Between the storms, farmworkers harvested strawberries in Oxnard. The rows were muddy and slippery. Photo courtesy: UFW

While fierce storms have flooded the state and the pandemic continues with new strains of COVID-19, our nation’s “essential” yet most vulnerable workers never stop their labor in the fields.

During breaks in the storm, farmworkers — wearing thin, plastic smocks — moved quickly into the cold, wet and muddy fields to pick produce.

When the storms were at their worst and they could not work at all, they expressed concern that they would not earn enough to pay for their own basic needs. 

Extreme weather is not new to farmworkers; last summer, they faced heat waves with triple digits under an unrelenting sun.  They were at risk for heatstroke — and yet, they still worked.

Although the back breaking labor to bring food to tables across the country is deemed “essential,” California’s farmworkers — whose majority is a migrant workforce and speaks primarily Spanish and indigenous languages — have yet to receive any guarantees of benefits or a salary commensurate with the labor they provide and the health risks they face.

From the start of the COVID-19 pandemic — when most people were required to stay at home — farmworkers were still required to work the fields because their work was classified as “essential” to sustain others’ lives. However, they did not receive the safeguards, most especially in the beginning when the vaccine wasn’t available. Farmworkers had to contend with a decision no one should have to make.

Should they risk their own health and possibly their life by working the fields or go without the money that sustains them for food or rent?

“When most of the communities were at home, they were out there making sure that we had opportunities to have something to feed our families, and they were getting exposed working as an essential worker for our community,” said Dr. Ilan Shapiro, chief health correspondent and medical affairs officer at AltaMed.

“We knew that our farmworkers were essential and important. But we never felt that until we were strolling into 2020,” said Dr. Shapiro.

Shapiro was among the speakers at a news briefing hosted by Ethnic Media Services and co-sponsored by the California Department of Public Health. The Vaccinate All 58 campaign was launched and announced by Gov. Gavin Newsom in December 2020, when the first doses of the COVID-19 vaccine arrived.

The campaign was aimed to provide equitable access to the vaccine and information in all 58 counties in California.  

Farmworkers, however, remain among those at highest risk for COVID-19 and continue to face ongoing challenges in accessing health care. 

While they work in open fields, they often carpool — traveling back and forth into the fields with other laborers and they live in close quarters, oftentimes sheltering with many others and sharing items including one restroom.

Food and agricultural workers suffered more excess deaths from COVID-19 than any other occupation. It’s estimated that farmworkers were 2.5 times more likely to get COVID-19 compared to the general state population and during the peak of the epidemic many lost family members.

The Impact of Doctors Leaving

Access to health care in rural communities — especially to farmworkers who are uninsured, coupled with doctors who left the field during COVID-19 — has increased their health care challenges.

“Sadly, right now, we have seen a huge amount of doctors, nurses and just health workers that chose to actually leave the field of medicine that California is actually suffering,” said Shapiro. “We do have a lack of doctors, nurses and healthcare workers and this was amplified during COVID-19 burnout and a lot of other factors.

“I would love California to produce more doctors in the UC system, I would love to actually have more rural programs there. When you have a doctor that speaks your language or understands your language, or your culture, you can actually have [a] better impact on outcomes of diabetes, hypertension and other things,” said Shapiro.

Community health workers or Promotoras, lay people who have received training to provide basic health education, have been credited for filling some gaps to help farmworkers, even though they aren’t professional healthcare workers.

Those Who Test Positive for COVID-19 Should Seek Treatment

While many who test positive for COVID-19 don’t report it or seek medical care, they may have an additional medical condition which they don’t know about, which can make them a high-risk case, warned Ed Kissam, member of the National Center for farmworker health advisory committee to the Centers for Disease Control and Prevention.

“Moreover, simply being unvaccinated or not being up to date with vaccinations also increases risk. So essentially, almost all farmworkers are at risk of having a serious case of COVID if they’re infected,” said Kissam.

It’s recommended that farmworkers test as soon as they have symptoms to get them linked to a provider.

The way to reduce health disparities, said Kissam, is implementing policies to reduce health disparities and tailoring it to the needs of farmworker communities to “test to treat.” Farmworkers exposed to poor living conditions, pesticides, poverty and hard physical labor are already in challenging circumstances. Getting farmworkers tested as soon as they have symptoms and linking them to a provider helps to get them Paxil, the antiviral which decreases the risk of serious illness by 90% in unvaccinated people.

“That’s crucial because the antivirals only work well within five days of people being impacted and having symptoms. Unfortunately, half of farmworkers, being used to difficulties in accessing medical care, never saw treatment for COVID-19, we have to improve that percentage,” said Kimmal.

“It’s fairly easy to get access to antivirals if you have a private physician, or a relationship with a community health center. However, if you’re uninsured, and have only in the past gone to emergency rooms or urgent care, you don’t have that relationship. And it’s hard to get set up for treatment right away.”

Farmworkers Cannot Be Undervalued

While most people hardly consider how their food gets to their supermarket or the work conditions that farmworkers endure, without their labor the food industry could not function. California’s farms are the largest producer of food in the United States and they are dependent on farmworkers. 

Without their labor, millions of pounds of food would go unharvested. There are more than 500,000 agricultural workers on California’s farms and at its packing facilities, producing almost two thirds of the nation’s fruit and nuts supply, and about 1/3 of its vegetables, 18% of all dairy products consumed in the United States and three quarters of all medium grain rice. 

However, with an estimated half of the workers being undocumented, there is a reluctance for them to complain about conditions out of fear of not being called back again to work and the message they receive is that they are easily replaceable.

So, without benefit of sick leave, oftentimes — even when feeling sick — farmworkers continue to work.

“We need to remember that farmworkers are very vulnerable historically. There’s a lot of fears. There’s a lot of intimidation because they don’t want to have to lose their jobs,” said Arcenio Lopez, executive director of the Mixteco/Indigena Community Organizing Project in Oxnard.

Lopez knows the challenges of indigenous farmworkers working in California firsthand. When he came to the United States at 21, he worked the strawberry fields which he described as a painful experience — physically and mentally. Now entering a third year with a mutating pandemic, Lopez explained it has been stressful, especially for farmworkers who lost family members and there was “a lot of miscommunication.”

“There’s an increase in anxiety, stress and mistrust that our communities have with the health system,” said Lopez who describes the situation as “complex.”

“There is a narrative that happens within the workers that if they complain, if they say something, that the next time they will not be recruited to come back to work in California. So there’s a lot of vulnerability there as well.”

Lopez also said that the landscape has changed and those outreaching to farmworkers should be aware that not all of them speak Spanish — many of those who now work the fields speak various native indigenous languages.

Farmworker communities, Lopez points out, are also mobile, which makes it challenging to track their health status.

“They might be here in Oxnard for a week, and they might be moved to up north California next week. They might be here temporarily for months, they might get COVID. And we don’t know what the consequences were.” Lopez explained that workers, in as little time as three months, may have returned to Mexico.

“California agricultural counties started doing outreach to farmworkers in a very uneven way. Some worked early and hard and while others dragged their feet,” said Kissam.

“I’m estimating that about half of California’s farm workers are vaccinated and that’s about 20 percentage points below the national average. Moreover, one of the issues that’s really crucial at this point with the new Omicron variants is that simply being vaccinated doesn’t provide the kind of protection we’d like,” said Kissam. “The CDC is calling for a huge emphasis on people getting up to date with vaccination with the latest, newly designed vaccine. Our progress nationally on that front is really worrisome, with only about 14% of the eligible people in the nation having gotten the up-to-date vaccinations and unfortunately, once again, farmworkers are disproportionately left behind.

“I just think that there has to be an ongoing recognition that as much as we’d like to see the pandemic over, it’s not over, the virus continues to evolve,” said Kissam. “There’s going to be a need for ongoing vaccinations in the coming months and years. And those are going to have to be funded. So, the first step is going to have to be federal policy and funding to support the kinds of outreach efforts that we’d all like to see, because otherwise, it can’t happen,” said Kissam.

“Republicans in Congress have opposed the administration’s request for COVID-19 funding to respond effectively; they asked for $22.5 billion in the spring. And they then asked for $9 billion, and whether there will be funding for continued free tests for uninsured people, continued free vaccinations and continued free treatment for uninsured people is up in the air with a current omnibus bill,” Kissam explained.

“The arguments for investing more in response are very compelling. A hospitalization on the average costs $41,000. And that means that each averted hospitalization is $41,000, not to mention the pain and misery of the person who does have a serious case and the possibility of long COVID,” said Kissam.

“It’s essential for the entire country to make sure that our farmworkers are healthy, taking care of and if it’s COVID-19, influenza, diabetes, hypertension — any of these things that we are struggling with need to be accounted for. The resources need to be given because how essential is oxygen? How essential is our food? How essential is it to be together with the family?” asked Shapiro.