TRSA’s Policy Push: Promoting Reusables, Safer Scrubs

The COVID-19 pandemic isn’t over yet, but Congress and the White House are busy trying to prepare for the next pandemic episode.

The COVID-19 pandemic exposed weaknesses in U.S. preparedness and response capabilities that policymakers are now trying to address to ensure that we don’t repeat the experience. TRSA members played an essential role during the pandemic, stepping up to fill supply-chain gaps and partnering with industries rocked by the pandemic. We’re using this momentum and pandemic lessons learned to promote TRSA and its members to Washington, D.C., policy makers, and to advocate for changes. There are two primary healthcare issues that TRSA is addressing: the need for industrial laundering of scrubs and expanding the use of reusables in the supply chain. The pandemic highlighted the importance of both issues.

TRSA, along with its international partners, recently conducted a study by De Montfort University to examine the survivability during laundering of the coronavirus on fabrics commonly used in the healthcare industry. The study found viruses like the strain that causes COVID-19 can survive on clothing and transmit to other surfaces for up to 72 hours, depending on the material used for the product. This in turn poses a risk for Healthcare Personnel Attire (HPAs) that is worn after work in public (e.g., in restaurants, grocery stores and on public transit). The study also showed that virtually all industrial-wash processes, other than low-temp home washing, will effectively eliminate any infection risk caused by coronavirus and other pathogens. The study findings showed that fabrics that are potentially contaminated should be managed in a controlled environment where the segregation of soiled linen is well regulated. It’s essential that medical facilities wash their HPAs in industrial facilities under the proper standards to deactivate viruses on fabrics in order to avoid contamination.

Currently, the U.S. market opts for disposable healthcare contact textiles (HCT) in more than 90% of uses in which reusable HCTs could serve as an equivalent or superior substitute. This reliance on disposable products has caused dangerous shortages. Reusable HCTs processed by Hygienically Clean-certified laundries support a more secure, safe and sustainable supply chain – as opposed to foreign-sourced disposable HCTs. During the pandemic, TRSA members addressed the HCT shortage by supplementing disposables with hygienically clean reusable HCTs. In addition to promoting supply-chain stability, reusable products are more environmentally sustainable than their single-use counterparts. One reusable gown can replace 75 single-use disposable gowns. Hospital gowns cleaned after each use create four times less solid waste than paper gowns. Reusables conserve resources and reduce pollution. In order to prevent problems with HCT shortages, and to help the environment, the U.S. should increase its use of HCTs in healthcare facilities.

As Washington, DC, policy makers prepare for legislative and regulatory changes, TRSA is leveraging its relationships and knowledge in order to make an impact in these areas. Lawmakers recently have held hearings on potential legislative fixes to address the problems that emerged during the COVID-19 pandemic. In April, the Senate Health, Education, Labor, and Pensions (HELP) Committee, led by Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC), announced a bipartisan effort to improve the nation’s public health and medical preparedness/response programs. The announcement listed priorities including, “improving and securing the supply chain for the U.S.’s critical medical supplies needed to swiftly address a public health threat. Additionally, in August, the U.S. House of Representatives formed the bipartisan Pandemic Preparedness Caucus, led by Reps. Lori Trahan (D-MA), Troy Balderson (R-OH), and Cindy Axne (D-IA). This caucus is focusing on “how to strengthen America’s response to the spread of COVID-19 domestically and how to better equip the United States in its fight against future pandemics.” The group is in continuous contact with the HELP Committee, and they are working closely toward common goals. As TRSA’s outside counsel on this issue, we’ve met with committee staff and lawmakers to introduce them to TRSA and its priorities as noted above.

The White House and executive branch agencies also are examining pandemic-related lessons. TRSA has reached out to the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) to explore efforts with these agencies to make changes. For example, the current CDC guidelines governing infection control are outdated, contradictory and out of step with current practices and advances in technology. There are opportunities for improvement on this front. Similarly, CMS has provided inaccurate and contradictory guidance on reusable linens through its survey and certification process. This has led some hospitals to discontinue their use of reusable linens. To eliminate this confusion, it’s necessary for CMS to issue clarifying guidance confirming that the use of disposable linens is not, in fact, best practice in the industry.

As for Congress’ broader agenda, on Nov. 15, President Joe Biden (D) signed a $1.2 trillion bipartisan infrastructure deal. Next up is the Democrat-led $1.75 trillion “social-infrastructure” bill/reconciliation package. Along with these measures, Congress must raise the debt ceiling and authorize funding for the federal government by the end of 2021. Thus, we anticipate that in 2022 Congress and the administration could move forward with improvements in the area of pandemic preparedness that could affect TRSA. We’ll continue working with legislators and the executive branch, while promoting TRSA’s pandemic preparedness agenda.

This article was written by Emily Felder and Adam Steinmetz, Ph.D., of Brownstein Hyatt Farber Schreck, a Washington, DC, law firm that TRSA has retained to help the association with regulatory and congressional advocacy. Readers may contact Felder, an attorney, at efelder@bhfs.com. Adam Steinmetz, Ph.D., is a policy analyst. Contact him at asteinmetz@bhfs.com.