September 19, 2020

CP Online Health

Eat Well, Life Well


Workers harvesting lettuce in Salinas Valley, California, are unable to maintain social distancing throughout long workdays. Photo: Laurin Rinder / Depositphotos

Sinthia Hernandez works as a broccoli picker in California’s Salinas Valley. In normal times, it is difficult work. In pandemic times, it is frightening, life-threatening work.

Hernandez is coping with both cancer and diabetes, putting her at greater risk of becoming severely ill or dying if she becomes infected with the coronavirus. Still, she must report to work each day because she is the sole breadwinner for her family — her mother, two children, and two siblings with major physical disabilities.Essential Coverage

“In these times, it’s necessity that makes us work despite the fear we have,” Hernandez told Frontline producer and correspondent Daffodil Altan in the heartbreaking documentary COVID’s Hidden Toll.

According to new research from the California Institute for Rural Studies (CIRS), agricultural workers in Monterey County are three times more likely to contract COVID-19 (PDF) than workers in other industries. Don Villarejo, PhD, founder of CIRS and author of the report, attributed the dramatically higher rate of infection among agricultural workers to working and living conditions that make it extremely difficult to practice physical distancing.

Coronavirus cases across California have been climbing rapidly in recent months, and Latinx workers, who make up an estimated 92% of the state’s agricultural workers (PDF), are bearing the brunt of the crisis. Though the virus first hit urban centers like Los Angeles and the Bay Area, it has since spread more widely in rural, agricultural regions.

“No Surprise” to See COVID-19 Spread Among Ag Workers

“We’ve seen this coming for a while,” George Rutherford, MD, a professor of epidemiology and biostatistics at UCSF, told Alexei Koseff and Erin Allday in the San Francisco Chronicle. “We saw it already in Imperial Valley and Coachella Valley in Riverside. We’re seeing it in Salinas Valley now, too. . . . Monterey County is lit up. And it’s no surprise that now it’s in the Central Valley.”

Monterey County has a case rate of 225 per 100,000 people, more than double what state officials consider a “passing” level for the 14-day case-rate metric. Riverside County has a case rate of 202 per 100,000, and San Joaquin County has a case rate of 308 per 100,000.

Those of us who are working have so much debt and bills to pay that the money sometimes isn’t even enough to buy one mask.

—Farmworker Sinthia Hernandez

Osmar Orellana, who also is profiled in the Frontline documentary, picks lettuce for a large produce grower in Salinas. Where he works, “everyone uses the same bathrooms and drinks water from the same drinking fountains,” Rosa Tuirán and Nick Roberts reported for a Frontline article accompanying the documentary. “In the fields, harvest crews work side-by-side cutting rows of vegetables, making it impossible to keep six feet apart.”

Orellana received a face mask from his employer, but many agricultural workers, including Hernandez, say their employers expect them to bring their own masks. “They are not giving us the essentials to protect ourselves,” Hernandez said. “Those of us who are working have so much debt and bills to pay that the money sometimes isn’t even enough to buy one mask because each mask costs three to four dollars at the store. And it’s disposable.”

Close Quarters, Lack of PPE

The combination of close working conditions and inconsistent protective gear from employers means that when one agricultural worker gets sick, it can quickly spread through an entire crew, which is typically 30 people, Max Cuevas, MD, CEO of the Federally Qualified Health Center Clinica de Salud del Valle de Salinas, told Frontline. “If each of those people goes out, they’re going to get three to four other people [sick], because that’s the infection rate. And so the thing snowballs.”

Max Cuevas, MD, of Clinica De Salud Del Valle De Salinas
Max Cuevas, MD

In April, Orellana heard that someone in his crew had tested positive for COVID-19. When he asked his supervisors about it, he was told that the company could not release any information. Soon after, Orellana developed a fever, headaches, and a sore throat. He decided to get a coronavirus test with two other family members who also work in the lettuce fields. All three tests came back positive.

Orellana lives with 10 family members, including the two who also work in the fields, four children, and elderly parents. After the three workers tested positive, they quarantined in a single room for 14 days to protect the rest of the household.

Cramped living conditions for agricultural workers compound the occupational hazards of their jobs during the COVID-19 crisis. Latinx, who comprise nearly all of the state’s agricultural workforce, are more likely than white people to live in multigenerational households. A 2018 Pew Research Center study found that 27% of Latinx live in multigenerational households, compared to 16% of white people. Having many people under the same roof makes self-isolating in the event of a positive COVID-19 diagnosis extremely difficult.

Deportation Worries

Furthermore, for the temporary agricultural workers in the US on H-2A visas, adherence to health and safety protocols in housing facilities depends on their employers. Employers must provide “housing, transportation to and from work and access to a kitchen at no extra cost for their migrant workers,” Amelia Lucas reported for CNBC. The housing provided is typically dorm-style, with shared living quarters, bathrooms, and kitchens.

It’s a horrible kind of fear that [undocumented farmworkers] learn to live with. You try to assure them, ‘Don’t be afraid of that one right now. Be afraid of the virus.’

—Max Cuevas, MD, Clinica de Salud
del Valle de Salinas

At one farmworker housing facility in Ventura County in early July, 188 out of 216 workers tested positive for the coronavirus. Each room in the facility can sleep about nine people, and at the time of the outbreak rooms were limited to five people, Erin Rode reported in the Ventura County Star.

Transportation to and from the fields is usually provided via carpooling, which is extremely risky right now. Hernandez told Frontline that she and other workers are “packed like sardines” into transport vans when they go to work.

Many agricultural workers live paycheck to paycheck and fear losing their jobs if they take time off to self-quarantine after a positive coronavirus test. For undocumented workers, that fear is heightened by worry that getting tested or seeking treatment could lead to deportation.

“Horrible Kind of Fear”

“This essential worker, a lot of them do, in fact, live in fear. They don’t want people to know that they’re here, undocumented,” said Cuevas, adding that many worry about what would happen to their families if they were deported. “It’s a horrible kind of fear that people learn to live with. You try to assure them, ‘Don’t be afraid of that one right now. Be afraid of the virus.’”

As cases of COVID-19 continue to climb in California agricultural areas, new supports announced by Governor Gavin Newsom aim to stop disease spread through testing, isolation, contact tracing, and data collection.

On July 24, Newsom announced the “Housing for the Harvest” program, which will provide temporary hotel housing to agricultural workers who have been exposed to or who test positive for the coronavirus. Initial efforts will focus on the Central Valley, Central Coast, and Imperial Valley, the regions with the most agricultural workers.

Newsom also expanded the state’s public awareness campaign around mask usage, increased paid sick leave and workers’ compensation for essential workers, proactive education efforts to help employers reduce risk for workers and customers, and required reporting of coronavirus outbreaks by employers to local public health departments.

Crucial Need for More Data

State Assemblymember Robert Rivas, who represents the Pajaro and Salinas Valleys of the Central Coast, told Frontline that data collection at the local level is essential. Local governments “should be releasing any and all data related to infections, outbreaks, because without that information, it’s nearly impossible to try to get this virus under control,” Rivas said.

On July 27, Newsom announced targeted actions to support the Central Valley. Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare Counties will receive $52 million in new federal aid to improve testing, the Chronicle reported.

The state will send “strike teams” to these eight counties to assist local public health, emergency, medical, community, and business organizations. This help includes evaluations and improvement in testing, contact tracing, disease investigation, data management, public education, and surge planning for local health care systems.

What questions do you have about COVID-19 trends across the state? Tweet at me with #EssentialCoverage or email me.

The post COVID-19’s Harvest of Danger appeared first on California Health Care Foundation.