COVID-19 Surveillance and Investigations in Workplaces — Seattle & King County, Washington, June 15–November 15, 2020

Bonwitt, Jesse; Deya, Ruth W.; Currie, Dustin W.; Lipton, Beth; Huntington-Frazier, Melinda; Sanford, Sara Jaye; Pallickaparambil, Aley Joseph; Hood, Julia; Rao, Agam K.; Kelly-Reif, Kaitlin; Luckhaupt, Sara E.; Pogosjans, Sargis; Lindquist, Scott; Duchin, Jeff; Kawakami, Vance; Birdie, Rosheen; Bliesner, Siri; Bro, Erika; Bui, Thu; DaCruz, Joan; Elcock, Maryellen; Lambert, Joanie; Leung, Ming; Marfa, Angelo; Mcmichael, Temet; Mummert, Laura; Pomerantz, Aaron; Sifrit, Nicola; Sutton, Renee; Thomforde, Christine; VonJoe, Christian; Look, Jennifer; Whitney, Holly

Workplace activities involving close contact with coworkers and customers can lead to transmission of SARS-CoV-2, the virus that causes COVID-19 (1,2). Information on the approach to and effectiveness of COVID-19 workplace investigations is limited. In May 2020, Public Health - Seattle & King County (PHSKC), King County, Washington established a COVID-19 workplace surveillance and response system to enhance COVID-19 contact tracing and identify outbreaks in workplaces. During June 15-November 15, 2020, a total of 2,881 workplaces in King County reported at least one case of COVID-19. Among 1,305 (45.3%) investigated workplaces,* 524 (40.3%) met the definition of a workplace outbreak.†Among 306 (58.4%) workplaces with complete data,§ an average of 4.4 employee COVID-19 cases¶ (median = three; range = 1-65) were identified per outbreak, with an average attack rate among employees of 17.5%. PHSKC and the Washington State Department of Health optimized resources by establishing a classification scheme to prioritize workplace investigations as high, medium, or low priority based on workplace features observed to be associated with increased COVID-19 spread and workforce features associated with severe disease outcomes. High-priority investigations were significantly more likely than medium- and low-priority investigations to have two or more cases among employees (p<0.001), two or more cases not previously linked to the workplace (p<0.001), or two or more exposed workplace contacts not previously identified during case interviews (p = 0.002). Prioritization of workplace investigations allowed for the allocation of limited resources to effectively conduct workplace investigations to limit the potential workplace spread of COVID-19. Workplace investigations can also serve as an opportunity to provide guidance on preventing workplace exposures to SARS-CoV-2, facilitate access to vaccines, and strengthen collaborations between public health and businesses.