US states struggle with what makes a worker ‘essential’ in the Covid rush

Corporate bosses have begun pushing for their workers to receive priority access to a coronavirus vaccine, as US states consider whether to adopt broad and potentially controversial federal guidance on how to define “essential workers.”

Alex Azar, the health secretary, promised on Friday that the vaccine made by Pfizer and BioNTech would begin shipping early next week, and that the drug regulator would be ready to authorize it in a few days. But while the first doses will be allocated to healthcare workers and those living and working in long-term care homes, the next phase of distribution is likely to be much more controversial.

The Centers for Disease Control and Prevention has proposed that “essential workers” be next in line, which will be considered by the agency’s vaccine advisory committee.

But the CDC’s definition of what makes a person economically essential is broad, representing 87 million people, including emergency and grocery workers, but also other professions like lawyers, bankers, and gun retailers.

States will have to make the final decision to adopt the CDC guidelines once they are approved, and several have already said they will. Many are already under heavy pressure from companies and industry groups to give their workers priority when plans are finalized.

Dara Khosrowshahi, Uber’s chief executive, sent a letter Thursday to New York Governor Andrew Cuomo, requesting that the company’s drivers be included among other front-line workers who receive priority access to the vaccine.

“They have transported healthcare workers to hospitals, delivered food to socially distancing people in their homes, and helped local restaurants stay in business,” he wrote. “As you finalize your statewide allocation and distribution plans, I encourage you to recognize the essential nature of your work.”

Abe Malkin, a physician at the elite medical practice Concierge MD, said his phone had been “ringing non-stop” with patients eager to receive a Covid-19 vaccine and large companies wanting supplies of the vaccine to get employees back to work. .

“I think there will be many more opportunities for companies to take advantage of the connections because there is much more gray area regarding essential workers and who really needs the vaccine.”

Under “law enforcement,” the CDC document lists “workers who support the operation of firearms or ammunition manufacturers, retailers, importers, distributors, and ranges.” And within financial services, not only bank branch staff are included, but also people working in commercial and investment banking.

The American Bankers Association said the banking lobby had “advocated that among bank employees already considered ‘essential’ by the government, those who come into contact with the public every day, such as tellers, should be considered for [the] CDC Phase 1b, along with essential workers in other industries ”.

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The list has already been reflected in draft distribution plans prepared by some states. One from Illinois, for example, says: “Essential frontline workers are expected to include those designated by the US Department of Homeland Security as belonging to categories of Critical Essential Infrastructure Workers who are at increased risk of exposure and cannot reduce risk through teleworking or isolation. ”

Many experts believe that the CDC and its advisory committee will have to define essential workers more strictly if they want to avoid a major public dispute.

Neither the CDC nor José Romero, chairman of the committee, responded to a request for comment. Helen Keipp Talbot, one of the other members of the committee, agreed that the list was very elaborate, but added: “Hopefully they make a lot of vaccines.”

Ashish Jha, dean of the School of Public Health at Brown University, warned that allowing the rich to jump in line would cause outrage. He called on state public health authorities to redefine “essential workers” as those who are “facing the people.”

“The grocery store worker becomes more important to vaccinations than a banker,” he said. “With all due respect to bankers, much of the work that bankers do can be done, at least for a while longer, remotely, while the grocery store cashier has to interact with hundreds of people.”

Additional information from Joshua Chaffin in New York

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