Your business is essential. How do you protect workers during a pandemic?

"I feel unsafe, myself," Hibaq Mohamed, a fulfillment associate at Amazon who works as a packer at the MSP1 facility in Shakopee, Minnesota, told sister publication Supply Chain Dive in an interview in early April.

Since this conversation, multiple reports have emerged of Amazon fulfillment associates testing positive for coronavirus. While there is not an official count on the total number of associates who have tested positive, unofficial counts climb into the hundreds, according to CNBC. Last month, a fulfillment associate at MDW8 died after testing positive for coronavirus, an Amazon spokesperson confirmed for Supply Chain Dive.

"We are saddened by the loss of an associate who had worked at our site in Waukegan, Illinois," the spokesperson said. "His family and loved ones are in our thoughts, and we are supporting his fellow colleagues."

Amazon is not alone. As coronavirus spreads across the country, some of the essential factories and warehouses that stayed open struggled to prevent the virus' spread within their facilities and gave managers pause for how they could keep operations going while maintaining safe conditions.

The e-commerce giant had begun temperature checks for its employees and said it was providing personal protective equipment to its associates when Supply Chain Dive spoke with Mohamed. But she said the company is sticking to its strict time off task metric, which makes it hard for associates to wash their hands on a regular basis.

"I feel unsafe, myself."

Hibaq Mohamed

Fulfillment associate at Amazon

Messaging within the company has also been worrying for Mohamed, who said an on-site health professional at the fulfillment center told her the coronavirus was "no worse than the flu." Health professionals insist the two should not be treated the same.

When Supply Chain Dive asked Amazon about the comments, it provided a list of actions the company has taken at its fulfillment centers including temperature checks, more frequent cleaning, communicating positive cases of associates to everyone at a facility and providing two weeks of pay for anyone who has to quarantine or who tests positive for coronavirus.

Mohamed's concerns and reports of breakouts at other companies highlight how hard it can be to stop the spread of virus at essential businesses.

Facilities: A recipe for transmission

The highest risk workers are in the health care sector. Next is any industry that interfaces with the public, like grocery or retail employees. Industries like manufacturing are the lowest risk as it is a coworker to coworker transmission, Travis Rhoden, the senior environmental health and safety editor at J. J. Keller & Associates, told Supply Chain Dive. But the news out of a Smithfield processing plant highlighted how coronavirus can spread even in environments considered to be lower risk.

"That Smithfield plant in South Dakota, it's a 100 plus-year-old factory, it has narrow corridors, people shoulder to shoulder. It's a perfect recipe for transmission of a pathogen."

Simon Ellis

Program VP for supply chain strategy at IDC

Concerns over communication, like those Mohamed highlighted, became a reality for the Smithfield Foods processing plant in Sioux Falls, South Dakota. Hundreds of employees at the location contracted coronavirus, and the Centers for Disease Control and Prevention issued more than 100 recommendations for how it can reopen safely, including language barriers as one potential issue. "Management expressed that communicating messages to their diverse staff presented challenges due to the number of languages spoken," reads the final CDC report released by the South Dakota governor's office.

"That Smithfield plant in South Dakota, it's a 100 plus-year-old factory, it has narrow corridors, people shoulder to shoulder. It's a perfect recipe for transmission of a pathogen," Simon Ellis, the program VP for supply chain strategy at IDC, told Supply Chain Dive in an interview.

The CDC provided a number of recommendations to the Smithfield location:

Staggering employees on lines so they don't stand across from each other.
Bringing in more temporary hand washing stations.
Creating barriers with plexiglass, stainless steel or durable polycarbonate.
Moving lockers to limit the number of employees in a locker room at one time.
Providing educational materials in "other languages commonly spoken in the plant," according to the agency's report.

"The Smithfield facility outbreak reinforces the importance of testing, tracing and treating COVID-19 infections and implementing enhanced environmental infection control protocols as a routine. Making sure policies are understood by employees is critical for compliance and companies should not disincentivize workers to stay home when ill," Kelly Reynolds, a professor in University of Arizona's Department of Environmental Health Sciences, told Supply Chain Dive.

Changes to the building

One step businesses can take is increasing airflow in their facilities to bring in more air from outside and increase the number of air exchanges that take place in a building, according to Peter Raynor, a professor of Environmental Health Sciences at the University of Minnesota.

"If there is somebody who has COVID and is asymptomatic, and don't know they're potentially transmitting the disease, those levels can be reduced with these types of controls," Raynor told Supply Chain Dive.

Most modern buildings should be able to change ventilation controls through a computer interface, he said.

Air purification and surface disinfection should be the two primary tools for businesses that are remaining open, according to Reynolds.

"So with air purification, you want to make sure you have something that's actually decontaminating the air," Reynolds said. "So either a HEPA filter that can filter out microorganisms or ozone eater which actually oxidizes any microbes that might get filtered through the system."

Administrative controls

Workplaces should follow the social and physical distancing measures suggested by federal agencies, Raynor said.

Workers need to be allowed the time to wash their hands (for 20 seconds), and they need to be able to stay home if they are feeling sick, Raynor said.

"If a worker has to leave the floor and go all the way to the restroom to wash their hands with water, they're probably not going to as frequently as if you have hand sanitizer stations readily available," Rhoden said.

Amazon is threatening to fire employees who do not follow social-distancing guidelines. But the updates are being provided to employees in automated voicemails and Mohamed worries the many workers, for whom English is their second language, will not get the necessary guidance.

Meanwhile, the reality of living paycheck to paycheck can make it difficult to take a day off when symptoms begin to develop, Mohamed said.

Travis Rhoden

Senior Environmental Health and Safety Editor at J.J. Keller & Associates

Amazon said it is being more flexible with its employees due to the virus. "If someone would rather not come to work, we are supporting them in their time off," Dave Clark, senior vice president of worldwide operations at Amazon, wrote in a blog post earlier this month. "If someone is diagnosed or comes to us who is presumptively diagnosed (but unable to get a test), we are giving them extra paid time off."

Anyone who has COVID-19 should stay away from the workplace for seven days after their symptoms have stopped, and anyone who has been in contact with a COVID-19-positive person should stay out of the workplace for 14 days, Reynolds said.

Changes to shifts can also eliminate some risk. An operation can add more so there are fewer people in the building at once, Rhoden said. Managers need to clearly communicate any changes to the workforce, he said.

The CDC has also recommended temperature checks as workers enter or exit a facility.

Transportation and logistics company XPO detailed some of the changes it's making at its facilities, which include "holding shift meetings outdoors where employees can remain 6 feet apart, redesigning traffic flows and changing shift schedules, installing barriers between workstations and having only one chair per table in break rooms," Meghan Henson, the company's chief human resources officer said during a recent earnings call. Still, these steps aren't enough for some XPO works to feel safe. Labor leaders held a webinar Tuesday titled "XPO Logistics Amid a Global Pandemic: Workplace Safety, Governance and Business Risks Laid Bare."

Protective gear

The CDC recommended people wear masks, and many companies, including Amazon, have started providing such protection to their employees. But experts say PPE effectiveness is limited depending on what is being used. There are three levels of face masks, Raynor said.

N95-level: A tight-fitting respirator that filters the air and protects the person wearing it, preserved for healthcare workers.
Medical- or surgical-level mask: Contains a medium that is less efficient at filtering the air compared to the N95 and is not as tight-fitting to the face.
Cloth mask: "Frankly not a lot of research" has been done on these masks, but what is available suggests their effectiveness ranges from 0% to 40%, according to Raynor.

"The danger with personal masks that are not medical grade is they can give you a false sense of security," Reynolds said. "You think you can go anywhere, you think I can get next to anyone."

Gloves, meanwhile, don't provide much protection from coronavirus since there is no evidence it is transmitted through the skin. At most gloves will remind workers not to scratch their faces, but there needs to be a place where employees can dispose of them easily if being used in a workplace, Raynor said.

Gloves can be useful for short-term activities like handling laundry that might be contaminated. In a healthcare setting, workers will take their gloves off when they leave a patient's room, they don't wear them around the hospital.

Reynolds said the best bet is wash your hands and avoid touching your face.

Cleaning, hygiene

Surfaces like doorknobs, railings, buttons or other frequently touched locations should be cleaned on a regular basis. Cleaning should be done with products containing bleach or alcohol levels of 65% or higher, but if a surface is dirty it should be cleaned with soap and water before the disinfectant is applied, Raynor said.

"Making sure you keep the surface contamination low is a strategy that you need to do multiple times a day if you have workers present," Reynolds said.

Make sure the cleaning rag is changed frequently or disposable wipes are used so contamination is not spread from one place to another, she said.

If a workplace needs to do a deep clean of the entire facility it can do so with a fogger that releases ozone, hydrogen peroxide or chlorine-based solutions, she added. This is not necessary in all cases and will depend on the situation as it only survives for hours to days depending on the surface and environment. And it's important to note while disinfectants used in foggers might be approved by the EPA to use against coronavirus, "it doesn’t mean that the method of application has been tested and registered to achieve the same results," Reynolds said. "Thus, you may not be able to achieve the same disinfectant efficacy with the same product in a wipe, for example."

Corrosion is also a consideration with misters, which tend to have larger droplet sizes than foggers, she said.

If a company wants to ensure the facility is being cleaned properly it can plant tracers — Glo Germ or microbial tracers — throughout a facility. This will allow for someone to audit the cleaning process and make sure all the necessary spots are being disinfected in the process, Reynolds said.

One helpful reminder is color-safe bleach doesn't have any actual bleach in it. "There's a misconception that that product, in particular, could kill a broad spectrum of germs," Reynolds said. "It may kill the coronavirus because the coronavirus is fairly easily inactivated, but we don't really know that yet."