Meat plants—a new front line in the covid-19 pandemicBMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2716 (Published 09 July 2020) Cite this as: BMJ 2020;370:m2716
- John Middleton, honorary professor or public health1,
- Ralf Reintjes, professor of epidemiology and public health surveillance2,
- Henrique Lopes, professor of public health3
- 1Wolverhampton University, Wolverhampton, UK
- 2Hamburg, Germany
- 3Unit of Public Health, Healthcare Sciences Institute, Universidade Católica, Portugal
- Correspondence to: J Middleton
Slaughterhouses and meat packing plants have been a major risk for covid-19 infection throughout the pandemic.12 Now these outbreaks are centre stage.3 They affect whole communities, have far reaching implications, and require intensive public health interventions.
In Germany, public health authorities have been grappling with a huge covid-19 outbreak in Gütersloh, North Rhine-Westphalia. More than 1500 of 7000 workers tested positive for covid-19, and 640 000 residents of two affected counties were returned to lockdown conditions.4 At one of Portugal’s biggest poultry slaughterhouses, at least 129 of the 300 workers contracted covid-19.5 The company was closed for a week; additional measures included screening all employees, providing new bathing areas, and strengthening disinfection. Outbreaks in England and Wales have been associated with meat processing in Anglesey, Merthyr Tydfil, Wrexham, and Kirklees.6
Slaughterhouses and meat processing plants are favourable environments for SARS-CoV-2 transmission.17 The virus thrives in lower temperatures and very high or very low relative humidity. Metallic surfaces retain live viruses for longer than other environments.89 A dense production of aerosols combining dust, feathers, and faeces is produced in the plants, and intense water use carries materials extensively over surfaces. Workers must speak loudly or shout over the noise, releasing more droplets and spreading them further.10 Workplaces are crowded, and social distancing is difficult.
Sociodemographic and workforce factors implicated in these outbreaks include a youthful workforce more likely to have asymptomatic infections; insecure poorly paid employment that discourages workers from disclosing symptoms for fear of penalty; long hours and coercive contracts; a reliance on migrant workers housed in inadequate overcrowded accommodation and transported on overcrowded buses; and limited or non-existent hygiene measures.17
Companies across the meat processing sector should conduct urgent risk assessments and implement a hierarchy of measures to prevent further outbreaks.17 These include staggering start, finish, and break times; reducing crowding by adding outdoor breakrooms; and installing barriers between workers, especially on production lines. All workers should be screened for symptoms, including fever, on arrival at work1 and isolated quickly if required.
They should also consider operational measures such as reducing the processing rate for animals and carcasses, mandating face coverings, embedding good practice in donning and doffing protective equipment, installing touch-free time clocks, and introducing enhanced cleaning and disinfection regimens.17 Health education materials for staff must be culturally appropriate and available in all languages relevant to the local workforce. Face coverings should be compulsory on all forms of mass transport. Finally, employers should encourage workers not to attend if ill, declare their symptoms, and self-isolate. Adequate sick pay is essential during all work absence.137
Early recognition of outbreaks requires strong local surveillance systems. Local health authorities need to work alongside businesses, occupational health services, and health and safety inspection services where these exist.3 They should have outbreak plans ready for rapid implementation, including efficient systems for testing, contact tracing, and isolation.13 All businesses must recognise their responsibility to public health—in addition to the usual corporate self-interest—and cooperate fully with the authorities when closures are required.14
In Germany, outbreaks in meat plants have led to local lockdowns. The reproduction number, or average number of secondary infections produced by one infected person has temporarily risen to 2.88.15 In most English regions R is already around 1-1.1,16 and the imperative to consider local lockdowns is now recognised after a spike of cases in Leicester.17The pandemic shows up longstanding inequalities in health, with migrant and other ethnic minority workers again in the frontline facing a high risk of infection.18 The Leicester outbreak, for example, has exposed the “open secret” of overcrowded working conditions and ultra low wages endured by some groups.17 Rapid and permanent improvements in working conditions and wages are needed, along with sound occupational health services for all19 and universal healthcare that includes migrant workers, to encourage help seeking when sick.
While the pandemic continues, meat processing plants will remain potential trigger points for a second wave. In Gütersloh, for example, infections are increasing among citizens unconnected with the meat plant or its staff.
The meat industry is highly profitable globally and a major driver of both antimicrobial resistance20 and climate breakdown.21 People may come to reflect on how they get their meat, what they are prepared to pay for it, and what conditions they expect the animals and the workers to endure so they can have it.
Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: JM is president of the Association of Schools of Public Health in the European Region.
Provenance and peer review: Commissioned; not externally peer reviewed.
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