Investigation of a SARS-CoV-2 Outbreak at an Automotive Manufacturing Site in England

Abstract

Workplace-related outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to occur globally. The manufacturing sector presents a particular concern for outbreaks, and a better understanding of transmission risks are needed. Between 9 March and 24 April 2021, the COVID-19 (coronavirus disease 2019) Outbreak Investigation to Understand Transmission (COVID-OUT) study undertook a comprehensive investigation of a SARS-CoV-2 outbreak at an automotive manufacturing site in England. The site had a total of 266 workers, and 51 SARS-CoV-2 infections. Overall, ventilation, humidity, and temperature at the site were assessed to be appropriate for the number of workers and the work being conducted. The company had implemented a number of infection control procedures, including provision of face coverings, spacing in the work, and welfare areas to allow for social distancing. However, observations of worker practices identified lapses in social distancing, although all were wearing face coverings. A total of 38 workers, including four confirmed cases, participated in the COVID-OUT study. The majority of participants received COVID-19 prevention training, though 42.9% also reported that their work required close physical contact with co-workers. Additionally, 73.7% and 34.2% had concerns regarding reductions in future income and future unemployment, respectively, due to self-isolation. This investigation adds to the growing body of evidence of SARS-CoV-2 outbreaks from the manufacturing sector. Despite a layered COVID-19 control strategy at this site, cases clustered in areas of high occupancy and close worker proximity.

Keywords: COVID-19; SARS-CoV-2; manufacturing; outbreak; workplace.

Figure 1

Timeline and epidemiological curve of COVID-19 outbreak investigation in a UK automotive manufacturing site between 13 February 2021 and 23 April 2021. Arrows indicate key dates of the outbreak and COVID-OUT study. The grey box indicates the period of time during which 51 acute SARS-CoV-2 infections were reported by the company. The line chart represents the 7-day case rate for the lower tier local authority area (LTLA) of the site (contains public sector information licensed under the Open Government Licence v3.0 from [10]; the date of download: 18 August 2021).

Figure 2

Baseline questionnaire responses of participants from an automotive manufacturing site—England, United Kingdom. (A) Proportion of participants reporting infection control measures at workplace before the pandemic and within 14 days prior to completing the questionnaire. (B) Proportion of participants reporting their daily number of contacts in different locations within the last 14 days of completing the questionnaire. Error bars represent 95% confidence intervals (CI). The following data were missing: handwashing before pandemic (n = 2) and in last 14 days (n = 3), gloves before pandemic (n = 4) and in last 14 days (n = 2), face covering before pandemic (n = 3) and in last 14 days (n = 3), surgical mask before pandemic (n = 2) and in last 14 days (n = 3), FFP2/ FFP3 mask before pandemic (n = 2) and in last 14 days (n = 2), Face shield in pandemic (n = 2) and in last 14 days (n = 2), protective glasses before pandemic (n = 4) and in last 14 days (n = 3), plastic apron before pandemic (n = 2) and in last 14 days (n = 3), household contacts (n = 0), work contacts (n = 1), commute contacts (n = 1), social contacts (n = 0), and essential contacts (n = 0).

Figure 3

Site floor plan of the automotive manufacturing site—England, United Kingdom. Site divided into three main sections: warehouse, production, and office and welfare (e.g., canteen). The office and welfare section is split across two floors and only the first floor is shown in the figure. The second floor contains offices (enclosed and open-plan), meeting rooms, toilets, and small canteen. The attack rate for specific areas was calculated by the number of positive cases in area divided by the total number of workers for the area. The volumes have been approximated for each section and do not account for the slopes of the ceilings. Abbreviations: Quality control (QC), Climate control (CC), W/C (Water closet), and Temperature (Temp).