We came to know the coronavirus last spring from nightly news of New York City’s urban crisis. But in June, so-called “embers” of hidden infections morphed into wildfires, sweeping across large swaths of rural North Carolina and other states, leaving families and communities with upended lives and ongoing risk.
While nursing homes and prisons made up most rural hot spots in the spring, growing evidence now points to a different major “engine of spread” that has lurked beneath the radar of public awareness and official recognition: meat-processing.
By mid-May, as if to complement North Carolina’s rank as a pork and poultry producer, our state was the national leader in COVID-19 outbreaks at meatpacking plants, according to the Food and Environment Reporting Network (FERN). At least 3,234 meatpacking workers have contracted the coronavirus in outbreaks at 37 plants as of July 24, according to the state Department of Health and Human Services (DHHS).
But spread that begins in the plant does not stay in the plant. In mid-June, The News & Observer reported that zip codes close to plants showed a rise in cases since May 1 that was 600 percent higher than the state average.
Our data verifies that such viral spread continues. Below we connect the dots between North Carolina’s ongoing community spread and meatpacking plants to demonstrate the need for enforceable safety regulations and transparent reporting of data to bring the contagion under control.
Let’s start with a quandary: High case rates (total cases adjusted for population) for COVID-19 are typically found in cities. So, why does Duplin County have the highest case rate in the state at 309/10,000 residents—close to twice the rate for populous Mecklenburg County (168/10,000)? Duplin is now “national class” in the dubious category of coronavirus infections, recently ranking 58th in a New York Times listing of the 100 U.S. counties with the most serious surges.
A “disease detective” (aka an epidemiologist) would look for a point source of spread—a prison or elder care facility. Data on such settings are routinely collected by the state. But a recent count of roughly 183 such cases in Duplin explain only a tenth of the 1,820 cases recorded in the county as of July 24.
The rash of meatpacking plants across southeastern counties, five in Duplin alone, is a vital clue. At least two Duplin plants have confirmed outbreaks, including the Butterball turkey plant near Mount Olive and the Villari Foods “Pork Company” plant in Warsaw.
We mapped two clusters of rural N.C. zip codes with high case rates—100 or more cases per 10,000 residents—that are within commuting distance of one or more meat-processing plants.
The southeast cluster (Figure 1), at the regional epicenter of the industry, includes Duplin County, northern Robeson, and portions of Cumberland, Sampson, Johnston, Bladen, and Lenoir Counties. This density of plants correlates with risk. Fourteen zip codes with case rates over 200 in this cluster have two or more plants within 15 miles.
Figure 2, our central cluster, extends across Lee, Chatham, Montgomery, and portions of Randolph and Stanly Counties. These zip codes are less contiguous than in the southeast because our rural-focused analysis meant leaving out the cities of Sanford and Asheboro, whose populations exceed our limit of 25,000.
See Figure 3 for an expandable, scroll-over interactive map of each zip code in the two clusters:
Twenty-five of the 41 zip codes with high infection rates in these two clusters have a high number of Hispanic residents (17–50 percent, compared to the state average of 10 percent). Fourteen zip codes, all in the southeast, have a relatively high African American population (28–47 percent, compared to the state average of 22 percent). There is also a Native American presence in Robeson County.
These high Hispanic and minority communities align with the demographics of meatpacking workers. Statewide, Hispanics constitute a disproportionate number of COVID-19 cases (42 percent), while deaths from the virus disproportionately affect African Americans (33 percent), in part due to both groups being overrepresented in “essential” high risk jobs, as well as the chronic health problems that have long plagued Black communities.
While elderly people are the bulk of those dying of the virus, 75 percent of cases are among people of working age, between 18 and 64. Younger cohorts have been testing positive since June. Since many minority families live in crowded multigenerational households, elderly relatives are at risk when workers are infected at work. Likewise, community spread occurs as they go about daily life, shopping for food, banking, and sharing carpools with coworkers.
Few meatpacking plants have confirmed reports of outbreaks, and North Carolina’s DHHS will not identify which plants have cases. But state health officials confirmed by email on July 24 that 27 such outbreaks remain active in 20 counties, including eight represented in these clusters.
Outbreaks have occurred in six plants in the southeast cluster, including the two Duplin plants above, plus two Smithfield Foods plants (Tar Heel and Clinton), Mountaire (Lumber Bridge), and Sanderson Farms (Saint Pauls), according to media accounts. Two outbreaks have been reported in the central cluster at the Mountaire plant (Siler City) and Pilgrim’s Pride plant (Sanford).
The June surge in urban cases is often attributed to the reopening of the economy, but the steep rise of cases in Figure 4 for predominantly rural Robeson and Duplin Counties show no deviations that line up with the state’s reopening on May 8 for phase 1 and May 22 for phase 2. Note the contrast with Wilkes County, where a massive outbreak at Tyson Foods in April was brought under control once Tyson, facing the threat of a court order, began sharing data on testing with health authorities, allowing isolation of infected workers.
Although news coverage of most plant outbreaks peaked in April and May, highly rural Duplin and Robeson Counties (Figure 4) saw new infections shoot up an alarming 45-fold in the two months ending June 10. This suggests that outbreaks and community spread continue in the southeast.
A survey of 36 worker complaints to the Occupational Safety and Health Agency (OSHA) about unsafe conditions in plants between April and early June supports this finding, as do reports from workers and rural nonprofits of worker families falling ill.
North Carolina’s DHHS boosted testing in July, so high case rates partly reflect hidden infections coming to light when more convenient, free testing is offered in rural areas. But since asymptomatic people often test negative roughly two weeks after being infected, this steady rise in cases over six weeks is consistent with ongoing spread.
Our state’s experience is not unique. As of July 23, at least 37,197 meatpacking workers had tested positive for the virus in 38 states, and 168 have died, reported FERN. Community spread from industry outbreaks is also common. In late May, the nonprofit found that rural counties with previous meatpacking outbreaks showed infection rates five times higher than the average for other U.S. rural counties. Multinationals such as Tyson, JBS, and Smithfield accounted for more than half of meatpacking cases nationwide.
After initial outbreaks closed about 25 plants across the country by late April, Tyson Foods lobbied the White House and placed ads in major papers warning of a meat shortage. The industry was rewarded by an executive order from President Donald Trump a day later requiring plants to stay open.
Since then, many companies have adopted temperature checks of workers, masks and gloves (PPE), and installed dividers between line workers and hand-washing stations. The large Smithfield Foods plant, with more than 4,000 workers in Tar Heel, is one of the rare unionized plants in the state. The United Food and Commercial Workers union credits Smithfield for new safety protocols, as well as paid sick leave for infected workers and those over age 60.
But complaints to OSHA, including six from workers in that plant, tell a more nuanced story. Several said social distancing was lacking, and one described “employees working elbow to elbow.” On May 6, a worker wrote: “Numbers of cases have gone up, management has not provided any PPE or any cleaning to protect workers.”
Scott Mabry, a spokesperson for NC-OSHA, said the agency received 75 meatpacking complaints since March, including seven in July. He said OSHA sends letters and follows up with employers but has not done inspections related to meatpacking complaints to date.
At the Siler City Mountaire plant, six to eight weeks passed before safety protocols were implemented, said Ilana Dubester of Hispanic Liaison. Although companies are supposed to inform workers exposed to employees who test positive, workers told her Mountaire would not give out this information. As a result, some took on the task of contact-tracing themselves.
They also said infected workers say supervisors pressure them to come back to work, a practice criticized in OSHA filings from workers for that plant as well as the Mountaire Plant in Lumber Bridge and the Smithfield plant in Wilson.
This practice flies in the face of the widely accepted two-week quarantine for people exposed to COVID-19, since even asymptomatic people can transmit the virus. But it is allowed in workplace guidelines that the Centers for Disease Control and Prevention (CDC) and OSHA published in April.
The Denver Post obtained emails revealing that the weaker rule was adopted within hours after JBS asked Vice President Mike Pence to intervene. Pence called Robert Redfield, director of the CDC, asking him to amend the guidelines (then in preparation) permitting workers who test positive to resume work if they are asymptomatic.
The guidelines have also been criticized for merely offering advice rather than rules. Debbie Berkowitz, a former OSHA chief of staff, said the language is so watered down with phrases like “if feasible” and “consider doing this” that they are essentially unenforceable.
“To protect the public from COVID-19, you have to protect workers. If you don’t, it continues to spread. So, in this pandemic, worker health is public health,” says Berkowitz, a worker-safety specialist at the National Employment Law Project.
In public statements, plant managers often cite “culture” to explain high Hispanic infection rates. At a recent townhall meeting, Sen. Thom Tillis speculated that Hispanic people’s rejection of masks was the problem, although surveys show Hispanics accept masks at a higher rate than whites.
One might also point to “culture” when billion- dollar companies that depend on the labor of immigrant employees fail to publish COVID-19 safety rules in their native language, a problem that the CDC found to be common in meatpacking plants that experienced outbreaks.
Some states, including Michigan, Minnesota and Illinois, have responded to outbreaks in meat plants by issuing regulations specifically targeted at meatpacking, Berkowitz says. Several others, including Virginia, adopted enforceable regulations that apply to all workplaces.
But North Carolina is going in the opposite direction. In early July, several lawmakers proposed linking worker-safety measures and paid medical leave to state grants intended to aid small and medium-sized meatpackers in the crisis, but their amendments were voted down. In the end Republican lawmakers voted to give $10 million in grants to the companies (and livestock producers), with no requirements other than to submit a safety plan.
Rep. Jimmy Dixon, a Duplin County Republican who opposed the amendments, said the plants could be trusted more than lawmakers on how to keep employees safe.
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Sandy Smith-Nonini is an adjunct asst. professor of anthropology at UNC-Chapel Hill who has done research on public health and working conditions of Latino workers.