Confirmed COVID-19 cases per economic activity during Autumn wave in Belgium

Objective To assess the COVID-19 incidence per economic activity during the Autumn wave 2020 in Belgium. Methods The 14-day incidence of confirmed COVID-19 cases per NACE-BEL code is described in the periods immediately preceding the Belgian more strict measures of October 19, 2020, and is evaluated longitudinally by a Gaussian-Gaussian modelling two-stage approach. Additionally, the number of high-risk contacts in working segments and regions is described. Results The peak of COVID-19 14-day incidence in most NACE-BEL sectors is reached in the period October 20-November 2, 2020 and was considerably higher than average in human health activities, residential care activities, fitness facilities, human resource provision, hairdressing and other beauty treatment and some public service activities. Human health activities, residential care activities, food and beverage service activities, hotels, arts, food retail activities, and human resources provision have high pre-lockdown incidences. The frequency of index cases that report more than two high risk contacts is increasing over time in all sectors. Conclusion Despite the restrictive protocols present in many sectors before the Autumn wave, employees in activities where close contact with others is high, show increased risk of COVID-19 infection. Especially sports activities are among the highest risk activities. Finally, the increasing amount of high-risk contacts by COVID-19 confirmed cases is compatible with the decreasing motivation over time to adhere to the measures. Key Messages What is already known about this subject? Certain occupational sectors, such as human health and care, food and beverage, cultural and sport activities, have been related to a high risk of SARS-CoV-2 infection at the workplace. What are the new findings? COVID-19 confirmed cases of employees are linked with the main economic activity of their employer. The effect of opening of sectors, potentially under restrictive protocols, is evaluated. Despite the restrictive protocols present in many sectors, employees in activities where close and/or prolonged contact with others is high exhibit increased risk of COVID-19 infection, even higher than the high-risk sector of human health and care. Full restriction of these sectors decreases adequately the COVID-19 incidences, even in those sectors with physical contacts that remain open, for example human health, care and food shops. Finally, the increasing amount of high-risk contacts by