In the nation’s patchwork response to the pandemic, Democratic congressman and physician Raul Ruiz is helping fill a gap by taking coronavirus testing directly to farmworkers in the Coachella Valley of California.
Wearing a yellow or blue plastic hospital gown, face shield, gloves and a mask, Ruiz has joined other medical professionals with Volunteers in Medicine and gone to schools, churches and trailer parks to administer COVID-19 tests to the workers. They often are anxious and fearful, but also eager for more information about the virus, Ruiz told NBC News.
“When I go out to test, I often see hard-working people coming in after a hard day at work, with calloused hands and dirty clothes from working out in the fields, picking crops, with a tired look on their face wanting to be reassured they don’t have the coronavirus,” Ruiz said.
Usually, it is a woman who brings her children and her husband and grandparents after a long day of work to get tested and make sure the family is virus free. It’s not unusual for three generations of a family to show up for the tests, he said.
“In the farmworker population, we are seeing increasing positivity rates and the rate of transmission is very high in the eastern Coachella Valley where farmworker communities exist,” Ruiz said.
Purdue University is tracking the impact of COVID-19 on agriculture and its workers and estimates about more than 93,000 agricultural workers have been infected with the coronavirus, with the most in Texas, followed by California.
Despite the spread of the coronavirus, Ruiz said workers he meets are “hungry to learn about the virus” and happy to see the medical volunteers in their community.
“Many feel empowered to take the virus seriously and to make better decisions,” he said. “They mentioned that it’s good to know that people care enough about them to go out to the community into trailer parks, where they live, in order to give them information. It makes it seem more real and more important and that it’s an urgent issue."
Much of the information distributed is in Spanish and sometimes the medical care comes with a bag of food.
“It’s not uncommon to identify follow-up needs and connect them with the only free clinic in the area," he said.
Ruiz plans to return to a mobile home park in Thermal, California, on Thursday, joining “promotoras,” community health workers, who also will be distributing diapers, infant formula and health care to new mothers and their children. They have been brought in with medical personnel from Borregos Clinics as well by Lideres Campesinas, a women's farmworker advocacy group.
From there he'll participate in an online Thursday health discussion on farmworker health disparities.
"Because of the coronavirus, some of these families are lacking access to basic necessities like diapers or milk for their children," said Jaretha McKinley, interim executive director of HealthConnect One, which trains community health workers that deliver services in other communities.
A son of farm workers, Ruiz is in his fourth term in Congress. He also has worked as an emergency room physician and helped direct medical relief in Haiti after its 2010 earthquake.
His medical skills and legislative role often intersect on policy issues. Ruiz wrote legislation passed by the House that was aimed at requiring medical personnel and equipment on the border after the deaths of young children who had been detained by Border Patrol.
Bailouts — but no requirements for workers, say advocates
Although Coachella Valley is home to many resort cities such as Palm Springs, the more rural and eastern Coachella Valley is home to many of the farm laborers who work the vast and abundant agriculture of the area. Many are Latinos and immigrants who long before the pandemic struggled with access to health care, inadequate housing, heat and pesticide exposure and lack of worker protections such as sick leave.
"One of the biggest frustrations we've had with Congress is they've given over $20 billion in bailouts to the agricultural sector without anything actually requiring them to take precautions to protect their workers," said Andrea Delgado, government affairs director for United Farm Workers Foundation.
She said the bailouts haven't been accompanied by legal requirements that the industry provide sick pay to workers, ensure that they are implementing Centers for Disease Control and Prevention recommendations and making personal protective equipment (PPE) available free of cost, she said.
"In some cases, they've been required to pay for their own PPE if they want to be able to work," Delgado said. Federal law requires sick leave for food industry workers with employers that have fewer than 500 employees and California Gov. Gavin Newsom signed an executive order that applies to larger food industry employers, including farmworkers.
Newsom has taken other steps to require breaks for food workers to wash their hands, social distancing for workers and other precautions. But often farmworkers don't know of those benefits and requirements, Delgado and Ruiz said.
Volunteers in Medicine has taken its “street medicine” to homeless encampments in the past. Ruiz said it has been a good model to use in the community for farmworkers because “the current system fails to capture precisely the people that are most at risk of transmitting the virus in the community.”
Drive-through testing with limited hours that might require missing work isn’t realistic for farmworkers and other essential workers who may not have transportation, be able to leave work or may be reluctant or distrustful of established health care, he said.
Beyond testing, Ruiz said there is need for assistance for farmworkers who test positive to be able to isolate away from family members. The workers need hotels or a shelter where they can quarantine and get meals for two weeks, he said.
“They go home and they don’t have the luxury of having a space or a spare bedroom for them to self-quarantine away from their family,” Ruiz said. “And oftentimes there’s three generations who share a two bedroom trailer, two bedroom apartment or two bedroom low-income housing … Eventually somebody in their family is going to get sick.”
Ruiz said his group is now starting to plan for fall and providing vaccines for flu season, while still contending with the coronavirus.