When we finally find a safe and effective Covid-19 vaccine, every nation in the world will want it. But for a while, there wont be enough to go around. So who should get access to the first doses?
One way to answer that question is to say: The nations that discover the vaccine or that can pay those who discover it will get first dibs. All the other nations will just have to wait until more doses can be manufactured.
This is vaccine nationalism, where every nation just looks out for itself, prioritizing its citizens without regard to what happens to the citizens of lower-income countries that cant afford to buy up doses. Its a path that most ethicists think is wrong. Its also the path the United States is currently on.
September 18 was the deadline for governments around the world to join the Covax Facility, a unique financing mechanism that asks countries to pool their resources together so that humanity has a better shot at discovering a successful vaccine quickly. In return, all participating countries are promised that when that day comes, theyll get equal access to the vaccine.
Some 156 countries signed agreements with Covax, representing 64 percent of the global population. The US did not.
Bad! Bad! is how Ezekiel Emanuel, a medical ethics expert at the University of Pennsylvania, characterized Americas decision. This is an opportunity for low- and middle-income countries to get a vaccine and not just have it as a rich boys club, he told me.
Ruth Faden, founder of the Johns Hopkins Berman Institute of Bioethics, also bemoaned the decision. Its just incredibly shoot-yourself-in-the-foot, on two levels, she said.
Economically, Faden argues, its in Americas self-interest to help ensure every other countrys population is vaccinated because until the fear of Covid-19 dissipates, trade and travel wont go back to normal. And health-wise, nobody is safe until everybody is safe. Thats because any Covid-19 vaccine we find is not going to be 100 percent effective. It cant fully protect everyone from getting infected, so one infected traveler entering the US can still cause an outbreak.
For these moral and pragmatic reasons, ethicists generally reject vaccine nationalism (though some think its fine for a government to prioritize its citizens within certain limits). Instead, they say we should think about distributive justice, figuring out how to get lifesaving resources to every human being in a fair way.
But that unobjectionable-sounding notion actually obscures a key question, one that ethicists are now fiercely debating: When we say we want to distribute a vaccine fairly, do we care more about equality or about equity?
Equality would mean each country gets the same proportion of vaccine doses relative to its population size, and at the same rate. Equity would mean we drive more vaccine doses to the countries most in need.
The distinction between these two approaches and which one wins out will shape who gets a vaccine quickly and wholl have to wait around, hoping they dont get sick in the meantime. Lets get clear on each approach, and understand why groups like the World Health Organization are pushing for equality right now, while some ethicists say thats a mistake.
The WHO is one of three groups leading the Covax Facility. The other two are Gavi, a public-private partnership that spearheads immunization efforts in developing countries, and the Coalition for Epidemic Preparedness Innovations, an international collaboration (formed as a Gates Foundation initiative after the West African Ebola epidemic) to make vaccines available quickly when outbreaks happen.
Covax is kind of like a mutual fund, but for vaccines. Its creating a diversified portfolio of vaccine candidates (currently, nine are in development and a further nine are under evaluation), the idea being that its better to back many candidates, knowing that some wont pan out.
Very few countries can do what the US is doing: Were backing seven horses at this point, so we can create our own diversified portfolio, Faden said. But many countries dont have the resources to do that for themselves. This is the answer to that problem.
Covax asks wealthier countries to fund the development and manufacturing of the vaccine candidates. Lower-income countries dont have to pay; theyll be supported through voluntary donations to a dedicated Covax mechanism called the Advance Market Commitment. Covax aims to buy and make available 2 billion doses by the end of 2021.
If that happens, itll be a huge deal. Covaxs effort to get countries to work with each other instead of against each other could save many lives worldwide. According to Gavi CEO Seth Berkley, its the biggest multilateral effort since the Paris climate agreement; certainly, its a big step in the right direction.
Heres how the WHO says Covax allocation should work: Once a safe and effective vaccine is discovered, there should be an initial phase where all participating countries get doses in proportion to their population, at the same rate. Essentially, 3 percent of every countrys population would get access to the vaccine before any country moves on to 4 or 5 percent. This proportional allocation would continue until every country has enough doses to vaccinate 20 percent of its population.
The WHO suggests the initial tranche of doses, aiming to cover 3 percent, would likely go to health care workers. The tranche covering 20 percent would likely go to high-risk adults, like older people and those with underlying conditions. (The WHO says 20 percent would be enough to cover these groups in most countries, though some countries have older populations and might need more. They can request enough doses for up to 50 percent of their population, but they wont receive doses for more than 20 percent until all other countries have been offered that amount.)
Soumya Swaminathan, the WHOs chief scientist, explained the rationale to a panel of reporters on September 15.
What weve done in the Fair Allocation Framework, at least in the first phase, is to go with the principle of equality, she said. Because in this case, the disease has spread across the world. It has not spared any country, high-income or low-income, whereas diseases like TB and malaria disproportionately affect low- and middle-income countries.
However, she said that after countries have received enough doses to vaccinate 20 percent of their populations, she expects to shift toward more allocation to those countries which appear to be needing it much more than other countries that is, equity.
Pressed as to why Covax doesnt adopt an equity model right from the get-go, Swaminathan candidly explained that the reason is pragmatic: If wealthier countries are told theyll have to wait in line for vaccine doses behind poorer countries, they may reject Covax.
Theres a big, big risk that if you propose a very idealistic model, you may be left with nothing, she said. She recalled the 2009 swine flu pandemic, when wealthy countries like the US scooped up most doses of the H1N1 vaccine. Low-income countries couldnt get access until later, by which point the acute phase of the pandemic was already over.
Thats the historical reality. We are trying to create a new reality, Swaminathan said. But you cannot leave behind the high-income countries. To say to them, You dont have a big problem right now and therefore you dont need the vaccine, may not be acceptable to them because the virus is there and waiting to spring back the moment people go back to normal. Without their agreement, its not going to be successful.
In other words, the WHO is conscious of the politics at play here.
Faden co-drafted the WHOs Values Framework for vaccine allocation, which does list equity among its guiding principles, even though it wouldnt kick in till later. Look, there is a real-world problem, she told me. We currently live in a global order that is profoundly unjust. We need a strategy that appeals to and works for high-income countries. The Covax Facilitys principle of simple equality for the first 20 percent is this strategic attempt to incentivize countries to get in the kind that can pay.
Other ethicists are pushing for a more idealistic framework, one that prioritizes equity from the start. Chief among them is Emanuel, the University of Pennsylvania expert. Even as he participates in several WHO working groups on Covid-19, hes trying to get the international body and other players to rethink their model.
Theres a very obvious problem, he says, with the WHOs approach: Two countries can have similar-size populations but very different Covid-19 case counts. Should they really both get enough doses to vaccinate 3 percent of their populations right off the bat? Or should we drive more help toward the country with the greatest disease burden so we save as many lives as possible?
Emanuel explained the problem with the former approach via analogy. Imagine youre an ER doctor, he told me. Youre very busy, so you walk into the ER and say each person gets five minutes of time irrespective of how sick they are. That makes no sense.
In a paper published September 11 in Science, he and a diverse group of experts propose an alternative framework called the Fair Priority Model. (Though there are a couple of other proposals out there putting forward frameworks for vaccine distribution, this is the only one that offers as substantive a model as the WHOs.)
The experts lay out a plan for distributing the vaccine in three phases. Positing that our main goal should be to avert premature deaths, they suggest using standard expected years of life lost (SEYLL) averted per dose as the criterion in phase one. They say we should give priority to countries that would reduce more SEYLL per dose.
In phase two, which aims to reduce pandemic-induced economic deprivation, they give priority to countries that would reduce more SEYLL and reduce more poverty. In phase three, which aims to end community spread, they give priority to countries with higher transmission rates.
This model offers a concrete way to reduce serious harms and prioritize disadvantaged people on an international scale. Emanuel said its more ethical than the WHOs current approach.
I wasnt born yesterday. I understand that sometimes you cant do exactly whats ethical because you need to get people to the table, he told me. But political expediency is one thing and ethics is another thing. What I object to is claiming this [WHO approach] is an ethical position. And they do claim that they use the ethics language of were being equitable and all this. But thats not transparent; thats actually false advertising.
Some might object that Emanuels own proposal is not equitable to countries with more elderly citizens: Saving them will save fewer years of life (thus netting less SEYLL per dose), but older citizens are still morally valuable.
Emanuel told me that hes heard this ageism critique a million times but that its ill-founded. (He has, it may be worth noting, idiosyncratic personal views about aging.) He noted that many surveys conducted around the world suggest that, all things being equal, the public prioritizes youth over older adults in the distribution of health resources. As a global society, we seem to value investing in youth, both because investing in them when theyre young yields greater dividends later on and because we dont want to cheat them of the chance at significant life experiences a deprivation that arguably constitutes a moral harm.
Emanuel contends that his group has arrived at the best way to enshrine three fundamental values: benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern.
We met every week, arguing, and we had a very diverse group, he said. You had utilitarians, you had people who are more Rawlsian, you had cosmopolitans who believe national borders are basically ethically irrelevant, and you had people who believe borders are very relevant. I think our position represents the best of ethics and a consensus about principles that transcends lots of different specific moral commitments.
Ultimately, is this proposal better than the WHOs? How you answer that depends somewhat on your specific moral commitments. From a utilitarians standpoint, for example, whichever proposal will do the best job at maximizing benefit and limiting harm to all people is the best approach. If the WHOs realpolitik enables it to get more paying countries into the Covax Facility, thus eventually enabling more vaccines for people who couldnt otherwise afford them, it might actually be the most ethical model.
Either way, Covax is now in business, and its multilateral, cooperative approach comes as a welcome counterpoint to the vaccine nationalism weve seen in other quarters. For countries that have signed agreements with the Facility, the next step is to cough up the cash: Payments are due October 9. This money will hopefully accelerate the development and manufacturing of the vaccine were all awaiting.
Jen Kirby contributed reporting to this article.
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The Food and Drug Administration is expected to issue new rules for an emergency use authorization for a coronavirus vaccine and they will make it very unlikely that an inoculation will be cleared before Election Day, according to a report.
The FDA is issuing the guidance to increase transparency and public trust amid polls about the politicization of the process to roll out a vaccine, according to the Washington Post.
The Pew Research Center has reported that the percentage of Americans who said they would get the shot if it were available now has dropped to just over 50 percent from 72 percent in May, according to the paper.
New rules are expected to be far stricter than those used for emergency clearance of hydroxychloroquine or convalescent plasma, a treatment that uses blood plasma from recovered patients, the news outlet reported.
Under the new guidance, the FDA would ask drug makers seeking an emergency use authorization, or EUA, to follow participants in late-stage clinical trials for a median of at least two months, beginning after they get a second shot, two people familiar with the matter told the Washington Post on condition of anonymity.
The agency which has said any vaccine would have to be 50 percent more effective than a placebo also is likely to look for at least five severe cases of the disease in the placebo group for each trial, as well as some cases among older people, the paper reported.
President Trump, who has predicted that a vaccine could be ready by Nov. 3, said during a recent interview on Fox News that his Democratic opponents have been criticizing the speedy timeframe of a potential US vaccine as a political move to harm him before the election.
Its hard to imagine how an (EUA) could possibly occur before December, Paul Offit, director of the Vaccine Education Center at Childrens Hospital of Philadelphia and a member of the FDAs advisory board on vaccines, told the outlet.
Moderna and Pfizer, which began Phase 3 clinical trials in the US on July 27, have given second doses to less than half their participants.
A new Pew Research Poll showed only of half Americans would get a vaccine, thats down from 72 percent in May.
FORT WORTH, Texas As the United States nears 7 million COVID-19 cases, there is increased focus on when a vaccine could be available.
Dr. Peter Hotez is a vaccine scientist and Dean of the National School of Tropical Medicine at Baylor College of Medicine. His estimate for a vaccine is next spring or summer.
We're doing as fast as we can, but it's still not a quick fix, Hotez said. You've got to give it time to show that there's a difference between those who are vaccinated in the placebo to know that they're going to work.
Thats the same estimate CDC director Robert Redfield gave last week.
Moderna, Pfizer and AstraZencas partnership with Oxford University are the furthest along in trials.
The U.S. already pre-ordered millions of doses to allow the companies to start making them.
I don't see that will have a good indication about one of these working till the end of the year, which again is still a world land speed record, Hotez said.
A new Pew Research Poll showed only of half Americans would get a vaccine, thats down from 72 percent in May.
Hotez says thats because Operation Warp Speed hasnt put out a strong communications effort to counter misinformation.
No communications means that you allow anti-vaccine and anti-science groups to dominate your communications, Hotez said. Were going to need more scientists speaking out to counter that.
Hotez says part of the issue is the White House previously abusing Emergency Use Authorizations and undermining top scientists.
The Department of Health and Human Services and operation warp speed has a lot of damage control and I hope they have they show the willingness to be able to do that, Hotez said.
Despite issues with the CDC and FDA, Hotez says he backs the Vaccines and Related Biological Products Advisory Committee that will have the final say.
The American people can trust that process is one of the most robust in the world in terms of releasing vaccines that are both that both work and are safe, he said.
The biggest unanswered question after the timeline is who will receive the vaccine first.
The National Academies of Sciences, Engineering, and Medicine released a tier approach prioritizing vulnerable populations and frontline workers, but the federal government has so far not unveiled plans.
So far the animals havent shown any ill effects from the vaccine that weve given them, so thats good. If we can show that we can protect the animals against infection, that would be really good, Dr. Steven Zeichner, a professor of pediatrics at UVA, said.
The COVID-19 vaccine got political this week. Heres a look at the facts. The Mercury News
(WTNH) Weve heard promising news about the Pfizer vaccine and weve been following how Yale has been running some of those clinical trials.
Infectious Disease Specialist at Yale Medicine and Associate Professor at Yale University, Dr. Onyema Ogbuagu, gives us an update on the trials, and talks about how the criteria for being in the vaccine trials has changed in the video above.
Recent news of the death of baseball player Tom Seaver brought attention to the condition called Lewy Body Dementia. A newly-released documentary on Robin Williams also revealed that the comedian suffered from Lewy Body Dementia in his final days.
Dr. Leon Meytin, Movement Disorders Specialist Hartford HealthCares Chase Family Movement Disorders Center, shines more light on the condition, the symptoms and what treatments are available in the video below.
SAN FRANCISCO, Calif. (KRON) -- On todays edition of Rob Blacks Winners and Losers, financial expert Rob Black talks with KRON4s James Fletcher about the grocery delivery boom, a looming recession and Coke stocks.
Double-dip recession likely if no new stimulus: Some say Congress's deadlock over a second stimulus package for Americans will tip the nation back into recession.
John Balentines tortured logic and excuse-making for the Trump administration is breathtaking, never more than in his Pandemic Peeves, part III (Sept. 11). His vilification of Dr. Anthony Fauci is undeserved and almost laughable.
Dr. Fauci is one of the worlds most respected infectious disease experts, having served the last six presidents in distinguished fashion and possessing six honorary doctorates. In denigrating Faucis work and nitpicking he had his mask off for a minute at a baseball game; President Trump never wears one Balentine is being small-minded. Fauci has had the courage to say when he was wrong on issues surrounding COVID-19. Trump never admits a mistake.
Balentine excoriates Faucis performance, yet has no problem with the president peddling bogus cures (Remember bleach and hydroxycholoroquine?) and not informing the public about the seriousness of the virus for months. He tells Bob Woodward one thing and the public another. Its all on tape. And, somehow, according to Trump, its Woodwards fault the public wasnt informed. Or as reporter Phil Rucker put it,But youre the president.
Balentine also has no problem with Trump ignoring the recommendations of his own CDC, having no plan to open schools safely, making fun of Joe Biden for wearing a mask and holding packed rallies with no social distancing and few masks. At his Nevada rally, most of the people within camera range were told to wear masks. Off camera, contrary to state regulations, there were no masks. Cute PR trick. Its on tape.
The presidents failures on COVID-19 have been monumental, yet Balentine sticks his head in the sand. He spends his time denigrating Dr. Fauci, the adult in the room.
Balentine says its amazing Trump still allows Fauci to be on the virus task force. In reality, it is amazing he has stayed. They call that taking one for the team.
Tom Lizotte
Biddeford
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Seasonal workers who packed asparagus at a west Michigan farm initially chalked up their exhaustion, dizziness and headaches to the demands of working 13 hour-shifts seven days a week.
But then some workers lost their sense of taste and smell and had a hard time breathing. Bymid-June, it was clear that Todd Greiner Farmsin Hart was dealing with a major COVID-19 outbreak among its workforce.
At least 94 people tied to the farm tested positive, the largest farm outbreak in Oceana County, according to county health department emailsobtained by the Documenting COVID-19 project at the Brown Institute for Media Innovation at Columbia University and provided to the Free Press.
Health department spreadsheets tracked the diagnosis of 55 cases from Todd Greiner Farms from under two weeks in June, in which nearly all of the employees identified as Hispanic or Latino. According to emails, the virus spread to farmworkers' families, with 15% of infections being household or secondary cases by mid-June.
It is crazy but I am sure underneath everyones story there is a connection to a migrant worker, Doreen Byrne wrote on June 28. Byrne is thecommunicable disease coordinator for District Health Department 10, which covers 10 counties in northwest Michigan.
Among those at Todd Greiner Farms who fell ill was a supervisor who died, two workers said. The man's death certificate lists his cause of death asCOVID 19 Pneumonia Complications."
Its not known how many of the states estimated 45,000 migrant and seasonal farmworkers, many of whom are Latino,have tested positive for COVID-19 since the pandemic hit in March. There have been at least 46outbreaks at agriculture, food processing and migrant camp settings as of Sept. 17, according to the Michigan Department of Health and Human Services.
MDHHSmandated COVID-19 testing by agriculture employers and migrant labor camp operators in August, a move that some farmers pushed back on with alegal fight.
Emails obtained under Freedom of Information Act requests show that health department officials in several counties had concerns around outbreaks and testing at farms well before the state mandate. Among the findings:
During a shift at Todd Greiner Farms in mid-June, a 25-year-old woman who was among several workers who asked not to be identified in this article out of concern for losing their jobs or not finding work in the futuresaid she started coughing so hard thatshe couldn't catch her breath. She described a chaotic day of ambulances rushing away one worker who turned alarmingly pale in the break room and another who had a hard time breathing. The woman said she left work that day and tested positive.
"That day, 30 people, including me, we all left," she said.
Todd Greiner Farms did not return emails seeking comment. A woman who answered the phone declined to comment, saying: "Nobody here would be interested" in talking about coronavirus cases.
Michigan farmers and their representatives defend their practices, saying the health and safety of their workers is one of their top concerns. They say this year has been a struggle for them, with many uncertain about their future.
"Our farms and our agricultural businesses have gone through extreme measures to protect the health and safety of their workers," said Ernie Birchmeier, a manager at the Michigan Farm Bureau. "It is critically important that we do that because we rely on a workforce to get the crops harvested, to get them packaged, to get them delivered. So our farms have taken this situation very seriously and continue to do so."
Migrant workers lay down a reflective material to help apples with ripening Monday, Aug. 31, 2020 at a farm near Grand Rapids.Mandi Wright, Detroit Free Press
Farmworkers serve a vital role in Michigans agriculture industry, which contributes $104.7 billion annually to the states economy, according to theMichigan Department ofAgriculture and Rural Development. Michigan, with more than 300 different commodities, is the second most agriculturally diverse state after California.
Some workers arrive as early as February to begin the planting season and stay as late as mid-November, moving from farm to farm. The fruit and vegetable season starts with asparagus in the spring and wraps up with apples in the fall.
Coronavirus outbreaks concern farmworker advocates and health experts. They say migrant laborers are at risk for exploitation and can be vulnerable to COVID-19, in part because they often work and live in crowded environments.
More: Lawsuit over coronavirus testing for Michigan farmworkers is dismissed
More: Michigan farm workers call for coronavirus safety
Historically, migrant workers have encountered a lack of labor protections, said Alexis Handal and LisbethIglesias-Rios, researchers at the University of Michigan School of Public Health who interviewed farmworkers in 2019 for a study called the Michigan Farmworker Project.Workers might not speak up about their health and safety because they're afraid of losing their jobs.
Theres some really important power dynamics at play here, and workers are not empowered to really have control of their working and living conditions, said Handal, an associate professor of epidemiology.
And the fear of deportation is huge for those who are undocumented, said Iglesias-Rios, a postdoctoral research fellow. That can mean staying quiet about problemssuch as a lack of masks and other personal protective equipment.
Having a silent workforce is dangerous during the pandemic, Iglesias-Rios said.
Adrian Vazquez-Alatorre, executive director of El Concilio, an immigrant advocacy group in Kalamazoo, said that Latino immigrant workers have struggled to get protection during the pandemic, especially earlier this year.
"They weren't giving them masks before,"Vazquez-Alatorre said of some greenhouses, farms and food processing centers. He said employers brushed aside workers' requests for masks and other protections.
Some workers who believe they contracted COVID-19 on the job told the Free Press that their employers showed little regard for their health and safety and didnt pay them for their time off after they tested positive. Yet, other farmworkers said their employers tested them before it was mandated and compensated them for sick time.
The worker at Todd Greiner Farms who got sick with COVID-19said she and her colleagues stood about 2 feet apart on the production line and would bump into each other as they grabbed bundles of asparagus off a belt.
I still feel like the people that were working there was just too many, said the woman, who lives in Hart. I was like, I dont see why you dont do a second shift ... and have more space between us.
Another worker,a 25-year-old Texas woman, said Todd Greiner Farms had protocol for hand-washing, wearing gloves and social distancing in break rooms.
"But working in the line, in the production line, we were all very close together. They didnt follow the 6-feet distancing," the woman said.
Both womensaid Todd Greiner Farms provided reusable cloth masks that were collected at the end of each shift for washing and redistributed to different workers.
How can you keep the virus away from people when youre doing that? How sure are you that the virus is going to be out or the germs are going to be out from those face masks? the Hart resident said.
She said workers were allowed to use their own masks, but she thinks the farm should have provided disposable masks.
She said frustrated workers walked out.
Her account of employees leaving is supported by emails among staff at District Health Department 10. Byrne, the communicable disease coordinator, wrote in a June 28email to another official that "the farm is closed for the season. The employees all walked out last week."
Agricultureoutbreaks spiked quickly over a few days in the beginning of June, saidRobin Walicki, clinical supervisor for District Health Department 10. In the department's 10-county coverage area, Oceana County saw the biggest jump, with additional cases at farms andfood processing plants inNewaygo and Mason counties.
"It ramped up so quicklythere in a couple days that I think it mightve taken us a little bit by surprise," Walicki told the Free Press. "There wasthe dip after everybody stayed home. We had a couple days with zero cases. I think we were lulled into a little bit of a sense of security. ...It just very quickly became very hard to follow up on all the contacts."
The health department brought in more translators and reassigned about 20 people from different divisions to help with contact tracing. Nurses worked daily for close to six weeks, Walicki said.
Walicki didn't have exact numbers Monday but said cases have increased only sporadically since MDHHS mandated farmworker testing in August as apple orchards prepared for the season.
"I think because of the fact that we might have newer peoplein the area with the different harvest season, were starting to see a few different peopleget tested," she said."Everybody else had been tested, isolated, quarantined."
In late August, after an outbreak in late June among four workers,Arbre Farms in the Oceana County village of Walkerville had its first what if they already tested positive scenario with a migrant worker,according to emails between the farm and health officials. The employee had tested positive less than two months earlier and was refused testing at multiple health clinics due to the fact that he already tested positive not long before.
Emails show some suspicion about how quickly farmworkers were returning to work and the issue of being retested.
It is my understanding that if someone has tested positive for COVID 19 previously, that no one in the area will retest them, wrote Arbre Farms HR Administrator Jennifer Juliano, as she asked whether she could employ workers who couldnt get tested. Confusion surrounding protocol meant they were directed from the county health department to the state.
Michael Fusilier of Manchester, who runs a small family-owned vegetable farm and greenhouse in Washtenaw County, said they've been protecting their workers.
"We do make sure everybody's wearing masks," Fusilier told the Free Press. "I have one of my ladies who was working for me, she's in charge of making sure our crews are doing the right things and trying to abide by the rules of the executive orders. And so we were trying very hard."
Adding to the uncertainty, Fusilier Family Farms had to shut down because of a state executive order that prevented greenhouses from selling any products. The Michigan Nursery and Landscape Association filed a lawsuit challenging the order. The state lifted the restrictions in April.
"That was a very stressful time, not knowing what was going on," Fusilier said. "We did lose some sales right off the bat because we weren't able to open as early as we normally do."
The state mandated that baseline testing had to be done by Aug. 24 and applied to agricultureemployers with more than 20 workers on-site at a time and migrant housing providers.Going forward, they must test new workers,as well as those who have been exposed to COVID-19 or have symptoms.
Employers and housing operators foot the bill for testing, but they can get help covering some or all of the costs.
A number of immigrant advocates supported thestate order, while some farms and farmworkers alleged it unfairly targeted farms and Latinos. Opponents filed a federal lawsuit challenging the order.
"We are very disappointed in the public health order that came out specifically targeting migrant and seasonal workers in the agricultural community," said Birchmeier, of the Michigan Farm Bureau, which backed the suit. "The workers themselves were very concerned about that."
The Farm Bureau said the order led to some Michigan farmworkers leaving fields and orchards.
But the 6th Circuit Court of Appeals sided with the state, and the two farms and four workers who brought the legal action withdrew their suitthis month.
Before the statemandated testing, Gov. Gretchen Whitmer in June ordered COVID-19 protections at the state's 782 licensed migrant labor housing camps.
The state Department of Agriculture and Rural Development says it has inspected all licensed migrant housing camps, most of which are in west Michigan, for compliance with theexecutive order. Among other things, the requirements include:
Aspokesman for the department of agriculture said Sept. 11 that all licensed camps were in compliance with the order, and no civil or criminal penalties hadbeen filed against any housing provider.
Migrant Legal Aid Executive Director Teresa Hendricks, left, and law clerk Molly Spaak hand out bags of face masks, hand sanitizer and gloves at a migrant camp in Kent County on Monday, Aug. 31, 2020.Mandi Wright, Detroit Free Press
But Teresa Hendricks, executive director of Migrant Legal Aid in Grand Rapids, said she and her staff have documented a number of issues while doing outreach at housing sites. The nonprofit law firm visited camps in west Michigan three days a week and handed out 4,600 reusable masks this summer.
Last year, Migrant Legal Aid referred 67 complaints about housing conditions and other issues to the department of agriculture. Theyve made 102referrals so far this year, Hendricks said.
She said the most common complaintsare housing camps not posting their COVID-19 preparedness plans, a lack of disinfectant products and no clear isolation areas for people who test positive.
Most farmworker housing is set up for workers to share rooms, which Hendricks said ranges from four-person bedrooms in trailers to barracks-style housing of 50 or more beds in one room. Whitmer's order requires camps to separate beds by 6 feet when possible and encourage residents to sleep head-to-toe.
I see the workers trying to make their own barriers between other workers, hanging sheets around their bed so that they dont combine airspace, Hendricks said. We see people trying to reuse surgical face masks, wash and then hang them on a line.
On a warm afternoon in late August, Hendricks and law clerk Molly Spaak packed a van with more than 100 bags of cloth masks, hand sanitizer, plastic gloves and information about how workers could reach them with complaints. They headed northof Grand Rapids to Kent Countys Fruit Ridge, where the apple harvest was just beginning.
A disposable face mask hangs on a clothesline at a migrant camp in Ottawa County.Migrant Legal Aid
At a camp south of Sparta, they met workers who'd recently arrived from Mexico on temporary agricultural visas, known as an H-2A, and planned to stay until late October. About a dozen men in a trailer-like building chatted in Spanish with Hendricks and Spaak.They said they were getting tested for COVID-19 the next day.
At another housing site tucked between rows of Honeycrisp and Gala apple trees, Spaak walked through the tidy camp to see whether anyone was home.
She approached the white, multi-person cabins, calling out, Hello. Hola. Alguien? Anyone?
They found 32-year-old Brenda Martinez home with her two young children while her husband and the rest of the farmworkers were out.Her husband has been a seasonal employee with Chase Orchards for four years. He likes it there, she said. Most of the other workers come through the H-2A program.
Her husband got sick in July and tested positive for COVID-19, Martinez said. Chase Orchards checked on her family while he was ill and off work, and neither Martinez nor her kids caught the virus.
Martinez's mother worked on a blueberry farm in Ottawa County this summer. Workers who tested positive there left because they didnt want to isolate, she said.
Brenda Martinez, 32, the wife of a farmworker, is reflected in the sunglasses of Migrant Legal Aid Executive Director Teresa Hendricks on Monday, Aug. 31, 2020 as Hendricks speaks to Martinez about COVID-19.Mandi Wright, Detroit Free Press
They wanted to work, so they just left, she said.
Hendricks said farmworker testing is well-intended, but the fact that people cant work while they have the virus is a hardship for those who arent paid sick time. She mentioneda woman who went a month without income while she had COVID-19. Because shes undocumented,she didn't feel she could demand tobe paid for the time she lost, Hendricks said.
A 43-year-old farmworker in Newaygo County, who asked to not be identified, saidhes concerned about the virus because he has four kids. But hes also afraid of losing his job if he tests positive. He said he doesnt understand why testing isnt required of workers in many other industries.
It should have applied to everybody, not just farmworkers, the man said through a translator. We dont know why its so focused on us.
Other agriculture workers said they were glad to be tested. Raquel Ramirez Hernandez, 59, is employed year-round at Peterson Farms in the Oceana County village of Shelby, where she packages peaches, apples, cherries and blueberries.
She said the company tested its workforce in late spring as temporary workers were arriving.
There was a very large influx of people, and we were all happy to get tested, Ramirez Hernandez, of Hart, said through a translator.
She tested negative at first. Thirty-seven peopleassociated with Peterson Farms tested positive as of mid-June, according to health department emails. Ramirez Hernandez contracted the virus in early July and was given paid sick time for two weeks off.
America Reyes, 52, a Texas resident living in Hart for the growing season, believes that she and other family members who contracted COVID-19 got itfrom two siblings who worked at Peterson Farms. Reyes said her siblings contracted with Peterson and werent paid for the hours they missed while sick.
A spokesman for Peterson Farms declined an interview request.
Other workers said they have faced similar problems.
Juana, 39, who asked that her last name not be used, has worked on farms in Michigan for 15 years and currently packs eggs.
She said she tested positive for the coronavirus in April and had to miss work for a month and a half, making it hard to pay her bills.
"COVID-19 has affected me in a lot of ways, mentally, financially, economically," Juana said through a translator during a news conference last month organized by immigrant advocates. "I was infected with COVID-19 because at work they did not provide us with security protections, did not give us masks. We had to buy masks with our own money. And many of us at work got sick due to the lack of protective equipment at our workplaces."
The Texas woman who worked at Todd Greiner Farms said before she got sick with COVID-19 in June, she and others on the production lineswere pushed to work quickly as the end of asparagus season neared.
She said people were so tired that they forgot to take care of themselves.
"They forgot to notice the fatigue that this virus costs you. They thought they were just tired because of work. I think it was because we were already infected," she said.
Contact Angie Jackson: ajackson@freepress.com; 313-222-1850. Follow her on Twitter: @AngieJackson23
Contact Niraj Warikoo: nwarikoo@freepress.com or 313-223-4792. Twitter @nwarikoo
