Armida Rivera was working as a supervisor at Monson Fruit Company near Yakima during the COVID-19 pandemic, when workers asked her to strike with them.
She didn't hesitate to say yes. But not long after, she was fired.
"They didn't have any protection against the virus. We didn't have soap for us to wash our hands," Rivera said in Spanish. "I don't regret saying yes. I wholeheartedly would do it again."
Rivera now serves as the Yakima organizer for the Latino Community Fund, supporting farmworkers facing the ongoing impacts of COVID-19. Across Washington, she is part of a broader effort, including community radio staff in Sunnyside and physicians at the University of Washington Long COVID Clinic, to connect disproportionately affected communities, like Latino farmworkers, with information and care.
Dr. Leo Morales, a UW medical school professor and researcher with the university’s Latino Center for Health, said survey data collected by the center showed that 41.2% of agricultural workers previously diagnosed with COVID-19 experienced long COVID.
The project defines long COVID as an illness affecting people with a probable or confirmed COVID-19 infection, with symptoms appearing within three months and lasting at least two months.
Morales said some long COVID cases may be linked to delays in vaccination and vaccine hesitancy. Dr. Anita Chopra, University of Washington Long COVID Clinic, added that physically demanding jobs, such as agricultural work, can make it difficult for workers to take time off.
Amy Liebman, chief program officer for the Migrant Clinicians Network, said other barriers, such as limited transportation, language barriers and fears related to immigration status, can further complicate diagnosis. The Migrant Clinicians Network is a nonprofit organization that works with community health workers and other health-related educators relating to immigrant and migrant families across the country.
“But who was on the front lines? Our farmworkers, right? And we cheered them on for being our essential workers,” Liebman said. “They were more exposed, and were also getting sick more often and dying more often than the standing population.”
'Giving families more answers'
In a corner of a Latino Community Fund office space, Rivera points to several stacked boxes: COVID face masks.
Rivera said since getting fired, she stayed in contact with many of the farmworkers who took part in the strike and often has masks in the office in case they need them. Organizations in Central Washington, she said, have stopped handing out face masks and other resources since COVID restrictions were lifted in 2023.
She said most of the farmworkers she has stayed in contact with still have lingering symptoms of dizziness since getting COVID. Others have been left with no sense of taste, she said.
“Anybody that has worked in agriculture knows how dangerous it is to feel dizzy and be on a ladder picking fruit,” Rivera said.
Radio KDNA, a Spanish radio station in Sunnyside, has kept some of its initiatives that began during the pandemic.
Elizabeth Torres, director of operations for the news station, said its partnership with the state Department of Health began during the pandemic and continued once the first COVID vaccine was available to community members.
She said the station often did interviews with the state health agency to update community members of new information and events for vaccine mobile clinics. She added that the majority of their listeners are farmworkers.
News Director Francisco Rios said through their continued partnership, the station has done interviews alongside the state health agency about the COVID booster shots, information on new strains and anything else health-related that could impact the area.
“As a radio station, alongside the Department of Health, we’re trying to continue giving families within the county more answers,” Rios said.
When the pandemic began, the station advocated for more language-inclusive information, he said, which has improved over time.
Rios recalled when the city’s local health department held a news conference to announce quarantine measures, the station asked for all flyers and news releases to be translated into Spanish.
“All the information at first was in English,” he said. “We asked if there were city officials who speak Spanish, doctors who speak Spanish, other leaders in the community who speak Spanish so we could have them come by the radio station and share the information just as they had been doing in English into Spanish.”
He emphasized that Yakima County was in Phase 1 for an extended amount of time due to high infection rates. Phase 1 mandated residents to stay isolated.
“We had a high infection rate because of the farmworkers. They were still required to work,” Rios said.
“The work we've been doing has been important, not just for the station, but for the communities of Yakima County. I believe Radio KDNA has been a fundamental leader for farmworkers.”
On a national level, Liebman said the Migrant Clinician Network has worked with multiple organizations in Washington to help improve health outcomes and migrant-specific resources for farmworkers.
This has included working alongside the Yakima Valley Farmworkers Clinic and the University of Washington's Pacific Northwest Agricultural Safety and Health Center.
Liebman said they also developed these relationships to build trust and encourage farmworkers to get the vaccine, but she wonders what issues and concerns haven't gotten addressed post-pandemic.
"The questions I always have when it comes to farmworkers suffering from a chronic illness are, are they still here in the U.S.? Do they go back to their home countries because they're unable to work, and so what does that look like? And how are we tracking them?" she said.
Liebman emphasized heightened immigration enforcement makes it difficult for farmworkers to want to participate in studies .
"We're not going to have good data, unfortunately, on a population that was very impacted by COVID," she said.
But Kendl Sankary, a physician at the Long COVID Clinic, said there are still several research projects happening nationwide, including one she is currently part of.
She said she is leading research in Washington as part of an international study examining how long COVID affects patients and its possible correlation with dementia.
This, she anticipates, will help get more answers.
“Our site is focused on the Asian American, Pacific Islander, Native Hawaiian population, and then Native Americans as well in the state of Washington," Sankary said. "It's a longitudinal study, so looking at the impact long term on people's cognition over time.”
She said this international study includes sites in Texas, New York and Argentina, each focusing on a different group. Sankary is still in the early stages of the research and anticipates it will be finished in three years. In the meantime, she’s been volunteering at the University of Washington Native student organizations to build trust within the community.
"There's lots of research going on where we're trying to figure this out, especially in populations that are hit hard by the condition," she said.
Improving patient care
After years of treating patients with lingering COVID symptoms, Dr. Anita Chopra is focused on preparing future providers to better recognize and diagnose long COVID.
Chopra, lead physician at the University of Washington Long COVID Clinic, has worked alongside Stanford University to develop a curriculum aimed at helping medical students and trainees identify the condition.
“It's very important for (providers) to understand what this condition is, what is being done, and what can they do, how to identify," Chopra said.
Chopra said she partnered with Dr. Hector Bonilla and Dr. Linda Geng, both physicians on Stanford's Long COVID Care team, to create a 13-module curriculum called "LEARN Long COVID." Although the curriculum is intended for emerging medical students and trainees, she said providers can also use it as needed.
The program was built through input from both UW and Stanford medical students and was supported by UW and the Washington State Department of Health, Chopra said.
Additionally, she said UW is working toward creating a program to empower primary care physicians to diagnose and manage Long COVID patients. However, due to its early stages of development, she said she isn't able to provide much information.
"The ultimate goal is to improve patient care," she said.
Yet, Morales said that despite physicians at the UW working to help educate providers and future providers on long COVID, this will only benefit Latino community members to the extent they have access to the healthcare system.
"As we know, many in the Latino community lack access due to uninsurance, and even among those eligible for insurance or insured, barriers to meaningful access abound, regarding geography, culture, linguistics and mistrust," he said.
"My view is that the education modules will have little to no impact on Latinos with long COVID in the short and medium term,” Morales said.
Still, on behalf of the Latino Community Fund team, Rivera said the studies and curriculums Chopra and Sankary are tackling are needed to demonstrate the impact COVID had, and continued to have, on Latino communities, especially among agricultural workers.
“People were deemed essential, and while some resources were provided, more are needed as people continue to face health issues,” Rivera said.
“This is necessary to implement the policy changes required to protect the community. We know that seeing the data drives policy changes and mobilizes resources,” she said.
This story is part of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by the Commonwealth Fund.
