US regulatory system failed to prevent thousands of deaths in frontline workers during the pandemic, analysis finds

An analysis published in the British Medical Journal examines the risks faced by frontline workers in the United States during the pandemic and suggests reforms that could protect population health and save lives. The piece is the first of a series of articles on US lessons learned during the pandemic.

Lead author Professor David Michaels at the George Washington University and his colleagues note that from the onset laws and regulations in the United States inadequately protected frontline workers. The gaps allowed a rapid spread of disease in US workplaces like meat packing plants. At the same time, these essential workers were rarely seen as a population that needed special attention or protections.

"The consequences of these failures were appalling and led to tens of thousands of deaths in frontline workers," said Michaels, who is a professor of environmental and occupational health at the GW Milken Institute School of Public Health.

"The risk of exposure was exacerbated by race- and labor-related economic inequality, resulting in disproportionally more of the nation's Black and Hispanic workers being killed or sickened by the virus." Michaels also served as the administrator for the US Occupational Safety and Health Administration from 2009 to 2017, the longest serving administrator in the agency's history.

Key findings from the analysis:

• COVID-19 disproportionately affected workers who had to go to work to keep society functioning
• Low-wage Black and Hispanic workers who could not work from home were disproportionately affected
• Actions by US occupational and public health agencies fell far short of what was needed to make workplaces safe during the pandemic
• Protecting worker health in the next pandemic requires action now for paid family and medical leave, better social supports and better workplace protections

The analysis, US workers during the COVID-19 pandemic: uneven risks, protections and predictable consequences, was authored by Michaels, Emily Spieler at Northeastern University School of Law and Gregory Wagner at the Harvard T. H. Chan School of Public Health.