Delays to OSHA Infectious Disease Rule Rankle Health Workers

The Biden administration’s failure to install new protections for health-care workers against infectious diseases left the industry waiting for President Donald Trump to unfreeze new regulations and name leaders at OSHA, again delaying long-anticipated rulemaking.

National Nurses United—the largest labor union and professional association for registered nurses—says their members can’t wait for another major health crisis like the Covid-19 pandemic to push for stronger protections for workers.

The screening and isolation of potentially infectious patients, more attention to ventilation systems, and personal protective equipment should be the essential minimum requirements for employers, according to Jane Thomason—NNU’s lead industrial hygienist. Preliminary results from an NNU survey of registered nurses found inconsistencies in their health-care facilities on all three issues.

“It’s possible to protect health-care workers from getting infected in the workplace,” Thomason said.

While Covid-related deaths have fallen from a high of more than 20,000 during the first week of 2021 to less than 800 during the first week of 2025, according to Centers for Disease Control and Prevention data, health-care workers are also dealing with increased cases of diseases like RSV and emerging cases of H5N1 bird flu.

The US Occupational Safety and Health Administration began working on an infectious disease rule more than a dozen years ago during the Obama administration. It went on the back burner until the Covid-19 pandemic led to calls for the rulemaking’s revival.

Any rulemaking for an infectious disease standard under a Trump administration is unlikely, according to management-side attorneys.

Infectious Disease Under Trump 2.0

OSHA has the Bloodborne Pathogens standard, but the agency has suggested the need for a another health standard that would address infectious diseases transmitted by other routes such as through contact, droplet, or airborne.

Until the leadership positions are filled at OSHA, it’s unclear what a Trump-led OSHA will focus on, Melissa K. Peters, co-lead of Nixon Peabody LLP’s OSHA practice, said.

Trump signed an executive order shortly after taking office that blocked federal agencies including OSHA from issuing new rules and instructed them to consider a 60-day hold on any regulations that had been issued but hadn’t gone into effect.

“All we know is nothing is really going to move forward until a secretary of OSHA is appointed and they’ve reviewed anything that’s there,” Peters said.

Labor agencies are set to veer from the enforcement priorities of the past four years, attorneys say.

Compounding the lack of interest in new OHSA regulations from this administration also makes the battle difficult for creating a federal infectious disease safety standard.

Infectious disease is an area that’s hard for the law and regulations to keep up with, said Leann M. Walsh, a partner at K&L Gates.

“Infectious disease prevention has always been very local oriented,” Walsh said in speaking to varying responses across the country of municipalities to the Covid-19 pandemic.

“Having flexibility and the ability to act quickly, versus a one size fits all type of approach seems to be more effective,” she added.

Challenges in Rulemaking

The Biden administration brought an infectious disease proposed rule all the way to White House review—one of the last stops before issuing a regulation—but then withdrew it days before Trump took office in January. The administration also terminated rulemaking aimed at slowing the spread of Covid-19 in health care facilities to broaden the agency’s focus on more infectious diseases.

Previous administrations also struggled with internal hurdles to create the regulation.

Jordan Barab—the former deputy assistant secretary for OSHA in the Obama administration—said that when standards or proposals go to OMB, they also go out to all other affected agencies.

The CDC—which has dealt with what type of masks should be required for adequate protection—has been a long-standing roadblock in determining what kinds of masks protect workers, said Barab.

“That’s been a perennial fight between OSHA and CDC,” Barab said.