Innovative Cohort Process to Minimize COVID-19 Infection for Migrant Farmworkers During Travel to Iowa

Abstract

Background: Migrant and seasonal farmworkers (MSFW) experience disproportionate infection, severe disease and death from COVID-19. This report describes an innovative process to address the safety of MSFW that utilized cohorting that eventually allowed for safe release to work in the fields on a large family farm in Iowa. Methods: Upon worker departure from Mexico, the employer arranged for bus seat assignments, mask use, and hand hygiene practice during the 3-day trip to Iowa. Upon arrival at the farm, surveillance testing and low-density housing cohorting based upon travel seat assignments allowed for early identification of infected workers and appropriate quarantine as per CDC guidelines. Upon completion of isolation or quarantine as appropriate, workers were released to congregate housing and work in the fields. Findings: Compared to a migrant farmworker COVID-19 outbreak without travel pre-planning, the cohorting process produced a 3.5% positivity rate compared to an earlier season July farmworker group on the same farm with a 12.7% positivity rate. Conclusions/Application to Practice: The success of this model points to the power of collaboration between farm employer, health care providers and workers to minimize worker infection and enable safe work in the fields. Increased state and federal support for MSFW protections could support infrastructure to proactively plan for prevention mechanisms to prevent the spread of known communicable disease. With support in place from the top down, employers, workers, and health care providers will be able to prioritize the management of infectious diseases and the needs of essential workers.

The Influence of Organizational Aspects of the U.S. Agricultural Industry and Socioeconomic and Political Conditions on Farmworkers’ COVID-19 Workplace Safety

“…Political economy of health theory suggests that the organization of the agricultural industry likely produced workplace safety inequities during the COVID-19 pandemic that shaped Latinx immigrant farmworkers' workplace risk of exposure to the novel coronavirus. Yet, the research on the occupational health and safety of Latinx farmworkers during the pandemic has largely focused on assessing morbidity and mortality trends in COVID-19 [1,4,7,38,39]; identifying individual-level risk factors of COVID-19related physical and mental health outcomes [2,6,9,40]; determining barriers to COVID-19 testing and vaccination [41,42]; and introducing strategies to mitigate the spread of COVID-19 among farmworkers that do not address the structural conditions that may produce risk of exposure [43,44]. Individualized approaches to understanding farmworker safety presume individual responsibility for occupational health and safety and may inadvertently place blame on individuals.…”

Combined Infection Control Interventions Protect Essential Food Workers from Occupational Exposures to SARS-CoV-2 in the Agricultural Environment

“…However, despite the demonstrated effectiveness of these interventions among the general population during short-duration activities, their impact on protecting essential food workers during extended-duration (e.g., a whole day) activities has been poorly characterized ( 28 – 37 ). For example, outdoor seasonal and migratory workers involved in produce production, harvest, and processing have extended SARS-CoV-2 exposure during their daily activities (e.g., field harvesting, shared transportation, crowded employer-provided housing) ( 38 – 40 ). To our knowledge, there are limited studies quantifying the impact of SARS-CoV-2 infection control strategies to reduce transmission among food workers.…”

Portrait of COVID-19 Outbreaks in the Workplaces of the Monteregie Region

“…The workplaces of these EAS have structural and operational practices that make it difficult for workers to wear a mask or maintain a distance of 2 meters between them during work shifts, breaks, entering, or leaving the facilities 8,14 . Not only do the agricultural and the food processing sectors present an additional challenge due to the strong presence of migrants, foreign born or temporary foreign workers (TFW) in countries such as Canada, the United States, and Europe, but they also have been shown to be more at risk than other sectors (excluding health care) regardless of the presence of TFW 13,16,20–23 …”

“…8,14 Not only do the agricultural and the food processing sectors present an additional challenge due to the strong presence of migrants, foreign born or temporary foreign workers (TFW) in countries such as Canada, the United States, and Europe, but they also have been shown to be more at risk than other sectors (excluding health care) regardless of the presence of TFW. 13,16,[20][21][22][23] Workplaces where TFWs are present also seemed to be more at risk of outbreaks. In a case study of an outbreak at one Iowa farm, TFWs farm workers had a 41% SARS-CoV-2 positivity rate, while no cases were found among other workers.…”