Even before the first positive cases of COVID-19 among employees of American Roots were confirmed through testing, owners Ben and Whitney Waxman were on the phone with the Maine Center for Disease Control and Prevention to let them know about a possible outbreak.

Within two business days, the Waxmans had brought in a team from Northern Light Mercy Hospital to conduct universal testing on all 110 workers at the Westbrook clothing manufacturer, which has been making personal protective equipment such as masks since April. After universal testing, nine more employees tested positive – all of whom were experiencing no symptoms – bringing the number of confirmed cases at American Roots to 11.

“We understood the likelihood that some type of outbreak was possible, no matter how stringent and militant we were as a workforce,” said Ben Waxman, whose workforce has more than tripled since it shifted to producing masks. “So we were prepared. To not be prepared right now is irresponsible.”

Since the pandemic hit Maine in mid-March, the Maine CDC has investigated 16 workplace outbreaks totaling 219 cases, about 7 percent of all confirmed cases in Maine. As of last week, half of those outbreaks were still active. The affected businesses include chicken and seafood processing facilities, construction sites and manufacturing plants, which are all the types of businesses that might be susceptible to an outbreak. Nearly all are businesses where employees aren’t interacting with customers.

Maine CDC’s director, Dr. Nirav Shah, said that although he doesn’t want to see outbreaks anywhere, each is an opportunity to assess the state’s response. How quickly can tests be conducted? How effective will contact tracing be?

In an interview last week, Shah said investigators have concluded that the outbreak at American Roots originated outside the facility but easily could have “spread like wildfire” inside. Early on in the pandemic, before experts understood fully how the disease spread and before masks and physical distancing were ubiquitous, this type of outbreak might have been catastrophic. But more than a week after that universal testing, which was followed by another round on Tuesday, no new cases were detected.

Shah said there is no question that the speed with which the company responded – including quarantining 10 people who had close contact with the 11 positive cases – coupled with distancing practices and universal mask wearing inside the factory, helped to limit the spread.

“I try to keep neutrality when talking about this, but the standard that American Roots set should be the standard that everyone sets going forward,” Shah said, quickly adding that most other businesses have also responded well to outbreaks.

American Roots employees acknowledged those initial days were scary.

“It’s been a roller coaster of emotions, really,” said Dave Butler, who has worked at the facility for two years. “We aren’t allowed to know who tested positive so you’re always wondering: Did I work right next to them?’”

Workplace outbreaks can produce anxiety for employees who might not feel safe going to work. Maine is an at-will state, which means there aren’t explicit protections for workers against being fired. But Dana Connors, president of the Maine State Chamber of Commerce, said he’s not heard of any situations where employers weren’t working with employees who might have concerns.

“I think people in Maine have embraced the notion that there is a responsibility that goes with the challenge of this pandemic,” he said. “So much of the success we’ve had is attributed to the right attitude.”

Ben and Whitney Waxman both said if an outbreak can happen at their business, it can happen anywhere.

“But it’s also a wake-up call to employers, that before you think about any profit, you have to protect the safety of workers,” Ben Waxman said. “The most valuable component of any company is its employees.”

WORKFORCE HAS TRIPLED

American Roots was founded in 2015 by the Waxmans as a clothing manufacturer – fleece and cotton jackets, hooded sweatshirts, winter hats, vests, scarves, all American-made.

The company grew from a handful of employees to about 30 and in 2018 moved from Portland into the historic Dana Warp Mill on Bridge Street in Westbrook. The mill also is home to Common Threads of Maine, a textile industry training program for new Mainers founded by Ben Waxman’s mother, Dory Waxman. Many individuals who went through the training have found work at American Roots – 80 percent of employees are new Mainers. More than a dozen languages are spoken there.

When the pandemic crippled businesses everywhere in mid-March, American Roots was forced to close and lay off all but a handful of employees. The Waxmans didn’t know for how long.

“Everybody just figured they’d come back when there was work,” said Adam Cleaves, who was one of the employees who stayed on and who, like most employees, is a member of United Steelworkers (USW) Local 366.

Within a couple of weeks, the Waxmans decided to pivot away from making clothes, which weren’t in high demand, to make personal protective equipment like face shields and masks, which were. The shift allowed American Roots to not only hire back all laid-off employees but add more. As of last week, the company had more than tripled its workforce.

“We didn’t know if it would work or not, but it did,” said Maria Lutina, head stitcher at American Roots, who came to Maine as an asylum seeker from Angola.

When the company reopened as a manufacturer of personal protective equipment, its employees became essential, but it also meant increased safety measures.

“Safety is our number one concern here, and that was true before all this,” Whitney Waxman said. “We know it’s a risk coming to work and have been doing everything we can to sanitize work stations, to require masks, to remind people to wash hands.”

Employees said those measures put them at ease.

Butler, who has asthma, didn’t come back to work right away because he worried about what might happen if he contracted the virus.

“There was such a sense of teamwork and camaraderie in opening back up,” he said. “And we started making things that would help people and save lives. All of us could have gone on unemployment instead. I’m glad that didn’t happen.”

The company continued to churn out face shields and masks – all with the understanding that having more than 100 workers in the same indoor space, even spread out and even wearing masks themselves, might not keep an outbreak from happening.

“I expected it eventually,” Butler said. “I just didn’t know when. You just can’t control all the outside forces.”

Connors, the chamber president, said Maine businesses are generally wary about if or when an outbreak will affect them.

“It can happen and probably will continue to happen, in spite of all the measures that businesses have taken,” he said.

QUICK RESPONSE

The first positive cases associated with American Roots were confirmed on Friday, July 10.

The Waxmans immediately shut down the facility for a deep cleaning, put out a public statement, and didn’t reopen until the following Tuesday, by which point they had arranged for universal testing of all employees. They have since conducted additional cleanings and another round of testing.

The state investigates all outbreaks, defined as at least three cases connected to one location. In addition to traditional contact tracing to find out how many people might have come into contact with someone who tested positive, the Maine CDC offers guidance on how to improve safety and, in some cases, coordinates testing and delivery of personal protective equipment. Those who test positive are asked to quarantine at least 14 days and are directed to social services, if needed.

“I have to say, in that situation you don’t know what to expect, but it went very smoothly,” Whitney Waxman said.

The Waxmans said other employees have stepped up with food deliveries to those who are quarantined.

“It has to be about more than just making sure employees are paid while they’re out,” Ben Waxman said.

Several other businesses share common space with American Roots at the Dana Warp Mill, and Waxman said he understands some of them might be concerned about the outbreak. All were notified, either by the Waxmans or the mill’s owner, Chinburg Properties. A representative for Chinburg did not return a phone message last week.

The outbreak at American Roots, a business with a large population of immigrants, underscores the racial disparity in cases of COVID-19 seen in Maine. To date, more than 800 individuals who have tested positive are Black, nearly one quarter of all cases, even though Black Mainers represent less than 2 percent of Maine’s population.

State officials and others have been aware of the racial disparity and said better communication and contact tracing is needed. Shah, who is the son of Indian immigrants and spent part of his early career in Cambodia, said having contact tracers who not only speak the language but are culturally sensitive, is critical. He offered a hypothetical.

“Imagine that you were to pick up and move to the Congo and there was a weird disease going around and you had no idea what to do,” he said. If an American were there to offer public health guidelines, “that would be a game-changer, right?”

Shah personally assisted during Maine’s biggest workplace outbreak to date at Tyson Foods, a chicken processing plant in Portland that employs several Cambodian immigrants. That outbreak – 55 cases documented in late April and early May – was the first outside of a health care facility and remains Maine’s biggest. There have been several large outbreaks at congregate living facilities as well, some of which have turned deadly because of the age and underlying health conditions of individuals who contracted the virus.

Shah said investigations of outbreaks in health care facilities almost always lead back to a staff member, since residents are not leaving the facility. With workplace outbreaks, he said, it’s sometimes harder to determine where the virus is being spread – inside or outside the workplace.

“We’ve seen a bit of both,” Shah said.

The fact that the outbreak at American Roots spread outside the workplace was comforting to the Waxmans and validation that the safety measures they have put in place made a difference.

“That probably reduced the likelihood of a really bad outbreak,” Shah said. “All the cases could be explained by outside interactions, which makes sense now that we know (the company) hires family members and others who know each other and might congregate outside of work.”

The same scenario happened at another outbreak this spring. Cape Seafood in Saco, a lobster and crab processing facility that shares owners with Luke’s Lobster, was investigated for a possible outbreak after employees there tested positive in late May and early June.

The company, which employs 120 people, tracked a total of 10 cases, but the Maine CDC’s investigation determined, as was the case with American Roots, that no transmission was happening inside the processing facility. The outbreak investigation was closed on Thursday, after 30 days had passed since its most recent case.

Maria Thomas, director of people and culture for Luke’s Lobster, said the facility was prepared for a possible outbreak and she believes those preparations prevented the virus from spreading.

“The whole process with the CDC’s investigation was extensive and they agreed that we took every step we could to control things,” she said.

The plant, like almost every other business, closed for a short time in March to retrofit its workspaces so that employees would be safer. But it soon reopened and, because food processors are essential businesses, has remained open.

Thomas said some employees expressed concerns in the beginning about coming back to work.

“We had some who communicated that they were high-risk and we worked with those individuals on a case-by-case basis,” she said. “Now we feel like the safest place for us is at work because of all the controls we have.”

If there is an outbreak at a workplace and workers don’t feel safe, they can discuss their concerns with their employer, but there are no explicit protections for most workers because Maine is an at-will state. Workers who are represented by a labor union or who are under a collective bargaining agreement have more protections. Jessica Pollard, spokeswoman for the Maine Department of Labor, said private sector workers can file complaints with the U.S. Occupational Safety and Health Administration if they believe an employer is not following CDC guidelines. Public sector workers can contact the Bureau of Labor Standards.

Most workplace outbreaks have occurred in businesses that are not public-facing, which makes it easier to do contact tracing. The most recent outbreak, at the Walmart in Presque Isle, is expected to be a bigger challenge because of the volume of non-employees who enter the store.

Ben Waxman said the best advice he can give to a business is to make sure they have a plan for universal testing before an outbreak hits, not after.

“We were fortunate,” he said. “Our test results came back in 24 hours, for the most part. In some cases, people are waiting seven days or more. That has to be better.”

Employees at American Roots are grateful, too, for the protections provided them.

“In general, people are handling it pretty well,” said Cleaves. “I don’t think we’re excited to get tested every week. It’s not comfortable, to put it lightly.”

Added Lutina: “If I’m scared, I would stay home, but I can’t be scared.

“Today, we are OK. But it’s serious.”

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