A Mobile Primary Care Clinic Mitigates an Early COVID-19 Outbreak Among Migrant Farmworkers in Iowa

Migrant and seasonal farmworkers are a vulnerable population with unique health and safety challenges related to the entire spectrum of the social determinants of health. These challenges place migrant and seasonal farmworkers at a disproportionate risk of infection and illness because of the COVID-19 pandemic. This report presents a case study of an early COVID-19 outbreak among migrant farmworkers in Iowa and describes the role that a nimble and responsive mobile federally qualified health center played in the successful mitigation and response to this outbreak. Early during the pandemic, the clinic adopted a new model of service delivery utilizing telemedicine primary care visits, followed by in-person visits when necessary. As the pandemic progressed, clinic staff strategized to provide increased pandemic-related support to agricultural employers and migrant farmworkers across the state. Emphasis was placed on on-site testing and education regarding social distancing, mask utilization, and hand washing. Eventually, as migrant workers were infected and became symptomatic, more complex mitigation strategies such as isolation, quarantine, and clinical follow-up were also implemented. This report describes how a mobile primary care clinic developed a pandemic responsive model to provide successful mitigation of an early COVID-19 outbreak among essential and highly vulnerable migrant farmworkers.