OSHA's COVID-19 healthcare ETS: withdrawn in 2021, rulemaking ended in 2025, and the log rule still on the books but not enforced

What it says#

On June 21, 2021 OSHA published an emergency temporary standard for occupational exposure to COVID-19 in healthcare, 86 FR 32376, codified as 29 CFR 1910 subpart U (sections 1910.502, 1910.504, 1910.505 and 1910.509). It took effect on publication, with compliance due July 6, 2021 for most provisions and July 21 for the physical barriers, ventilation and training paragraphs. It applied to "all settings where any employee provides healthcare services or healthcare support services," and it required a written COVID-19 plan, patient screening and management, standard and transmission-based precautions, facemasks or respirators, controls for aerosol-generating procedures, six feet of distance where feasible, physical barriers, cleaning and disinfection, ventilation, employee health screening and medical removal with pay, paid time for vaccination, training, anti-retaliation protections, a COVID-19 log, and reporting of work-related fatalities and in-patient hospitalizations. Its definition of aerosol-generating procedures named five dental ones: ultrasonic scalers, high-speed dental handpieces, air/water syringes, air polishing and air abrasion.

The scope paragraph is what mattered to a dental office. Under 1910.502(a)(2)(iii) the standard did not apply to "non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings." OSHA's own FAQ used that exception as its first example of a workplace outside the rule. A practice that asked its screening questions at the door and sent symptomatic patients home was never covered; a practice that did not screen was.

Under the OSH Act an emergency standard also serves as a proposed rule, and the Act contemplates a permanent standard within six months. On December 27, 2021 OSHA posted a statement that it "anticipates a final rule cannot be completed in a timeframe approaching the one contemplated by the OSH Act" and was "withdrawing the non-recordkeeping portions of the healthcare ETS." The COVID-19 log and reporting provisions, 1910.502(q)(2)(ii), (q)(3)(ii)-(iv) and (r), stayed, because OSHA had adopted them under a different section of the Act, section 8, with a good-cause finding to skip notice and comment. The statement said OSHA would "vigorously enforce the general duty clause and its general standards, including the Personal Protective Equipment (PPE) and Respiratory Protection Standards," and would accept compliance with the ETS as satisfying those obligations.

The permanent rule never came. OSHA reopened the record on March 23, 2022 for thirty days and held hearings from April 27 to 29 and on May 2, 2022; over three comment periods it received 873 timely comments. A nurses' union asked the D.C. Circuit to force a permanent standard and lost on August 26, 2022. OSHA sent a draft final rule to the Office of Management and Budget on December 7, 2022. On April 10, 2023 the President signed H.J. Res. 7 ending the national emergency, and the public health emergency ended May 11, 2023. On January 15, 2025 OSHA published a one-sentence summary at 90 FR 3665: "OSHA is terminating its COVID-19 rulemaking." Its reasoning was that "the public health emergency is over" and that healthcare workers would be better protected by a broader infectious diseases standard. A footnote added that the log and reporting provisions "are therefore permanent and remain in effect."

Three weeks later, on February 5, 2025, an enforcement memo told regional administrators that "effective immediately and until further notice, OSHA will not enforce those COVID-19 recordkeeping and reporting requirements." On July 1, 2025 OSHA proposed to remove the ETS "and its associated recordkeeping and reporting provisions from the Code of Federal Regulations," 90 FR 28336, with comments due September 2, 2025, later extended to November 1, 2025. On March 31, 2026 a second memo replaced the first: OSHA is "exercising its enforcement discretion to not cite employers for violations of 29 CFR Part 1904 for failure to record COVID-19 cases or to report COVID-19 fatalities and hospitalizations," treating COVID-19 like the common cold and flu, and "while that rulemaking is pending, OSHA is continuing the enforcement stay announced February 5, 2025" for the subpart U log and reporting provisions.

Who it applies to#

As of the check date, no one is being cited under subpart U. The eCFR still displays 1910.502 in full, with the note that Title 29 is current through September 9, 2026, and the Federal Register docket OSHA-2020-0004 shows the July 2025 proposal and its August 2025 extension as the newest documents, with no final rule. The standard's history matters to a dental office in two ways. First, the exemption for screened ambulatory settings means most practices were never inside it, so a 2021 COVID-19 plan written "for the ETS" was voluntary at the time and is not required now. Second, the general standards OSHA named when it withdrew the rule, PPE, respiratory protection and bloodborne pathogens, plus the general duty clause, are what an inspector would cite today for a respiratory hazard, and they are covered in their own entries in this directory.

What changed#

For most of 2021 dental offices received conflicting advice: consultants sold ETS compliance packages, while OSHA's own scope paragraph excluded any office that screened at the door. From December 27, 2021 the substantive rule was gone, leaving a log and reporting duty that OSHA said it would keep. From February 5, 2025 even that was unenforced, and since March 31, 2026 OSHA no longer cites ordinary Part 1904 recording of COVID-19 cases either. The one thing that has not happened is the deletion: as of September 2026 the text remains printed in the CFR, so a search of 29 CFR still finds the COVID-19 log requirement, and the correct reading of it is that it is stayed and slated for removal, not in force.

Where the source is#

OSHA's COVID-19 Healthcare ETS page carries the December 27, 2021 status statement and links to the regulatory text, the Federal Register documents, the FAQ and the fact sheets; its rulemaking page records the January 15, 2025 termination. The ETS itself, the termination notice, the July 1, 2025 proposal and the August 20, 2025 extension are free on govinfo. The February 5, 2025 and March 31, 2026 memos are in OSHA's standard interpretations library, and the current text of subpart U is on the eCFR. All were read directly for this entry; osha.gov refuses some automated fetches, so a browser may be needed.