California officials have signaled optimism that the latest, most deadly wave of the pandemic is starting to abate as the most populous US state doles out vaccinations. But healthcare workers in Fresno county said their emergency rooms and intensive care departments are still inundated with patients.
“Sure, if your hospital goes from 200% capacity to 150%, of course they’ll say it’s looking better,” said Amy Arlund, an ICU nurse at the Kaiser Fresno hospital. “But in my entire 20-year career, I’ve not seen this many people, this sick.”
Situated in the heart of California’s Central Valley, Fresno county has been overwhelmed by the coronavirus pandemic. Hospitals in the region are still running short of ICU beds, medical staff and equipment. And the county is running critically short on vaccines – quashing hopes for a quick respite. Most affected are the tens of thousands of agricultural workers in the region, who have been toiling through the pandemic to supply what amounts to a quarter of the US food supply.
About one in every 11 people in Fresno have tested positive for the coronavirus since the start of the pandemic, and even as hospital admissions begin to slow, the county of about 999,000 people is recording about 450 new cases per day.
“I work like 60 to 80 hours a week because there’s so much to do, and there’s not enough physicians,” said Kenny Banh, the emergency medical director at Community Regional medical center in Fresno.
The pandemic has thinned the region’s ranks of medical workers. Two weeks back, Community Regional was short about 400 physicians, nurses and other staff. “There were patients in the hallways because there weren’t enough nurses to keep all of our floors open,” Banh said. Intubated patients in the overflowing ICU were at times being tended to by nurses who had no experience with the procedure.
“It’s starting to get better now – where a lot of our staff have either gotten Covid-19 and recovered, or they’ve had the vaccine,” he said. But still, there aren’t enough trained health workers to staff the hospitals – which remain at or over-capacity – and the coronavirus testing and vaccination centers.
Fresno has been short not only on staff, but also on vaccine doses. Officials said the county had received 113,000 doses since the Pfizer and Moderna vaccines were approved for use in December. With weekly vaccine allocations from the state tapering down slightly in February, “we’re going to get to a point where we’re going to have to really reduce our distribution,” said Joe Prado, the county’s community health division manager. The county has vaccinated its residents at half the rate of Napa county, to the north, per state data. Fresno ranked 38th of California’s 58 counties by the proportion of residents who had received a coronavirus jab. Other Central Valley counties lagged even further behind.
Vaccines were in such short supply in Fresno last week that officials shut down mass vaccination sites. Local supervisors have written to the governor, and a city councilman even wrote directly to Joe Biden: “Please send more vaccines.”
With hospitals filled to the brink and vaccines in short supply, the region’s agricultural workers have been among the most vulnerable residents. Farm workers, and especially Latino farm workers, have been most affected by the pandemic not just in Fresno, but across the state. An analysis by researchers at the University of California, found that 39% more food and agricultural workers have died during the pandemic than before the virus struck.
“I am afraid because we have to work if we have to pay our bills,” said Imelda Valdivia, who works at a grape farm in Bakersfield, California, south of Fresno. She and her co-workers will get 14 days of paid sick leave if they test positive for Covid-19. “But we don’t know how our bodies will react. What if it takes longer to recover?”
About 60 to 70% of the state’s agricultural workers are undocumented immigrants, and many have been afraid to get coronavirus tests or seek medical care, even if they suspect they have the infection, for fear that the personal information and forms they have to fill out at clinics and testing centers could be used to later track them.
“Foreign workers have been stopped by Ice [Immigration and Customs Enforcement] as they’re going to work – it’s a real fear,” said Diana Tellefson Torres, the executive director of United Farm Workers Foundation.
One year into the pandemic, workers are still complaining about unsafe conditions on farms and at meatpacking plants – a lack of soap or hand sanitizer, cramped work quarters and housing, not enough masks or PPE to go around, Torres said.
And so far, few of them have received the vaccine. Fresno officials have said they have enough doses to fully vaccinate 3,000 essential agriculture workers, covering a fraction of the 70,000 to 90,000 who work in the fields. Language barriers and difficulties to sign up for the online systems used to schedule vaccination appointments are further complicating distribution.
“I think governments really need to think about how workers are going to actually get the vaccine,” said Vicente Reyes, a college student and farm worker.
“When I heard that the vaccine was going to come out in California, I thought, ‘It’s going to be revolutionary,’” said Reyes, who is also a member of the United Farm Worker Foundation.
He and his parents, who also work in the fields, don’t have healthcare and have been terrified of catching Covid-19. “We were thrilled about the vaccine, but then we were very concerned – because we don’t know how we’re going to access it.”
Fresno officials said they were partnering with farmers, setting up mobile vaccination centers in or near fields and processing centers, so they can take the vaccine directly to workers. At one such event in west Fresno last week, dozens of workers were able to get their first dose. “Vaccinating our essential farm workers will ensure the safety of their workplaces, their homes, their families, our food supply and the vital services that they perform,” said Brian Pacheco, Fresno county supervisor. But, he said, “We simply do not have enough vaccine.”
While the most vulnerable await their doses, health workers in Fresno said their next major concern was a rise in misinformation and anti-vax sentiment. Protests against mask requirements at grocery stores and malls have become a fairly regular occurrence across the region – and in this latest stage of the pandemic, Banh, the medical director, said he had been disheartened to see so many of his neighbors blatantly ignore health advisories to avoid gatherings and maintain physical distance.
Arlund, the Kaiser nurse, said that she had been treating patients who deny, “right up until the time that they are intubated and put in a medically induced coma, that it’s Covid. They don’t believe they have Covid-19 right until the minute they die.”
The breaking point for her, she said, was when her own family began to deny that Covid-19 was real. “They say I’m just trying to create fear. They say they’re just going to live their lives, like normal,” she said. Twelve of her family members in the area have tested positive so far, she said.
Meanwhile, four of her co-workers – and many more patients – have died of the virus. She said: “We were really stretched thin before this pandemic. But this is just beyond what we can handle.”