Virginia COVID-19 Response: Meat and Poultry Processing Plants

This data will be updated at the beginning of each month.

The meat and poultry data blog looks different this month—why the change?

The number of COVID-19 cases, outbreaks, hospitalizations and deaths associated with meat and poultry processing plants continue to remain very low throughout Virginia. As long as there is community transmission of COVID-19, it is likely that we will continue to see occasional cases in meat and poultry processing plant workers over time. The focus of the COVID-19 response efforts for meat and poultry processing plant workers has shifted from supporting outbreak investigations to providing vaccine access to this essential workforce.

What efforts have been made to improve COVID-19 vaccine access to meat and poultry processing workers?

VDH and the food sector have been working on various ways to distribute COVID-19 vaccines to meat and poultry processing workers. These include working with occupational health providers and local health departments. In addition to these efforts community-based organizations have been working to share information about COVID-19 vaccines with workers in the food and agriculture sector.

  • The Lord Fairfax Health District (LFHD) has been working with local food processors to set up vaccination clinics. They’ve vaccinated local fruit growers and a few food processing plants and are continuing to reach out to businesses to arrange coming on site to get more people vaccinated. Since January 2021, LFHD has vaccinated at least:
    • 405 meat and poultry processing plant workers
    • 255 dairy workers
    • 170 produce workers
    • 130 other food production workers
    • 43 migrant workers
  • The Central Shenandoah Health District (CSHD) scheduled 15 clinics onsite at poultry plant facilities, administering over 2,770 1st and 2nd COVID-19 vaccine doses. The health district utilized Community Health Workers to work with poultry plant workers and their families to get connected to other clinics if they were unable to or uncomfortable with receiving the vaccine at the onsite clinics at their place of employment. These efforts supported the districts’ larger, weekly clinics at the Rockingham County Fairgrounds and James Madison University where essential workers, including poultry plant workers, food processing, and agricultural workers, were invited to come and receive a COVID-19 vaccine. Furthermore, CSHD engaged with poultry plant facilities to establish COVID-19 vaccine programs within their occupational health programs. So far, this effort has resulted in the establishment of one COVID-19 vaccine program at a local poultry plant.
  • The Eastern Shore Health District (ESHD) has:
    • Been offering COVID-19 vaccinations to seasonal workers as they arrive on the Shore and coordinating that effort with local farm managers and crew leaders.  Out of approximately 130 workers currently on the Shore, it is estimated that  80-85% have been vaccinated; some received the vaccine before they arrived.
    • Partnered with Eastern Shore Rural Health to provide three onsite vaccination events at poultry plant facilities. Hispanic and Haitian Creole outreach workers helped provide education to workers as part of these events. A total of 91 night shift workers were vaccinated during these events and similar events are planned for day shift workers in early June. The Elite Marketing Group will be helping to host a pre-vaccination “party” with snacks and educational information as part of these upcoming events.
    • Offered weekly walk-in vaccination clinics on Tuesdays and Wednesdays at the local health department.
    • Partnered with Legal Aid and Eastern Shore Rural Health to plan an upcoming outdoor event at the local YMCA, to specifically offer COVID-19 vaccines to the refugee, immigrant and migrant populations. There will be informational tables for organizations who provide services to this community and walk-up vaccine opportunities for anyone 12+ with all three authorized vaccines available to maximize vaccine uptake.
    • Hired one Hispanic and one Haitian Creole Community Health Worker who will be working primarily with poultry, agricultural, aquaculture and seasonal workers, which comprise a large part of the refugee, immigrant and migrant community.
Why is COVID-19 vaccination so important?

COVID-19 vaccination is an important tool to help us get back to normal; every vaccine administered helps us get closer to reaching population immunity. Population immunity means that enough people in a community are protected from getting a disease because they’ve already had the disease or because they’ve been vaccinated. Population immunity makes it hard for the disease to spread from person to person. It even protects those who cannot be vaccinated, like newborns or people who are allergic to the vaccine. Learn more about the benefits of getting vaccinated.

Why the focus on meat and poultry processing workers?

Initial cases of COVID-19 associated with meat and poultry processing plants were reported in Virginia in March of 2020. Cases peaked in April and May of 2020 with large outbreaks reported in several processing plants throughout the United States, including Virginia. Workers in these facilities need to work closely to one another, often for prolonged periods of time, making transmission of COVID-19 from one worker to another easy. Protecting this vulnerable workforce is important to protect both the workers, who produce the food we eat, and the communities in which they live.

In addition to vaccination, what other interventions were put in place to prevent the transmission of disease within these facilities and the wider communities in which they exist?

The Virginia Department of Health worked with affected facilities to put a variety of interventions in place to reduce disease transmission. The most common interventions implemented in Virginia included:

  • educating employees about the transmission of COVID-19
  • screening employees for signs and symptoms of illness
  • adding hand hygiene stations
  • adding physical barriers between workers where physical distancing was not possible, and
  • requiring universal face coverings

For more information about recommended interventions for meat and poultry processing facilities, check out the links below:

Enhanced Public Reporting of COVID-19 Outbreaks

What is now included that was not reported before?
Beginning on May 7, 2021, the Virginia Department of Health (VDH) will publicly report outbreaks with laboratory evidence from any diagnostic test meeting the COVID-19 outbreak definition. Previously, VDH only publicly reported COVID-19 outbreaks with laboratory confirmed cases from molecular amplification tests (MATs), like PCR tests. Now, VDH will report COVID-19 outbreaks with cases identified by any diagnostic test, such as antigen tests, to more accurately represent the burden of COVID-19 outbreaks.

Why?
COVID-19 cases associated with an outbreak are often underreported. This is because not everyone seeks testing or are identified as part of an outbreak during the public health investigation by VDH staff. However, the impact on a community is the same regardless of whether an outbreak consists of cases with positive PCR or antigen tests. In an effort to inform the community about what is occurring in their area, it is important to share all COVID-19 outbreaks that are being investigated.

Why now?
As testing and reporting of COVID-19 cases have evolved, so has VDH’s approach to outbreak reporting. Early in the pandemic, only people with a positive PCR test were classified as a COVID-19 case. However, later, when antigen tests received Emergency Use Authorization  from the United States Federal Drug Administration (FDA), people with positive antigen tests  were counted as probable cases of COVID-19. Many healthcare facilities and school-based testing programs use only antigen testing options. Reporting outbreaks with positive lab results from antigen or PCR tests more accurately informs the public about how many COVID-19 outbreaks there are in their community.

Will VDH include outbreak data since the beginning of the pandemic?
No, outbreak data will be updated retrospectively from January, 1, 2021. VDH conducted an evaluation of COVID-19 outbreak data and methods for public reporting. Analysis of COVID-19 outbreak data shows an increase in reported outbreaks with antigen only lab tests beginning January 1, 2021. VDH is prioritizing outbreak data for 2021 to share relevant and actionable data to the public now.

COVID-19 Outbreaks Associated with Meat and Poultry Processing Plants in Virginia

This data will be updated at the beginning of each month.

What is a COVID-19 outbreak?

An outbreak is an increase in the number of cases of disease observed. In Virginia, an outbreak of COVID-19 is defined as two (2) or more lab-confirmed cases associated with a facility.

How many outbreaks have occurred in meat and poultry processing facilities in Virginia?

To date, a total of 17 COVID-19 outbreaks in meat and poultry processing facilities in Virginia have been identified.

How many confirmed cases of COVID-19 have been associated with these outbreaks? How many people experienced serious illness resulting in hospitalization or death?

The total number of confirmed cases, hospitalizations and deaths associated with these outbreaks is shown in the tables below.

Confirmed Cases1 Hospitalizations1,2 Deaths1
1368 54 9

 

Confirmed Cases by Region1
Central 61
Eastern 810
Northern 0
Northwestern 497
Southwest 0
TOTAL 1368

How have the outbreaks associated with meat and poultry processing facilities changed over time?

Initial cases of COVID-19 associated with meat and poultry processing plants were reported in March of 2020. Cases peaked in April and May. Facilities implemented multiple interventions to reduce and prevent viral transmission. Cases have since decreased significantly and only sporadic cases are being reported at this time.

What interventions were put in place to prevent the transmission of disease within these facilities and the wider communities in which they exist?

The Virginia Department of Health worked with affected facilities to put a variety of interventions in place to reduce disease transmission. The most common interventions implemented in Virginia included:

  • educating employees about the transmission of COVID-19
  • screening employees for signs and symptoms of illness
  • adding hand hygiene stations
  • adding physical barriers between workers where physical distancing was not possible, and
  • requiring universal face coverings

For more information about recommended interventions for meat and poultry processing facilities, check out the links below:

Might more cases be seen in these facilities over time?

As long as there continues to be increased community transmission of COVID-19, it is likely that we will continue to see occasional cases in meat and poultry processing plant workers over time.

Footnotes:

For more information about epidemiologic data shared by the Virginia Department of Health, check out our Five Things to Remember When Interpreting Epidemiologic Data.1 All data is preliminary and subject to change over time.

2 Hospitalization status at time case was investigated by VDH. This underrepresents the total number of hospitalizations in Virginia.

Source: Cases – Virginia Electronic Disease Surveillance System (VEDSS)

Excess Deaths in Virginia during the COVID-19 Pandemic

What are excess deaths?

Excess deaths are the number of deaths over the expected average, while taking into account monthly variation and population growth by year. Death certificates filed through the Virginia Department of Health’s (VDH) Office of Vital Records (OVR) are used to make these calculations. Typically, all-cause mortality, which means looking at total death certificates due to any cause or manner of death (essentially looking at all deaths in the state), are used to make these calculations.

How were the total excess deaths examined during the COVID-19 pandemic?

In 2019, nearly 70,000 deaths occurred in Virginia according to data obtained from death certificates from VDH OVR. Using these same data from 2015 to 2019 by month of death and accounting for monthly variation and population growth, it was estimated that Virginia would have experienced 70,750 expected deaths in Virginia in 2020 if the COVID-19 pandemic never occurred. These estimations were calculated through March 2021.

These expected deaths were compared to preliminary totals of actual death certificates filed by month of death for 2020 and for the start of 2021. Adjusting this review from the start of the pandemic in March 2020, data were examined through February 2021 and accounted for one year of preliminary data. It was estimated that from March 2020 to February 2021, Virginia would have expected to see 70,704 total deaths but instead actually experienced a preliminary total of 82,772 deaths of all cause-mortality; an excess of 12,068 deaths, or 17.1% from the expected total (Figure 1).

Figure 1. Number of Expected Deaths (no pandemic) compared to preliminary number of actual deaths by year and month of death, 2020-March 2021

What types of deaths made up the excess death category?

Some known and unknown increases in specific categories of death made up the 12,068 excess deaths during March 2020 to February 2021.

  • The largest portion of the total excess deaths was made up of confirmed COVID-19 deaths (9,847 or 81.6%) based on death certificates filed or VDH disease investigations where, after review, it was determined that COVID-19 was a cause or contributor to death (how VDH counts COVID-19 deaths is listed here). COVID-19 deaths are natural deaths, and pursuant to the Code of Virginia § 32.1-283, the vast majority of these deaths do not fall under jurisdiction of the Office of the Chief Medical Examiner (OCME) unless other circumstances of the death make it an OCME case.
  • When reviewing the other categories of excess deaths that made up the total excess deaths, one must review deaths that fall under OCME jurisdiction and natural deaths that do not fall under OCME jurisdiction.
    • For the OCME cases, two general categories of OCME deaths were examined among the total excess: drug overdose deaths and non-drug overdose deaths. First, while 2019 set the record for the largest number of fatal drug overdoses ever seen in Virginia, like most other states, Virginia experienced a large increase in fatal drug overdoses beginning in March 2020 and continuing throughout the pandemic. Using the same methodology calculations of expected deaths to excess deaths, it was estimated that Virginia experienced 673 excess drug deaths by month of death when comparing 2019 totals (5.6% of total excess deaths). Similarly, using 2019 numbers by month and comparing preliminary totals of all OCME cases but removing excess drug deaths, a category of non-drug overdose excess OCME deaths by month were identified (n=909 or 7.6% of total excess deaths).
    • For the excess deaths not under OCME jurisdiction, COVID-19 deaths and excess OCME cases (both drug overdose and non-drug overdose deaths) were compared to the total number of excess deaths (n=12,068), resulting in a category of unknown natural deaths not under OCME jurisdiction (n=629 or 5.2% of total excess deaths) (Figure 2).

Figure 2. Number and percent of excess deaths by known and unknown causes march 2020-february 2021
What are the implications of the excess deaths during the pandemic?

Undoubtedly, the COVID-19 pandemic will go down as one of the most significant world events in recent history. The physical health, mental health, and livelihood of billions of people across the globe have been significantly impacted by COVID-19. In the United States, life expectancy, the rank order of leading causes of death, mortality rates, and various other statistical measures of public health are expected to change based on this single event.

Although 81.6% of the excess deaths were due to COVID-19, the remaining 18.4% were deaths not directly related to COVID-19 infection. Among the excess OCME cases, fatal drug overdoses, which were already declared an epidemic in Virginia in 2016, were exacerbated during the pandemic with a preliminary estimate of over a 45% increase in overdose deaths in 2020 compared to 2019. Various hypotheses about reasons for this increase have been considered, but a deeper dive into these theories is needed by the academic community.

The total annual homicides for 2020 also contributed to the excess non-drug overdose OCME cases. Total homicides in 2020 reached the highest number recorded in Virginia in the last few decades with a preliminary total of 541 homicides; an increase of 80 additional homicides from 2019, or a 17.4% increase. Deaths at home where the person who died had not been treated by a physician in the last year, making the death an OCME case by Code of Virginia, also increased in 2020 compared to past years.

Interestingly, but also thankfully, annual statewide suicide numbers did not increase or decrease in 2020 when compared to numbers in past years. Given that drug overdoses have many of the same risk factors as suicide, one would assume that if one of these events increased during the pandemic, so would the other; however, that was not demonstrated statewide in Virginia OCME data.

Lastly, the category of unknown natural deaths not under OCME jurisdiction needs further investigation into the commonalities in this category. This review was based on preliminary OCME data in comparison to preliminary all-cause mortality data from all death certificates filed in the state, so additional investigation from VDH OVR or other researchers needs to be performed on the non-OCME natural excess deaths. Further investigations into this unknown category of excess deaths is needed to focus prevention efforts in an attempt to prevent additional deaths during and after the COVID-19 pandemic.

Data notes and limitations

Data calculations used VDH OVR data from 2015-2019 to estimate monthly 2020 and 2021 expected numbers of deaths while accounting for monthly variation and population growth. Data was extracted March 18, 2021 and analyzed from March 2020 to February 2021 and accounted for one year of preliminary data at the time of publication. All data presented should be considered preliminary and subject to change.

COVID-19 Outbreaks Associated with Meat and Poultry Processing Plants in Virginia

This data will be updated at the beginning of each month.

What is a COVID-19 outbreak?

An outbreak is an increase in the number of cases of disease observed. In Virginia, an outbreak of COVID-19 is defined as two (2) or more lab-confirmed cases associated with a facility.

How many outbreaks have occurred in meat and poultry processing facilities in Virginia?

To date, a total of 17 COVID-19 outbreaks in meat and poultry processing facilities in Virginia have been identified.

How many confirmed cases of COVID-19 have been associated with these outbreaks? How many people experienced serious illness resulting in hospitalization or death?

The total number of confirmed cases, hospitalizations and deaths associated with these outbreaks is shown in the tables below.

Confirmed Cases1 Hospitalizations1,2 Deaths1
                   1338 53 9

 

Confirmed Cases by Region1
Central 61
Eastern 774
Northern 0
Northwestern 503
Southwest 0
TOTAL 1338
How have the outbreaks associated with meat and poultry processing facilities changed over time?

Initial cases of COVID-19 associated with meat and poultry processing plants were reported in March of 2020. Cases peaked in April and May. Facilities implemented multiple interventions to reduce and prevent viral transmission. Cases have since decreased significantly and only sporadic cases are being reported at this time.

Confirmed cases graphic

What interventions were put in place to prevent the transmission of disease within these facilities and the wider communities in which they exist?

The Virginia Department of Health worked with affected facilities to put a variety of interventions in place to reduce disease transmission. The most common interventions implemented in Virginia included:

  • educating employees about the transmission of COVID-19
  • screening employees for signs and symptoms of illness
  • adding hand hygiene stations
  • adding physical barriers between workers where physical distancing was not possible, and
  • requiring universal face coverings

For more information about recommended interventions for meat and poultry processing facilities, check out the links below:

Might more cases be seen in these facilities over time?

As long as there continues to be increased community transmission of COVID-19, it is likely that we will continue to see occasional cases in meat and poultry processing plant workers over time.

Footnotes:

For more information about epidemiologic data shared by the Virginia Department of Health, check out our Five Things to Remember When Interpreting Epidemiologic Data.

1 All data is preliminary and subject to change over time.

2 Hospitalization status at time case was investigated by VDH. This underrepresents the total number of hospitalizations in Virginia.

Source: Cases – Virginia Electronic Disease Surveillance System (VEDSS)