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Letter to Deputy Minister Janet Menard, Chief Coroner for Ontario Dr. Dirk Huyer and Ontario Health President and CEO Matthew Anderson regarding supports for migrant agricultural workers during COVID-19
Dear Hon. Deputy Minister Menard, Dr. Huyer and Mr. Anderson,
We write to you to highlight the urgent need for a broad province-wide strategy to protect the health of migrant agricultural workers during the COVID-19 crisis. A growing number of outbreaks in the migrant worker communities and two deaths in the Windsor-Essex area have made it clear that this group is one of the most at-risk in Ontario.
Several Alliance for Healthier Communities members serve migrant farm workers in multiple regions, including Norfolk, Windsor-Essex, Chatham Kent, Harrow, Brantford, St Catharine’s, Brock, Port Hope and other communities in between and are familiar with the barriers these workers face. We also work closely with the Occupational Health Clinic for Ontario Workers.
Since the beginning of the COVID-19 pandemic, the Alliance, among other advocate groups, have been calling for additional supports to prevent the outbreaks, including proactive surveillance testing, access to educational and health promotion materials in multiple languages, adequate infection control measures, prioritizing public health and Ministry of Labour coordination. Please see links to our letter to Minister Elliott and Minister MacNaughton sent on March 24 and our letter to Deputy Minister Helen Angus and Ontario Health CEO Matt Anderson sent on April 7. In both letters, we outlined our concerns along with specific recommendations and offered help developing solutions.
While there have been some positive developments, like the expansion of OHIP and the Guidance for Temporary Foreign Workers (TFWs), a lot of our questions and concerns remain unanswered. There is still no province-wide proactive surveillance testing strategy or transparent outbreak reporting. We don’t have clarity about who’s responsible for migrant agricultural workers strategy. In the absence of a coordinated strategy, the work has fallen to individual public health units, and the growing number of outbreaks demonstrates that the measures currently in place are not sufficient.
We urge you to implement the following measures as soon as possible to manage and to prevent future COVID-19 cases, outbreaks and deaths, and ensure food security.
- Broad proactive surveillance testing strategy for all migrant agricultural workers. During the Ministry of Health briefing on Protecting Ontarians through Enhanced Testing delivered on May 29, proactive surveillance testing was presented as part of the strategy, and agri-food business was at the top of the list of essential workers. Migrant agricultural workers should be prioritized for targeted testing considering their living and working conditions often make physical distancing challenging and put them at a higher risk of COVID-19. We know some regions are already moving ahead with broad testing of all migrant workers in their area. Proactive surveillance testing needs to be implemented across the province to prevent future outbreaks.
- Transparent and timely reporting on the number of cases and outbreaks among migrant agricultural workers. During our meeting on May 29 with the Ministry of Children, Community and Social Services regarding action and reporting on the provincial action plan for vulnerable people and congregate settings, we were told seasonal farm workers were on their list. However, the outbreaks are still not being reported in a separate category, similar to the cases in long-term care settings.
- Analysis of investigation into outbreaks by both the Ministry of Health (via Public Health) and the Ministry of Labour, Training and Skills Development and transparent reporting of the results. This would help identify root causes of the outbreaks, e.g. lack of compliance with the guidelines; inadequacy of directives or poor/insufficient communications of directives; inability to comply with directives; unrealistic expectations of farmers; lack of personal protective equipment (PPE); non-reporting of symptoms or conditions by workers due to fear; lack of COVID-19 related information or confidential health care contact information; language challenges preventing workers to report symptoms in a timely manner; or employers not being able to perform adequately the multiple roles that are now expected of them as public health educators, health assessors and infection control officers. Access to this information would help apply what is learned and adjust strategy as needed.
- Enhanced culturally safe supports for workers who are sick and self-isolating. Bonifacio Eugenio-Romero, a worker in the Windsor-Essex area, was self-isolating in a hotel room when he developed difficulty breathing and died within 30 minutes of calling the EMS. While the measures were put in place to do daily phone check-ins, with an in-person follow-up if necessary, for workers in self-isolation, closer monitoring is required. Lack of supportive networks compounded by language and cultural barriers puts migrant workers in a precarious position. Beyond physical needs there are mental health needs. Being in isolation is being alone and the stress of no one to talk to, uncertainty regarding income continuity and the inability to reach their families is incredibly stressful for these workers. As the Windsor-Essex public health officials are reviewing and enhancing their response plan right now, it is an important learning opportunity for other regions with a large concentration of migrant workers. There are promising practices already in place that need to be replicated in other areas, like the COVID-19 task force that includes a nurse practitioner, an EMS worker, a Spanish interpreter and a registered nurse checking in on workers in self-isolation in the Windsor-Essex area, performing on-site testing, providing infection control advice and answering questions.
- Adequate resources for translation services. Migrant workers in the hospital, those in quarantine, and workers who have health concerns and don’t know who to call need access to care and supports in their languages. In some instances, workers have been known to connect with Spanish-speaking support services in other provinces as they do not know who to contact in close proximity to them here in Ontario. Public health units are sometimes scrambling to find translation support for investigation and intervention. Often they are relying on Alliance members and community volunteers. Without adequate resources, this is unsustainable and insufficient to provide proper care, outbreak management and prevention.
Last week, the Ontario government sent out a news release “celebrating local agri-food heroes.” Migrant agricultural workers were not mentioned even though their contribution to the food supply chain is indisputable. Over the past few months, we have read numerous media stories about farmers scrambling with food production because the numbers of migrant workers arriving this year have been impacted by COVID-19. Farmers keep saying that these workers have the skills and experience that cannot be easily replaced with local workforce. Yet, again and again we fail to treat them with the dignity and respect they deserve and they remain invisible and expandable.
We need to act now to keep migrant agricultural workers safe, prevent future outbreaks and deaths, and maintain food supply.
We look forward to seeing these recommendations implemented and are ready to discuss them in more details.
CEO, Alliance for Healthier Communities