COVID-19 and essential workers: Healthcare delays among organic farmers.

INTRODUCTION AND OBJECTIVE: While the overall impact of COVID-19 is still being assessed, there is strong evidence that the pandemic has greatly aggravated traditional flaws of healthcare systems around the globe. Understanding the healthcare impact of the COVID-19 pandemic is essential for emergency preparedness and the prevention of collateral damage. The food and agriculture sector is an essential service and critical to food availability and access. However, literature on the healthcare impact of COVID-19 in farmers is scarce. This study aimed to explore healthcare delays caused by the COVID-19 pandemic in certified organic producers. METHODS: An observational Cross-sectional study based on answers of an electronic self-reported survey. Participants included were United States certified organic producers listed in the Organic Integrity Database. RESULTS: Respondents represented 40 states; response rate was estimated at 11%. Analyses were conducted on 344 records. A high majority were non-Hispanic Whites with a four-year college education or more. More than 90% had health insurance. More than one-third (36.5%) of respondents reported healthcare delays. Female producers were nearly twice as likely to report non-COVID-19 related healthcare delays as their male counterparts (OR 1.95, 95% CI: 1.10-3.44). CONCLUSION: This study provides national data on healthcare delays among organic producers and their households and identifies sex differences in non-COVID-19 related healthcare delays. This study is the first to collect data on organic producers and can serve as a baseline for future studies; it may inform practice, research and policy on emergency preparedness, protection of essential workers, and healthcare services and quality.

Phenotypic transformation of CD52(pos) to CD52(neg) leukemic T cells as a mechanism for resistance to CAMPATH-1H.

Immunotherapy utilizing CAMPATH-1H for patients with chemotherapy-refractory chronic lymphocytic leukemia has yielded encouraging results with many reports of complete remission. Here we report the outcome of two patients with CD4-positive T cell prolymphocytic leukemia treated with CAMPATH-1H. Both patients responded rapidly to treatment and subsequently developed CD4 lymphopenia. One patient remained in complete remission after 14 weeks of treatment. Serial peripheral blood flow cytometry revealed that the CD52 antigen was present throughout treatment. The other patient who was initially CD52-positive, became CD52-negative after 6 weeks of treatment, and developed progressive symptoms of T cell prolymphocytic leukemia. Immunotherapy was stopped, chemotherapy proved futile, and the patient died. This change in phenotype from CD52-positive to -negative during CAMPATH-1H therapy points out a need to develop strategies for maintaining antigenic expression during monoclonal antibody therapy.