ABSTRACT

Migrant and seasonal farmworkers are a vulnerable population with unique health and safety challenges related to the entire spectrum of the social determinants of health. These challenges place migrant and seasonal farmworkers at a disproportionate risk of infection and illness because of the COVID-19 pandemic. This report presents a case study of an early COVID-19 outbreak among migrant farmworkers in Iowa and describes the role that a nimble and responsive mobile federally qualified health center played in the successful mitigation and response to this outbreak. Early during the pandemic, the clinic adopted a new model of service delivery utilizing telemedicine primary care visits, followed by in-person visits when necessary. As the pandemic progressed, clinic staff strategized to provide increased pandemic-related support to agricultural employers and migrant farmworkers across the state. Emphasis was placed on on-site testing and education regarding social distancing, mask utilization, and hand washing. Eventually, as migrant workers were infected and became symptomatic, more complex mitigation strategies such as isolation, quarantine, and clinical follow-up were also implemented. This report describes how a mobile primary care clinic developed a pandemic responsive model to provide successful mitigation of an early COVID-19 outbreak among essential and highly vulnerable migrant farmworkers.

摘要

移民和季节性农场工人是弱势群体，面临着与健康的整个社会决定因素相关的独特健康和安全挑战。由于 COVID-19 大流行，这些挑战使移民和季节性农场工人面临不成比例的感染和疾病风险。本报告介绍了爱荷华州农民工早期 COVID-19 爆发的案例研究，并描述了灵活且响应迅速的联邦合格移动医疗中心在成功缓解和应对此次爆发中所发挥的作用。在大流行初期，该诊所采用了一种新的服务提供模式，即利用远程医疗初级保健访问，然后在必要时进行亲自访问。随着疫情的发展，诊所工作人员制定战略，为全州的农业雇主和农民工提供更多与流行病相关的支持。重点放在有关社交距离、口罩使用和洗手的现场测试和教育上。最终，随着农民工被感染并出现症状，隔离、检疫和临床随访等更复杂的缓解策略也得到了实施。本报告描述了一家移动初级保健诊所如何开发大流行响应模型，以成功缓解 COVID-19 在基本和高度脆弱的农民工中的早期爆发。随着移徙工人被感染并出现症状，还实施了更复杂的缓解策略，例如隔离、检疫和临床随访。本报告描述了一家移动初级保健诊所如何开发大流行响应模型，以成功缓解 COVID-19 在基本和高度脆弱的农民工中的早期爆发。随着移徙工人被感染并出现症状，还实施了更复杂的缓解策略，例如隔离、检疫和临床随访。本报告描述了一家移动初级保健诊所如何开发大流行响应模型，以成功缓解 COVID-19 在基本和高度脆弱的农民工中的早期爆发。