A rash of coronavirus outbreaks at dozens of meat packing plants across the nation is far more extensive than previously thought, according to an exclusive review of cases by USA TODAY and the Midwest Center for Investigative Reporting.

And it could get worse. More than 150 of America’s largest meat processing plants operate in counties where the rate of coronavirus infection is already among the nation’s highest, based on the media outlets’ analysis of slaughterhouse locations and county-level COVID-19 infection rates.

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These facilities represent more than 1 in 3 of the nation’s biggest beef, pork and poultry processing plants. Rates of infection around these plants are higher than those of 75% of other U.S. counties, the analysis found.

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And while experts say the industry has thus far maintained sufficient production despite infections in at least 2,200 workers at 48 plants, there are fears that the number of cases could continue to rise and that meat packing plants will become the next disaster zones.

"Initially our concern was long-term care facilities," said Gary Anthone, Nebraska's chief medical officer, in a Facebook Live video on Sunday. “If there's one thing that might keep me up at night, it's the meat processing plants and the manufacturing plants."

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As companies scramble to contain the outbreaks by closing more than a dozen U.S. plants so far — including a Smithfield pork plant in South Dakota that handles 5% of U.S. pork production — the crisis has raised the specter of mass meat shortages.

But experts say there's little risk of a dwindling protein supply because, given the choice between worker safety and keeping meat on grocery shelves, the nation’s slaughterhouses will choose to produce food.

“If this goes on for a long time, there is a reality of a shortage,” said Joshua Specht, an assistant professor of history at the University of Notre Dame who studies the meat industry. “The politics of this could play out that they reopen at enormous risks to workers, rather than face an actual shortage… I wouldn’t bet against that.”

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© U.S. Government Accountability Office report Workers stand close together on a poultry processing line as shown in this photo from a U.S. Government Accountability Office report.

The meat packing industry was already notorious for poor working conditions even before the coronavirus pandemic. Meat and poultry employees have among the highest illness rates of all manufacturing employees and are less likely to report injuries and illness than any other type of worker, federal watchdog reports have found.

And the plants have been called out numerous times for refusing to let their employees use the bathroom, even to wash their hands — one of the biggest ways to reduce the spread of the coronavirus.

Amplifying the danger is that, in many places, meat processing companies are largely on their own to ensure an outbreak doesn’t spread across their factory floors.

Factory workers, unions, and even managers say the federal government — including the U.S. Centers for Disease Control and Prevention and the Occupational Safety and Health Administration — has done little more than issue non-enforceable guidance. On its website, for example, the CDC has released safety guidelines for critical workers and businesses, which primarily promote common sense measures of sanitization and personal distancing.

State health departments have also taken a backseat role in all but a few places.

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© Tyson Foods Tyson Foods has installed plastic barriers between worker stations at its meat and poultry plants to protect against transmission of the coronavirus

A bill introduced in the U.S. House of Representatives on Tuesday would require OSHA to issue enforceable safety standards to protect workers from COVID-19. A day earlier, 32 Democratic and two independent U.S. senators sent their concerns in a letter to the Trump administration, asking what was being done to protect food workers and the supply chain.

“Breakdowns in the food supply chain could have significant economic impacts for both consumers and agricultural producers,” the letter read. “It is also imperative that precautions are taken to ensure the stability and safety of our food supply.”

But rather than increase safety and oversight, the U.S. Department of Agriculture relaxed it in the midst of the pandemic. Just this month, the agency allowed 15 poultry plants to exceed federal limits on how many birds workers can process in a minute.

That’s more than in any previous month in the waiver program’s history. Several worker protection agencies have found that increasing line speeds causes more injuries.

And it could lead to more infections, the United Food and Commercial Workers International Union said in a statement: “These waivers guarantee that workers are more crowded along a meatpacking line and more workers are put at risk of either catching or spreading the virus.”

Most of the plants that received waivers are owned by Tyson Foods and Wayne Farms, according to a department record. One of them — a Wayne Farms facility in Albertville, Alabama — disclosed this week that 75 of its workers tested positive and one died. The plant will slow production to improve safety, it told AL.com.

“This is so dangerous for workers and the public," Debbie Berkowitz, who spent six years as chief of staff and senior policy advisor at OSHA and is now director of the National Employment Law Project’s worker health and safety program.

Berkowitz said she’s never seen anything like the recent flurry of approvals. "They did this behind closed doors with no input by the public and with no consideration to the impact on food or workers' safety.”

A spokesperson with the Food Safety and Inspection Service, the USDA agency that grants the waivers, said the agency has stopped accepting additional waiver requests.

Companies say they are taking steps to keep workers safe from outbreaks as they continue to feed the nation.

After the coronavirus sickened nearly 200 workers and killed two at a Tyson plant in Iowa, the company responded by making sweeping safety improvements at all its facilities, said Worth Sparkman, a company spokesperson.

Tyson installed plastic barriers between workers on the lines, allowed more time between shifts and removed chairs in break rooms to keep workers at a safe distance, Sparkman said.

“At all locations we’re working to educate our team members and reinforce the importance of social distancing, wearing protective facial coverings and frequent hand washing outside of work as well,” he said. “This is especially important in locations where there is community spread occurring.”

Tyson reopened its Columbus Junction, Iowa plant on Tuesday after having closed it April 6 to contain the outbreak. The company announced Wednesday that it would indefinitely suspend operations at its Waterloo pork processing plant this week.

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But meat processing workers elsewhere remain fearful for their safety.

A 50-year-old employee named John at Smithfield’s Sioux Falls plant told USA TODAY that there’s no way to stay six feet apart from coworkers on the production line, in the cafeteria or in the locker room. The employee asked to use only his first name for fear that speaking out would cost him his job.

As people around him at the plant became infected with COVID-19, John said, he started feeling sick and went to get his temperature checked, thinking he needed to leave. But he was stopped, he said.

“They told me I was OK and I needed to work,” said John, who has worked at the plant for a decade. “I said nope, and I came home.”

In early April, he learned he had tested positive for COVID-19.

“Those people don’t care about us,” John said. “If you die, they’ll just replace you tomorrow.”

Plants close, production plummets

By the time it closed its doors on April 12, Smithfield’s Sioux Falls plant had more than 200 confirmed cases of COVID-19. In the days since then, the case count has swelled to nearly 900, including workers and those they’ve interacted with, making it the biggest single cluster of COVID-19 infections in the nation.

CDC employees are touring the plant to develop a reopening plan expected to be released this week.

© Erin Bormett, The Argus Leader A car sporting a sign calling for a safe and healthy workplace drives past Smithfield Foods, Inc. in Sioux Falls on April 9, 2020 during a protest on behalf of employees after many workers complained of unsafe working conditions due to the COVID-19 outbreak. The pork processing plant in South Dakota is closing temporarily after more than 80 employees tested positive for the coronavirus.

But it’s not just Smithfield. As of Tuesday night, coronavirus infections had spread in at least 48 U.S. meat packing plants, sickening more than 2,200 people and killing 17, USA TODAY and the Midwest Center for Investigative Reporting found. The outbreaks also have prompted the closure of at least 17 facilities, including that of the JBS pork plant in Worthington, Minnesota, on Monday.

The Worthington JBS is among the 153 meat processing plants that USA TODAY and the Midwest Center for Investigative Reporting identified as operating in counties with a high rate of coronavirus. Any rate above one infection per 1,000 people puts a county in the top 25% of U.S. counties reporting COVID-19 infection rates.

Other plants on the list include the Tyson pork-processing facility in Columbus Junction, where 186 workers fell ill and two died after COVID-19 swept through the factory.

The Tyson plant is located in Louisa County, where 19 out of every 1,000 people have tested positive for the novel coronavirus. It’s the highest rate of any county with a large meat processor.

Tyson also has a poultry processing facility in Mitchell County, Georgia, where at least four workers have tested positive for coronavirus. The facility remains open, despite more than 9 out of every 1,000 county residents testing positive for COVID-19.

A JBS facility in Grand Island, Nebraska also remains open even after 237 workers tested positive there. The plant is located in Hall County, where 7.5 of every 1,000 people has tested positive.

National meat production is already hurting. Industry analysts say the factory closures cause choke points, with livestock backing up on farms and consumers struggling to find some products. Statistics from the U.S. Department of Agriculture show weekly beef production plummeting from late March onward, now down 19% from the same time a year ago.

While about 2.5 billion pounds of red meat and poultry products are typically warehoused in commercial freezers at any one time as they move along the supply chain, it’s not enough to prevent a shortage, said Don Close, a senior animal protein analyst at Rabo AgriFinance. The freezers typically only hold about one week’s supply of meat, USDA statistics show.

Despite this, experts say the meat industry has enough flexibility and redundancy to avoid mass shortages.

“At this point I think it’s a fairly remote possibility,” said Altin Kalo, senior economist at the Steiner Consulting Group. “But we’re living through times that there are things that are happening that I never thought we would see. We have oil that trades at a negative.”

Higher illness rates, worse protection

If the industry can avoid a mass shortage, workers say it will be at their expense.

Jean Hakizimana, 34, was employed as a cleaner at Smithfield’s Sioux Falls plant and recently tested positive for COVID-19. His wife, who doesn’t work at the plant, also tested positive.

As the outbreak spread, he said, he didn’t feel safe in the plant. He wasn’t provided with a mask, he said, but one wouldn’t have helped anyway because the heavy spraying of water would have just soaked it.

“You can’t do the job with the mask,” he said. “You have to take it off to keep working.”

Hakizimana also said that social distancing in a meat processing plant, where workers stand about a foot apart, is impossible.

“There was no way to keep six feet apart,” he said, “because the belt is so fast.”

Line speed was cited as a primary concern among meat and poultry workers in a 2016 U.S. Government Accountability Report that said employees felt their bosses cared more about production than worker safety.

Plant workers told investigators that “employers do not want the line to slow down even when the plant is understaffed,” the GAO report said, adding that industry officials disagreed. “According to representatives of a meat industry trade association, staffing is typically increased when line speed increases.”

The same GAO report noted that meat and poultry workers experienced higher illness rates than other manufacturing workers — nearly 160 cases per 10,000 full-time meat and poultry workers in 2013, compared to about 40 cases for manufacturing overall.

But those rates are likely higher, the report said, because both workers and their employers may underreport injuries and illnesses. For the worker, it’s from fear of job loss, the report said, For the employer, it’s from fear of the potential costs associated with those injuries and illnesses.

What’s more, the health units in these meat packing plants have numerous problems, including “lack supervision of medical personnel, personnel working outside their scope of practice, out-of-date health unit protocols, inappropriate response to injuries and illness, lack of quality assurance, poor worker access to health units, and inadequate recordkeeping,” a 2017 GAO report found.

States on the sideline

Meat packing plants in Iowa, though, are now in a more protected position than most.

On Monday, Iowa Gov. Kim Reynolds announced the state will focus COVID-19 testing on meat packing plants, swabbing all employees. “Strike teams” of epidemiologists and infectious disease nurses will also trace those who contacted infected workers and other Iowans. Later, Reynolds added that 250 National Guard members had been activated and that their mission includes helping to keep meat-processing plants open.

Despite the potential for meat packing plants to mutate into hotbeds of infection due to the close quarters in which employees work, Reynolds said she declined to close the facilities outright due to their importance to the food supply.

"We must do our part to keep them open in a safe and responsible way," Reynolds said.

Processing facilities in other states aren’t getting the same support. While Iowa has 23 major meat processing plants, four states have more: Arkansas (33), Georgia (32), Texas (32), and North Carolina (24).

Texas Department of State Health Services spokeswoman Lara Anton said the agency is aware of two COVID-19 outbreaks in meat processing plants and that it “actively investigates” such outbreaks.

“We’ve sent an environmental assessment team into one of the facilities and a team will be going into the other facility,” Anton said.

Georgia did not respond to an inquiry, while Arkansas and North Carolina said they had only issued guidance.

“We are monitoring closely for positive cases in any industry situations like this, and working with those businesses when needed,” said Meg Mirivel, a spokeswoman for the Arkansas Department of Health.

Mirivel also cited a three-page “guidance” for businesses, which noted the state health department would only know if an employee of a meat packing plant tested positive for coronavirus if they volunteered their employment information at the time of the test.

Kelly Haight Connor, a spokeswoman for the North Carolina Department of Health and Human Services, said that agency currently relies on county health departments to perform interventions like contact tracing. The state otherwise has also issued guidance.

“Going forward, it will take a much larger team to aggressively trace the contacts of everyone who tests positive,” Haight Connor said, adding the health department is “working to structure contact tracing collaboratively between the state and counties.”

Even in places with some of the nation’s highest infection rates, facilities are left to police themselves. Of the 10 major meat-packing counties with the highest COVID-19 infection rates, five are in hard-hit New Jersey.

Managers at two of those factories reached by phone Monday said they have had little interaction with health authorities at any level.

“Officially, from the government, we haven’t received anything,” said Simone Bocchini, president of Fratelli Beretta, which distributes Italian cured meats nationwide.

Bocchini said the company took action on its own more than a month ago. Its facility in Morris County, where 8 of every 1,000 residents has tested positive for coronavirus, checks employee temperatures, sanitizes all surfaces and common areas, and provides copious hand sanitizer to employees, Bocchini said.

“We implement them like they were part of the (rules),” Bocchini said.

He declined to say whether any employees had tested positive for COVID-19, citing personnel privacy.

Asked about any actions the New Jersey Department of Health has taken to protect major food processors, spokeswoman Dawn Thomas wrote in an email that inspections “may be performed by local health departments.” She did not respond to follow-up questions asking if that means the state is not taking additional measures.

The state capital of Trenton in Mercer County, where just under 7 out of every 1,000 residents has tested positive, contains two major meat processing plants. But a county spokesperson said Mercer doesn’t have a health department, and a counterpart in Trenton did not respond to an inquiry about any measures the city is taking.

Specht, the Notre Dame professor, said he doubts health departments at all levels have the resources to ensure safe conditions at every facility, following a history of attrition.

“You can get things on paper,” Specht said, “but I don’t know where they get the manpower to enforce.”

Feds absent near Philly

Union workers at four Pennsylvania meat packing plants stricken by coronavirus say the federal government has ignored their push for safer working conditions.

“Early on we were putting calls into OSHA that went completely unanswered,” said Wendell Young, IV, the president of the United Food and Commercial Workers Union Local 1776 in the Philadelphia suburbs.

In an attempt to better protect meat packers from COVID-19, Young said, the union has been negotiating with those four companies, which include the JBS beef-packing plant in Souderton that closed in late March due to an outbreak.

But OSHA and the CDC weren’t part of those discussions, Young said.

“OSHA did not issue any orders or directives,” Young said, “nor did they ramp up inspections or enforcement.”

Instead, he said several companies voluntarily agreed to make changes, such as placing barriers between employees, issuing personal protective equipment, and instructing managers to enforce proper personal distance.

Those measures led to a scheduled re-opening of the Souderton JBS plant on Monday, but Wendell said workers have nothing but the company’s word that the changes will continue.

One of those workers is Carmen Dominguez. Prior to the plant’s temporary shutdown, she operated a machine that packages meat. Now she’s a union steward, making sure her co-workers follow new distancing guidelines. She says for the time, employees feel safe.

But she wonders about the long term and whether any government backstop will be needed.

“At the moment, everything is going well,” Dominguez said in Spanish through an interpreter on Tuesday. “We try to make sure that they continue doing the right thing, but if not, probably we will need somebody that can help.”

OSHA will also be “issuing guidance” specifically for meat processing workers, said a spokesperson at the U.S. Department of Labor, which includes OSHA. The agency is also “enforcing” the CDC’s guidance through a regulatory power that says employers have a duty to protect workers from known hazards, the spokesperson said.

“When OSHA finds such a violation, a citation would be issued and a civil monetary penalty imposed,” the spokesperson said via email.

According to records OSHA posted on its website, there were two findings against meat processors in March for violating COVID-19 safety guidelines. The records showed a dozen more open cases at meat plants.

USA TODAY also sent a list of questions about what steps the CDC has taken to ensure safe workspaces in the Pennsylvania factories, or anywhere else. Bert Kelly, a spokesperson for the agency, responded with a one sentence email.

“Please check in with OSHA, FDA or local regulators about this topic,” Kelly wrote.

This story is a collaboration between USA TODAY and the Midwest Center for Investigative Reporting. The Center is an independent, nonprofit newsroom covering agribusiness, Big Ag and related issues. USA TODAY is funding a fellowship at the center for expanded coverage of agribusiness and its impact on communities.

This article originally appeared on USA TODAY: Coronavirus at meat packing plants worse than first thought, USA TODAY investigation finds