COVID-19 Among Workers in Meat and Poultry Processing Facilities — 19 States, April 2020

Jonathan W. Dyal, MD; Michael P. Grant, ScD; Kendra Broadwater, MPH; Adam Bjork, PhD; Michelle A. Waltenburg, DVM; John D. Gibbins, DVM; Christa Hale, DVM; Maggie Silver, MPH; Marc Fischer, MD; Jonathan Steinberg, MPH; Colin A. Basler, DVM; Jesica R. Jacobs, PhD; Erin D. Kennedy, DVM; Suzanne Tomasi, DVM; Douglas Trout, MD; Jennifer Hornsby-Myers, MS; Nadia L. Oussayef, JD; Lisa J. Delaney, MS; Ketki Patel, MD, PhD; Varun Shetty, MD; Kelly E. Kline, MPH; Betsy Schroeder, DVM; Rachel K. Herlihy, MD; Jennifer House, DVM; Rachel Jervis, MPH; Joshua L. Clayton, PhD; Dustin Ortbahn, MPH; Connie Austin, DVM, PhD; Erica Berl, DVM; Zack Moore, MD; Bryan F. Buss, DVM; Derry Stover, MPH; Ryan Westergaard, MD, PhD; Ian Pray, PhD; Meghan DeBolt, MPH; Amy Person, MD; Julie Gabel, DVM; Theresa S. Kittle, MPH; Pamela Hendren; Charles Rhea, MPH; Caroline Holsinger, DrPH; John Dunn; George Turabelidze; Farah S. Ahmed, PhD; Siestke deFijter, MS; Caitlin S. Pedati, MD; Karyl Rattay, MD; Erica E. Smith, PhD; Carolina Luna-Pinto, MPH; Laura A. Cooley, MD; Sharon Saydah, PhD; Nykiconia D. Preacely, DrPH; Ryan A. Maddox, PhD; Elizabeth Lundeen, PhD; Bradley Goodwin, PhD; Sandor E. Karpathy, PhD; Sean Griffing, PhD; Mary M. Jenkins, PhD; Garry Lowry, MPH; Rachel D. Schwarz, MPH; Jonathan Yoder, MPH; Georgina Peacock, MD; Henry T. Walke, MD; Dale A. Rose, PhD; Margaret A. Honein, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2020;69(18):557-561. 

In This Article

Abstract and Introduction

Introduction

Congregate work and residential locations are at increased risk for infectious disease transmission including respiratory illness outbreaks. SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is primarily spread person to person through respiratory droplets. Nationwide, the meat and poultry processing industry, an essential component of the U.S. food infrastructure, employs approximately 500,000 persons, many of whom work in proximity to other workers.[1] Because of reports of initial cases of COVID-19, in some meat processing facilities, states were asked to provide aggregated data concerning the number of meat and poultry processing facilities affected by COVID-19 and the number of workers with COVID-19 in these facilities, including COVID-19–related deaths. Qualitative data gathered by CDC during on-site and remote assessments were analyzed and summarized. During April 9–27, aggregate data on COVID-19 cases among 115 meat or poultry processing facilities in 19 states were reported to CDC. Among these facilities, COVID-19 was diagnosed in 4,913 (approximately 3%) workers, and 20 COVID-19–related deaths were reported. Facility barriers to effective prevention and control of COVID-19 included difficulty distancing workers at least 6 feet (2 meters) from one another[2] and in implementing COVID-19-specific disinfection guidelines.* Among workers, socioeconomic challenges might contribute to working while feeling ill, particularly if there are management practices such as bonuses that incentivize attendance. Methods to decrease transmission within the facility include worker symptom screening programs, policies to discourage working while experiencing symptoms compatible with COVID-19, and social distancing by workers. Source control measures (e.g., the use of cloth face covers) as well as increased disinfection of high-touch surfaces are also important means of preventing SARS-CoV-2 exposure. Mitigation efforts to reduce transmission in the community should also be considered. Many of these measures might also reduce asymptomatic and presymptomatic transmission.[3] Implementation of these public health strategies will help protect workers from COVID-19 in this industry and assist in preserving the critical meat and poultry production infrastructure.[4]

In early April, CDC was alerted to COVID-19 cases among workers in several meat and poultry processing facilities and responded to state and local authorities' requests for on-site or remote technical assistance. Qualitative on-site and remote risk assessments were conducted. All states that had reported at least one case of COVID-19 in a meat or poultry processing facility were contacted for further information. CDC requested aggregate data on the number of meat or poultry facilities affected, number of workers in affected facilities, number of workers with a COVID-19 diagnosis, and number of COVID-19–related deaths among workers. States reported COVID-19 among workers using their own case definitions.

By April 27, CDC had received aggregate data on COVID-19 cases from 19 of 23 states reporting at least one case related to this industry; there were 115 meat or poultry processing facilities with COVID-19 cases, including 4,913 workers with diagnosed COVID-19 (Table 1). Among 17 states reporting the number of workers in their affected facilities, 3.0% of 130,578 workers received diagnoses of COVID-19. The percentage of workers with diagnosed COVID-19 ranged from 0.6% to 18.2%. Twenty COVID-19–related deaths were reported among workers.

Qualitative data from the facility risk assessments identified common characteristics among processing facilities and their workers that might increase risk for transmitting or acquiring SARS-CoV-2 (Table 2). Facility challenges included structural and operational practices that made it difficult to maintain a 6-foot (2-meter) distance while working, especially on production lines, and in nonproduction settings during breaks and while entering and exiting facilities. The pace and physical demands of processing work made adherence to face covering recommendations difficult, with some workers observed covering only their mouths and frequently readjusting their face coverings while working. Some sites were also observed to have difficulty adhering to the heightened cleaning and disinfection guidance recommended for all worksites to reduce SARS-CoV-2 transmission.

Solutions to structural and operational challenges that some facilities adopted included adjusting start and stop times of shifts and breaks to increase physical distance between workers. Outdoor break areas were added at some facilities to decrease contact between workers. Some facilities installed physical (e.g., plexiglass) barriers between workers; however, this was not practical for all worker functions. Symptom and temperature screening of workers was newly instituted in some facilities and improved in others.

Sociocultural and economic challenges to COVID-19 prevention in meat and poultry processing facilities (Table 2) include accommodating the needs of workers from diverse backgrounds who speak different primary languages; one facility reported a workforce with 40 primary languages. This necessitates innovative approaches to educating and training employees and supervisors on safety and health information. In addition, some employees were incentivized to work while ill as a result of medical leave and disability policies and attendance bonuses that could encourage working while experiencing symptoms. Finally, many workers live in crowded, multigenerational settings and sometimes share transportation to and from work, contributing to increased risk for transmission of COVID-19 outside the facility itself. Changing transportation to and from the facilities to increase the number of vehicles and reduce the number of passengers per vehicle helped maintain physical distancing in some facilities.

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