COVID-19 Workplace Outbreaks in Utah, 2020: Hispanic and Nonwhite Workers Hit Hardest

Knowing which industries have COVID-19 workplace outbreaks can help target public health action, but the overall picture hadn't been described. The Utah Department of Health (UDOH) analyzed its surveillance data for March 6–June 5, 2020. "Workplaces" here excludes health care, congregate living and schools, whose outbreaks are handled separately. This report was posted as an MMWR Early Release on August 17, 2020.

How it was done

• A workplace outbreak: two or more lab-confirmed cases among coworkers at the same facility within 14 days.
• Workplaces were sorted into the 20 sectors of the North American Industry Classification System (NAICS), using Utah's register of businesses; some small sectors were combined.
• Incidence per 100,000 workers used 2019 Census workforce estimates.
• Workers' race and ethnicity in outbreaks were compared with each sector's whole workforce.

Results

Utah reported 11,448 confirmed cases in the period: 1,389 (12%) tied to workplace outbreaks, 1,081 (9%) to outbreaks in other settings, and 8,978 (78%) to no outbreak. Of 277 outbreaks, 210 (76%) were in workplaces, across 15 of the 20 sectors (median 4 cases, range 2–79).

Manufacturing, wholesale trade and construction together had 806 of the 1,389 cases (58%).

The gap between the share of Hispanic and nonwhite workers among outbreak cases and their share of each sector's workforce, Utah, March 6–June 5, 2020. Figure from CDC's report.

The disparity

Hispanic and nonwhite workers made up under 24% of the workforce in the 15 affected sectors, yet 970 of the 1,335 outbreak cases with known race and ethnicity (73%): 783 Hispanic, 187 nonwhite, against 365 non-Hispanic white. The gap appeared in every sector, largest in wholesale trade (58 percentage points) and manufacturing (53).

Compared with people aged 15 and over whose cases weren't part of an outbreak, workers in outbreaks were:

• a little older (median 41 vs 38 years);
• more often Hispanic (56.4% vs 39.8%) and male (61.4% vs 50.6%);
• less often hospitalized (6.1% vs 7.6%), with no difference in severe outcomes.

Why, and what to do

Long-standing health and social inequities put Hispanic and nonwhite workers disproportionately in frontline jobs — essential and direct-service work — where exposure may be higher, as seen in meat processing outbreaks elsewhere. They also have less flexible schedules and fewer telework options, and unpaid or punitive sick leave can keep sick workers on the job, spreading infection and delaying care.

• Follow CDC's sector-specific guidance, which accounts for different processes and working conditions, and help employers put it into practice; CDC and UDOH offer plain-language business guides.
• Keep the virus out of workplaces, with both community and workplace measures.
• Use culturally and linguistically responsive materials and messages that reach workers of racial and ethnic minority groups.
• Offer flexible schedules, nonpunitive paid sick leave and telework — equitably.
• Collect detailed occupation data on cases, to see which jobs carry the most risk.

Limits

• Not every workplace outbreak was detected, especially in small workplaces, and mild cases may have gone untested.
• Worker-to-worker spread couldn't be confirmed; some cases came from home, the community or commuting.
• There were no individual occupation data.
• Utah's stay-at-home directives affected sectors differently, so results may not apply elsewhere.
• Workforce counts couldn't exclude health care, education and congregate-living workers, so some rates are underestimated.

Sources

Based on Bui DP, McCaffrey K, Friedrichs M, et al., "Racial and Ethnic Disparities Among COVID-19 Cases in Workplace Outbreaks by Industry Sector — Utah, March 6–June 5, 2020," MMWR Morbidity and Mortality Weekly Report, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The source gives the nonwhite share of outbreak cases as 19%, which does not match its own counts (187 of 1,335), so only the counts are given.