As economic and political pressure has built to relax “shelter in place” public health orders for control of coronavirus disease 2019 (Covid-19), industry, professional service firms, retail and service establishments, and educational institutions seek to establish norms that protect workers, customers, clients, students, and visitors. A public health order represents a minimum disease-prevention standard, adherence to which is not elective, but may not satisfy all legal requirements with respect to the personal safety of workers and others.1 The “general duty” clause of the Occupational Safety and Health Act requires all employers to take reasonable steps to reduce risk to employees,2 and establishments have common-law obligations to ensure that their premises that are open to the public are maintained in a safe condition without concealed, reasonably avoidable hazards.3 Responsible conduct of a business or facility in a pandemic represents opportunities for private entities to contribute to public health by implementing traditional and innovative disease-control measures, such as contact tracing with the use of mobile applications (“apps”) on personal devices.
The Massachusetts High Technology Council, as the leading technology and biomedical industry association in that state, recently assembled a group of medical, business, and legal experts (including the first author) to address these issues and assist state government in determining reopening standards.4 In this article, building on the work of that expert panel, we seek to identify the major public health challenges faced by private entities in resuming on-site operations and explore ways in which this might be done most effectively, consistent with applicable regulations. We focus primarily on the operation of commercial establishments, particularly in regard to workers and customers. Educational and other institutional and service settings face broader challenges, because of their custodial and quasi-custodial relationships with students and clients, who most often have no employment relationship to these entities but whose close institutional ties lead them to spend much continuous time within their facilities. We highlight instances in which student and client relationships pose challenges that are substantially different from those that attend commercial establishments. Health care facilities, owing to acute risk of transmission from ill persons, require more intensive infection-control practices already well explored and not recapitulated here.
Font: https://www.nejm.org/doi/full/10.1056/NEJMsr2019953?query=featured_home
