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Illnesses caused by viruses (COVID-19) among healthcare and social assistance workers occurred at a rate about five times greater than all workers in 2020

By Samuel Kissinger

Throughout 2020, healthcare and social assistance workers played a critical role by directly providing care to patients infected with the COVID-19 virus.¹ During the year, the number of workplace injuries and illnesses increased 40.1 percent in the healthcare industry; it was the only private industry sector to experience an increase. These workers were out for a median of 12 days in 2020, up from 7 days in 2019.

This Beyond the Numbers article explores data on the nonfatal workplace injuries and illnesses experienced in the private healthcare and social assistance industry with a focus on illnesses due to COVID-19 that required days away from work.

The Survey of Occupational Injuries and Illnesses (SOII) collected data on cases of COVID-19 when workers were infected because of performing their work-related duties.² For reference year 2020, the SOII captured COVID-19 cases requiring at least 1 day away from work in a category titled “other diseases due to viruses, not elsewhere classified.” Most years, estimates for this category were suppressed because of low case counts that did not meet publication criteria, with 2015 being the most recent year data were published (20 cases). Therefore, estimates for this category in 2020 represent employer-reported COVID-19 cases that resulted in at least 1 day away from work. For the remainder of this article, all estimates for the category “other diseases due to viruses, not elsewhere classified” in 2020 will be referred to as COVID-19 cases.

Overview of workplace injuries and illnesses in 2020

In 2020, total nonfatal injury and illness cases decreased or remained the same in all private industry sectors, except for the healthcare and social assistance sector, which increased 40.1 percent to 806,200 occupational injuries and illnesses, up from 575,200 in 2019. The incidence rate of total recordable cases in the healthcare and social assistance sector was 5.5 cases per 100 full-time equivalent workers, an increase from 3.8 in 2019.

Of the total cases in 2020 in the healthcare and social assistance sector, 447,890 cases resulted in 1 or more days away from work, an increase from 151,410 cases in 2019. (See chart 1.) These cases in the healthcare and social assistance sector occurred at an incidence rate of 304.3 cases per 10,000 workers in 2020, compared to 120.7 cases per 10,000 workers in all private industry. Cases involving days away from work in healthcare and social assistance required a median of 12 days away from work in 2020, up from a median of 7 days in 2019.

Cases requiring days away from work classified as COVID-19 constituted 288,890 cases in the healthcare and social assistance sector in 2020. These cases represented 74.1 percent of the total 390,020 cases requiring days away from work in all private industry. These cases occurred at an incidence rate of 196.3 cases per 10,000 workers in healthcare and social assistance, about 5 times greater than the rate of 40.0 in all private industry.

Cases requiring days away from work by healthcare industry

Nursing and residential care facilities had a total of 205,780 cases involving days away from work in private industry establishments in 2020, up over 300 percent from 44,020 cases in 2019. The incidence rate for all cases requiring days away from work in the industry was 791.7 cases per 10,000 workers in 2020, significantly higher than the rate of 170.9 in 2019. There were 155,730 COVID-19 cases in the nursing and residential care facilities industry in 2020, which accounted for 75.7 percent of all cases requiring days away from work in the industry. COVID-19 cases occurred at an incidence rate of 599.1 cases per 10,000 workers. (See table 1.)

Table 1. Nonfatal occupational injuries and illnesses involving days away from work, private industry, 2020

Industry	Total cases	COVID-19 [1]
		Number of cases	Percent of total	Incidence rate per 10,000 workers
Total private industry	1,176,340	390,020	33.2%	40.0
Healthcare and social assistance	447,890	288,890	64.5	196.3
Ambulatory healthcare services	70,110	38,330	54.7	66.4
Hospitals	148,360	87,920	59.3	220.2
Nursing and residential care facilities	205,780	155,730	75.7	599.1
Social assistance	23,630	6,910	29.2	29.4
[1] All estimates for the category “other diseases due to viruses, not elsewhere classified” in 2020 are referred to as COVID-19 cases. Source: U.S. Bureau of Labor Statistics.

Hospitals in private industry had 148,360 cases involving days away from work in 2020, an increase from 52,140 in 2019. These cases occurred at a rate of 371.7 cases per 10,000 workers in 2020, a significant increase from the rate of 129.7 in 2019. Of the total cases requiring days away from work in hospitals in 2020, 87,920 cases, or 59.3 percent, were due to COVID-19. (See chart 2.)

The rate of COVID-19 cases was highest in nursing and residential care facilities at 599.1 cases per 10,000 workers. This is followed by a rate of 220.2 in hospitals, 66.4 in ambulatory healthcare services, and 29.4 per 10,000 workers in social assistance.

Workplace injuries and illnesses by occupation

Another way to look at injuries and illnesses in healthcare and social assistance is to examine the cases by occupation within the industry sector. Nursing assistants had 95,890 nonfatal injuries and illnesses involving days away from work in the sector in 2020, a significant increase from 27,320 cases in 2019.³ This can be attributed to 65,260 cases classified as COVID-19 that required days away from work in 2020, representing 68.1 percent of the total in this occupation within the industry sector.

Registered nurses had 78,050 total cases requiring days away from work in the healthcare and social assistance industry sector in 2020, an increase from 19,820 in 2019. There were 53,440 cases classified as COVID-19 in 2020, accounting for 68.5 percent of all cases requiring days away from work in this occupation within the sector. (See chart 3.)

Licensed practical and licensed vocational nurses had 28,870 cases requiring days away from work in the healthcare and social assistance sector in 2020, up from 5,270 in 2019. Of these, 22,680 cases involving days away from work were due to COVID-19, which accounted for 78.6 percent of the cases that occurred among the occupation.

Increase in visits to a medical treatment facility in 2020

In the healthcare and social assistance sector, there were 72,350 injuries and illnesses, or 16.2 percent of all cases requiring days away from work, which resulted in visits to a medical treatment facility, including 61,500 cases that were visits to the emergency room only. The remaining 10,850 cases were overnight hospitalizations. The incidence rate of cases involving days away from work requiring medical treatment facility visits was 49.2 per 10,000 workers, and the rate for emergency room visits was 41.8. These incidence rates increased from the 2019 rates, which were 38.5 and 35.7, respectively.

Table 2. Nonfatal occupational injuries and illnesses involving days away from work by medical treatment facility visits, healthcare and social assistance industry, 2019–20

Medical treatment facility visits	Number of cases		Incidence rate per 10,000 workers
	2019	2020	2019	2020
Total	57,580	72,350	38.5	49.2
Emergency room visits only	53,460	61,500	35.7	41.8
In-patient overnight hospitalizations	4,120	10,850	2.8	7.4
Source: U.S. Bureau of Labor Statistics.

Conclusion

The COVID-19 pandemic in 2020 posed greater workplace hazards for workers in the healthcare and social assistance industry sector. The sector experienced a rise in the number of nonfatal occupational injuries and illnesses in 2020, much of it because of the increase in cases requiring days away from work from COVID-19. The SOII captured these work-related cases of COVID-19 coded as “other diseases due to viruses, not elsewhere classified,” helping to identify industries and occupations with higher COVID-19 contraction rates.

In 2020, there were 447,890 cases involving days away from work in the healthcare and social assistance industry sector. Of these, 288,890 cases were classified as COVID-19, which occurred at an incidence rate of 196.3 cases per 10,000 full-time equivalent workers. Nursing and residential care facilities saw a more than 300-percent increase in nonfatal injuries and illnesses involving days away from work from 2019 to 2020, of which 75.7 percent were cases classified as COVID-19. Additionally, nursing assistants and registered nurses experienced significant increases in the number of injuries and illnesses within the industry sector in 2020, mostly attributed to an increase in illnesses due to COVID-19.

This Beyond the Numbers article was prepared by Samuel Kissinger, an economist in the Office of Compensation and Working Conditions, U.S. Bureau of Labor Statistics. Email: Kissinger.Samuel@bls.gov; telephone: (202) 691-6167.

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