(CNN) As a farmworker, Salvador Calzadillas has been deemed "essential" during the Covid-19 pandemic. What he feels, though, is underpaid and at risk.
Calzadillas, who works near Bakersfield, California, said he mostly has had to scrounge up his own masks and protective gear since the start of the pandemic. He's repeatedly switched jobs and employers -- from picking blueberries and cherries, to thinning greens to cleaning carrots to weeding grapevines -- in search of better pay and safer working conditions.
"They do give us masks and gloves here; they just started that last week," he said recently of his latest job, at a vineyard. But most places he's worked, he said, "the companies don't give us anything."
Calzadillas and other farmworkers have good cause to be worried. In recent weeks, Tennessee, Oregon, Washington, North Carolina, Colorado, Michigan, Florida, New Jersey and New York have reported coronavirus outbreaks infecting dozens to hundreds of workers on farms and fruit and vegetable processing facilities. These outbreaks are separate from the well-reported clusters at meat processing plants and industrial poultry and hog farms.
The Centers for Disease Control and Prevention notes on its website that farmworkers face a particular risk of infection from being in close contact with one another in fields, in shared housing or transport, and because of limited access to clean water for hygiene.
Health officials say some of the outbreaks appear to have spread in part because of crowded farmworker housing or close working conditions. But worker advocates also blame federal policies that block undocumented farmworkers and those in mixed-status families from stimulus payments and health care assistance, and a lack of federal action to impose mandatory coronavirus protections for agricultural workers.
Roughly half of US crop farmworkers are undocumented, according to the US Department of Agriculture. The CDC recommends that farms "consider modifying policies" so workers aren't penalized if they take sick days.
But workers and advocates say those recommendations overlook a broader problem: Because undocumented workers are excluded from federal coronavirus assistance, unemployment insurance and Medicaid, "they're not going to tell someone they're sick, if they're not going to get paid" while staying home, or if they fear losing their jobs, said Melinda Wiggins, executive director of the advocacy group Student Action with Farmworkers, in North Carolina.
"The vast majority of farmworkers have no health insurance," said Armando Elenes, secretary treasurer of the United Farm Workers union. "Their biggest worry is getting sick and not being able to work ... They don't have a fallback plan; they can't collect unemployment. They've got no safety net."
One undocumented plant nursery worker in central Florida, who was diagnosed with Covid-19 last month, told CNN that she wasn't offered paid sick days. She said she and her husband, who have worked in the US for 12 years, relied on home remedies rather than seeking medical care.
"My husband had some fever, headaches, he felt poorly ... he works in construction, but when he tested positive, he had to leave his work for 20 days," she said. "Then I felt sick and tested positive six days later ... we don't have health insurance; it's very complicated to figure out what to do."
The woman asked not to be named because she feared being targeted by immigration authorities. She said she was able to stay home when she got sick only because her husband went back to his construction job as soon as he tested negative.
Nationally, counties with more farmworkers have seen significantly higher levels of death from the coronavirus, according to a study in pre-publication, awaiting peer review, from researchers at the University of California, San Diego and Emory University's Rollins School of Public Health, in Georgia.
"You can see it seeping into the more rural areas of the country," said Rebecca Fielding-Miller, the study's lead author and a social epidemiologist at UCSD's school of public health, about the pandemic. "I desperately worry it won't be able to be addressed the way it was in New York and LA."
Advocates have criticized the Trump administration for avoiding mandatory measures to protect farmworkers. As has been true across other parts of the economy, the CDC and Occupational Safety and Health Administration (OSHA) largely have stuck to issuing recommendations and voluntary guidelines to protect workers.
Bruce Goldstein, president of the advocacy group Farmworker Justice, said government officials "have focused on the need to keep food production running, but they have done nothing to prevent the workers from getting too sick to be able to perform their jobs."
OSHA didn't respond to CNN questions about why it hasn't issued mandatory measures. But in a statement, an OSHA spokeswoman wrote that "OSHA has been acting to protect America's workers by providing extensive guidance to employers and workers on COVID-19 response," and that the agency "will take the steps needed to address unsafe workplaces, including enforcement action, as warranted."
Without safety mandates from the federal government, farm owners and labor contractors say they are left to work closely with local health officials to protect workers.
In April, an outbreak hit Stemilt, a fruit company in Wenatchee, Washington. The company tested 71 workers at one of its orchards -- and found 36, though asymptomatic, tested positive for Covid-19. The company, which already had been following CDC recommendations for hygiene and distancing, quarantined the affected workers and made mask wearing mandatory, among other steps, said Roger Pepperl, Stemilt's marketing director.
"We worked diligently with the health district and with all public resources to bring out best practices," he said.
Even so, in late May, Stemilt was hit with another outbreak, on its apple-packing line affecting at least 25 workers. "Isolation, testing and taking care of people helped us get to a stable situation," said Pepperl, "and, thank goodness, we had nothing more than mild symptoms."
From a single Covid-19 case reported on May 16, an outbreak among employees at Firestone Pacific Foods, a Vancouver, Washington, fruit-packer, eventually grew to 132 cases by June 18, said Marissa Armstrong, a spokeswoman for the Clark County Public Health Department. The plant closed May 18 for two weeks of deep cleaning, among other safety measures.
"We didn't mandate they shut down; they worked with us voluntarily, and worked with us to facilitate testing for all their employees," Armstrong said.
Josh Hinerfeld, Firestone Pacific's chief executive, said the company had taken safety measures beforehand, including, from April 29 on, requiring employees to wear masks. "I thought we had implemented appropriate measures based on the CDC guidelines," he told CNN. "Despite these precautions, 44% of our employees tested positive for Covid-19."
While the plant was closed, a state labor health and safety consultant counseled Hinerfeld on what to do, as he walked through the facility holding up his cell phone to give her a virtual tour.
"She could see things I wasn't seeing," he said.
Hinerfeld said he thinks regulators and health officials should roll out more resources to help businesses keep their workers safe.
"Sending hyperlinks to CDC guidelines is not as useful as a virtual walk through of the work environment with a trained industrial hygienist ... Now that we know how much more is required, we want to make sure others do as well."
On May 28, Washington Gov. Jay Inslee issued an emergency proclamation requiring orchards and farms in the state to provide, at no cost to employees, masks and other protective equipment, handwashing stations, and to ensure physical distancing or barriers between workers, among other steps. Other emergency rules issued May 13 require farms that provide workers with housing to separate beds by at least six feet or install barriers between them; to improve cleaning and sanitizing; and to identify and separate workers with suspected or confirmed coronavirus cases.
Last month, Oregon adopted extensive and mandatory emergency rules requiring farms to provide more hand-washing stations and toilets, face masks, social distancing, separation in housing, and other measures. On May 29, Oregon Gov. Kate Brown announced a $30 million state initiative to help the agriculture industry deal with Covid-19, including providing: more than one million face masks and personal protective equipment; 5,000 gallons of hand sanitizer; outreach and education programs; and assistance with alternative housing, hand-washing stations, portable toilets, and more.
Reyna Lopez, executive director of the Oregon farmworker advocacy group Pineros y Campesinos Unidos del Noroeste, said that before the latest measures, workers had no incentive to say anything if they got sick.
Now, she said, Oregon "is really asking (farm) employers to step up."
In California, Gov. Gavin Newsom issued executive orders in April mandating two weeks of paid sick leave for any farmworkers and other food sector workers who are subject to a quarantine or isolation order or medical directive; and providing $100 million to subsidize child-care costs for essential workers.
When California's Department of Industrial Safety issued Covid-19 safety recommendations for agricultural businesses, it noted that, "This guidance does not introduce any new legal obligations," before adding that "most California workplaces must consider the disease a workplace hazard. Officials told CNN this means, "Employers are required to provide face coverings and other necessary materials or supplies (disinfecting wipes, gloves, etc.) for their employees."
Other states with coronavirus outbreaks, including Florida, Tennessee, and North Carolina, also have stuck with issuing guidelines and recommendations, despite multiple outbreaks on farms.
OSHA records reviewed by CNN show that, through June 14, agricultural workers have filed more than 100 coronavirus-related complaints across more than a dozen states, not including animal or dairy operations. Complaints included employers not providing masks, wash stations, or other hygiene facilities: not requiring social distancing; and failing to screen workers, among others.
Kevin Reuning, an assistant political science professor at Miami University of Ohio who tracks OSHA complaints for a union-affiliated website, said that because relatively few workers take the initiative to file complaints, there are likely many more similar violations.
At its Ventura County, California, greenhouses, where it grows tomatoes and cucumbers, Houweling's Group follows all the CDC guidelines, said health and safety manager Miguel Campos. That includes thermometer checks at entry for employees, free masks and gloves, social distancing, outreach to check if absent employees may have coronavirus, and so on.
"We also follow any guidelines put out by the county, and we have contact with local officials ... saying, 'hey, this is what we're doing,'" said Campos. "It benefits us to go up and above."
Have any federal, state or local officials checked to ensure Houweling's is following coronavirus guidelines? "No." said Campos. "But we understand we could be spot-checked at any time."
Meanwhile, in Bakersfield, Calzadillas said he and his wife, who are both from Oaxaca, Mexico, are trying to be vigilant about staying healthy. They have picked crops in California for 14 years. They have four children, the oldest is 12, all US citizens. He said he and his wife talk constantly about what might happen if one or both of them fall ill.
"What would happen to the children?" he asked. "How would we pay the costs for our home? How would we pay the hospital bill?"