COVID-19 test positivity by occupation using the Delphi US COVID-19 trends and impact survey, September-November 2020

Background The potential for work to be a risk factor for coronavirus disease 2019 (COVID-19) was recognized early in the pandemic based on the likelihood of work-related differences in exposures to COVID-19 in different occupations. Due to intense demands of the pandemic, implementation of recommendations to collect information on occupation in relation to COVID-19 has been uneven across the United States. The objective of this study was to investigate COVID-19 test positivity by occupation. Methods We analyzed data collected from September 8 to November 30, 2020, by the Delphi Group at Carnegie Mellon University US COVID-19 Trends and Impact Survey, offered daily to a random sample of US-based Facebook users aged 18 years or older, who were invited via a banner in their news feed. Our focus was ever testing positive for COVID-19 in respondents working outside the home for pay in the past 4 weeks. Results The major occupational groups of "Production", "Building and grounds cleaning and maintenance," "Construction and extraction," "Healthcare support," and "Food preparation and serving" had the five highest test positivity percentages (16.7%-14.4%). Highest detailed occupational categories (28.6%-19.1%) were "Massage therapist," "Food processing worker," "Bailiff, correctional officer, or jailer," "Funeral service worker," "First-line supervisor of production and operating workers," and "Nursing assistant or psychiatric aide." Differences in test positivity by occupation remained after adjustment for age, gender, and pre-existing medical conditions. Conclusion Information on differences in test positivity by occupation can aid targeting of messaging for vaccination and testing and mitigation strategies for the current and future respiratory infection epidemics and pandemics. These results, obtained before availability of COVID-19 vaccines, can form a basis for comparison to evaluate impacts of vaccination and subsequent emergence of viral variants.