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These workers likely became a “major source of transmission” for COVID-19 without even knowing it because most of the study participants were asymptomatic.
The analysis, published Thursday in the journal Occupational and Environmental Medicine, is the first to demonstrate the significant rate of asymptomatic infection, exposure risks and psychological distress that supermarket workers have felt during the pandemic.
In the study, 20% of 104 grocery store workers tested at a Boston store in May had positive nasal swab tests.
This was a significantly higher infection rate than that seen in surrounding communities, the researchers said. Workers dealing with clients were five times more likely to test positive for COVID-19 than their colleagues in other positions.
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But three out of four of those who tested positive had no symptoms.
“We were definitely surprised to see that there were so many asymptomatic people,” said Dr. Justin Yang, an assistant professor at Boston University School of Medicine and a Harvard School of Public Health investigator who worked on the study. “This is definitely very alarming, as it means that retail store employees are exposed to customers and act as intermediaries for the virus, almost like a super spreader.”
The study workers had tried to take precautions. Nearly all, 91%, said they wore a mask at work and 77% said they also wore masks outside of work. However, only about 66% said they could consistently practice social distancing at work.
This inability to distance themselves socially had both an emotional and physical impact. Nearly a quarter of people in customer service jobs said they had anxiety and depression issues compared to 8% of workers who didn’t have to interact with customers. Employees who commuted to work by bike, car or on foot were less likely to experience depression than those who used public transportation, the study found.
“If you’re in an environment where you’re literally in front of a customer, you can’t be taller than six feet, and that’s really stressful for essential employees,” Yang said.
At least 108 supermarket workers have died and more than 16,300 have been infected or exposed to Covid-19, the International Union of United Food and Commercial Workers, or UFCW, said on Thursday. The union represents 1.3 million employees.
Infection rates among workers in this study appear high, Yang said. By comparison, an earlier study of Covid-19 infections among Dutch healthcare workers found the infection rate to be around 10%.
Yang said he hopes this study will prompt the government and store owners to provide better guidance, routine testing and protection for grocery store workers.
There has been a national movement to designate supermarket workers as first responders, which would give them priority access to tests and personal protective equipment.
In an editorial for CNN in August, Marc Perrone, UFCW president and Democratic vice presidential candidate Kamala Harris, argued that supermarket workers should also be paid for dangerous living conditions.
Non-union grocery workers often have little to no health care coverage, which means they could face costly health care bills if they contract COVID-19.
Some states have increased support for supermarket workers by increasing access to childcare and requiring shoppers to wear masks. Three states offer free trials for these workers and four offer workers’ compensation, according to the UFCW, but none of the states provide full first-response status to supermarket workers, and the rules are inconsistent from state to state.
“We spend a lot of time talking about health workers, and they are important, but we are missing a lot of pieces of the puzzle if we don’t look at the exposure of non-health workers,” Yang said. “Their voices are not really being heard. I thought it was important to put this out so that government agencies and store owners could take note of this and see that they should protect their employees more.”
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