On June 5, 2020, the California Department of Occupational Safety and Health (Division), also known as Cal/OSHA, issued a hazard alert to healthcare facilities regarding the availability of COVID-19 personal protective equipment (PPE). The alert set forth the following two mandates:

1.  California’s healthcare workers must have immediate access to respirators if a sudden emergency occurs involving patients with suspected or confirmed cases of COVID-19.

Cal/OSHA prompted this alert based on numerous allegations that some California hospitals do not have respirators immediately available for healthcare workers for emergency aerosol-generating procedures involving suspected or confirmed COVID-19 patients.  While these allegations are still under investigation, it is important that healthcare facilities ensure that healthcare workers have access to respirators for emergency procedures. 

2.  Healthcare providers cannot implement inventory control strategies that impede immediate access to respiratory protection for healthcare workers who must respond to sudden emergencies such as cardiac or respiratory arrest in patients with suspected or confirmed cases of COVID-19.

Cal/OSHA issued the hazard alert on inventory control procedures because of allegations that respirators for emergency care have been unavailable due to inventory control policies that did not ensure immediate on-demand availability of respirators for emergency procedures.  In issuing the alert, the Division pointed to California’s Aerosol Transmissible Disease (ATD) Standard (California Code of Regulations title 8 section 5199), which requires California hospitals to provide powered air-purifying respirators (PAPRs) and other PPE for aerosol-generating procedures involving suspected or confirmed cases of COVID-19.  A hospital’s inventory control procedures cannot interfere with the immediate availability of respirators for emergency procedures.  California hospitals must ensure that healthcare workers have approved respirators for use by all employees in the area where life-saving emergency care is performed on patients with suspected or confirmed cases of COVID-19, such as during aerosol-generating procedures performed in an infection isolation room, transferring a patient to an isolation room, obtaining a PAPR, or where PAPRs and/or isolation rooms are not available due to a surge in COVID-19 cases. 

Healthcare facilities are encouraged to review the Cal/OSHA alert and consult with counsel if they have questions about compliance.