Doctors and emergency first responders who are exposed to COVID-19 could lose their jobs if they don’t show up for work despite the risks, under provisions in a sweeping pandemic response package.
Hospitals, urgent care centers, nursing homes, and other health care facilities could deny leave to medical workers, even if they’ve been exposed, because of coronavirus-related emergencies.
Under the bill, some workers could take off work for 12 weeks under an expansion of the Family and Medical Leave Act that includes COVID-19 quarantine as a qualified reason for leave. But the bill carves out an exemption to keep doctors in clinics and paramedics in the field, according to unions, trade groups and congressional aides.
The bill also allows for two weeks of paid sick leave for medical needs related to COVID-19, but health care providers and paramedics could be cut out of those sick days, too, the U.S. Chamber of Commerce said.
The bill empowers Labor Secretary Eugene Scalia to exempt “certain health care providers and emergency first responders” from taking sick leave if they contract COVID-19, should hospitals face a shortage.
The bill “leaves it up to Trump cronies like Secretary Scalia whether employers should extend leave to health care workers,” said Dalia Thornton, a director of the American Federation of State, County and Municipal Employees, said on a call with reporters Monday.
A Democratic aide confirmed that the bill would provide “regulatory authority to exempt them if there are massive shortages and the pandemic starts developing massive shortages of workers in this sector.”
Sick days could be denied to health care providers even without that authority being exercised, according to the chamber.
The decision to maximize the number of health care providers treating patients by possibly excluding them from quarantine and sick leave comes as hospitals prepare for a crush of COVID-19 patients. As testing ramps up and more people experience serious illness, epidemiologists anticipate a shortage of medical workers.
The bill also would exempt businesses with more than 500 employees and businesses with fewer than 50 employees if they determine that offering leaves would threaten the viability of their business.
Jamila Taylor, director of health care reform at The Century Foundation, a liberal think tank, said that while right now it’s hard to imagine health care providers being pressured to report to work with COVID-19, the bill creates the possibility that they could be fired if they don’t. Combined with an impending economic downturn, that could have a “chilling effect,” she says.
“For one thing, it’s going to invoke fear,” Taylor said. “I definitely think we could see a chilling effect on workers. They might not be upfront when they are feeling sick if they don't have the time to take off and they have to put food on the table and keep things afloat.”
Unions criticized the parts of the bill that would leave health care workers vulnerable, saying a surge of cases in hospitals is practically inevitable and that forcing health care workers to stay on the job could accelerate the spread of the novel coronavirus.
“It is hard to imagine a worse ‘cure’ for the almost certain surge of COVID-19 patients in our health care system than denying sick leave to nurses and other health care workers when they have been exposed to the virus, and apparently even when they are already experiencing symptoms of the illness,” said National Nurses United Executive Director Bonnie Castillo.
According to the Department of Labor’s definition of health care providers, workers excluded from the expanded leave could include doctors, nurse practitioners, clinical social workers, and physician assistants.
Push for changes
The White House advocated for the carve-outs for medical workers during negotiations with congressional Democrats, according to two Democratic aides and advocates aligned with Democrats tracking the issue with the Paid Leave for All campaign.
A White House spokesperson did not respond to multiple requests for comment.
Democratic leadership made the changes as what they dubbed “technical tweaks” to the bill Monday.
House Speaker Nancy Pelosi, D-Calif., released a statement Tuesday afternoon saying Democrats “staved off the Administration’s attempt to eliminate workers’ health care guaranteed under the Family and Medical Leave Act mandate” and that Democrats plan to expand paid leave in future bills. The statement did not directly address the exemption for health care providers.
The loopholes follow lobbying by business groups to scale back the paid leave provisions of the pandemic response bill, saying they would be too onerous.
The Chamber of Commerce said in a March 12 letter to Pelosi and Senate Majority Leader Mitch McConnell that the expansion of paid sick leave was “poorly tailored to the situation” and proposed addressing the issue in a bill down the line.
The development comes as providers across the country have tested positive for COVID-19. Two emergency room doctors in New Jersey and Washington state are in critical condition, according to the American College of Emergency Physicians.
Hospitals are experiencing a severe shortage of the N95 respirators that can block the airborne transmission of viruses, according to the American Hospital Association and the American Medical Association. Research published by the National Institutes of Health on Tuesday suggests that SARS-CoV-2, the virus that causes COVID-19, can survive in aerosols for up to three hours, and that people may acquire the virus through the air.
A single COVID-19 patient admitted to a California facility in February led to 124 health care workers being placed under a two-week-long quarantine, according to NNU.
President Donald Trump has likened the federal response to the pandemic to a war.
But critics say the loopholes show the White House is not showing adequate concern for the health care providers fighting it.
“If they are so important, why did the White House fight against provisions protecting these workers?” said Debbie Berkowitz, a director at the National Employment Law Project.
In late February, unions including the AFL-CIO began pressing lawmakers to require that the Occupational Safety and Health Administration issue legal requirements ensuring employers protect at-risk workers in hospitals and airports from catching COVID-19 amid a shortage of face masks. That provision was included in Democrats’ initial draft, but was nixed from the bill negotiated with the White House.