COVID-19 Outbreaks and Mortality Among Public Transportation Workers — California, January 2020–May 2022

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Work-related factors can contribute to risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, and subsequent COVID-19-attributable outcomes, including death.Comparing COVID-19 metrics across industries can help identify workers at highest risk.Elevated COVID-19 mortality rates have been reported among all transportation workers, as well as specifically in public transportation industries (1-3).The California Department of Public Health (CDPH) calculated public transportation industry-specific COVID-19 outbreak incidence during January 2020-May 2022 and analyzed all laboratory-confirmed COVID-19 deaths among working-age adults in California to calculate public transportation industry-specific mortality rates during the same period.Overall, 340 confirmed COVID-19 outbreaks, 5,641 outbreak-associated cases, and 537 COVID-19-associated deaths were identified among California public transportation industries.Outbreak incidence was 5.2 times as high (129.1 outbreaks per 1,000 establishments) in the bus and urban transit industry and 3.6 times as high in the air transportation industry (87.7) as in all California industries combined (24.7).Mortality rates were 2.1 times as high (237.4deaths per 100,000 workers) in transportation support services and 1.8 times as high (211.5) in the bus and urban transit industry as in all industries combined (114.4).Workers in public transportation industries are at higher risk for COVID-19 workplace outbreaks and mortality than the general worker population in California and should be prioritized for COVID-19 prevention strategies, including vaccination and enhanced workplace protection measures.This report assessed confirmed COVID-19 outbreaks in California workplaces that began during January 1, 2020-May 26, 2022, and were reported to CDPH as of June 27, 2022.Confirmed COVID-19 outbreaks were defined as the occurrence of three or more probable or confirmed COVID-19 cases within a 14-day period among persons who are epidemiologically linked in the setting, are from different households, and are not identified as close contacts of one another in any other case investigation (4).Since January 1, 2021, California employers have been required to report workplace clusters of three or more COVID-19 cases within 14 days to their local health department (LHD); previously, outbreak reporting requirements varied by setting and jurisdiction.LHDs report confirmed COVID-19 outbreaks and the number of outbreak-associated cases, which might include workers and nonworkers, to CDPH.MMWR / August 19, 2022 / Vol.71 / No. 33 1055 US Department of Health and Human Services/Centers for Disease Control and Prevention SummaryWhat is already known about this topic?Workers who perform in-person work and come into close, frequent contact with other workers or the public might be at increased risk for SARS-CoV-2 exposure and infection.What is added by this report?Public transportation industries in California experienced cumulative COVID-19 outbreak incidence and mortality rates 1.5 times as high as that for all industries; outbreak incidence was 5.2 times as high, and mortality was 1.8 times as high in bus and urban transit industries as in all industries.What are the implications for public health practice?Public transportation workers should be prioritized for COVID-19 prevention strategies, including vaccination and enhanced workplace protection measures.

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