Pandemic Darlings The pandemic economy, in original documents
Home Court filings Full Docket Scotus 21A244 032 Dec 30 2021 Main Document 20211230132243997 21A244 247 Bsac American Public Health Assoc (U.S.)

Court filing

21A244 032 Dec 30 2021 Main Document 20211230132243997 21A244 247 Bsac American Public Health Assoc (U.S.)

Filed December 30, 2021 in Scotus; one of 28 filings from this case.

Record facts

CourtSupreme Court of the United States
Filed2021-12-30

Full text

Nos. 21A244 & 21A247 
In the Supreme Court of the United States 
 
IN RE MCP NO. 165, OCCUPATIONAL SAFETY & HEALTH  
ADMINISTRATION, INTERIM FINAL 
RULE: COVID-19 VACCINATION & TESTING,  
86 FED. REG. 61402  
(Caption continued on inside cover) 
 
On Applications for Stay Pending Certiorari 
 
MOTION OF AMERICAN PUBLIC HEALTH  
ASSOCIATION, ASSOCIATION OF SCHOOLS AND 
 PROGRAMS OF PUBLIC HEALTH, 12 LEADING  
PUBLIC HEALTH AND HEALTH CARE  
ORGANIZATIONS, 30 DEANS OF LEADING ACADEMIC 
PROGRAMS, AND 109 LEADING PUBLIC HEALTH 
AND HEALTH POLICY SCHOLARS FOR LEAVE TO 
FILE ATTACHED BRIEF AS AMICI CURIAE  
IN SUPPORT OF RESPONDENTS 
 
 
 
NEIL K. SAWHNEY 
GUPTA WESSLER PLLC 
100 Pine Street, Suite 1250 
San Francisco, CA 94111 
(415) 573-0336 
 
 
DEEPAK GUPTA 
     Counsel of Record 
GUPTA WESSLER PLLC 
2001 K Street, NW 
Suite 850 North 
Washington, DC 20006 
(202) 888-1741 
deepak@guptawessler.com 
 
 
Counsel for Amici Curiae 
 
December 30, 2021 

 
 
NATIONAL FEDERATION OF INDEPENDENT BUSINESS, et al., 
Applicants, 
v.         
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, et 
al., 
Respondents. 
 
OHIO, et al., 
Applicants, 
v.         
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, et 
al., 
Respondents. 

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American Public Health Association, Association of 
Schools and Programs of Public Health, Academy of Man-
aged Care Pharmacy, Alliance of Community Health 
Plans, American College of Osteopathic Emergency Phy-
sicians, American College of Preventative Medicine, Asso-
ciation of American Medical Colleges, College of Ameri-
can Pathologists, Council of State and Territorial Epide-
miologists, National Hispanic Medical Association, Na-
tional Medical Association, National Safety Council, Asso-
ciation of periOperative Registered Nurses, and National 
League for Nursing, 30 deans of leading academic pro-
grams, and 109 leading public health and health policy 
scholars respectfully move for leave to file the attached 
brief as amici curiae in support of the federal respondents 
and affirmance. 
The proposed amici seek to file this brief to demon-
strate to the Court that the overwhelming public-health 
and scientific consensus supports the Occupational Health 
and Safety Administration’s rule requiring employers to 
ensure that employees are either vaccinated against 
COVID-19, or wear masks and undergo regular testing. 
Through this brief, the proposed amici also seek to ex-
plain that well-established evidence, buttressed by more 
recent, cutting-edge empirical studies during the pan-
demic, shows that vaccination can effectively reduce 
SARS-CoV-2 exposure and transmission in workplace set-
tings. The proposed amici are concerned that staying en-
try of OSHA’s vaccinate-or-test standard will delay 
measures needed to control the spread of COVID-19 and 
will further endanger American workers.  
Given the Court’s expedited consideration of this mat-
ter of significant national interest, the proposed amici 
provided notice to all parties of their intent to file by email 

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on December 28, 2021. Counsel for the applicants in No. 
21A244 stated that they do not oppose this motion, and 
counsel for the applicants in No. 21A247 consent to it. The 
federal respondents take no position on this motion.  
CONCLUSION  
 For the foregoing reasons, the proposed amici re-
spectfully request that the Court grant leave to file the 
attached amicus brief at the time submitted. 
Respectfully submitted, 
DEEPAK GUPTA 
   Counsel of Record 
Gupta Wessler PLLC 
2001 K Street, NW 
Suite 850 North 
Washington, DC 20006 
(202) 888-1741
deepak@guptawessler.com
NEIL K. SAWHNEY 
Gupta Wessler PLLC 
100 Pine Street, Suite 1250 
San Francisco, CA 94111 
(415) 573-0336
December 30, 2021 
  Counsel for Amici Curiae 

 
Nos. 21A244 & 21A247 
In the Supreme Court of the United States 
 
IN RE MCP NO. 165, OCCUPATIONAL SAFETY & HEALTH  
ADMINISTRATION, INTERIM FINAL 
RULE: COVID-19 VACCINATION & TESTING,  
86 FED. REG. 61402  
(Caption continued on inside cover) 
 
On Applications for Stay Pending Certiorari 
 
BRIEF OF AMICI CURIAE AMERICAN PUBLIC 
HEALTH ASSOCIATION, ASSOCIATION OF SCHOOLS 
AND PROGRAMS OF PUBLIC HEALTH, 12 OTHER 
LEADING PUBLIC HEALTH AND HEALTH CARE  
ORGANIZATIONS, 30 DEANS OF LEADING ACADEMIC 
PROGRAMS, AND 109 LEADING PUBLIC HEALTH 
AND HEALTH POLICY SCHOLARS IN SUPPORT OF  
RESPONDENTS 
 
 
 
NEIL K. SAWHNEY 
GUPTA WESSLER PLLC 
100 Pine Street, Suite 1250 
San Francisco, CA 94111 
(415) 573-0336 
 
 
DEEPAK GUPTA 
     Counsel of Record 
GUPTA WESSLER PLLC 
2001 K Street, NW 
Suite 850 North 
Washington, DC 20006 
(202) 888-1741 
deepak@guptawessler.com 
 
 
Counsel for Amici Curiae 
 
December 30, 2021 
 

 
NATIONAL FEDERATION OF INDEPENDENT BUSINESS, et al., 
Applicants, 
v.         
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, et 
al., 
Respondents. 
 
OHIO, et al., 
Applicants, 
v.         
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, et 
al., 
Respondents. 

 
 
-i- 
TABLE OF CONTENTS 
Table of authorities .............................................................. ii 
Interest of amici curiae and summary of argument ........ 1 
Argument ................................................................................ 3 
I. 
COVID-19 is a particularly severe 
danger in the workplace, and it poses 
special risks for workers. ................................... 3 
II. 
Vaccines are the most effective tools for 
reducing COVID-19 transmission and 
infection in the workplace. ................................. 9 
III. 
OSHA properly determined that its 
vaccinate-or-test standard is essential to 
protect workers. ................................................ 14 
Conclusion ............................................................................ 17 
 
 

 
 
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TABLE OF AUTHORITIES 
 Cases 
American Dental Association v. Martin,  
984 F.2d 823 (7th Cir. 1993) ......................................... 15 
South Bay United Pentecostal Church v. 
Newsom,  
140 S. Ct. 1613 (2020) .................................................... 16 
Statutes and Regulations 
19 C.F.R. § 1910.1030(b) ..................................................... 15 
29 C.F.R. § 1910.1030 .......................................................... 15 
29 U.S.C. § 655(c)(1) ............................................................ 14 
COVID-19 Vaccination and Testing; Emergency 
Temporary Standard,  
86 Fed. Reg. 61402 (Nov. 5, 2021) ...................... passim 
Other Authorities 
Alberto J. Caban-Martinez et al., High Burden of 
COVID-19 among Unvaccinated Law 
Enforcement Officers and Firefighters, 
medRxiv (preprint, posted Nov. 26, 2021) ........... 11, 12 
Anika Singanayagam et al., Community 
transmission and viral load kinetics of 
SARS-CoV-2 Delta (B.1.617.2) variant in 
vaccinated and unvaccinated individuals, 
Lancet Infectious Diseases (2021) ............................... 11 

 
 
-iii- 
Annalee Yassi et al., Infection control, 
occupational and public health measures 
including mRNA-based vaccination against 
SARS-CoV-2 infections to protect healthcare 
workers from variants of concern: a 14-
month observational study using 
surveillance data, 16 PLOS ONE (2021) ................... 13 
Ashley Fowlkes et al., Centers for Disease 
Control and Prevention, Effectiveness of 
COVID-19 Vaccines in Preventing SARS-
CoV-2 Infection Among Frontline Workers 
Before and During B.1.617.2 (Delta) Variant 
Predominance, 70 Morbidity and Mortality 
Weekly Rpt. 1167 (Aug. 27, 2021), 
https://perma.cc/Q3EW-4GYM .................................... 12 
Catherine H. Bozio et al., Centers for Disease 
Control and Prevention, Laboratory-
Confirmed COVID-19 Among Adults 
Hospitalized with COVID-19–Like Illness 
with Infection-Induced or mRNA Vaccine-
Induced SARS-CoV-2 Immunity—Nine 
States, January–September 2021, 70 
Morbidity and Mortality Weekly Report 1539 
(Oct. 29, 2021), https://perma.cc/RS9F-FPXJ ........... 10 
Centers for Disease Control and Prevention, 
Scientific Brief: SARS-CoV-2 Transmission 
(May 7, 2021), https://perma.cc/RY72-9YAJ ................ 4 

 
 
-iv- 
Devan Hawkins, Letitia Davis, & David Kriebel, 
COVID-19 deaths by occupation, 
Massachusetts, March 1–July 31, 2020, 64 
American Journal of Industrial Medicine 238 
(2021) ................................................................................. 6 
Earl Strum et al., Healthcare workers benefit 
from second dose of COVID-19 mRNA 
vaccine: Effects of partial and full 
vaccination on sick leave duration and 
symptoms (preprint, posted Nov. 21, 2021) ............... 12 
Francis J. Mahoney et al., Progress Toward the 
Elimination of Hepatitis B Virus 
Transmission Among Health Care Workers 
in the United States, 157 Archives of Internal 
Med. 2601 (1997) ............................................................ 15 
Hans R. House et al., Agricultural workers in 
meatpacking plants presenting to an 
emergency department with suspected 
COVID-19 infection are disproportionately 
Black and Hispanic, 28 Academic 
Emergency Medicine [Special Issue: 
(In)Equity in EM] 1012 (2021) ....................................... 9 
Heather M. Scobie et al., Centers for Disease 
Control and Prevention, Monitoring 
Incidence of COVID–19 Cases, 
Hospitalizations, and Deaths, by 
Vaccination Status—13 U.S. Jurisdictions, 
April 4–July 17, 2021, 70 Morbidity and 
Mortality Weekly Report 1284 (Sept. 10, 
2021), https://perma.cc/QD6J-P24N ........................... 10 

 
 
-v- 
Kaiser Family Foundation, Does The Public 
Want To Get A COVID-19 Vaccine (Sept. 
2021) ................................................................................ 13 
Kevin P. Fennelly, Particle sizes of infectious 
aerosols: Implications for infection control, 8 
Lancet Respiratory Med. 914 (2020) ............................. 4 
Kristin J. Cummings et al., Disparities in 
COVID-19 Fatalities among Working 
Californians, medRxiv (preprint, posted 
Nov. 11, 2021) ................................................................... 5 
Lauren Hirsch, Days away from its deadline, 
Tyson Foods reaches a 96 percent 
vaccination rate, N.Y. Times (Oct. 26, 2021), 
https://perma.cc/B2EU-RSU6 ..................................... 13 
Lok Wong Samson, et al., Associations Between 
County-level Vaccination Rates and COVID-
19 Outcomes Among Medicare Beneficiaries, 
Rep. No. HP-2021-23, Office of the Assistant 
Secretary for Planning and Evaluation, U.S. 
Department of Health and Human Services 
(Oct. 2021), https://perma.cc/PN3Y-8J32 ................... 10 
Mark W. Tenforde, Wesley H. Self, Katherine 
Adams et al., Association Between mRNA 
Vaccination and COVID-19 Hospitalization 
and Disease Severity, 326 JAMA 2043 (2021) ........... 10 
North Carolina Department of Health and 
Human Services, COVID-19 Clusters in 
North Carolina, https://perma.cc/SGW8-
USTM (last updated Nov. 22, 2021) .............................. 4 

 
 
-vi- 
Oregon Health Authority, COVID-19 Weekly 
Report (Nov. 17, 2021), 
https://perma.cc/4VFR-V2BR ....................................... 6 
Po Ying Chia et al., Virological and serological 
kinetics of SARS-CoV-2 Delta variant 
vaccine-breakthrough infections: a multi-
center cohort study, medRxiv (preprint, 
posted July 31, 2021) ..................................................... 11 
Pouran D. Faghri et al., COVID-19 Pandemic: 
What has work got to do with it?, 63 Journal 
of Occupational and Environmental Medicine 
e245 (2021) ........................................................................ 9 
Ross J. Harris et al., Effect of Vaccination on 
Household Transmission of SARS-CoV-2 in 
England, New England Journal of Medicine 
(Aug. 19, 2021), https://perma.cc/MP8W-
DSPM .............................................................................. 11 
Seyed M. Moghadas et al., The impact of 
vaccination on COVID-19 outbreaks in the 
United States, National Institute of Health 
(preprint, revised Jan. 2, 2021) ................................ 9, 10 
Shawn Hubler, ‘Mandates Are Working’: 
Employer Ultimatums Lift Vaccination 
Rates, So Far, N.Y. Times (Sept. 30, 2021) ................ 13 

 
 
-vii- 
Staff of House Select Subcommittee on the 
Coronavirus Crisis, 117th Congress, 
Memorandum re: Coronavirus Infections 
and Deaths Among Meatpacking Workers at 
Top Five Companies Were Nearly Three 
Times Higher Than Previous Estimates 
(Committee Print 2021), 
https://perma.cc/ZAC7-264F ..................................... 7, 9 
Sumehda Gupta, et al., Vaccinations Against 
COVID-19 May Have Averted Up to 140,000 
Deaths in the United States, 40 Health 
Affairs 1465 (2021) ......................................................... 10 
Tamara Pilishvili et al., Effectiveness of mRNA 
Covid-19 Vaccine among U.S. Health Care 
Personnel, New England Journal of Medicine 
(Sept. 22, 2021) ......................................................... 12, 13 
Tiana N. Rogers et al., Racial Disparities in 
COVID-19 Mortality Among Essential 
Workers in the United States, 12 World 
Medical & Health Policy (Special Issue: 
Symposium on Coronavirus 2019: Social 
Determinants, Disparities, and Impacts) 1 
(2020) ................................................................................. 8 
Ting-Yu Yeh & Gregory P. Contreras, Full 
vaccination against COVID-19 suppresses 
SARS-CoV-2 delta variant and spike gene 
mutation frequencies and generates 
purifying selection pressure, medRxiv 
(preprint, posted Aug. 10, 2021) .................................. 14 

 
 
-viii- 
Washington State Department of Health, 
Statewide COVID-19 Outbreak Report (2021), 
https://perma.cc/S5KQ-CU7N ....................................... 6 
Yea-Hung Chen et al., Excess mortality 
associated with the COVID-19 pandemic 
among Californians 18-65 years of age, by 
occupational sector and occupation: March 
through November 2020, 16 PLOS ONE 
(2021) ......................................................................... 5, 6, 8 
Zuelma Contreras et al., Industry Sectors 
Highly Affected by Worksite Outbreaks of 
Coronavirus Disease, Los Angeles County, 
California, USA, March 19–September 30, 
2020, 27 Emerging Infectious Diseases 1769 
(2021) ......................................................................... 5, 7, 8 
  

-1- 
 
INTEREST OF AMICI CURIAE AND  
SUMMARY OF ARGUMENT1 
Even before the Delta and Omicron variants, COVID-
19 had profoundly transformed American working life. 
The virus has shut down workplaces, triggered significant 
workplace restrictions, infected millions of employees, and 
sent hundreds of thousands to the hospital or the morgue. 
And particular workplaces, such as meatpacking plants, 
have repeatedly emerged as our nation’s worst hotspots, 
bringing illness and death to those who toil in them. 
Recent weeks have made clear that the pandemic is far 
from over. As the Sixth Circuit observed below, “the virus 
rages on, mutating into different variants, and posing new 
risks” to employers and employees alike. Ohio App. for 
Stay, App.A-4. Still, in the past two years, we have devel-
oped two critical tools—vaccination and testing—to effec-
tively prevent the virus’s spread. In light of these develop-
ments, and exercising its responsibility to protect the 
health of America’s workers and the safety of its work-
places, OSHA issued an emergency temporary standard 
requiring covered employers to ensure that employees are 
either vaccinated against COVID-19, or wear masks and 
undergo regular testing. See COVID-19 Vaccination and 
Testing; Emergency Temporary Standard, 86 Fed. Reg. 
61402 (Nov. 5, 2021). 
The Sixth Circuit correctly held that OSHA acted well 
within its statutory authority in issuing its vaccinate-or-
test standard. See App.A-9–17. This brief, on behalf of 
 
1 All parties have consented to the filing of this brief. No counsel 
for a party authored this brief in whole or in part and no person other 
than amici and their counsel made a monetary contribution to its 
preparation or submission.  

-2- 
 
many of the nation’s leading public-health and healthcare 
scholars and professional organizations, explains how that 
rule also reflects the most recent scientific evidence and 
research. And it also directly responds to the petitioners’ 
repeated assertions that COVID-19 is “not an occupa-
tional danger”—that, in other words, “the COVID-19-re-
lated risk presented by work is the same risk that arises 
from human interaction more broadly.” Ohio App. for 
Stay, 12; see, e.g., id. at 9 (arguing that COVID-19 is a dan-
ger “presented by human life generally,” not by work).  
Nothing could be further from the truth. The evidence 
is clear: The nature of both the virus and in-person work 
makes the workplace particularly at risk for COVID-19 
transmission and infection. Because it is an airborne path-
ogen primarily transmitted through the inhalation of 
small respiratory particles, SARS-CoV-2 spreads espe-
cially well between people who must spend hours together 
in close quarters indoors.2 That accurately describes the 
wide range of America’s workplaces—from food-pro-
cessing plants and car factories to retail stores and offices. 
The science is also clear about the best way to combat 
COVID-19’s spread—vaccines. All the evidence shows 
that vaccination significantly reduces the likelihood that 
workers will transmit COVID-19 and infect other work-
ers, especially when combined with regular testing and 
other mitigation measures. And vaccination drastically 
reduces the chance of hospitalization and death. For these 
reasons, numerous employers have already imposed 
 
2 “SARS-CoV-2” refers to the virus and “COVID-19” refers to the 
disease it causes. For the reader’s convenience, however, this brief 
(like much of the scientific literature) will often refer to “COVID-19” 
to mean both the virus and the disease. 

-3- 
 
vaccine requirements, which have engendered widespread 
vaccination uptake and have consistently proven effective.  
Amici curiae file this brief to explain that OSHA’s vac-
cinate-or-test standard reflects this overwhelming scien-
tific and public-health consensus. Amici are a diverse 
group of scholars and professional organizations of public 
health and healthcare practitioners who share a deep com-
mitment to the health and safety of America’s workers. 
They include more than one hundred of the country’s lead-
ing educators, scholars, and public health and healthcare 
professionals, as well as 30 deans and associate deans of 
leading academic programs across the United States. The 
individual amici are joined by 14 of the country’s leading 
public health and healthcare organizations, which collec-
tively represent tens of thousands of public health and 
healthcare practitioners.   
ARGUMENT 
I. 
COVID-19 is a particularly severe danger in the 
workplace, and it poses special risks for workers.  
Workers, and the workplaces in which they work, are 
particularly at risk of COVID-19 infection. The mechanics 
of how the virus is transmitted should make this proposi-
tion self-evident. SARS-CoV-2 is an airborne virus that 
spreads through an infected person’s respiratory parti-
cles. See 86 Fed. Reg. at 61409.3 As OSHA explains in its 
rule, airborne transmission may occur “when people are in 
close contact with one another in indoor spaces,” particu-
larly “in indoor spaces without adequate ventilation where 
small respiratory particles are able to remain suspended 
in the air and accumulate.” Id. High risk exposure and 
 
3 All subsequent citations to the OSHA rule’s preamble are la-
beled “Pmbl.” 

-4- 
 
infection can occur with relatively brief exposure (less 
than 15 minutes), and “employees can be exposed to the 
virus in almost any work setting.” Id. at 61409, 61411–12.4 
Whether working in cubicles clustered in an office build-
ing or shoulder-to-shoulder in a food-processing plant, 
employees “share common areas like hallways, restrooms, 
lunch rooms[,] and meeting rooms.” Id. It is little surprise, 
then, that indoor workplace environments—where indi-
viduals work in close contact with other employees for 
many hours each day—are particularly susceptible to the 
risk of a COVID-19 outbreak as compared to other set-
tings.  
That is precisely what the public-health evidence has 
shown. OSHA’s vaccinate-or-test standard relies on nu-
merous empirical studies that have found that workers in 
various occupational sectors have had COVID-19 at sub-
stantially higher rates than their surrounding communi-
ties. See, e.g., Pmbl.61412–14 (citing studies). State-level 
data confirm that the workplace environment often facili-
tates and accelerates the spread of the disease—in North 
Carolina, for example, nearly 80% of COVID-19 “clusters” 
in the state, and nearly 40% of deaths, have been work-
place-related.5 Workers in a wide range of workplaces—
like grocery stores, fitness facilities, schools, corrections 
and detention facilities, and others—experienced up to 
 
4 See also, e.g., Centers for Disease Control and Prevention, Sci-
entific 
Brief: 
SARS-CoV-2 
Transmission 
(May 
7, 
2021), 
https://perma.cc/RY72-9YAJ; Kevin P. Fennelly, Particle sizes of in-
fectious aerosols: Implications for infection control, 8 Lancet Respir-
atory Med. 914, 914–24 (2020), https://perma.cc/9XHX-FNFW. 
5 See N.C. Dep’t of Health and Human Servs., COVID-19 Clusters 
in 
North 
Carolina 
(last 
updated 
Nov. 
22, 
2021), 
https://perma.cc/SGW8-USTM; see Pmbl.6412. 

-5- 
 
five times greater rates of infection than the general pub-
lic. Id. at 61414 (citing studies).  
Moreover, “larger employers are more likely to have 
many employees gathered in the same location” and 
therefore more likely to have “larger,” “longer” out-
breaks.6 For this reason, OSHA’s decision to focus on em-
ployers with more than 100 employees is not just reason-
able—it is empirically supported. See App.A-29–30. 
The increased risk of viral transmission in workplaces 
has had a devastating effect on workers. That workers 
who are required to work in person experience dispropor-
tionate COVID-19 mortality rates is empirically well-es-
tablished.7 Indeed, substantial evidence confirms links be-
tween in-person occupational sectors and “high excess 
mortality during the pandemic.”8 Evidence from Califor-
nia, for instance, shows that “excess mortality rose 
sharply in several essential sectors” where “[i]n-person 
essential workers” were “not protected by shelter-in-place 
policies,” suggesting that the rise in mortality is associ-
ated with in-person work.9 Data from other states 
 
6 Id. at 61512; see, e.g., Zuelma Contreras et al., Industry Sectors 
Highly Affected by Worksite Outbreaks of Coronavirus Disease, Los 
Angeles County, California, USA, March 19–September 30, 2020, 27 
Emerging Infectious Diseases 1769 (2021), https://perma.cc/7RTS-
KDRU (“[F]acilities employing more on-site staff had larger and 
longer outbreaks.”).  
7 See, e.g., Kristin J. Cummings et al., Disparities in COVID-19 
Fatalities among Working Californians, medRxiv (preprint, posted 
Nov. 11, 2021), https://perma.cc/9V7C-WALA. 
8 Yea-Hung Chen et al., Excess mortality associated with the 
COVID-19 pandemic among Californians 18-65 years of age, by oc-
cupational sector and occupation: March through November 2020, 16 
PLOS ONE at 2 (2021), https://perma.cc/AZK2-QZZG. 
9 Id. at 8. 

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similarly finds a statistically significant higher excess 
mortality rate for workers who predominately work in 
person.10 
These empirical findings are consistent with a “grow-
ing body of literature demonstrating occupational risks 
for SARS-CoV-2 infection.”11 And they dovetail with 
OSHA’s determination that workers who have no choice 
but to work in person—and who have “little ability to limit 
contact with . . . coworkers, clients, members of the public, 
patients, and others”—face increased risk of illness, hos-
pitalization, and death as a result of COVID-19. 
Pmbl.614,08. In fact, public-health scholars have con-
cluded that “there would have been 57% fewer COVID-19 
deaths” if, among other factors, “all individuals had the 
COVID-19 mortality associated with the safest … occupa-
tional position”—“non-essential, telework.”12 The evi-
dence thus supports OSHA’s decision to focus its vac-
cinate-or-test standard on in-person workers, and to ex-
empt employees who work alone, remotely, or exclusively 
outdoors. See Pmbl.61419. 
The meatpacking industry’s experience with COVID-
19 is a particularly instructive—and well-studied—
 
10 See Oregon Health Auth., COVID-19 Weekly Report at 79–85 
(Nov. 17, 2021), https://perma.cc/4VFR-V2BR; Devan Hawkins, 
Letitia Davis & David Kriebel, COVID-19 deaths by occupation, Mas-
sachusetts, March 1–July 31, 2020, 64 Am. J. of Indust. Med. 238 
(2021), https://perma.cc/E3L7-R6DN; Washington State Dep’t of 
Health, 
Statewide 
COVID-19 
Outbreak 
Report 
(2021), 
https://perma.cc/S5KQ-CU7N. 
11 Chen, supra n.8, at 7. 
12 Ellicott C. Matthay et al., Contributions of occupation charac-
teristics and educational attainment to racial/ethnic inequities in 
COVID-19 mortality, medRxiv at 3 (preprint, posted Oct. 30, 2021), 
https://perma.cc/476F-Q39C. 

-7- 
 
example of how the virus can sweep through workplaces. 
Disease spread in meatpacking plants has been so severe 
that, following “multiple reports of widescale coronavirus 
outbreaks within and around meatpacking facilities, the 
[Congressional] Select Subcommittee initiated an investi-
gation into coronavirus infections and deaths in meatpack-
ing plants.”13 Data from “five of the largest meatpacking 
conglomerates, which represent over 80 percent of the 
market for beef and over 60 percent of the market for pork 
in the United States,” indicated that certain plants had 
nearly half of their workforce contract COVID-19 in the 
first year of the pandemic—multiples higher than the per-
centage of the U.S. population that had contracted the dis-
ease at that time.14  
That food processing workers are particularly at risk 
of transmission might not come as a surprise. They endure 
“long shifts in enclosed facilities” shared “with hundreds, 
if not thousands, of other workers,” with “collective[]” 
breaks in the “same” “common areas,” in “close quarters” 
on the “facility floor,” “unable to socially distance by vir-
tue of the production line layout[].” Id. at 4. But while the 
“high-density, fast-paced environments of food production 
facilities pose a barrier to proper adherence to COVID-19 
prevention measures, such as social distancing . . . and 
cleaning of shared spaces,” “these challenges are not 
unique to food production facilities.”15  
 
13 Staff of H. Select Subcomm. on the Coronavirus Crisis, 117th 
Cong., Memorandum re: Coronavirus Infections and Deaths Among 
Meatpacking Workers at Top Five Companies Were Nearly Three 
Times Higher Than Previous Estimates at 1 (Comm. Print 2021), 
https://perma.cc/ZAC7-264F. 
14 Id. at 1–2. 
15 Contreras, supra n.6, at 1769. 

-8- 
 
Like those in food production and meatpacking, work-
ers in “other sectors” encounter “distinctive” factors re-
lated to in-person work, such as “increased contact with 
the public” or “shared equipment[] and common spaces,” 
that “similarly increase the risk of COVID-19 worksite ex-
posure.”16 High COVID-19 case incidence rates have oc-
curred in the workforces of many important economic sec-
tors—in manufacturing, transportation and warehousing, 
and wholesale trade. “High-density environments,” “close 
contact in production lines, long shifts, shared equip-
ment[] and common spaces,” “shared transportation,” 
“poor ventilation and sanitation,” and “increased contact 
with the public” all contribute to “particular[] risk for 
COVID-19 exposure.”17  
The COVID-19 pandemic has also pulled back the cur-
tain on the way that workplace conditions and risks can 
exacerbate the existing health disparities between white 
workers and workers of color. The early months of the 
pandemic sickened and killed people of color in the United 
States at higher rates than non-Hispanic white people.18 
This is not only a result of underlying economic and health 
disparities but is also because people of color occupy a dis-
proportionately high number of jobs that qualify as 
 
16 Id. at 1769, 1772. 
17 Id. at 1770, 1772–73. 
18 See Tiana N. Rogers et al., Racial Disparities in COVID-19 
Mortality Among Essential Workers in the United States, 12 World 
Med. & Health Pol’y (Special Issue: Symposium on Coronavirus 2019: 
Social 
Determinants, 
Disparities, 
and 
Impacts) 
1 
(2020), 
https://perma.cc/AJW8-C8AV; Chen, supra n.8, at 7 (“Excess mortal-
ity in high-risk occupational sectors was evident across all race and 
ethnic groups in stratified analyses, with notably high relative and 
per-capita excess in Latino and Black Californians.”). 

-9- 
 
“essential work” or otherwise require them to work in per-
son.19 
Regardless of race or socioeconomic status, the evi-
dence is clear: In-person workers “are at greater risk of 
SARS-CoV-2 infection” because their “working conditions 
bring[] them into closer contact with those already in-
fected,” and are “at greater risk of more severe infections 
when exposed to SARS-CoV-2.”20 The workplace, in other 
words, presents particularized and special dangers of 
COVID-19 transmission and infection. OSHA was there-
fore right to determine that the virus poses an especially 
grave danger to America’s in-person workers and to act 
quickly and decisively to address that grave danger. 
II. Vaccines are the most effective tools for reducing 
COVID-19 transmission and infection in the 
workplace. 
There is no better way to prevent the transmission, 
morbidity, and mortality of COVID-19 than vaccination. 
The scientific evidence supporting this conclusion, too, is 
clear. As OSHA explained, numerous large-scale studies 
have confirmed the “power of vaccines to safely protect in-
dividuals” from transmission and infection of COVID-19, 
including from the Delta variant. Pmbl.614117–19, 61431.21 
 
19 See also, e.g., Contreras, supra n.6, at 1773; 117th Cong., Mem-
orandum re: Coronavirus, supra n.13, at 8; Hans R. House et al., Ag-
ricultural workers in meatpacking plants presenting to an emer-
gency department with suspected COVID-19 infection are dispropor-
tionately Black and Hispanic, 28 Acad. Emergency Med. [Special Is-
sue: (In)Equity in EM] 1012 (2021), https://perma.cc/8CNQ-T6QV. 
20 Pouran D. Faghri et al., COVID-19 Pandemic: What has work 
got to do with it?, 63 J. of Occupational & Envtl. Med. e245, e247 
(2021), https://bit.ly/3Eu2q1f. 
21 See, e.g., Seyed M. Moghadas et al., The impact of vaccination 
on COVID-19 outbreaks in the United States, Nat’l Inst. of Health at 

-10- 
 
Unvaccinated adults of prime working age (18 to 49 years) 
are 15.2 times more likely to be hospitalized and 17.2 times 
more likely to die of COVID-19 than fully vaccinated peo-
ple in the same age range.22 And so-called “natural immun-
ity” is no substitute: Vaccines are five times more effective 
in preventing serious illness and hospitalization than a 
previous COVID-19 infection.23  
Although vaccines are generally effective at prevent-
ing infection, hospitalization, and death, they are 
 
2 (preprint, revised Jan. 2, 2021), https://perma.cc/9MRU-PKBB 
(finding that widespread COVID-19 vaccination has made a “substan-
tial impact on mitigating COVID-19 outbreaks”); Lok Wong Samson, 
et al., Associations Between County-level Vaccination Rates and 
COVID-19 Outcomes Among Medicare Beneficiaries, Rep. No. HP-
2021-23, Office of the Assistant Secretary for Planning and Evalua-
tion, U.S. Dep’t of Health and Hum. Servs., at 1 (Oct. 2021), 
https://perma.cc/PN3Y-8J32 (estimating reduction of approximately 
265,000 COVID-19 infections and 39,000 deaths among Medicare ben-
eficiaries); see also Sumehda Gupta, et al., Vaccinations Against 
COVID-19 May Have Averted Up to 140,000 Deaths in the United 
States, 40 Health Affs. 1465 (2021), https://perma.cc/ZA2E-T3C8; 
Mark W. Tenforde et al., Association Between mRNA Vaccination 
and COVID-19 Hospitalization and Disease Severity, 326 JAMA 
2043, 2048 (2021) https://perma.cc/B3R7-X7F6. 
22 Heather M. Scobie et al., CDC, Monitoring Incidence of 
COVID–19 Cases, Hospitalizations, and Deaths, by Vaccination Sta-
tus—13 U.S. Jurisdictions, April 4–July 17, 2021, 70 Morbidity & 
Mortality Weekly Rpt. 1284 (Sept. 10, 2021), https://perma.cc/QD6J-
P24N; see Pmbl.61418. 
23 Catherine H. Bozio et al., CDC, Laboratory-Confirmed 
COVID-19 Among Adults Hospitalized with COVID-19–Like Illness 
with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Im-
munity—Nine States, January–September 2021, 70 Morbidity & 
Mortality Weekly Rpt. 1539 (Oct. 29, 2021), https://perma.cc/RS9F-
FPXJ. 
 

-11- 
 
particularly so in the workplace context. Extensive evi-
dence has shown that vaccination “reduce[s] the presence 
and severity of COVID-19 cases in the workplace,” and ef-
fectively “ensur[es]” that workers are protected from be-
ing infected and infecting others. Pmbl.61434, 61520, 
61528–29 (citing studies). This is true for two straightfor-
ward reasons. First, vaccinated employees are in the ag-
gregate significantly less likely to bring the virus into the 
workplace. Pmbl.61418–19; see also, e.g., Pmbl.61403, 
61418–19, 61435, 61438, 61528–29. Second, even those vac-
cinated workers who get infected are far less likely to 
spread the virus. See id. Although it is true that COVID-
19 vaccines, like other vaccines, do not completely prevent 
transmission of COVID-19 to others, growing evidence 
shows that they significantly decrease it.24  
A recent study of COVID-19 transmission and infec-
tion among law enforcement officers, firefighters, and 
other first responders highlights the vital need for vac-
cination of workers. The study found that the incidence of 
COVID-19 in unvaccinated firefighters was five times 
higher than in vaccinated firefighters—and twenty times 
higher for unvaccinated law enforcement officers.25 On 
 
24 See, e.g., Anika Singanayagam et al., Community transmission 
and viral load kinetics of SARS-CoV-2 Delta (B.1.617.2) variant in 
vaccinated and unvaccinated individuals, Lancet Infectious Dis-
eases (2021), https://perma.cc/A7K9-WUP2 (vaccinated individuals 
spread Delta to the unvaccinated at twice the rate as to the vac-
cinated); Po Ying Chia et al., Virological and serological kinetics of 
SARS-CoV-2 Delta variant vaccine-breakthrough infections: a 
multi-center cohort study, medRxiv (preprint, posted July 31, 2021), 
https://perma.cc/JQ3E-YS2V (shorter infectious period for vac-
cinated individuals); Ross J. Harris et al., Effect of Vaccination on 
Household Transmission of SARS-CoV-2 in England, New Eng. J. 
of Med. (Aug. 19, 2021), https://perma.cc/MP8W-DSPM. 
25 Alberto J. Caban-Martinez et al., High Burden of COVID-19 

-12- 
 
average, according to the study, first responders were sick 
with COVID-19 for over two weeks and missed close to 40 
hours of work due to their illness. These findings, the au-
thors wrote, “suggest that state and local governments 
with large numbers of unvaccinated first responders may 
face major disruptions in their workforce due to COVID-
19 illness” absent meaningful vaccination-and-testing re-
quirements.26  
Other research during the COVID-19 pandemic has 
confirmed the efficacy of vaccination against workplace 
transmission and infection. A study of frontline workers 
from December 2020 through August 2021 concluded that 
“full vaccination with COVID-19 vaccines was 80% effec-
tive in preventing” COVID-19 infection, “further affirm-
ing the highly protective benefit of full vaccination up to 
and through the most recent summer U.S. COVID-19 pan-
demic waves.”27 And studies of vaccination in health-care 
workers have shown that vaccinated employees are not 
just less likely to be infected—on average, they miss fewer 
days of work and experience milder symptoms if they are 
infected.28   
 
among Unvaccinated Law Enforcement Officers and Firefighters, 
medRxiv 
at 
6 
(preprint, 
posted 
Nov. 
26, 
2021), 
https://perma.cc/SW9H-864Z. 
26 Id. at 4. 
27 Ashley Fowlkes et al., CDC, Effectiveness of COVID-19 Vac-
cines in Preventing SARS-CoV-2 Infection Among Frontline Work-
ers Before and During B.1.617.2 (Delta) Variant Predominance, 70 
Morbidity & Mortality Weekly Rpt. 1167 (Aug. 27, 2021), 
https://perma.cc/Q3EW-4GYM. 
28 See Earl Strum et al., Healthcare workers benefit from second 
dose of COVID-19 mRNA vaccine: Effects of partial and full vaccina-
tion on sick leave duration and symptoms (preprint, posted Nov. 21, 
2021), https://perma.cc/4ZL6-G6HV; see also, e.g., Tamara Pilishvili 

-13- 
 
Given the compelling data, it is not surprising that 
many employers with experience dealing with widespread 
COVID-19 outbreaks have recognized the need to require 
vaccination. To return to the meatpacking industry, as 
noted above, meatpacking facilities suffered particularly 
extensive and severe COVID-19 outbreaks in the early 
days of the pandemic. Several major employers responded 
with vaccine requirements covering their entire work-
force, which have proved highly effective at achieving ad-
herence. Less than three months after Tyson Foods man-
dated coronavirus vaccines for all its 120,000 U.S. work-
ers, for example, more than 96 percent are vaccinated.29 
This is true across industries. As OSHA explained in its 
rule, “[e]vidence shows that mandating vaccination has 
proven to be an effective method for increasing vaccina-
tion rates” and that “[s]ignificant numbers of workers 
would get vaccinated if their employers required it.” 
Pmbl.61435 (citing Kaiser Family Found., Does The Pub-
lic Want To Get A COVID-19 Vaccine (Sept. 2021)). In-
deed, “many workers who were vaccinated over the last 
four months were motivated by their employer requiring 
vaccination.” Id.; see, e.g., Shawn Hubler, ‘Mandates Are 
Working’: Employer Ultimatums Lift Vaccination Rates, 
So 
Far, 
N.Y. 
Times 
(Sept. 
30, 
2021), 
 
et al., Effectiveness of mRNA Covid-19 Vaccine among U.S. Health 
Care 
Personnel, 
N. 
Eng. 
J. 
Med. 
(Sept. 
22, 
2021), 
https://perma.cc/W7ZS-DE23; Annalee Yassi et al., Infection control, 
occupational and public health measures including mRNA-based 
vaccination against SARS-CoV-2 infections to protect healthcare 
workers from variants of concern: a 14-month observational study 
using 
surveillance 
data, 
16 
PLOS 
ONE 
(2021), 
https://perma.cc/NJF9-QS3R. 
29 Lauren Hirsch, Days away from its deadline, Tyson Foods 
reaches a 96 percent vaccination rate, N.Y. Times (Oct. 26, 2021), 
https://perma.cc/B2EU-RSU6. 

-14- 
 
https://perma.cc/JE86-3T69 (observing that when em-
ployers require workers to get vaccinated, vaccination 
rates increase to over 90 percent). 
Finally, it should not be overlooked that vaccination 
in the workplace reduces the opportunities for the virus to 
continue to mutate by reducing transmission and length of 
infection—meaning that vaccination could prevent future, 
more deadly, variants of COVID-19.30 The escalating 
global concerns about the recently discovered Omicron 
variant serve as a timely reminder that vaccination is an 
indispensable tool that not only protects worker health 
and safety, but can prevent widescale social and economic 
disruption. 
III. OSHA properly determined that its vaccinate-or-
test standard is essential to protect workers. 
The Occupational Safety and Health Act of 1970 allows 
OSHA to issue emergency temporary standards when the 
agency “determines (A) that employees are exposed to 
grave danger from exposure to substances or agents de-
termined to be toxic or physically harmful or from new 
hazards, and (B) that such emergency standard is neces-
sary to protect employees from such danger.” 29 U.S.C. 
§ 655(c)(1). As explained above, the public-health evidence 
makes abundantly clear that both criteria are satisfied 
here. Because they work in person, employees covered by 
the standard are subject to severe and particularized risk 
of illness, hospitalization, and death as a result of COVID-
 
30 See Ting-Yu Yeh & Gregory P. Contreras, Full vaccination 
against COVID-19 suppresses SARS-CoV-2 delta variant and spike 
gene mutation frequencies and generates purifying selection pres-
sure, 
medRxiv 
at 
2 
(preprint, 
posted 
Aug. 
10, 
2021), 
https://perma.cc/JMB2-VUMF (study of 16 countries finding that 
“the vaccination coverage rate is inversely correlated to the mutation 
frequency of the . . . SARS-CoV-2 delta variants”). 

-15- 
 
19. And the empirical data collected since the release of 
COVID-19 vaccines indicates that vaccination is by far the 
most effective tool to prevent further transmission and in-
fection.  
Given the evidence, OSHA reasonably decided that its 
vaccinate-or-test standard was necessary to address the 
grave danger that COVID-19 poses to American workers. 
This decision is not unprecedented: The agency “has long 
recognized the importance of vaccinating workers against 
preventable illnesses to which they may be exposed on the 
job.” Pmbl.61433–34. In 1991, under President George 
H.W. Bush, OSHA adopted what is known as the “blood-
borne pathogens standard” to prevent the transmission of 
hepatitis B, hepatitis C, and HIV. See 29 C.F.R. 
§ 1910.1030. As part of that standard, the agency required 
employers to make the hepatitis B vaccine available to em-
ployees in any workplace with potential exposure to blood-
borne pathogens. See id. § 1910.1030(b); see generally Am. 
Dental Ass’n v. Martin, 984 F.2d 823, 824 (7th Cir. 1993). 
That standard resulted in a significant increase in the 
number of employees accepting hepatitis B vaccination, 
and “a dramatic decline in the incidence of HBV infec-
tions” among covered workers.31 The bloodborne patho-
gens standard addressed viruses whose potential trans-
mission “between workers is minimal in comparison to the 
SARS-CoV-2 virus; Hepatitis B and HIV are transmitted 
through blood and certain body fluids, whereas the SARS-
CoV-2 virus spreads through respiratory droplets that can 
travel 
through 
the 
air 
from 
worker-to-worker.” 
Pmbl.61436. Therefore, OSHA determined that, in the 
 
31 See Francis J. Mahoney et al., Progress Toward the Elimina-
tion of Hepatitis B Virus Transmission Among Health Care Workers 
in the United States, 157 Archives of Internal Med. 2601, 2604 (1997), 
https://perma.cc/E289-HKD9. 

-16- 
 
case of COVID-19, merely offering vaccination to workers 
would be insufficient. To protect against workplace spread 
of this rapidly transmitted, airborne virus, it was neces-
sary to require vaccination or regular testing and mask-
ing. See id. 
That determination warrants deference. As Chief Jus-
tice Roberts has recognized, the “precise question” of 
what restrictions should be imposed during “the pandemic 
is a dynamic and fact-intensive matter subject to reasona-
ble disagreement.” S. Bay United Pentecostal Church v. 
Newsom, 140 S. Ct. 1613, 1613 (2020) (Roberts, C.J., con-
curring in denial of certiorari). Congress has entrusted 
OSHA with the responsibility to protect workplace safety 
and health, particularly when workers are faced with a 
grave danger—which the COVID-19 pandemic indisputa-
bly is. Based on an extensive administrative record replete 
with public-health and scientific evidence showing that 
vaccination is the most effective tool to prevent COVID-
19 transmission and infection in the workplace, the agency 
issued its vaccinate-or-test standard. Given this careful 
and deliberative process, OSHA’s rule “should not be sub-
ject to second-guessing by an ‘unelected federal judiciary,’ 
which lacks the background, competence, and expertise to 
assess public health.” Id. at 1614. Even more so when, as 
here, the agency adopted its rule to deal with “changing 
facts on the ground.” See id.  
And the facts on the ground continue to change. In the 
last month, countries around the world have once again 
closed their borders and instituted lockdowns in response 
to the threat of the new, more transmissible Omicron 
variant. Cases are once again rising, and increased 
hospitalizations and deaths are likely to follow. The public-
health evidence has uniformly concluded that vaccines are 
the primary way to prevent the rise and spread of such 

-17- 
 
variants, thereby protecting our nation’s workplaces and 
workers. Because OSHA’s vaccinate-or-test standard 
appropriately reflects this overwhelming scientific 
consensus, this Court should uphold it. 
CONCLUSION   
 The decision below should be affirmed. 
Respectfully submitted, 
DEEPAK GUPTA 
   Counsel of Record 
Gupta Wessler PLLC 
2001 K Street, NW 
Suite 850 North 
Washington, DC 20006 
(202) 888-1741 
deepak@guptawessler.com 
 
NEIL K. SAWHNEY 
Gupta Wessler PLLC 
100 Pine Street, Suite 1250 
San Francisco, CA 94111 
(415) 573-0336 
 
December 30, 2021 
  Counsel for Amici Curiae 
 

-App.1- 
 
APPENDIX 
 
Institutional Amici Curiae 
 
American Public Health Association. APHA cham-
pions the health of all people and all communities; 
strengthens the profession of public health; shares the lat-
est research and information; promotes best practices; 
and advocates for public health issues and policies 
grounded in scientific research. APHA represents more 
than 22,000 individual members and is the only organiza-
tion that combines a nearly 150-year perspective, a broad-
based member community, and the ability to influence 
federal policy to improve the public’s health. 
Association of Schools and Programs of Public 
Health. ASPPH is the voice of accredited academic public 
health, representing more than 135 schools and programs 
accredited by the Council on Education for Public Health. 
The Association seeks improved health for everyone, eve-
rywhere by strengthening the capacity of its members. 
Academy of Managed Care Pharmacy. AMCP is the 
professional association leading the way to help patients 
get the medications they need at a cost they can af-
ford. AMCP’s diverse membership of pharmacists, physi-
cians, nurses, biopharmaceutical professionals, and other 
health care specialists leverage their expertise in clinical 
evidence and economics to optimize medication benefit de-
sign and population health management. AMCP helps pa-
tients access cost-effective and safe medications, including 
vaccines using evidence-based medication use strategies 
while promoting affordable health care solutions. 
Alliance of Community Health Plans. ACHP is a na-
tional leadership organization of top-performing health 

-App.2- 
 
plans and provider organizations. ACHP’s members are 
not-for-profit, community-based and regional health plans 
that provide high-quality health coverage and care to 
more than 24 million Americans, in 36 states and the Dis-
trict of Columbia. We are leading the industry in practical, 
proven reforms around primary care delivery, value-
based payment and data-driven systems improvement. 
American College of Osteopathic Emergency Phy-
sicians. ACOEP provides invaluable personal and profes-
sional support to the emergency medicine community, em-
powering members to provide outstanding care for them-
selves and their patients while successfully navigating the 
evolving practice of medicine. 
The American College of Preventive Medicine. 
ACPM is a professional, medical society of more than 
2,000 physicians dedicated to improving the health and 
quality of life of individuals, families, communities and 
populations. Preventive medicine physicians bridge the di-
vide between public health and clinical practice applying 
their knowledge and skills in medicine, social, economic, 
and behavioral sciences to improve health through disease 
prevention and health promotion. ACPM advocates for 
policy and practice that bolsters disease prevention efforts 
and creates healthier communities. 
Association of American Medical Colleges. AAMC 
is a nonprofit association dedicated to transforming health 
through medical education, health care, medical research, 
and community collaborations. Its members are all 155 ac-
credited U.S. and 17 accredited Canadian medical schools; 
more than 400 teaching hospitals and health systems; and 
more than 70 academic societies. 
College of American Pathologists. As the world’s 
largest organization of board-certified pathologists and 

-App.3- 
 
leading provider of laboratory accreditation and profi-
ciency testing programs, CAP provides services to pa-
tients, pathologists, and the public by fostering and advo-
cating excellence in the practice of pathology and labora-
tory medicine worldwide. Pathologists are physicians 
whose diagnoses drive care decisions made by patients, 
primary care and specialist physicians, and surgeons. 
Council of State and Territorial Epidemiologists. 
CSTE works to advance public health policy and epidemi-
ologic capacity. We support effective public health surveil-
lance and epidemiologic practice through training, capac-
ity development, and peer consultation; develop standards 
for practice; promote effective use of epidemiologic data 
to guide public health practice and improve health; and ad-
vocate for scientifically based policy. CSTE has 2200+ 
members working in applied epidemiology across all do-
mains including occupational health, acute and chronic 
diseases and conditions. 
National Hispanic Medical Association. Estab-
lished in 1994, NHMA is a non-profit association repre-
senting the interests of 50,000 licensed Hispanic physi-
cians in the United States. The mission of the organization 
is to empower Hispanic physicians to lead efforts to im-
prove the health of Hispanic and other underserved popu-
lations in collaboration with Hispanic state medical socie-
ties, residents, medical students, and other public and pri-
vate sector partners. 
National Medical Association. Established in 1895, 
NMA is the nation's oldest and largest professional and 
scientific organization representing more than 50,000 Af-
rican American physicians and their patients, and advo-
cating for parity and justice in medicine, the elimination of 
health disparities and promotion of health equity. 

-App.4- 
 
National Safety Council. NSC has been America’s 
leading safety advocate for over 100 years. As a mission-
based nonprofit organization, NSC works to eliminate the 
leading causes of preventable death and injury, focusing 
our efforts on the workplace, roadways, and impairment. 
We create a culture of safety to keep people safer in the 
workplace and beyond so they can live their fullest lives. 
Our more than 15,500 member companies represent 7 mil-
lion employees at nearly 50,000 U.S. worksites. 
The Association of periOperative Registered 
Nurses. AORN was founded in 1949 to establish a national 
community for operating room nurses who sought to share 
best practices for patients undergoing surgery. The or-
ganization represents 43,000 professionals who share a 
passion for advancing perioperative nursing and ensuring 
patient safety and optimal outcomes. 
The National League for Nursing. NLN is the oldest 
nursing organization in the United States, representing 
more than 1,200 nursing schools, 40,000 members, and 25 
regional constituent leagues. The NLN provides teaching 
resources and faculty development opportunities to assist 
them to educate and clinically prepare our nation’s nurses. 
The League promotes excellence in nursing education to 
build a strong, diverse nursing workforce to advance the 
health of our nation and the global community. 
 
 

-App.5- 
 
Individual Amici Curiae* 
 
Deans and Associate Deans 
1. Amy Lauren Fairchild, PhD, MPH, Dean and Profes-
sor of Health Services Policy and Management, Col-
lege of Public Health, The Ohio State University 
2. Ana V. Diez Roux, MD, PhD, MPH, Dana and David 
Dornsife Dean, Dornsife School of Public Health, 
Drexel University 
3. Ashish K. Jha, MD, MPH, Dean, Professor of Health 
Services, Policy and Practice, Brown University 
School of Public Health  
4. Ayman El-Mohandes, MBBCh, MD, MPH, Dean, 
CUNY Graduate School of Public Health & Health 
Policy 
5. Barbara K. Rimer, DrPH, Dean, Alumni Distin-
guished Professor, UNC Gillings School of Global 
Public Health 
6. Bernadette Boden-Albala, MPH, DrPH, Director and 
Founding Dean, Program in Public Health, Profes-
sor, Department of Health, Society and Behavior, 
Program in Public Health, Department of Neurology, 
School of Medicine, Susan and Henry Samueli Col-
lege of Health Sciences, University of California, Ir-
vine 
7. Boris D. Lushniak, MD, MPH, Dean, University of 
Maryland School of Public Health 
 
* Amici listed here have joined this brief in their individual capac-
ity only, and do not represent the interests of any institution with 
which they may be affiliated. 

-App.6- 
 
8. Cheryl Healton, DrPH, MPH, Dean and Professor of 
Public Health Policy and Management, NYU School 
of Global Public Health 
9. Edith A Parker, DrPH, MPH, Dean, University of 
Iowa College of Public Health 
10. Elaine H. Morrato, DrPH, MPH, CPH, Founding 
Dean and Professor, Parkinson School of Health Sci-
ences and Public Health, Loyola University Chicago 
11. Eyal Oren, PhD, MS, Interim Director, Professor, Di-
vision of Epidemiology & Biostatistics, Core Investi-
gator, Institute for Behavioral and Community 
Health, School of Public Health, San Diego State Uni-
versity 
12. James W. Curran, MD, MPH, Dean and Professor, 
Emory University Rollins School of Public Health 
13. John R. Finnegan, PhD, Professor and Dean, School 
of Public Health, University of Minnesota-Twin Cities 
14. Jonathan M. Samet, MD, MS, Dean and Professor, 
Colorado School of Public Health 
15. John T. Monahan, JD, Interim Dean, School of Nurs-
ing and Health Studies, Professor, Department of 
Medicine, Senior Lecturer, Law Center, Georgetown 
University 
16. Linda Forst, MD, MPH, Senior Associate Dean, 
School of Public Health, Professor, Environmental 
and Occupational Health Sciences, Attending Physi-
cian, Occupational Medicine, UlHealth, University of 
Illinois at Chicago 
17. Lynn R. Goldman, MD, MPH, MS, Michael and Lori 
Milken Dean of Public Health, Professor, Environ-
mental and Occupational Health, Milken Institute 

-App.7- 
 
School of Public Health, The George Washington 
University 
18. M. Daniel Givens, DVM, PhD, DACT, DACVM–Vi-
rology, Professor and Dean, Virginia-Maryland Col-
lege of Veterinary Medicine 
19. Mark L. Williams, PhD, M. Joycelyn Elders Profes-
sor and Dean, Fay W. Boozman College of Public 
Health, University of Arkansas for Medical Sciences 
20. Michael G. Perri, PhD, Dean, College of Public 
Health and Health Professions, University of Florida 
21. Megan L. Ranney, MD, MPH, FACEP, Professor of 
Emergency Medicine, Alpert Medical School, Associ-
ate Dean of Strategy and Innovation, School of Public 
Health, Brown University 
22. Michele Barry, MD, FACP, FASTMH, Drs. Ben and 
A. Jess Shenson Professor of Medicine and Tropical 
Diseases, Director of the Center for Innovation in 
Global Health, Senior Associate Dean for Global 
Health, Stanford University 
23. Muge Akpinar, MD, MPH, Professor and Dean, 
School of Public Health, University of Nevada, Reno 
24. Perry N. Halkitis, PhD, MS, MPH, Dean, Professor 
of Biostatistics and Urban-Global Public Health, Di-
rector, Center for Health, Identity, Behavior & Pre-
vention, Rutgers School of Public Health 
25. Robert M. Weiler PhD, MPH, Senior Associate Dean 
for Academic Affairs and Professor, George Mason 
University Graduate Programs in Public Health 
26. Sherry Glied, PhD, Dean, Robert F. Wagner Gradu-
ate School of Public Service, New York University 

-App.8- 
 
27. Sten H. Vermund, MD, PhD, Anna M.R. Lauder Pro-
fessor of Public Health and Dean, Yale School of Pub-
lic Health 
28. Susan Klitzman, DrPH, MPH, CPH, Senior Associate 
Dean for Administration and Professor, CUNY Grad-
uate School of Public Health and Health Policy 
29. Tetine Sentell, PhD, Interim Dean, Professor of Pub-
lic Health, Thompson School of Social Work & Public 
Health, University of Hawai‘i at Mānoa 
30. Wayne H Giles, MD, MS, Dean and Professor, School 
of Public Health, University of Illinois at Chicago 
Academic Chairs 
1. Alexander J. Travis VMD, PhD, Director, Cornell 
University Master of Public Health Program, Chair, 
Department of Public & Ecosystem Health 
2. Andrea Baccarelli, Chair and Professor of Environ-
mental Health Sciences, Columbia University Mail-
man School of Public Health 
3. Anthony L. Schlaff, MD, MPH, Director, Public 
Health Program, Professor, Department of Public 
Health and Community Medicine, Tufts University 
School of Medicine 
4. Carrie A. Redlich, MD, MPH, Professor of Medicine, 
Occupational and Environmental Medicine and Pul-
monary, Director, Yale Occupational and Environ-
mental Medicine Program, Yale School of Medicine 
5. George Friedman-Jimenez, MD, DrPH, Director, Oc-
cupational Physician and Epidemiologist, Belle-
vue/NYU Occupational Environmental Medicine 
Clinic, Bellevue Hospital and NYU Grossman School 
of Medicine 

-App.9- 
 
6. Laura L. Hungerford, DVM, MPH, PhD, CPH, 
FNAP, Professor and Head, Department of Popula-
tion Health Sciences and Virginia Tech Public Health 
Program, Virginia-Maryland College of Veterinary 
Medicine 
7. Manya Magnus, PhD, MPH, Professor & Interim 
Chair, Department of Epidemiology, The George 
Washington Univeristy Milken Institute School of 
Public Health 
8. Mary-Katherine McNatt, DrPH, MPH, MCHES, 
CPH, COI, Chair and Associate Professor, Depart-
ment of Public Health, A.T. Still University College of 
Graduate Health Studies 
9. Melissa Perry, ScD, MHS, Professor and Chair of 
Environmental and Occupational Health, The George 
Washington University 
10. Michael E. Martell, PhD, Associate Professor and 
Chair, Economics, Bard College 
11. Nils Hennig, MD, PhD, MPH, Director, Graduate 
Program in Public Health, Associate Professor, Pedi-
atric Infectious Diseases, Environmental Medicine 
and Public Health, Health System Design and Global 
Health, Icahn School of Medicine at Mount Sinai 
12. Peter Orris, MD, MPH, Professor and Chief, Occupa-
tional and Environmental Medicine, University of Illi-
nois Hospital and Health Sciences System 
13. Robert M. Wachter, MD, Professor and Chair, Dept 
of Medicine, University of California, San Francisco 
14. Jonathan Levy, ScD, Professor and Chair, Depart-
ment of Environmental Health, Boston University 
School of Public Health 

-App.10- 
 
15. Jonathan Patz, MD, MPH, Tony J McMichael Profes-
sor and John P Holton Chair of Health and the Envi-
ronment, Director, Global Health Institute, Nelson 
Institute, Center for Sustainability and the Global 
Environment (SAGE) and Department of Population 
Health Sciences, School of Medicine & Public Health, 
University of Wisconsin 
Scholars 
1. Adam M. Finkel, ScD, CIH, Clinical Professor of En-
vironmental Health Sciences, University of Michigan 
School of Public Health, Former Director of Health 
Standards, OSHA, Former Regional Administrator 
(VIII) 
2. Andy Slavitt, Former Senior Advisor to the Biden 
Administration COVID Response 
3. Barry S. Levy, MD, MPH, Adjunct Professor of Pub-
lic Health, Tufts University School of Medicine, Past 
President, APHA 
4. Beate Ritz, MD, PhD, Professor of Epidemiology, 
Environmental Health, and Neurology, Fielding 
School of Public Health and Geffen School of Medi-
cine, UCLA 
5. Bernard D. Goldstein, MD, Professor Emeritus and 
Dean Emeritus, University of Pittsburgh Graduate 
School of Public Health 
6. Beth Rosenberg, ScD, MPH, Associate Professor, 
Department of Public Health and Community Medi-
cine, Tufts University School of Medicine 
7. Brian S. Schwartz, MD, MS, Professor of Environ-
mental Health and Engineering, Epidemiology, and 

-App.11- 
 
Medicine, Johns Hopkins Bloomberg School of Public 
Health  
8. C. William Keck, Past President, APHA, Professor 
Emeritus, Department of Family and Community 
Medicine, Northeast Ohio Medical University 
9. Celeste Monforton, DrPH, MPH, Public Health Lec-
turer, Texas State University   
10. Craig Slatin, ScD, MPH, Professor Emeritus, Zuck-
erberg College of Health Sciences, University of Mas-
sachusetts Lowell, Editor, New Solutions: A Journal 
of Environmental and Occupational Health Policy 
11. David M. Cutler, PhD, Otto Eckstein Professor of 
Applied Economics, Faculty of Arts and Sciences, 
Harvard University 
12. David Kriebel, ScD, Professor Emeritus, University 
of Massachusetts Lowell 
13. David Ozonoff, MD, MPH, Professor Emeritus of En-
vironmental Health, Boston University School of 
Public Health 
14. David Rosner, PhD, MPH, Lauterstein Professor and 
Co-Director, Center for the History and Ethics of 
Public Health, Mailman School of Public Health and 
Department of History, Columbia University 
15. David Vlahov, PhD, RN, Professor of Nursing, Yale 
School of Nursing  
16. David H. Wegman, MD, MSc, Professor Emeritus, 
Department of Work Environment, UMass Lowell, 
Adjunct Professor, Harvard School of Public Health 
17. Debbie Berkowitz, Former Chief of Staff and Senior 
Policy Advisor, OSHA, US Department of Labor 

-App.12- 
 
18. Donald K. Milton, MD, DrPH, MPower Professor, 
Professor, Environmental and Occupational Health, 
School of Public Health, University of Maryland 
19. Edward L. Baker MD, MPH, MSc, Former Assistant 
Surgeon General, RADM (ret), USPHS, Adjunct Pro-
fessor, Harvard Chan School of Public Health, Ad-
junct Professor, UNC Gillings School of Global Public 
Health 
20. Emily A. Spieler, JD, Edwin W. Hadley Professor of 
Law, Northeastern University 
21. Eric A. Feldman, JD., Ph.D., Deputy Dean for Inter-
national Programs, Heimbold Professor of Interna-
tional Law, Professor of Medical Ethics & Health 
Policy, University of Pennsylvania Carey Law School 
22. Eric Topol, MD, EVP and Professor, Molecular Medi-
cine, Scripps Research, Founder and Director, 
Scripps Research Translational Institute 
23. Ezekiel J. Emanuel, MD, PhD, Vice Provost for 
Global Initiative, Co-Director, Healthcare Transfor-
mation Institute, Levy University Professor, Perel-
man School of Medicine and The Wharton School, 
University of Pennsylvania 
24. Gerald Markowitz, PhD, MA, Distinguished Profes-
sor of History, John Jay College of Criminal Justice 
and The Graduate Center, CUNY 
25. Gregory R. Wagner, M.D., Department of Environ-
mental Health, Harvard T.H. Chan School of Public 
Health 
26. Helene D. Gayle, MD, MPH, President and Chief Ex-
ecutive Officer, The Chicago Community Trust 

-App.13- 
 
27. Henry Aaron, PhD, Bruce and Virginia MacLaury 
Chair, Senior Fellow, Economic Studies Program, 
Brookings Institution 
28. Hillary Nelson, PhD, MPH, Director, MPH Program, 
University of Pennsylvania 
29. Jack Caravanos, DrPH, CIH, Clinical Professor, 
Global and Environmental Public Health, New York 
University, School of Global Public Health 
30. Jack Dennerlein, PhD, MS, Professor, Bouvé College 
of Health Sciences, Northeastern University, Adjunct 
Professor of Ergonomics and Safety, Harvard T.H. 
Chan School of Public Health 
31. James A. Merchant, MD, DrPH, Emeritus Professor 
of Medicine and Public Health, Emeritus Founding 
Dean, College of Public Health, University of Iowa 
32. Jay H. Glasser, PhD, MS, FFPH, Hon FRSPH, Hon 
FCPMA, President, Medicine and Public Health Ini-
tiative, Past President, APHA 
33. Jay Himmelstein, MD, MPH, Professor Emeritus, 
Population and Quantitative Health Sciences, UMass 
Chan Medical School 
34. Joel Kaufman, MD, MPH, Professor, Environmental 
& Occupational Health Sciences, Medicine, and Epi-
demiology, University of Washington 
35. John R. Balmes, MD, Professor of Medicine, Univer-
sity of California, San Francisco, Professor of Envi-
ronmental Health Sciences, School of Public Health, 
University of California, Berkeley 
36. John P. Moore, PhD, Professor of Microbiology and 
Immunology, Weill Cornell Medical College, New 
York 

-App.14- 
 
37. Jordan Barab, Former Deputy Assistant Secretary, 
OSHA, US Department of Labor 
38. Jose L. Jimenez, PhD, Distinguished Professor of 
Chemistry, Fellow of CIRES, University of Colorado-
Boulder 
39. Joseph Telfair, DrPH, MSW, MPH, FRSPH, Past 
President, APHA 
40. Joshua M. Sharfstein, MD, Professor of the Practice 
in Health Policy and Management, Johns Hopkins 
Bloomberg School of Public Health 
41. Julia Raifman, ScD, Assistant Professor, Health Law, 
Policy, and Management, Boston University School of 
Public Health 
42. Katherine Swartz, PhD, Professor of Health Econom-
ics and Policy, Harvard School of Public Health 
43. Karen B. Mulloy, DO, MSCH, Associate Professor, 
Case Western Reserve University School of Medicine 
44. Kari Hartwig, DrPH, MPH Program Director, Asso-
ciate Professor, St. Catherine University 
45. Kenneth Olden, PhD, Former Director, National In-
stitute of Environmental Health Sciences and Na-
tional Toxicology Program, Founding Dean, City Uni-
versity of New York School of Public Health 
46. Kenneth Rosenman, MD, FACE, FACOEM, 
FACPM, Professor of Medicine, Chief of the Division 
of Occupational and Environmental Medicine, Michi-
gan State University  
47. Kyle Steenland, PhD, PhD, MS, Professor, Depart-
ment of Environmental Health, Rollins School of Pub-
lic Health, Emory University 

-App.15- 
 
48. Laura Punnett, ScD, Professor, Department of Bio-
medical Engineering, Co-Director, Center for the 
Promotion of Health in the New England Workplace, 
Senior Associate, Center for Women and Work, Uni-
versity of Massachusetts Lowell 
49. Lee S. Newman, MD, MA, FACOEM, FCCP, F. 
Colleg. Ramazzini, Distinguished University Profes-
sor and Center Director, Center for Health, Work 
and Environment, Department of Environmental and 
Occupational Health, Department of Epidemiology, 
Colorado School of Public Health, Department of 
Medicine, University of Colorado School of Medicine 
50. Leslie I. Boden, PhD, Professor, Boston University 
School of Public Health 
51. Linda S. Birnbaum, PhD, DABT, ATA, Scientist 
Emeritus and Former Director, National Institute of 
Environmental Health Sciences and National Toxicol-
ogy Program, Scholar in Residence, Nicholas School 
of the Environment, Duke University 
52. Linda C. Degutis, DrPH, MSN, Lecturer, Yale 
School of Public Health, Past President, APHA, For-
mer Director, National Center for Injury Prevention 
and Control, CDC 
53. Linda Rae Murray, MD, MPH, Adjunct Assistant 
Professor, University of Illinois School of Public 
Health, Past President, APHA 
54. Linda Rosenstock, MD, MPH, UCLA Professor of 
Medicine and Public Health, Former NIOSH Direc-
tor 

-App.16- 
 
55. Lisa M. Carlson, MPH, MCHES, Past President, 
APHA, Executive Administrator, Research Admin-
istration, Emory School of Medicine 
56. Magda Schaler-Haynes, JD, MPH, Adjunct Professor 
of Health Policy and Management, Mailman School of 
Public Health, Columbia University 
57. Mark R. Cullen MD, Professor of Medicine and Bio-
medical Data Science, Stanford University (retired) 
58. Melissa A. McDiarmid, MD, MPH, DABT, Professor 
of Medicine and Epidemiology and Public Health, Di-
rector, Division of Occupational and Environmental 
Health, University of Maryland School of Medicine 
59. Melvin D. Shipp, OD, MPH, DrPH, Past President, 
APHA, Former Dean and Professor Emeritus, The 
Ohio State University College of Optometry 
60. Michael E. Bird, MSW, MPH, Past President, APHA, 
National Public Health Consultant, Native Public 
Health Consultant 
61. Michael Felsen, Former Regional Solicitor, US De-
partment of Labor, Boston  
62. Michael Silverstein, MD, MPH, Former Director of 
Policy, OSHA, US Department of Labor, Former Di-
rector, Washington State OSHA 
63. Michael S. Sinha, M.D., J.D., M.P.H., Harvard Medical 
School Center for Bioethics 
64. Michael T. Osterholm, PhD, MPH, Director, Center 
for Infectious Disease, Research and Policy, Univer-
sity of Minnesota 
65. Myron Allukian Jr., DDS, MPH, Past President, 
APHA 

-App.17- 
 
66. Nancy Krieger, PhD, Professor of Social Epidemiol-
ogy, Harvard T.H. Chan School of Public Health 
67. Nicholas A. Ashford, PhD, JD, Professor of Technol-
ogy and Policy, Massachusetts Institute of Technol-
ogy 
68. Noah S. Seixas, PhD, MS, Professor Emeritus, De-
partment of Environmental and Occupational Health 
Sciences, University of Washington, School of Public 
Health 
69. Oliver Fein, MD, Professor of Clinical Medicine 
Emeritus, Weill Cornell Medical College 
70. Oni Blackstock, MD, MHS, Founder and Executive 
Director, Health Justice 
71. Pamela M. Aaltonen, PhD, RN, Professor Emerita, 
Purdue University, Past President, APHA 
72. Patricia D. Mail, PhD, MPH, MS, Past President 
APHA, Secretary, Board of Directors for Franke To-
bey Jones 
73. Phillip J. Landrigan, MD, MSc, FAAP, Director, Pro-
gram for Global Public Health and the Common 
Good, Director, Global Observatory on Pollution and 
Health, Professor of Biology, Schiller Institute for In-
tegrated Science and Society 
74. Richard Fairfax, Former Deputy Assistant Secre-
tary, OSHA, US Department of Labor 
75. Richard J. Jackson, MD, MPH, FAAP, HonAIA, Ho-
nASLA, Professor Emeritus, UCLA Fielding School 
of Public Health 
76. Rob McConnell, MD, Professor of Population and 
Public Health Science, Director, Southern California 

-App.18- 
 
Environmental Health Science Center, University of 
Southern California 
77. Robyn R.M. Gershon, MHS, DrPH, Clinical Profes-
sor, Department of Epidemiology, Program Director, 
Early Career Research Development, New York Uni-
versity School of Global Public Health 
78. Rosemary K. Sokas, MD, MOH, Professor of Human 
Science and of Family Medicine, Georgetown Univer-
sity School of Nursing and Health Studies 
79. Saad B. Omer, MBBS, MPH, PhD, FIDSA, Director, 
Yale Institute for Global Health, Professor of Medi-
cine (Infectious Diseases), Yale School of Medicine, 
Susan Dwight Bliss Professor of Epidemiology of Mi-
crobial Diseases, Yale School of Public Health 
80. Sara Rosenbaum, JD, Harold and Jane Hirsh Profes-
sor, Health Law and Policy, Department of Health 
Policy and Management, Milken Institute School of 
Public Health, The George Washington University 
81. Scott L. Zeger, PhD, John C. Malone Professor of Bi-
ostatistics, Epidemiology and Medicine, Bloomberg 
School of Public Health, Johns Hopkins University  
82. Seth Trueger, MD, MPH, FACEP, Associate Profes-
sor of Emergency Medicine, Northwestern Univer-
sity, Feinberg School of Medicine, Emergency Physi-
cian, Northwestern Memorial Hospital, Digital Media 
Editor, JAMA Network Open 
83. Sheldon Krimsky, PhD, MS, Lenore Stern Professor 
of Humanities and Social Sciences, Adjunct Profes-
sor, Public Health and Community Medicine, Tufts 
University 

-App.19- 
 
84. Sherry Baron, MD, MPH, Professor, Barry Com-
moner Center for Health and the Environment, 
Queens College, Affiliate Professor, Graduate School 
of Public Health and Health Policy, City University of 
New York 
85. Sonia M. Suter, JD, MS, The Kahan Family Research 
Professor of Law, Founding Director, Health Law In-
itiative, The George Washington University Law 
School 
86. Stephen Zoloth, PhD, MPH, Professor, Department 
of Health Sciences, Northeastern University 
87. Steven Markowitz, MD, DrPH, Director and Profes-
sor, Barry Commoner Center for Health and the En-
vironment, Queens College, City University of New 
York 
88. Susan S. Addiss, MPH, MUrS, Past President, 
APHA, Vice-Chair, Board of the East Shore Health 
District, Branford, CT 
89. Timothy Stoltzfus Jost, JD, Emeritus Professor, 
Washington and Lee University 
90. Tom Frieden, President and CEO of Resolve to Save 
Lives, NAM Member, Former Director, Centers for 
Disease Control 
91. W. Ian Lipkin, MD, John Snow Professor of Epidemi-
ology and Director, Center for Infection and Immun-
ity, Mailman School of Public Health, and Professor 
of Neurology, Cell Biology and Pathology, Vagelos 
College of Physicians and Surgeons, Columbia Uni-
versity 
92. William Foege, MD, MPH, retired, Professor Emeri-
tus, Emory University, Past President, APHA 

-App.20- 
 
93. William M. Sage, MD, JD, James R. Dougherty Chair 
for Faculty Excellence, School of Law, Professor of 
Surgery and Perioperative Care, Dell Medical School, 
The University of Texas at Austin 
94. William N. Rom M.D., MPH, Sol and Judith Berg-
stein Professor of Medicine, Emeritus Research Pro-
fessor, NYU School of Medicine, Research Scientist, 
NYU School of Global Public Health

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