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Federal Register / Vol. 86, No. 116 / Monday, June 21, 2021 / Rules and Regulations activity where the facemask presents a hazard.

confirmed COVID19 are contained in paragraph g of this section.

must ensure that the employee is as far apart from all other people as feasible.

Note to paragraph f1iiiF. With respect to paragraphs f1iiiD through F
of this section, the employer may determine that the use of face shields, without facemasks, in certain settings is not appropriate due to other infection control concerns.

4 Use of respirators when not required. i The employer may provide a respirator to the employee instead of a facemask as required by paragraph f1 of this section. In such circumstances, the employer must comply with 1910.504.
ii Where the employer provides the employee with a facemask as required by paragraph f1 of this section, the employer must permit the employee to wear their own respirator instead of a facemask. In such circumstances, the employer must also comply with 1910.504.
5 Respirators and other PPE based on Standard and Transmission-Based Precautions. The employer must provide protective clothing and equipment e.g., respirators, gloves, gowns, goggles, face shields to each employee in accordance with Standard and Transmission-Based Precautions in healthcare settings in accordance with CDCs Guidelines for Isolation Precautions incorporated by reference, 1910.509 and ensure that the protective clothing and equipment is used in accordance with subpart I of this part.
g Aerosol-generating procedures on a person with suspected or confirmed COVID19. When an aerosol-generating procedure is performed on a person with suspected or confirmed COVID19:
1 The employer must limit the number of employees present during the procedure to only those essential for patient care and procedure support.
2 The employer must ensure that the procedure is performed in an existing AIIR, if available.
3 After the procedure is completed, the employer must clean and disinfect the surfaces and equipment in the room or area where the procedure was performed.

Note to paragraph h. Physical distancing can include methods such as: Telehealth;
telework or other remote work arrangements;
reducing the number of people, including non-employees, in an area at one time; visual cues such as signs and floor markings to indicate where employees and others should be located or their direction and path of travel; staggered arrival, departure, work, and break times; and adjusted work processes or procedures to allow greater distance between employees.

iv Where a face shield is required to comply with this paragraph or is otherwise required by the employer, the employer must ensure that face shields are cleaned at least daily and are not damaged. When an employee provides a face shield that meets the definition in paragraph b of this section, the employer may allow the employee to use it and is not required to reimburse the employee for that face shield.
2 Respirators and other PPE for exposure to people with suspected or confirmed COVID19. When employees have exposure to a person with suspected or confirmed COVID19, the employer must provide:
i A respirator to each employee and ensure that it is provided and used in accordance with 1910.134 and ii Gloves, an isolation gown or protective clothing, and eye protection to each employee and ensure that the PPE is used in accordance with subpart I of this part.
Note to paragraph f2. When there is a limited supply of filtering facepiece respirators, employers may follow the CDCs Strategies for Optimizing the Supply of N95
Respirators available at: https
www.cdc.gov/coronavirus/2019-ncov/hcp/
respirators-strategy/index.html. Where possible, employers are encouraged to select elastomeric respirators or PAPRs instead of filtering facepiece respirators to prevent shortages and supply chain disruption.

3 Respirators and other PPE during aerosol-generating procedures. For aerosol-generating procedures performed on a person with suspected or confirmed COVID19, the employer must provide:
i A respirator to each employee and ensure that it is provided and used in accordance with 1910.134; and ii Gloves, an isolation gown or protective clothing, and eye protection to each employee and ensure that the PPE is used in accordance with subpart I of this part.
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Note 1 to paragraph f3. For aerosolgenerating procedures on a person suspected or confirmed with COVID19, employers are encouraged to select elastomeric respirators or PAPRs instead of filtering facepiece respirators.
Note 2 to paragraph f3. Additional requirements specific to aerosol-generating procedures on people with suspected or
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Note to paragraph g. Respirators and other PPE requirements during aerosolgenerating procedures are contained in paragraph f3 of this section.

h Physical distancing. 1 The employer must ensure that each employee is separated from all other people by at least 6 feet when indoors unless the employer can demonstrate that such physical distancing is not feasible for a specific activity e.g., hands-on medical care. This provision does not apply to momentary exposure while people are in movement e.g., passing in hallways or aisles.
2 When the employer establishes it is not feasible for an employee to maintain a distance of at least 6 feet from all other people, the employer
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i Physical barriers. At each fixed work location outside of direct patient care areas e.g., entryway/lobby, checkin desks, triage, hospital pharmacy windows, bill payment where each employee is not separated from all other people by at least 6 feet of distance, the employer must install cleanable or disposable solid barriers, except where the employer can demonstrate it is not feasible. The barrier must be sized e.g., height and width and located to block face-to-face pathways between individuals based on where each person would normally stand or sit. The barrier may have a pass-through space at the bottom for objects and merchandise.
Note to paragraph i. Physical barriers are not required in direct patient care areas or resident rooms.

j Cleaning and disinfection. 1 In patient care areas, resident rooms, and for medical devices and equipment, the employer must follow standard practices for cleaning and disinfection of surfaces and equipment in accordance with CDCs COVID19
Infection Prevention and Control Recommendations and CDCs Guidelines for Environmental Infection Control, pp. 86103, 147149 both incorporated by reference, 1910.509.
2 In all other areas, the employer must:
i Clean high-touch surfaces and equipment at least once a day, following manufacturers instructions for application of cleaners; and ii When the employer is aware that a person who is COVID19 positive has been in the workplace within the last 24
hours, clean and disinfect, in accordance with CDCs Cleaning and Disinfecting Guidance incorporated by reference, 1910.509, any areas, materials, and equipment under the employers control that have likely been contaminated by the person who is COVID19 positive e.g., rooms they occupied, items they touched.
3 The employer must provide alcohol-based hand rub that is at least 60% alcohol or provide readily accessible hand washing facilities.

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