As part of NIOSH’s efforts to keep stakeholders up to date on the CDC and NIOSH coronavirus disease 2019 (COVID-19) response, below is a summary of new information posted this week.

General Resources

Two New NIOSH Science Blogs are Now Available on Respiratory Protection

• The Blog, Respiratory Protection vs. Source Control – What’s the Difference?, helps readers understand the difference between respiratory protection, which protects the wearer, and source control, which protects others.
• The Blog, Supplementing the Supply of N95s With Reusable Elastomeric Half Mask Respirators, discusses the use of reusable elastomeric half mask respirators (EHMRs) as a substitute for N95 respirators. This comes as organizations rely on other types of respiratory protection due to the high demand and limited supply of N95 respirators during the COVID-19 pandemic.

Industry-Specific Resources

Update to Wildland Firefighter FAQs   

Updates to the Wildland Firefighter FAQs webpage address new concerns, clarify that testing recommendations are relevant to prevent infection and the spread of COVID-19 regardless of test result or exposures, and update the screening terminology to be consistent across the CDC website.

Limiting Workplace Violence Infographic Translated

The webpage Limiting Workplace Violence Associated With COVID-19 Prevention Policies in Retail and Services Businesses has a newly translated infographic. “Basic dos and don’ts for EMPLOYEES to prevent workplace violence” has been translated into eight languages: Chinese, Korean, Vietnamese, French, Haitian-Creole, Portuguese, Spanish, and Russian.

New Fact Sheets

CDC recently published fact sheets for two additional groups that provide suggestions for preventing the spread of COVID-19

• Hotel, resort, and lodge employees and employers
• Paratransit operator employees and employers

President Trump and the U.S. Department of Health and Human Services (HHS), through the Assistant Secretary for Health, issued guidance under the Public Readiness and Emergency Preparedness Act (PREP Act) to expand access to safe and effective COVID-19 vaccines when they are made available. This guidance authorizes state-licensed pharmacists to order and administer, and state-licensed or registered pharmacy interns acting under the supervision of the qualified pharmacist to administer, COVID-19 vaccinations to persons ages 3 or older, subject to certain requirements.

“This action builds upon our Administration’s progress toward delivering a safe, effective, and widely available vaccine by 2021,” said Assistant Secretary for Health ADM Brett P. Giroir, M.D. “Allowing pharmacists to order and administer COVID-19 vaccines will greatly expand convenient access for the American people.”

The authorization preempts any state and local laws that prohibit or effectively prohibits those who satisfy these requirements from ordering or administering COVID-19 vaccines as set forth above. The authorization does not preempt state and local laws that permit additional individuals to administer COVID-19 vaccines to additional persons.

Access a copy of the guidance – PDF*

Information on Operation Warp Speed

Clinical resources on vaccines, including continuing education training on best practices

Pennsylvania Governor Tom Wolf announced that restaurants may increase indoor occupancy to 50 percent starting September 21. To ensure that these businesses operate safely as Pennsylvania continues to mitigate the spread of COVID-19, and to instill customers and employees with confidence knowing that they can dine safely, restaurants will ​commit to strictly complying to all public health safety guidelines and orders through a self-certification process.

“While our aggressive and appropriate mitigation efforts have kept case counts low, we must continue to take important steps to protect public health and safety as we head into the fall. At the same time, we must also support the retail food services industry that has struggled throughout this pandemic,” Gov. Wolf said. “The self-certification ensures that ​restaurants can expand indoor operations and commit to all appropriate orders so that employees and customers alike can be confident they are properly protected.”

Restaurants that self-certify will appear in the Open & Certified Pennsylvania searchable online database of certified restaurants across the commonwealth. Consumers will be able to access this database and find certified businesses in their area, ensuring that consumers can make more informed choices about the food establishments they are looking to patronize.

The self-certification documents and information about the Open & Certified Pennsylvania program can be found online starting September 21 and will contain the following:

• A list of requirements contained in the current restaurant industry guidance and enforcement efforts;
• A statement that the owner has reviewed and agrees to follow these requirements;
• The business’ maximum indoor occupancy number based on the fire code; and
• A statement that the owner understands that the certification is subject to penalties for unsworn falsification to authorities.

Any restaurant that wishes to ​increase to 50 percent indoor capacity on September 21 must complete the online self-certification process by October 5. Business owners should keep a copy of the self-certification confirmation they will receive by e-mail. Social distancing, masking and other mitigation measures must be employed to protect workers and patrons. Further, starting September 21 restaurants that have alcohol sales will close alcohol sales at 10:00 PM.

Additionally, restaurants that self-certify will be mailed Open & Certified Pennsylvania branded materials, such as window clings and other signage designating their certification, which they can display for customers and employees.

The self-certification will be used as part of ongoing enforcement efforts conducted by Department of Agriculture and Pennsylvania State Police Bureau of Liquor Control Enforcement, and will be shared with the departments of State, Labor & Industry and Health, and other enforcement agencies. Restaurants operating at 50 percent capacity will have their self-certification status checked as part of ongoing enforcement by these agencies starting on October 5, and will focus on educating businesses. The commonwealth will continue its measured approach to easing restrictions, keeping the rest of the targeted mitigation tactics specific to the food retail industry in place as restaurants increase capacity to 50 percent.

Further, a restaurant’s listing in the Open & Certified Pennsylvania restaurant database shows it cares about its customers, employees, community and the economic future of the state.

The self-certification process is modeled after a similar mitigation effort in Connecticut, and the alcohol sales limitation is modelled after a similar mitigation effort in Ohio.

Boosting consumer confidence is critical for restaurants, as according to the most recent Longwoods International tracking study of American travelers, only 40 percent of Americans are comfortable dining in local restaurants.

“We recognize the impact that the COVID-19 pandemic has had on Pennsylvania’s small businesses, especially on our restaurants,” added Gov. Wolf. “Through this self-certification process, our commonwealth’s restaurant industry will ensure the safety and well-being of both employees and patrons alike, and will be able to begin a return to normal operations and financial recovery.”

Restaurant owners with additional questions about the self-certification program can contact covidselfcert@pa.gov.

In July, following the recommendations of the federal government and in response to a rise in COVID-19 cases, Governor Wolf and Secretary of Health Dr. Rachel Levine signed orders for targeted mitigation efforts for all Pennsylvania businesses in the food services industry, including restaurants, wineries, breweries, private clubs and bars. Commonwealth and local agencies continued and even increased appropriate enforcement measures.

The governor has urged the General Assembly to support his plan to provide additional recovery for small businesses, including proposing $100 million in forgivable loans and grants for the hospitality, leisure and service industries.

The governor has also urged Congress to quickly provide financial relief to the nation’s restaurants by passing the Real Economic Support That Acknowledges Unique Restaurant Assistance Needed to Survive (RESTAURANTS) Act. The bipartisan bill in Congress provides $120 billion to help independent restaurants with the economic challenges created by the COVID-19 pandemic.

The administration of Pennsylvania Governor Wolf released frequently asked questions for restaurant owners to reference following the newly announced self-certification process.

This new process, Open & Certified Pennsylvania, ensures that customers and employees know that they can dine safely at restaurants ​committed to strictly complying with all public health safety guidelines and orders as we work to mitigate the spread of COVID-19 in the commonwealth.

“The novel coronavirus has created new challenges for Pennsylvania businesses, and it is critical that we provide avenues of support for our restaurants, which have been disproportionately impacted,” Department of Community and Economic Development Secretary Dennis Davin.

“Open & Certified Pennsylvania will instill consumer faith and allow our small businesses to recover more quickly, and we want to make the process as simple and easy as possible. The list of frequently asked questions we are releasing today will help ensure that this transition goes as smoothly as possible for Pennsylvania businesses.”

Any restaurant that wishes to ​increase to 50 percent indoor capacity on September 21 must complete the online self-certification process by October 5.

Restaurant owners with additional questions about the self-certification program can contact covidselfcert@pa.gov.

Becker’s Hospital Review reported on the 14 rural hospitals that have closed this year. It is worth noting that eight closures occurred during the COVID-19 pandemic, a time when access to health care services is more important than ever before. Additionally, local reporting in Georgia confirms that two more rural hospitals are slated for closure in October. Last year set the record for the greatest number of rural hospital closures in a single year at 18; 2020 is on pace to smash that record.

Kaiser Health News provided reporting on the impact of the COVID-19 pandemic on rural hospital closures. Sarah Jane Tribble writes, “As COVID-19 continues to spread, an increasing number of rural communities find themselves without their hospital or on the brink of losing already cash-strapped facilities.” The article also quotes UNC Gillings School of Global Public Health professor Mark Holmes, who says, “We know that a [rural hospital] closure leads to higher mortality pretty quickly…That’s pretty clear.”