Articles

By Caroline Poplin, MD, JD
Of Counsel and Medical Director

When it comes to the coronavirus, I have good news and bad news. The good news is that there are two things we can and should do to fight the virus without locking down the country again, even though we are now way behind the starting line. The bad news? Success requires action from the federal government.

Provide Essential Equipment

First, government must ensure adequate supplies of tests (including swabs and reagents), and standard personal protective equipment by invoking the Defense Production Act (DPA). It appears that the ventilator shortage has been resolved, at least for now, by the one-time use of the DPA for one contract — with General Motors — and medical advances in treating the virus that reduce the need for ventilators.

However, the dire shortage of tests, and slow turnaround times, are a continuing problem as the virus surges again. As recently as last month, the federal government was planning to close seven testing sites in Texas — including in two hotspots, Houston and Dallas — at the end of June. After serious bipartisan pushback from the state, the feds agreed to a 2-week extension for five of the sites.

The ongoing shortage means tests are limited to patients with symptoms, or a doctor’s note — those we could presume would be positive. But the people we really need to test are pre-symptomatic or asymptomatic carriers who might be shedding virus while going about as usual in their communities for up to 2 weeks. That is why we need lots more tests ASAP, so we can test the asymptomatic people in a hotspot, especially as cases climb in 39 states.

We also need to remove barriers to testing. Currently, uninsured people have to pay market price for the test, and are supposed to self-quarantine for 2 weeks, regardless of whether that costs them 2 weeks’ pay or even their jobs. Instead, COVID-19 tests and treatment should be free and available to all, without penalty or citizenship questions.

The president’s insistence that the virus will just “go away” soon, his obsession with optics (such as keeping official case numbers low by limiting tests, without, of course, affecting the true incidence of disease), his bald lie that 99% of cases are “harmless,” and his effort to distance himself from blame for the catastrophe, have all made the problem worse.

The fact that the U.S. is also still short of personal protective equipment (PPE) — N-95 masks, face shields, gowns, gloves, and eye protection for all those who need them — is outrageous and dangerous. As of July 13th, more than 780 healthcare workers had died of COVID-19, a tragic loss for the individuals and their families, but also for Americans who needed their care to recover.

To solve this problem, the federal government (FEMA, perhaps) should have ordered a massive supply of PPE from domestic manufacturers, using the DPA, which President Trump has used hundreds of thousands of times to order vital military products. It should have negotiated a fair price — cost plus maybe 5% profit — then sold the supplies at cost to whoever needed them. The process would be completely transparent, with no unseemly profiteering.

Instead, the process for obtaining PPE has been chaotic and corrupt: states find themselves bidding against one another and the federal government, hospitals have seen supplies they ordered seized by the federal government. A more expensive, ineffective, unaccountable process is hard to imagine. Meantime, the number of cases is soaring.

Protect Essential Workers

Because of the continuing shortage of PPE, it has largely been limited to hospitals and nursing homes where there are already known COVID patients. But the best way to reduce the spread of the virus is to test, and provide PPE, where outbreaks are most likely. That includes places in which people are breathing hard or cannot work at a distance, such as at large manufacturing plants with fast assembly lines where work stations are close together. Whenever people look carefully at such places — meat processors, chicken processors, warehouses like those run by Amazon — we find outbreaks. Protection of workers is necessary for them, of course, but also for us.

Many essential workers must work just to make ends meet. If the plant reopens and they are offered a job and decline for any reason — including fear of illness — workers lose their unemployment benefits. If they are forced to self-quarantine, they are not paid. If they complain, they are fired. So they come in even if they are sick. Because President Trump has declared these businesses essential, state and local authorities cannot easily close them down for cleaning. And many owners refuse to release any information to workers or the authorities: how many workers are sick, how many have died, or who they are.

Doesn’t this sound like working conditions of a century ago — workers forced to risk their lives for a pittance to goose the profits of wealthy owners who risk nothing and can easily afford to pay for PPE and change the configuration of work stations? Upton Sinclair described such conditions in the meat-packing industry in “The Jungle,” published in 1905.

Such activities by employers are illegal now. In the early part of the last century, states passed workers’ compensation laws, requiring employers to compensate workers for injuries and illnesses contracted at work. In 1935, Congress passed the Labor Relations Act, a key New Deal measure which required companies to bargain about wages and working conditions with workers elected by unions. Over the years, unfortunately, anti-union employers have found ways — in Congress and the courts — to water down these protections, but they are still good law.

In 1970, Congress passed, and President Nixon signed, the Occupational Safety and Health Act to specifically address worker safety on the job, and created an agency (OSHA) to enforce it and issue standards to address specific problems. Employers’ responsibilities under the act include providing a safe workplace and finding and correcting safety and health problems. That sounds clear enough, doesn’t it? However, as a government lawyer for 10 years (FDA, Environmental Protection Agency), I learned that success of laws like these requires agencies like OSHA to promulgate well-reasoned regulations, to provide the regulated community with details, and to vigorously enforce compliance.

The agency lays out the responsibilities of employers in its pamphlet, “Workers’ Rights“: “Employers have the responsibility to provide a safe workplace. Employers MUST provide their employees with a workplace that does not have serious hazards and must follow all OSHA safety and health standards [boldface original]. Employers must find and correct safety and health problems.”

Under the Trump administration, not only has OSHA failed to issue regulations to protect workers from this particularly contagious virus, but instead has assured employers that “good faith efforts” are enough. Worse, Senate Majority Leader Mitch McConnell (R-Ky.) is demanding a 5-year liability shield for all employers in the bill he is now negotiating in the Senate. That tells me that some employers will fail to take necessary measures (“Too expensive! Impractical!”) unless they are held legally responsible for preventing COVID in the workplace. By contrast, the House bill passed in May would require OSHA to put issue an emergency safety standard to protect workers.

The Bad News

When it comes to the coronavirus, I have good news and bad news. The good news is that there are two things we can and should do to fight the virus without locking down the country again, even though we are now way behind the starting line. The bad news? Success requires action from the federal government.

Provide Essential Equipment

First, government must ensure adequate supplies of tests (including swabs and reagents), and standard personal protective equipment by invoking the Defense Production Act (DPA). It appears that the ventilator shortage has been resolved, at least for now, by the one-time use of the DPA for one contract — with General Motors — and medical advances in treating the virus that reduce the need for ventilators.

However, the dire shortage of tests, and slow turnaround times, are a continuing problem as the virus surges again. As recently as last month, the federal government was planning to close seven testing sites in Texas — including in two hotspots, Houston and Dallas — at the end of June. After serious bipartisan pushback from the state, the feds agreed to a 2-week extension for five of the sites.

The ongoing shortage means tests are limited to patients with symptoms, or a doctor’s note — those we could presume would be positive. But the people we really need to test are pre-symptomatic or asymptomatic carriers who might be shedding virus while going about as usual in their communities for up to 2 weeks. That is why we need lots more tests ASAP, so we can test the asymptomatic people in a hotspot, especially as cases climb in 39 states.

We also need to remove barriers to testing. Currently, uninsured people have to pay market price for the test, and are supposed to self-quarantine for 2 weeks, regardless of whether that costs them 2 weeks’ pay or even their jobs. Instead, COVID-19 tests and treatment should be free and available to all, without penalty or citizenship questions.

The president’s insistence that the virus will just “go away” soon, his obsession with optics (such as keeping official case numbers low by limiting tests, without, of course, affecting the true incidence of disease), his bald lie that 99% of cases are “harmless,” and his effort to distance himself from blame for the catastrophe, have all made the problem worse.

The fact that the U.S. is also still short of personal protective equipment (PPE) — N-95 masks, face shields, gowns, gloves, and eye protection for all those who need them — is outrageous and dangerous. As of July 13th, more than 780 healthcare workers had died of COVID-19, a tragic loss for the individuals and their families, but also for Americans who needed their care to recover.

To solve this problem, the federal government (FEMA, perhaps) should have ordered a massive supply of PPE from domestic manufacturers, using the DPA, which President Trump has used hundreds of thousands of times to order vital military products. It should have negotiated a fair price — cost plus maybe 5% profit — then sold the supplies at cost to whoever needed them. The process would be completely transparent, with no unseemly profiteering.

Instead, the process for obtaining PPE has been chaotic and corrupt: states find themselves bidding against one another and the federal government, hospitals have seen supplies they ordered seized by the federal government. A more expensive, ineffective, unaccountable process is hard to imagine. Meantime, the number of cases is soaring.

Protect Essential Workers

Because of the continuing shortage of PPE, it has largely been limited to hospitals and nursing homes where there are already known COVID patients. But the best way to reduce the spread of the virus is to test, and provide PPE, where outbreaks are most likely. That includes places in which people are breathing hard or cannot work at a distance, such as at large manufacturing plants with fast assembly lines where work stations are close together. Whenever people look carefully at such places — meat processors, chicken processors, warehouses like those run by Amazon — we find outbreaks. Protection of workers is necessary for them, of course, but also for us.

Many essential workers must work just to make ends meet. If the plant reopens and they are offered a job and decline for any reason — including fear of illness — workers lose their unemployment benefits. If they are forced to self-quarantine, they are not paid. If they complain, they are fired. So they come in even if they are sick. Because President Trump has declared these businesses essential, state and local authorities cannot easily close them down for cleaning. And many owners refuse to release any information to workers or the authorities: how many workers are sick, how many have died, or who they are.

Doesn’t this sound like working conditions of a century ago — workers forced to risk their lives for a pittance to goose the profits of wealthy owners who risk nothing and can easily afford to pay for PPE and change the configuration of work stations? Upton Sinclair described such conditions in the meat-packing industry in “The Jungle,” published in 1905.

Such activities by employers are illegal now. In the early part of the last century, states passed workers’ compensation laws, requiring employers to compensate workers for injuries and illnesses contracted at work. In 1935, Congress passed the Labor Relations Act, a key New Deal measure which required companies to bargain about wages and working conditions with workers elected by unions. Over the years, unfortunately, anti-union employers have found ways — in Congress and the courts — to water down these protections, but they are still good law.

In 1970, Congress passed, and President Nixon signed, the Occupational Safety and Health Act to specifically address worker safety on the job, and created an agency (OSHA) to enforce it and issue standards to address specific problems. Employers’ responsibilities under the act include providing a safe workplace and finding and correcting safety and health problems. That sounds clear enough, doesn’t it? However, as a government lawyer for 10 years (FDA, Environmental Protection Agency), I learned that success of laws like these requires agencies like OSHA to promulgate well-reasoned regulations, to provide the regulated community with details, and to vigorously enforce compliance.

The agency lays out the responsibilities of employers in its pamphlet, “Workers’ Rights“: “Employers have the responsibility to provide a safe workplace. Employers MUST provide their employees with a workplace that does not have serious hazards and must follow all OSHA safety and health standards [boldface original]. Employers must find and correct safety and health problems.”

Under the Trump administration, not only has OSHA failed to issue regulations to protect workers from this particularly contagious virus, but instead has assured employers that “good faith efforts” are enough. Worse, Senate Majority Leader Mitch McConnell (R-Ky.) is demanding a 5-year liability shield for all employers in the bill he is now negotiating in the Senate. That tells me that some employers will fail to take necessary measures (“Too expensive! Impractical!”) unless they are held legally responsible for preventing COVID in the workplace. By contrast, the House bill passed in May would require OSHA to put issue an emergency safety standard to protect workers.

The Bad News

Unfortunately, the Republican party decided years ago that the federal government should be made so small that, per Grover Norquist, he could drown it in the bathtub. The president treats the government like an extension of the Trump Organization: he can do as he pleases — squeeze it for money, reward his friends, and punish his enemies. At the same time, he is not responsible for anything. No Republican will stop him.

Instead, Republicans are certain that everything can be handled more efficiently (at least more profitably!), by private enterprise operating in a totally deregulated free market.

Really??

Now we know.

The Good News

The federal government has the authority, the mandate, and the resources to ultimately defeat COVID19, although it will cost more — in money and in lives — than if we had had a responsible government in January 2020.

But, alas, it appears we must wait for relief until January 2021.

Caroline Poplin, MD, JD, is an attorney and internist in Bethesda, Maryland. She is a former staff internist for the National Naval Medical Center, and currently practices medicine part-time at the Arlington Free Clinic in Virginia. She is also of counsel at Guttman, Buschner & Brooks, a law firm which pursues Medicare and Medicaid fraud.

I was in my late 20s, attending a conference for women lawyers in the 1970s. I sat in the front row of a large auditorium for the keynote address. The speaker was Ruth Bader Ginsburg, the founder of the American Civil Liberties Union Women’s Rights Project. I was mesmerized.

She was all that I wanted to be. To devote one’s life to the fight for civil rights, to use legal skills to effect justice, better yet to make a difference — I could think of nothing greater. And I was not alone; generations of civil rights lawyers looked to emulate her.

Ginsburg’s vision of gender equality was decades ahead of her time. It went beyond just empowering women to compete for “men’s” roles. While stereotypes distorted women’s view of what was possible, they also impeded men, no less trapped in gender-based assumptions. Equality meant that both sexes should be free to assume all of society’s roles without preconceptions. My son can be a caregiver; my daughter can be an executive. When the school administrators wanted Ginsburg to come to school to discuss her son’s misconduct, she famously said, “This child has two parents.”

Her record as an advocate before the Supreme Court was outstanding; she argued six cases before the court, winning five. If she had done nothing else in her life, that alone would have been an extraordinary legacy.

While she continued to be animated by her life’s passion for equality when she joined the court, she was not the “activist” caricature some in the media have portrayed her to be. She was anxious to avoid upending precedent, determined to be respectful of the opinions of her colleagues. She believed in incremental legal change and emphasized the limited role that a court plays in a constitutional democracy.

In Ginsburg’s understanding, courts have a critical role to play in identifying new understandings of the Constitution, but they must do so by “measured motions.” They are part of a dialogue with other organs of government and with the people as well. She was critical of the reasoning in Roe v. Wade, because it had accomplished too much too soon. She was, as the New York Times’s Linda Greenhouse described at the time of her confirmation, a “judicial-restraint liberal.”

She would apply the court’s precedents but take pains to situate them in their social and historical context. A Ginsburg decision would tirelessly recount the history of gender-based classifications, the “stunningly anachronistic” generalizations about men and women, as she described them, that were embedded in the law.

When, shortly after she joined the court, she wrote the majority opinion requiring that women be admitted to the all-male Virginia Military Institute, her analysis was classic Ginsburg: a lengthy description of the school, its prestige, its role in preparing men and only men for high-status roles in government and industry. In cases challenging affirmative action programs, she would recite the data that showed the persistence of racial inequity in housing, education and employment, the lingering effects of “centuries of law-sanctioned inequality.” She prefigured today’s debate about systemic discrimination.

Ginsburg brought her own experiences to bear, insisting that legal rules be understood in “the realities of the workplace,” a reality she understood well. When a Supreme Court majority rejected Lilly Ledbetter’s pay discrimination claim because she had sued too late, Ginsburg dissented, teaching her colleagues about how pay discrimination, unlike discrimination in promotions or hiring, was hidden from view; Ledbetter sued as soon as she found out about it. Goodwin Liu, a justice on the California Supreme Court and a former Ginsburg clerk, has said that when Ginsburg was recounting Ledbetter’s story, she was also telling her own.

Her judicial influence has to be measured not simply in the decisions she authored, but also in the decisions of her colleagues and lower-court judges, I among them. It extends to areas far beyond gender and race discrimination, including cases about access to justice, disability discrimination, the right to counsel.

Ginsburg was a reluctant dissenter, concerned about the moral weight of a decision when the court did not speak in a single voice. But in recent years, her role changed with the court’s shifting membership. She dissented more and more — when the majority gutted the Voting Rights Act or enabled businesses to opt out of contraceptive coverage for employees based on a broad religion-based exemption. She dissented when the majority spoke paternalistically about women who felt compelled to end a pregnancy in the second trimester.

In 2013, years after that conference at which I first heard her speak, I gave the Ruth Bader Ginsburg address at the New York City Bar Association. The justice introduced me, with an unforgettable sense of humor and warmth. Afterward, she sent me a gift, not a fancy academic treatise, but a signed book of her late husband’s recipes, with a moving note. If I published my talk, she wanted to make certain that I included the story about Sadie, my mother. That story? Even though I had graduated Yale Law School, Sadie wanted me to take the Triborough Bridge toll taker’s test – just in case!

A famous hockey player, Wayne Gretsky, said the key to success was: “Skate to where the puck is going, not to where it’s been.”

In this country, essential workers, who must work to keep the country going during the pandemic but often can’t work from home — first responders and health care providers, of course, but also grocery clerks, bus drivers, subway workers, utility repair people, letter carriers and warehouse workers, as well as those designated by Trump, such as workers at meat processing plants — must be shielded from the virus, not just for their own sake, but for ours.

In the last six months, we have learned much about COVID 19. It is highly contagious. It spreads in respiratory droplets when we cough, sneeze (or sing) that can travel six feet or so before falling to the ground; also by aerosols, tiny droplets mixed with the air that can linger for hours and be inhaled; it can contaminate surfaces, like door knobs. Transmission is more likely in closed, poorly ventilated spaces.

Just as problematic, the virus has an average incubation period of a bit more than a week, during which the patient has no symptoms, but is nonetheless shedding virus. Indeed, many cases of COVID 19 are so mild that people assume (or used to assume) that they had just a cold. But we know now that this virus can be lethal: more than 187,000 Americans have died so far, some under 65 without known risk factors, just eight months after the virus first appeared here.

Essential workers are in a tight spot. If they leave their job because they fear corona virus, they are barred from collecting unemployment. If they are laid off and then recalled, or if someone offers them a job and, fearing the virus, they decline, same result. If they stay home because they have symptoms, or close contact with someone sick, they don’t get paid, because they have no sick leave. Generally their wages are so low they cannot afford not to work. So some come to work despite symptoms (and of course, sick without symptoms.) If they complain, they may be fired, even though that is illegal.

Many Americans (not to mention President Trump) are impatient for the economy to re-open. Respected public health infectious disease experts like Dr. Anthony Fauci say we can manage without starting all over again in lockdown, if we are conscientious about wearing face masks, maintaining social distance of at least six feet at all times except at home (unless there are vulnerable family members), good hand hygiene, avoiding crowds and poorly ventilated indoor spaces.

But we know now that some workplaces — where thousands of workers are deemed ‘essential’ — are hotbeds of COVID19 outbreaks: meat-packing plants are the classic case. As of July 10, nearly 30,000 meatpackers were known to have been sickened by the virus, at least 100 have died and many others suffer from lingering side effects. .(There may well be more: some large employers, like Amazon, resist releasing COVID19 illness and death statistics, even to their employees.) Employers claim that they are protecting workers, but in places where people must work fast and hard, work stations are much closer than six feet and many people stand side by side, breathing hard from exertion, for hours, or must complete so many distant tasks in so few seconds that there is no time for hand washing (let alone 20 seconds as per CDC) — for these jobs, front door temperature checks and face masks are just not sufficient protection. The other precautions recommended by Dr. Fauci — at least six feet between individuals, avoiding large crowds, especially indoors, are not impossible, but they are more expensive. They would likely result in lower profits for employers, and higher prices for consumers.

Essential workers in consumer-facing workplaces — transit workers, grocery and pharmacy clerks, delivery drivers, mail carriers — also may encounter the virus often. The workplace may require masks and distancing, but sometimes customers don’t, can’t, or won’t, comply. As of May 15, more than 3865 New York transit workers had tested positive, 118 had died. As of July 23, at least 3267 postal workers were infected with the virus; 75 had died.

Unlike classic occupational injuries — carpal tunnel syndrome, broken bones, etc. — with COVID19, what starts at work doesn’t necessarily stay at work. Those infected at work take the virus wherever they go: we have now seen how quickly and stealthily the virus spreads through communities. And it works both ways: as employers remind everyone, the virus can start in the community and come to the factory. Customers who reject precautions can infect service employees and other customers — like bus drivers and their passengers. Either way — the virus doesn’t care — if the employer doesn’t take adequate precautions as required by his or her particular workplace, in a short time, a few infected workers can spread the infection to hundreds of others in the plant and the community.

Employers are the only ones with the knowledge and the means to take adequate precautions, including widespread, routine testing of asymptomatic as well as symptomatic workers, even complete shutdown for deep cleaning if necessary. Some companies I’m sure, are doing the right thing, but with others reluctant to supply any information to public authorities and employees, about how many have tested positive and who (so contact tracing is possible), it’s hard to know. Some employers insist on a doctor’s note, or a positive test obtained by the employee, to excuse him or her from work.

The situation is especially fraught because people of color make up a disproportionate share of essential employees, and they are particularly vulnerable to the virus: some have more pre-existing conditions, or limited access to health care, crowded, often multigenerational, housing conditions, poverty, limited English. The victims of COVID in the U.S. are disproportionately people of color.

The virus is the hockey puck — we must focus attention where we expect outbreaks to occur. If we continue to play catch-up, lockdowns will be more frequent and extensive.

Bad corporate behavior, which the President encourages (“the virus is under control, let get the economy roaring!!”), endangers not just essential workers, but all of us.

The failure to take all necessary precautions where COVID spreads easily is about money: profit for the employer, customer satisfaction, without risk to either companies or consumers. The people forced to risk their lives, every day, are poorly paid, inadequately protected, employees.

I don’t want anyone to risk their life for my convenience, or to enhance employers’ profits.

But this is not just my preference: it is the law in this country.

Americans have been concerned about worker safety since Upton Sinclair published his novel, The Jungle (exposing conditions in meatpacking plants!), in 1906. In 1911 Wisconsin was the first state to pass a workers’ compensation statute, which required employers to carry no-fault insurance for injury or illness contracted at work. By 1949, all the states had passed such laws, obviating the need to prove employer negligence every time a worker was injured. (Our systems were modeled on one designed by Chancellor Otto von Bismarck of Prussia in 1884.) In1936, Congress passed the National Labor Relations Act, a key part of the New Deal. That law authorized unions elected by workers to negotiate with employers about wages and working conditions.

Employers have vigorously and successfully fought these measures in the courts from then until now, seriously weakening them.

In 1970, Congress tried again. It passed, and President Nixon signed, the Occupational Safety and Health Act, which required employers to provide safe workplaces. The Act simultaneously created the Occupational Safety and Health Agency to enforce the law, by issuing standards for particular industries or hazards, investigating employee complaints, and sanctioning employers for violations. (States with a State plan approved by OSHA, with standards as high or higher than federal standards, can also take enforcement action.)

The language of the statute is crystal clear. In Section 5(a), Congress says:“ Each employer:

(1)Shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or likely to cause death or physical harm to his employees;

(2)Shall comply with occupational safety and health standards promulgated under this Act.”

This statutory provision is known as the General Duty Clause.

In OSHA’s handbook, “Worker’s Rights”, the Agency explains: “Employers must find and correct safety and health problems. OSHA further requires that employers try to eliminate or reduce hazards first by making feasible changes in working conditions — switching to safer chemicals, enclosing processes to trap harmful fumes, or using ventilation systems to clear the air are examples of effective ways to get rid of or minimize risks — rather than just relying on personal protective equipment [PPE] such as masks, gloves or earplugs.”(OSHA 3021-OGR 2017)

As of July 22, U.S. OSHA had received 6,832 complaints about failure to adequately protect workers against COVID19. State agencies received 17,013 complaints, including (but not limited to) insufficient PPE, non-compliance with the CDC’s limited guidance referenced in OSHA guidelines. As of June 9, Eugene Scalia, Secretary of Labor (and son of the late Justice) was forced to admit to Congress that since the onset of the virus, OSHA had issued only a single COVID 19 citation –to a Georgia nursing home for “failing to report the hospitalization of 6 employees within 24 hours” — categorized as the lowest level infraction — and fined the facility $6500. As of June 30, OSHA apparently closed 5522 complaints without any action — apparently without any investigation. (The reason the dates are all different is that information is scattered and scarce on the internet.) We will see what OSHA does with this one, filed by the National Nurses Union on August 24 against hospital system HCA (a for-profit Fortune 500 company for 25 years).

OSHA has issued no specific standard for COVID19 in any workplace, and apparently does not plan to. It has issued “guidance” and “recommendations”, but as the Agency makes clear, in the first sentence of its COVID19 booklet: “[t]his guidance is not a standard or regulation, and it creates no new legal obligations…The recommendations are advisory in nature…”.

However, the General Duty Clause should still be available. To cite an employer, the Agency needs to show: (1) the employer failed to keep the workplace free of a hazard to which the employees were exposed; (2) the hazard was recognized; (3) the hazard was causing or was likely to cause death or serious physical harm; and (4) there was a feasible and useful method to correct the hazard.

Except in some circumstances for the last requirement, COVID19 seems to fill the bill easily.

Deborah Berkowitz, formerly chief of staff, then senior policy advisor, at OSHA, explained to NPR that “Secretary Scalia has said over and over again — that I don’t think they really believe that the government has a role here. They believe in real limited government.” The Agency expects employers to comply voluntarily. It says “it will exercise discretion about whether to pursue enforcement actions if companies undertake “good faith efforts” to comply with existing regulations.” (“Existing regulations” for COVID are the general regulations applicable to all businesses.) OSHA’s single citation, of a recordkeeping violation at that, tells us that despite thousands of complaints, thousands of sick workers, and a significant number of worker deaths, the Agency is satisfied with the level of employer compliance.

Congressional Republicans, don’t want to take any chances, however: they say they won’t sign another COVID relief bill without an employer liability shield. They “know” worker lawsuits about catching COVID are all frivolous. Speaker of the House Nancy Pelosi instead wants to protect workers, and the rest of us, since we know that what starts at work doesn’t stay at work. The House COVID 19 bill would require OSHA to issue emergency standards for corona virus in the workplace.

Employers would have to fund the required measures, of course, not taxpayers. Companies could pass the costs on to consumers, which would also be fair. And a responsible Federal government would help, using the Defense Production Act (DPA) (which the Trump administration has used before) to require American industry to produce all the PPE, COVID tests, reagents, swabs, gowns etc. the country needs to control the pandemic, for a fair price — cost plus a reasonable profit. The government would sell the equipment at cost to any company, government institution (first responders, schools) or other group that needed it. As Governor Cuomo noted, when we go to war, we don’t require each state to provide its own tanks.

The government can, and should, organize independent labs to speed up the results of the tests — like the electricity grid, says Dr. Atul Gawande.

This is why we have government. It was Abraham Lincoln who said that the” legitimate purpose of government is to do for a community of people, whatever they need to have done, but cannot do…for themselves…in their individual capacities.” American companies and healthcare providers — eight months in — are still short of necessary COVID19 supplies.

Anyone who thinks the free market can handle anything, even a war or a national pandemic, more efficiently than a responsible federal government working with state and local partners, has not been paying attention.

President Trump pays no attention to anything except his reelection. As for the 187,000 (and counting) COVID deaths, all he says is “It is what it is,” by which he means, change the subject, don’t you care about violence in the streets?

We need employers to adequately protect our essential workers, voluntarily if possible, by force of law if necessary. And this needs to happen quickly. The federal government must help. That will help all of us stay safe.

We say our essential employees are heroes. They should be treated as such, not like disposable equipment.

Written by Caroline Poplin, M.D., J.D. Poplin graduated from Yale Law School and practiced law with the FDA and the EPA. Currently Of Counsel & Medical Director at Guttman, Buschner, & Brooks PLLC.

Getting a case down to its “gist” and to its “core,” retired federal judge Nancy Gertner said, involves picking the evidence that’s most favorable to your side. “That kind of selection is inevitably argument,” she said, as part of a webinar on openings presented Tuesday by NITA and CVN.

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