How Housekeepers and Domestic Helpers Can Safely Return to Work - The New York Times

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Around the world, millions of domestic workers were abruptly sent away when coronavirus shutdowns and social distancing orders were imposed. Now as communities begin to reopen, many people are wondering when it will be safe to open their houses again to domestic helpers.

If you are an employer worried about the health risks of letting house cleaners, nannies and health aides back into your quarantined home, remember that it’s the worker who faces the biggest risk of being exposed to your germs and those of the other households where they work. Taking practical steps to keep the worker healthy, including providing masks and gloves, opening windows, solving transportation challenges and offering paid sick leave, will lower risk for everyone in the home.

“The risk is definitely tipped toward them getting sick and not necessarily being the one to infect you,” said Shan Soe-Lin, a lecturer at Yale University and managing director of Pharos Global Health Advisors, a nonprofit advising communities and businesses on how to reopen safely. “There is way more evidence that these essential workers who are in frequent contact with people are the ones getting sick — not the customers.”

Communication and trust are essential. Domestic workers often don’t feel comfortable raising issues about health, safety and pay, so the employer should start the conversation. The best way to keep your family safe is to promise sick pay and encourage workers to stay home when they feel ill or have a fever or any respiratory symptoms. Reassure your employee that you won’t dock pay if you or someone in the home becomes ill and the worker needs to stay away. Home temperature checks are an option, although lack of fever is not a reliable indicator of health. If temperature checks are used, everyone in the house should take part.

“The trust has to go both ways,” Dr. Soe-Lin said. “You have to tell your housekeeper when someone in your home isn’t feeling well.”

In the United States alone, about 2.2 million people, most of them women, are employed as domestic workers, according to the Economic Policy Institute. When the pandemic prompted shutdowns and social distancing orders, about 70 percent of domestic workers surveyed lost all wages and jobs, said Ai-jen Poo, executive director of the National Domestic Workers Alliance. Although some home employers continued to pay nannies and house cleaners during the shutdown, “It was rare,” said Ms. Poo.

Betania Shephard, a Philadelphia house cleaner, with her children at the National Domestic Workers Alliance meeting in Las Vegas in February. Since then, she has lost most of her business because of the coronavirus pandemic.Credit...Betania Shephard

Now as lockdowns are ending, many workers are not being rehired and are discovering that the glut of workers means prospective employers are paying less than before the pandemic, said Ms. Poo.

People are most likely to catch coronavirus when they spend extended time in close contact with an infected person in an enclosed space with poor ventilation. For workers whose jobs don’t require human contact — like house cleaners, pet sitters and home repair technicians — residents should leave the home while the worker is inside completing the job. Open as many windows and doors as possible to improve ventilation, said Linsey Marr, an aerosol scientist at Virginia Tech.

If it’s not practical to leave the house, everyone should stay in a closed room or separate part of the house where the worker isn’t expected to clean or perform other work.

“The safest approach is to have the household members be out of the house so there’s no direct person-to-person interaction,” said Julia Marcus, an infectious disease epidemiologist and assistant professor in the department of population medicine at Harvard Medical School. “Do the payment remotely, and you’ve substantially reduced risk with no in-person contact.”

Home employers also should provide gloves and masks to workers and ask that they be worn inside the home when practical. (A home repair person or electrician, for instance, may find gloves make it difficult to complete the job.) The mask and gloves are mostly to protect the worker. Even though the risk of breathing in virus is low if everyone has left the house, housekeepers are at risk of shaking viral particles loose as they change bed linens and sort the laundry of someone who was recently ill. Masks and gloves also help workers avoid touching their faces, a potential source of infectious spread.

And if the worker sneezes or coughs while cleaning, the mask will keep surfaces inside the home from getting contaminated. (The risk from touching a contaminated surface or object is low and not typically how the virus spreads.)

“They’re not coming into your home to cough on everything — they’re coming into your home to clean,” said Dr. Marcus. “There’s a possibility that there could be droplets left on a surface in your house after cleaning, but that seems like a long chain of events that would need to happen for infection to occur from a house cleaner.”

Employers should also tell workers if they are in a high-risk profession and what steps they are doing to stay safe during the pandemic. “We’re hearing from our members that the burden and responsibility of safety is falling entirely on the worker,” said Ms. Poo. “Employers are expecting workers to get tested, and get antibody tests, and pay out of pocket for Uber, and bring their own protective equipment without any increase in pay.”

Frequent testing for coronavirus is not typically recommended since a test gives only a snapshot of the person’s health the day of the test. An antibody test can offer some reassurance, but the tests are not always reliable and don’t guarantee immunity.

Betania Shephard works as a house cleaner in Philadelphia, cleaning several homes and rental properties. She didn’t work at all in March and April, and her husband, who works in construction, is also out of work. She began cleaning a few houses again in May, but work is slow. Only one family continued to pay her wages during her time off, and a stranger helped pay her telephone bill.

The Coronavirus Outbreak

• Frequently Asked Questions and Advice

  Updated June 16, 2020

  • I’ve heard about a treatment called dexamethasone. Does it work?

    The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

  • What is pandemic paid leave?

    The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

  • Does asymptomatic transmission of Covid-19 happen?

    So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

  • What’s the risk of catching coronavirus from a surface?

    Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

  • How does blood type influence coronavirus?

    A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

  • How many people have lost their jobs due to coronavirus in the U.S.?

    The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

  • Will protests set off a second viral wave of coronavirus?

    Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

  • My state is reopening. Is it safe to go out?

    States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

  • What are the symptoms of coronavirus?

    Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

  • How can I protect myself while flying?

    If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

  • How do I take my temperature?

    Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.

  • Should I wear a mask?

    The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

  • What should I do if I feel sick?

    If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

  • How do I get tested?

    If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

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“Lots of people don’t care about their domestic employees,” said Ms. Shephard, who has two young children. “House cleaners are so important, more valuable than anything during this pandemic because we clean so that nothing is contaminated,” she said. She purchased her own gloves and masks with help from a fund set up for domestic workers, but she worries about the risks of exposure to coronavirus since she is cleaning rental homes used by people traveling from other parts of the country. “We are protecting the next guest who enters.”

Home health aides and nannies face additional risk because their jobs require them to come into close and prolonged contact with children, the elderly or members of the household who are disabled. In those cases, families should consider including the household worker as part of the family bubble. Without intruding on their health privacy, employers can ask workers if they are concerned about their personal health risks or have a vulnerable family member. Consider all the potential exposures your worker brings to your bubble, and the exposures your household brings to the worker’s family.

Does the worker need to take a bus or subway to get to you? If it’s not possible for you to drive them or pay for a car service, talk to them about making their commute safer by wearing a mask, gloves and an outer layer that can be removed at the door.

Home health aides should wear masks, as should their patients if possible. Caregivers and employers should agree on precautions, such as frequent hand-washing, not sharing serving dishes and social distancing when they go for walks or to the park.

Pay attention to what’s happening in your community. If overall case counts start to rise or if test positivity rates creep above 5 percent, you may want to tighten your quarantine and allow your domestic worker to do the same with their family. The Domestic Workers Alliance has created online return-to-work guides for employers.

“It really is about fostering good communication between families and workers,” said Ms. Poo. “Have an open and ongoing conversation about risk of exposure. It’s a two-way street, and it’s about being honest and thinking about safety collectively.”

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