New CDC Guidelines Could Worsen Virus Spread and COVID-19 Racial Disparities

A suspected coronavirus patient was taken into Montefiore Medical Center in the Bronx last week.Credit…Desiree Rios for The New York Times

New guidelines from the Centers for Disease Control and Prevention (CDC) encouraging workers exposed to the coronavirus to stay on the job would likely worsen the spread of the coronavirus and exacerbate the disparity of infected cases, and deaths, of African Americans that has become a national scandal.

Under its new recommendations, the CDC revokes previous guidelines that most workers who are exposed to the virus should be isolated for a period of 14 days. Instead, CDC says essential workers can mainly just wear a mask and not practice social distancing, “as work duties permit,” a significant loophole that can be easily exploited by employers.

“The loosened guidelines are dangerous, and risk exposing other workers and the public to infection, with supposed mitigation measures that are far less effective in reducing the threat of spreading the virus,” said NNU Executive Director Bonnie Castillo, RN.

Further, the guidelines cover categories of employees expected to still be on the job, such as home health aides, public employees, transportation, energy, and janitorial and custodial workers, where African Americans, who already experiencing alarmingly high levels of COVID-19 infections and deaths, are disproportionately concentrated.

Even the CDC has acknowledged the deadly disparity, in a statement today, noting that of its own data of 580 hospitalized COVID-19 patients with race/ethnicity data, 33 percent were black, “suggesting that black populations might be disproportionately affected by COVID-19.”

Recognition of the high number of African American deaths from COVID-19 has drawn increasingly widespread public and media notice — with deaths as high as up to three times the percentage of black residents in Chicago, Los Angeles, Detroit, New Orleans, Milwaukee, Washington D.C., New York, St. Louis and other cities, as well as statewide for, among others, Alabama, Florida, Maryland, North Carolina, and South Carolina.

As NNU has noted, these grim statistics are just the latest chapter in what NNU Executive Director Bonnie Castillo, RN calls “the long, deplorable history of racial disparity in health care in access to medical services and treatment.”

In addition to working in larger percentages of the “essential” services that are the focus of the new guidelines, African American workers are also less likely to have access to the limited supply of testing, which is reinforced by the failure of the new CDC guidelines to require or even advise that exposed workers be tested.

African American workers in high-risk jobs of infections are also endangered due to the ongoing, historic racial disparity in health care, including higher levels of lack of insurance, fewer health care services and other resources, and higher levels of pre-existing health conditions. Those include hypertension, cited by both the CDC and New Orleans officials in reporting high percentage of COVID-19 cases, as well as diabetes, asthma, and chronic pulmonary and coronary disease.

And, while the CDC recommends the use of facial covering for the asymptomatic workers being pressed to continue working, many have also noted that African Americans are statistically less likely to wear face masks in public for their own protection due to societal racism and fear of being racially profiled by police, store owners, and others — which increases their risk of infection.

In response to the racial disparity, NNU has called for rapidly expanding testing and treatment, including elimination of all out of pocket costs, and prioritizing placement of comprehensive health care services for underserved African American, Latino and Native American communities “for those who are serving the public and bearing an unequal burden of exposure, and suffering,” Castillo said.

The latest CDC guidelines continue the pattern of weeks of CDC rolling back protective standards, especially for nurses and other health care workers.

That includes weaker guidelines on personal protective equipment that has encouraged hospitals to push the use of unsafe PPE, from loose-fitting surgical masks to bandanas, rather than N95 respiratory masks, unsafe methods including reuse and decontamination of N95 masks, for which there is no validated scientific evidence that it is safe, and press exposed staff to prematurely come back to work.

Donations of personal protective equipment were collected to distribute to medical workers in Chicago.Credit…Scott Olson/Getty Images

Similarly, the new CDC guidelines for other workers give broad license to employers to pressure workers to remain in the workplace at risk to themselves and others. The guidelines do not require or advise employers to install engineering controls, isolate workers exposed to COVID infected individuals, ensure social distancing in the workplace, or provide effective personal protective equipment.

With the U.S. now accounting for nearly four times as many confirmed coronavirus infections, and 17 percent of the world’s COVID-19 deaths despite only comprising 4.25 percent of the global population, “it is outrageous for the CDC to continue to lower protective standards and encourage any employers to expose workers to greater risk,” Castillo said.

National Nurses United, with more than 175,000 members nationwide, is the largest union and professional association of registered nurses in U.S. history.