Connecticut Epidemiologist Newsletter   •   February 2021   •   Volume 41, No.2

COVID-19 Outbreak Among Farm Workers at a Migrant Worker Camp―Connecticut, August 2020

Authors: Colleen Lynch, UConn School of Medicine; Vivian Leung, MD, Connecticut Department of Public Health.

On August 21, 2020, the Connecticut Department of Public Health (CTDPH) was notified of an outbreak of COVID-19 among migrant farm workers on a farm (Farm A) in Hartford County. CTDPH worked with many stakeholders including other state agencies, local government officials and non-governmental organizations to investigate and control this outbreak. This report highlights the importance of close collaboration among state and local authorities and community partners in protecting the health of vulnerable populations during the COVID-19 pandemic.

On August 11, a worker who resided in communal housing at a migrant worker camp on Farm A reported respiratory symptoms to the owner. A local community health center (CHC) tested the symptomatic farm worker, and two other farm workers residing at Farm A, for SARS-CoV-2. After review of infection control processes and touring the worker living quarters, the CHC and other collaborating agencies provided farm workers with health education materials about COVID-19 and guidance on social distancing and sanitation. The camp’s owner was advised to obtain a professional cleaning service for the living quarters.

On August 13, the symptomatic farm worker received a positive test result for SARS-CoV-2; the two others tested negative. To prevent spread of illness throughout the living quarters, the camp owner placed the SARS-CoV-2 positive worker in a hotel for isolation. On August 14, a mobile testing unit tested 91 farm workers for SARS-CoV-2 (68 residing at the farm camp and 23 other farm workers); 33 (36%) tested positive. Among those who tested positive, it is unknown how many resided on Farm A. On August 20, an additional 28 workers were tested; all were negative.

Workers who tested SARS-CoV-2 positive continued working as a part of the essential critical infrastructure workforce (1). They were physically separated from non-positive workers for all activities including housing, cooking, toilet facilities, work in fields, work in barns, and transportation between farms. All workers wore facemasks and socially distanced. A recommendation for repeat testing was given by CTDPH to ensure control of the outbreak. The CHC mobile testing unit performed repeat testing on 33 farm workers residing at Farm A who were in quarantine on August 30; all tested negative.

Discussion

The CTDPH was notified of an outbreak among migrant farm workers at Farm A in Hartford County on August 21, 2020. CTDPH convened coordination calls with stakeholders in state and local government during August 21–23, 2020. State and local officials were not aware of the guidance and support provided by community health partners until a meeting with non-governmental partners on August 26. Stakeholders included the local health department, Connecticut Department of Labor, Connecticut Department of Agriculture, the Massachusetts League of Community Health Centers, Connecticut River Valley Farmworker Health Program, multiple Connecticut CHCs, local municipal officials, and local law enforcement. These groups played an integral role in identifying and providing outbreak control guidance to Farm A. In addition to providing testing, community partners delivered personal protective equipment and cleaning supplies to Farm A. The farm owner implemented infection control measures suggested by the CHCs to ensure the health and safety of the workers and that of the community.

There were many challenges encountered during this outbreak response. A lack of clarity regarding reporting roles and responsibilities when an outbreak of COVID-19 is detected on a migrant worker farm contributed to delayed notification of both state and local public health authorities. The Connecticut General Statutes, public health code and Health Insurance Portability and Accountability Act of 1996 describe reporting requirements and release of information for public health activities (2,3,4).

Difficulties included identifying the agencies that had knowledge of the outbreak, steps taken to investigate it, and what guidance was provided to the owner and farm workers. After the role of state and local public health authorities was established, CTDPH was able to formalize the coordination among the group of stakeholders, the timeline of the outbreak was established, and additional control measures were identified and pursued.

This COVID-19 outbreak highlights the vulnerability of persons residing in congregate living settings such as those on Farm A (5). The farm workers regularly gathered for activities and dining, and shared restrooms and equipment, which increased the risk for viral transmission. Extended periods in an enclosed space, such as shared transportation between different work farms, also increased the risk of transmission (6).

Prevention measures such as masking, distancing, and frequent handwashing can prevent and mitigate outbreaks in congregate living facilities and shared transportation. Congregate living settings should also plan for rapid containment once COVID-19 is detected. Testing all residents immediately after a case is identified can help contain disease spread by identifying those who need to isolate due to a positive SARS-CoV-2 result or close contact with an infected individual. Repeat testing is useful for identifying those who subsequently become infected and need to isolate.

The response of the many state and local community partners contributed to the control of this COVID-19 outbreak and supported the health of these migrant workers. As a result of this outbreak, CTDPH developed and shared with stakeholders a standard operating procedure to guide the response to COVID-19 in Connecticut’s agricultural sector. This protocol will help ensure a timely and coordinated response to prevent the spread of COVID-19 among migrant farm workers and help protect this potentially vulnerable and critical population in Connecticut.

References

1. Cybersecurity & Infrastructure Security Agency. Critical Infrastructure Sectors. https://www.cisa.gov/critical-infrastructure-sectors. Accessed February 11, 2021.
2. Connecticut General Statutes, 19a-2a, 19a-215. Accessed February 9, 2021.
3. Connecticut public health code, 19a-36-A3-4. Accessed February 9, 2021.
4. CDC. Health Insurance Portability and Accountability Act of 1996. https://www.cdc.gov/phlp/publications/topic/hipaa.html. Accessed February 9, 2021.
5. CDC. Guidance for Shared or Congregate Housing. https://www.cdc.gov/coronavirus/2019-ncov/community/shared-congregate-house/guidance-shared-congregate-housing.html. Accessed February 4, 2021.
6. CDC. Scientific Brief: SARS-CoV-2 and Potential Airborne Transmission. https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html. Accessed February 4, 2021.

This page last updated 2/23/2021.