Stat. 798. See below for current Federal COVID-19 Legislation.

Potential closings and restrictions have raised issues as to what programs, if any, will be able to provide benefits to the employees because of the involuntary nature of the closings and disruptions. A Harvard School of Public Health study reveals that 80% of businesses foresee severe problems in maintaining operations if there was an outbreak in 2009. 

The workers’ compensation system could be requested to provide temporary disability benefits for occupational disease absences on a massive scale never before experienced. Pre-emption by superseding emergency regulatory actions may curtail employment that will trigger the implementation of State workers’ compensation benefits. The employer and the workers’ compensation insurance carriers will be required to pay temporary disability and medical benefits as a direct consequence of efforts to prevent the spread of a communicable disease. The carefully crafted employee-employer notification structure integrated into the workers’ compensation system may be partially or entirely disrupted by the consequences and chaos of the global health emergency.

Workers’ Compensation claims arising out of a potential pandemic 2019-nCoV [coronavirus] virus will need to fit into the convoluted framework statutory acts and regulation. Reimbursement from the usual collateral third-party reimbursement sources may be restricted. In addition to the Doctrine of Sovereign Immunity, enjoyed by the Federal and State governments, other legislation including The “Public Readiness and Emergency Preparedness Act" (PREP Act) limits liability of others under certain specific emergency circumstances.

The enormity of a 2019-nCoV [coronavirus] virus pandemic presents a new and novel challenge to the system and one that must be considered by both Federal and State planners. Workers’ Compensation programs have adapted to emergencies before including natural disasters and terrorist attacks. The urgency of the situation requires that the system be prepared now.

Read more about coronavirus - Live Updates

Daily situation report  - UN World Health Organization [WHO] as updated

Occupational Safety and Health Administration [OSHA] Standards & Workers' Rights As updated

Coronavirus Disease 2019 (COVID-19) US CDC - Live Updates 

Center for Infectious Disease Research & Policy (CIDRAP) Novel Coronavirus (COVID-19) Resource Center - Live Updates

Bloomberg Philanthropies Public Health Initiatives (Live Updates)

COVID-19 US State-By-State Projections IHME - Live Updates

Novel Coronavirus Resources (COVID-19) American Society for Microbiology - Live Updates

Coronavirus - Latest Live Updates NYTimes

Coronavirus Statistical Counters Worldmeter.com) Live Updates

News About Coronavirus - British Medical Journal: Live Updates

US VA Novel Coronavirus Disease (COVID-19) Live Updates

COVID-19 Outbreak: Rights, roles, responsibilities of health workers, including key considerations for occupational safety and health WHO

Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19), February 2020

Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China, NEJM, February 18, 2020 DOI: 10.1056/NEJMc2001899

New Jersey Department of Health Surveillance Criteria and Testing for Novel Coronavirus 2019 (2019-nCoV) nj.gov 2/28/20

New Jersey Update and Interim Guidance on New CDC Testing Criteria for 2019 Novel Coronavirus (COVID-19) nj.gov 3/4/20

Political Responses to the Coronavirus (COVID-19) pandemic 2020-Ballotpedia Live Updates

Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States (Early, Targeted, Layered Use of Nonpharmaceutical Interventions, CDC Feb. 2007

Notice To The NJ Bar: Public Access To Court Events During Covid-19 - Directives #11-20 ("Supreme Court Guidelines On Media Access And Electronic Devices In The Courts") And #12-20 ("Principles And Protocols For Virtual Court Operations During The Covid-19 Coronavirus Pandemic") njjudiciary.com AOC 4/28/2020

CDC Guidelines to re-open America 5/20/20
Live Dashboards - Statistics / Demographics

Coronavirus COVID-19 Global (Worldwide) Cases by Johns Hopkins CSSE-Live Updates

State of NY COVID-19 Dashboard-Live Updates

State of NJ COVID-19 Dashboard-Live Updates

Projection Models For COVID-19


MRC Centre for Global Infectious Disease Analysis-Imperial College London - Live Updates

Federal COVID-19 Legislation

H.R.6201 - Families First Coronavirus Response Act Enacted 3/18/2020
require employers to provide paid sick leave to employees, establish requirements for providing coronavirus diagnostic testing at no cost to consumers,

H.R.6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 Enacted 3/6/2020 $8.3 Billion
developing, manufacturing, and procuring vaccines and other medical supplies; grants for state, local, and tribal public health agencies and organizations; loans for affected small businesses; evacuations and emergency preparedness activities at U.S. embassies and other State Department facilities; and humanitarian assistance and support for health system

H.R. 6800 HEROES Act [Health and Economic Recovery Omnibus Emergency Solutions Act] (Introduced 05/12/2020]

Track Government Policy-making Related to Coronavirus Skopos Labs Tracker - Live Updates

Read more relevant articles

Chloroquine or hydroxychloroquine for COVID-19: why might they be hazardous?” , The Lancet, Published Online May 22, 2020, https://doi.org/10.1016/ S0140-6736(20)31174-0

"The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission, "Valentyn Stadnytskyi, Christina E. Bax, Adriaan Bax, Philip Anfinrud
Proceedings of the National Academy of Sciences May 2020, 202006874; DOI:10.1073/pnas.2006874117 

Schuchat A. Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020. MMWR Morb Mortal Wkly Rep. ePub: 1 May 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6918e2external icon

What The World Can Do To Prevent Future Pandemics, M Liu, Washington Post 4/17/2020

OSHA Steps Backwards on COVID-19 Occupational Exposures 4/12/2020

CIDRAP Podcast Dr. Osterholm CIDRAP - Podcast Live Updates

Covid-19 -- The Law and Limits of Quarantine N Engl J Med 2020; 382:e28 DOI: 10.1056/NEJMp2004211 April 9, 2020

Pandemic Preparedness in the workplace and the Americans with Disabilities Act ,US EEOC 03-21-20

Hadfield et al., Nextstrain: real-time tracking of pathogen evolution, Bioinformatics (2018)

New York’s governor ordered the state’s residents to stay indoors and most businesses to keep workers at home NY Times 3/20/2020

Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand Imperial College COVID-19 Response Team 03-16-2020

Veterans Affairs department reports first coronavirus death CNN 3/16/2020

US Moves Nearer to Shutdown Amid Coronavirus Fears - AP 3/15/2020

What the U.S. health system needs now to fight COVID-19 pls.org 3/13/2020

NJ Division of Workers' Compensation operations during the COVID19 pandemic NJ-DWC 4/22/20

Why the U.S. Wasn't Ready for the Coronavirus TheDaily Podcast NYTimes 3/11/2020

Social Distancing During the 1918 Influenza Pandemic and Lessons for Coronavirus Disease 2019 (COVID-19) Jennifer Tsang 3/8/2020

Emergency Federal Coronavirus Funding - Better late than never 3/8/2020

CDC Coronavirus Guidance Sets a Standard for Employer Responsibility and Liability 2/28/2020


Read more about coronavirus - News

OSHA Sued to Implement Mandatory Worker Safety Standards at Meatpacking Facilities 5/7/20

NJ  Workers compensation reform introduced to deal with coronavirus crisis NJ-AFL-CIO 4/14/2020

Genome sequencing: Cryptic transmission of SARS-CoV-2 in Washington State, Bedford T, et al., medRxiv: 2020.04.02.20051417, https://doi.org/10.1101/2020.04.02.20051417 Posted 4/16/2020

Michael R. Bloomberg to Help City Leaders Respond to Coronavirus in the United States bloomberg.org 3/10/2020

Coronavirus in N.Y.: Cuomo Attacks C.D.C. Over Delays in Testing NYTimes 3/8/2020

New Jersey man hospitalized for coronavirus is first case in the state NY Post 3/5/2020

VA stepping up coronavirus monitoring at medical facilities Military Times 3/4/2020

Burke RM, Midgley CM, Dratch A, et al. Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19 — United States, January–February 2020. MMWR Morb Mortal Wkly Rep. ePub: 3 March 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6909e1external icon
NY Insurers Ordered to Waive Cost-Sharing for Coronavirus Testing NYState 3/2/2020

How to Confront the Coronavirus at Every Level NYTimes 3/2/2020

How Prepared Is the U.S. for a Coronavirus Outbreak? NYTimes 3/1/2020

First Covid-19 outbreak in a U.S. nursing home raises concerns STAT+ 2/29/2020

Responding to Covid-19 — A Once-in-a-Century Pandemic? Bill Gates DOI: 10.1056/NEJMp2003762 2/28/2020

U.S. mulls using sweeping powers to ramp up production of coronavirus protective gear Reuters 2/28/2020

Positive RT-PCR Test Results in Patients Recovered from COVID-!19, doi:10.1001/jama.2020.2783 2/27/2020

Covid-19 — Navigating the Uncharted, DOI: 10.1056/NEJMe2002387, 2/28/2020.List of authors.Anthony S. Fauci, M.H. Clifford Lane, M.D., 

U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says NYTimes 2/27/2020

C.D.C. Confirms First Possible Community Transmission of Coronavirus in U.S. NYTimes 2/26/2020

Is it a Pandemic Yet? NYTimes 2/24/20

White House to ask Congress for emergency coronavirus funding Politico 2-23-2020

CDC: Prepare for school and business closings, communities and hospitals should prepare now - Transcript for CDC Telebriefing: Update on COVID-19 2-21-2020

U.S. prepares for coronavirus pandemic, school and business closures: health officials Reuters 2/21/2020

Coronavirus-infected Americans flown home against CDC’s advice Washington Post 2/20/2020

China disinfects bank notes and quarantines them for 14 days as Beijing announces 143 new coronavirus deaths and global toll rises past 1,600 Daily Mail 2-15-2020

China says 1,716 health workers infected by coronavirus, six dead Reuters 2/14/2020

CDC Update on Novel Coronavirus - Transcript of Telebriefing 2/12/2020


Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travelers from Wuhan, China, 20–28 January 2020, Eurosurveillance, Volume 25, Issue 5, 06/Feb/2020
Severe acute respiratory syndrome-related coronavirus – The species and its viruses, a statement of the Coronavirus Study Group, bioRxiv 2020.02.07.937862; doi:

https://doi.org/10.1101/2020.02.07.937862 .
Patel A, Jernigan DB. Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak — United States, December 31, 2019–February 4, 2020. MMWR Morb Mortal Wkly Rep. ePub: 5 February 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6905e1

“First Case of 2019 Novel Coronavirus in the United States,” Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, M.D., John Wiesman, Dr.P.H., Hollianne Bruce, M.P.H., Christopher Spitters, M.D., Keith Ericson, P.A.-C., Sara Wilkerson, M.N., Ahmet Tural, M.D., George Diaz, M.D., Amanda Cohn, M.D., LeAnne Fox, M.D., Anita Patel, Pharm.D., Susan I. Gerber, M.D., Lindsay Kim, M.D., Suxiang Tong, Ph.D., Xiaoyan Lu, M.S., Steve Lindstrom, Ph.D., Mark A. Pallansch, Ph.D., William C. Weldon, Ph.D., Holly M. Biggs, M.D., Timothy M. Uyeki, M.D., and Satish K. Pillai, M.D.et al., for the Washington State 2019-nCoV Case Investigation Team*, NEJM 1/30/2020, DOI: 10.1056/NEJMoa2001191.

U.S. Official Promise "Aggressive Measures" to Contain Coronavirus 01-03-20 NYTimes

US-HHS Declares Public Health Emergency for US for 2019 Novel Coronavirus 01-31-2020 has.gov

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China 01-24-2020 Lancet

CDC Confirms Person-to-Person Spread of the Coronavirus in the United States 01-30-2020 CDC

First case of person-to-person transmission of Wuhan virus in the US is confirmed 01-30-20 CNN

World Health Organization [UN] Declares Global Health Emergency 01-30-2020 (WHO)

Senator Edward J Markey Letter to President Trump 01-27-2020

Ten of thousands likely infected now: HKU experts 01-27-2020

In bid to curb virus, China arms tell staff to work from home even after holidays end 01-27-2020 (Reuters)

CDC 2019-nCoV page

Should workers be vaccinated against bioterrorism 166 N.J.L.J.1173 (December 31, 2001)

Relating information:

Back To Work Needs Congressional Support 4/17/2020

The Coronavirus Preparedness and Response Supplemental Appropriations Act, [CPRSAA] 2020 (March 6, 2020)

Is the workers' compensation system ready for the 2019-nCoV [coronavirus] virus? Live Updates

CDC Coronavirus Guidance Sets a Standard for Employer Responsibility and Liability 2/28/2020

New Jersey Benefits and the Coronavirus (COVID-19): What Employees Should Know 3/17/2020

OSHA Steps Backwards on COVID-19 Occupational Exposures 4/12/2020

Health Care Workers Are at a Heightened COVID Risk 4/14/2020

Links you may find useful: (Courtesy of my son, Michael A. Gelman, MD PhD, Staff Physician VAMC Bronx)
Literature Search Engine: https://cord19.aws (COI disclaimer: my brother works for Amazon)
CDC Instructions for Home Isolation: https://tinyurl.com/COVID-home-care
CDC Guidance to End Home Isolation: https://tinyurl.com/COVID-dc-home (Updated 03-May)
CDC Guidance to Discontinue Hospital Isolation: https://tinyurl.com/COVID-dc-hosp (Updated 30-Apr)
CDC HCP Return to Work: https://tinyurl.com/C19-HCP-RTW (Updated 30-Apr)
CDC Position Paper on Symptom-Based Strategy: https://tinyurl.com/CDC-sx-based (Updated 03-May)
CDC Infection Control Guidance: https://tinyurl.com/COVID19-IC
CDC Travel Risk Assessment: https://tinyurl.com/C19-public-risk (Updated 01-May)
CDC Community Risk Assessment: https://tinyurl.com/C19-comm-risk
EPA List of Disinfectants for Use Against SARS-CoV-2: https://tinyurl.com/epa-list-n
CDC HCP Exposure Risk Assessment: https://tinyurl.com/C19-HCP-risk (Archived Apr-12)
….

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Blog: Workers ' Compensation
Twitter: jongelman
LinkedIn: JonGelman
LinkedIn Group: Injured Workers Law & Advocacy Group
Author: "Workers' Compensation Law" West-Thomson-Reuters

Citation Reference: Gelman, Jon L., Is the Workers' Compensation System Ready for the Covid-19 [Coronavirus] Virus? (April 20, 2020). https://www.workerscompensation.com/news_read.php?id=35620. Available at SSRN: DOI: 10.2139/ssrn.3581770

Updated: 05-22-2020