Notes from the Field: Characteristics of Meat Processing Facility Workers with Confirmed SARS-CoV-2 Infection — Nebraska, April–May 2020

Matthew Donahue, MD1,2; Nandini Sreenivasan, MD3; Derry Stover, MPH2; Anu Rajasingham, MPH3; Joanna Watson, DPhil3,4,5; Andreea Bealle, MPH3; Natasha Ritchison6; Thomas Safranek, MD2; Michelle A. Waltenburg, DVM1; Bryan Buss, DVM2,7; Jennita Reefhuis, PhD3 (

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Coronavirus disease 2019 (COVID-19) has been reported nationwide among meat processing facility workers (1). In late April 2020, through flyers and text messages, workers at a Nebraska meat processing facility were invited by the facility, in partnership with the Nebraska Department of Health and Human Services, to be tested for current SARS-CoV-2, the virus that causes COVID-19, at their worksite, free of charge. Specimens were analyzed using reverse transcription–polymerase chain reaction (RT-PCR) by a contracting laboratory. This investigation was determined by CDC to be public health surveillance.* Among 1,216 Nebraska-resident meat processing facility workers tested, 375 (31%) had positive results. During May 8–25, case investigators attempted to interview the 349 workers who had positive test results and available phone numbers; five refused, 99 were not reached after five attempts, and four did not report symptom status, leaving 241 (69%) of the attempted interviews for analysis.

Among the 241 interviewed workers, 57% were male, the median age was 41 years (range = 18–76 years), and 46% were Hispanic (

Reducing workplace exposures is crucial for preventing COVID-19 among meat processing facility workers. Despite broad availability of a flexible medical leave policy and fever screening, approximately one third of workers included in this investigation reported close contact with an ill person at work, which supports the need for symptom screening§ in addition to fever screening and ongoing access to testing. Fewer workers reported contact with an ill person outside work; risk factors such as crowded living conditions and shared transportation were reported infrequently. Approximately one third of workers with COVID-19 were asymptomatic, underscoring the limitations of relying on symptom or fever screening alone, particularly because asymptomatic persons with COVID-19 potentially contribute to transmission (3,4). That nearly one half of interviewed workers worked in close proximity to others highlights the need for physical barriers between workers, physical distancing throughout the facility (especially locations prone to crowding, such as production areas and cafeterias or break areas), and consistent and correct use of masks to reduce transmission in the workplace¶ in this critical industry (5,6).

Acknowledgments

Allison Newman; COVID-19 investigation and contact tracing teams; workers mentioned in this report; the meat processing facilities across Nebraska.

Corresponding author: Matthew Donahue, phu0@cdc.gov.

1Epidemic Intelligence Service, CDC; 2Nebraska Department of Health and Human Services; 3CDC COVID-19 Emergency Response Team; 4Division of Global Health Protection, Center for Global Health, CDC; 5Western States Division, National Institute for Occupational Safety and Health, CDC; 6Dakota County Health Department, Dakota City, Nebraska; 7Division of State and Local Readiness, Center for Preparedness and Response, CDC.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

• U.S. Department of Health and Human Services, Title 45 Code of Federal Regulations 46, Protection of Human Subjects. https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=83cd09e1c0f5c6937cd9d7513160fc3f&pitd=20180719&n=pt45.1.46&r=PART&ty=HTML.

† Close contact was defined as being within 6 feet (2 m) for ≥10 minutes in the 2 weeks preceding symptom onset or testing.

§ Symptom screening should include some of the wide range of symptoms that persons with COVID-19 have reported (e.g., fever, cough, shortness of breath, headache, fatigue, myalgia, loss of smell or taste, and sore throat). https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.

¶ https://www.unmc.edu/healthsecurity/education/programs/docs/Playbook.pdf.

References

• Dyal JW, Grant MP, Broadwater K, et al. COVID-19 among workers in meat and poultry processing facilities—19 states, April 2020. MMWR Morb Mortal Wkly Rep 2020;69:557–61. CrossRef PubMed
• CDC. Coronavirus disease 2019 (COVID-19) 2020 interim case definition, approved April 5, 2020. Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020
• Furukawa NW, Brooks JT, Sobel J. Evidence supporting transmission of severe acute respiratory syndrome coronavirus 2 while presymptomatic or asymptomatic. Emerg Infect Dis 2020;26. CrossRef PubMed
• Kimball A, Hatfield KM, Arons M, et al.; Public Health – Seattle & King County; CDC COVID-19 Investigation Team. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility—King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020;69:377–81. CrossRef PubMed
• CDC. Meat and poultry processing workers and employers: interim guidance from CDC and the Occupational Health and Safety Administration (OSHA). Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/meat-poultry-processing-workers-employers.html
• CDC. Implementing safety practices for critical infrastructure workers who may have had exposure to a person with suspected or confirmed COVID-19. Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/critical-workers/implementing-safety-practices.html

† Information on preferred language was included instead of race because more complete and detailed information was available for this diverse population. Other languages include Burmese, Cambodian, French, Karen, Lao, Malay, Oromo, Romanian, Tigrinya, and Vietnamese.
§ Other underlying conditions that were asked about and reported infrequently include: renal conditions, liver conditions, autoimmune disorders, neurologic disorders and other chronic conditions.
¶ Six workers reported underlying cardiovascular disease and diabetes.
** Close contact was defined as being within 6 ft (2 m) of an ill person for ≥10 minutes in the 2 weeks preceding symptom onset or testing.
†† No information is available on why the workers who did not go to work in the 14-day period were absent.
§§ Six workers had multiple occupational roles.
¶¶ Those working on the belt in harvesting, processing, and rendering were considered to work in proximity (<4 ft [<1.5 m]) to one another.
*** Four workers used multiple modes of transportation to get to work.
††† Six workers had two household members who worked outside the home in different industries. It is possible that multiple household members who worked in the same plant are included in this study.

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