“This pandemic is saying to us that the old normal would be a waste, that it would dishonor all the people who have died and who have sacrificed to save lives. The old normal would mean that the people we deemed essential workers still lack health care, still lack living wages and sick leave. No. We sent you into battle without armor, so to speak, and you fought for us — now we have to change that.”
– The Reverend William Barber
A moral awakening to essential workers
Healthcare workers treating COVID-19 patients are celebrated for their valiant caregiving, and ethicists are beginning to explore what society owes them for putting their lives on the line. Faden (2020), for example, called for a Heroes Fund to provide disability and death benefits for healthcare workers and their families. Public figures have also lauded essential pharmacists, veterinarians, grocery, delivery, and sanitation workers (Bush & Obama, 2020).
As non-essential businesses shutter, there is sudden attention to what kind of jobs have been designated essential and who performs such work. This has simultaneously revealed the importance of essential work and its devaluation. It has also illuminated the interlocking forms of disadvantage experienced by many categories of workers, and the hardship associated with their work, even prior to COVID-19.
The essential workforce consists disproportionately of low-wage workers. Home health aides, for example, make $11.52/hour on average, and most live in low-income households (Scales, 2020) This essential workforce is also an overwhelmingly female workforce: one in three jobs held by women is designated essential and non-white women more likely to hold essential jobs than any other group (Robertson & Gebeloff, 2020). Some categories of essential workers also lack basic benefits: for example, home health care workers are rarely provided with paid sick leave or health insurance, leaving them especially vulnerable during this pandemic (Woods, 2020, Gleckman 2020). Some groups of essential workers, for example meat processors, draw heavily from immigrant communities, rendering them ineligible to receive COVID-19 economic aid and social services.
The COVID-19 pandemic exacerbates the physical risks, practical challenges, and mental burdens of many forms of essential work. Yet many essential workers lack the financial wherewithal to opt out of this work, even as the associated risks increase.
The COVID-19 pandemic has expanded recognition of the moral wrongs and social injustices of underpaying and mistreating many essential workers. Some have even framed this as a moment for moral awakening about our collective obligations toward essential workers. (NYT Editorial Board, 2020; Sandel, 2020). But as essential workers come into focus, we must direct our concerned gaze to those who often go overlooked. Here, we focus on three categories of workers — meat processing workers, workers offering deathcare, and home health aides — whose efforts are undervalued, out-of-sight, and/or stigmatized. We consider the toll that laboring during COVID takes on these workers, and what remedies they are owed.
Meat processing workers
Meatpacking is a strenuous, dangerous enterprise. At the kill stage, workers stun, slaughter, and bleed animals, transitioning them from life to death. The intensity leaves workers breathing heavily, literally and figuratively. In processing and packing, workers stand shoulder-to-shoulder “on the line,” breaking down carcasses with sharp knives at breakneck speeds with USDA inspectors close by (HRW, 2019). Afterwards, “third-shift cleaners” race to wash and sanitize heavy equipment between shifts (Waldman & Merhotra, 2017). This work exacts a physical and mental toll. But due to immigration status, language barriers, lack of healthcare, low-incomes, and social marginalization, sufficient care or treatment for occupational harms is rare (HRW, 2019).
The brutally industrial orientation of modern meatpacking facilities and the workforce’s pre-existing vulnerabilities created conditions conducive to rapid spread of COVID-19 throughout the meat and poultry processing sector. Plants were slow to implement protective measures, claimed that physical distancing was impossible, and created perverse incentives for the ill or exposed to report for duty with attendance bonuses and free lunches. (Samaha & Baker, 2020.) Faced with losing their jobs, workers continue to clock in despite the risks of contracting or transmitting the virus. At the time of writing, thousands of meat processing workers across the United States have confirmed COVID-19; at least thirteen have perished.
This situation produces dual anxieties for workers — fear of contracting COVID-19 and fear of going without income. While some in this largely immigrant workforce have made a decent life for themselves on relatively modest wages, they typically have many family members (here and abroad) depending upon them for financial support and little savings. The COVID-driven closures of massive processing plants are causing supply chain disruptions (Mirabella, 2020): without inspected slaughter, millions of animals are being euthanized on farms; without a steady supply of meat, concerns about food and protein shortages and resulting social unrest mount. These consequences weigh heavily on the workers who take pride in their unseen but essential work that helps to affordably feed themselves and others.
As COVID-19 claims the lives of hundreds of thousands in a few short months, deathcare workers — people employed in morgues, funeral homes, embalming facilities, cemeteries, and crematories — in areas of intense outbreak have been called upon to perform their solemn work at a volume and pace more familiar to meat processing workers. Scenes from multiple countries depict an overwhelmed deathcare system: in New York, refrigerated trucks park behind hospitals (Feuer & Salcedo, 2020); in Spain, ice rinks are used to buy time before embalming (Goodman et al, 2020), and in Ecuador, bodies were simply left in the streets, forcing families to drape loved ones in plastic (Amario & Solano, 2020). Novel strategies are needed when morgues are overcapacity, funeral homes are running waitlists, and mourners are prohibited from gathering (Mongelli et al, 2020).
Deathcare workers perform labor that is both materially and emotionally significant. Centrally, their roles involve “ritually putting the dead body in its place, managing the relations between the living and the dead, and providing explanations for the existence of death” (Laderman, 2003). Deathcare workers inherently face occupational risks of exposure to bloodborne and airborne pathogens (Davidson & Benjamin, 2006), which now include the novel coronavirus. They must handle the deceased with extra caution even while personal protective equipment (PPE) is in short supply (Riga, 2020). Beyond the physical risks and rigors of this work, some deathcare workers experience intense anxiety, panic attacks, and compassion fatigue (Kessler, 2017). In the time of COVID-19, as they work at a grueling pace, under heightened risk, and with very constrained ability to facilitate mourning, even workers accustomed to dealing with death struggle to retain a sense of humanity about the process and may find themselves in ever-greater need of mental health care and emotional support (Allen, 2020).
Home health aides
Home health aides (HHA) help disabled, elderly and ill people with activities of daily living, such as feeding, bathing, and housework. By helping to keep ill and elderly people — those most vulnerable to COVID-19 — out of nursing homes, they are serving a vital function during the pandemic. Yet HHAs, a low-paid workforce offered poor benefits at baseline, may lack basic protections against COVID-19 in their workplaces. For HHAs, practicing social distancing with clients who need to be physically picked up, washed, and fed is impracticable. Additionally, because HHAs work inside private homes where they have limited control over the physical environment, they may be exposed to surfaces that are not regularly sanitized. Many HHAs also lack PPE, given that scarce PPE is being allocated to hospitals first and neither state nor federal governments have supplied home health care agencies with PPE for their employees (Jamison, 2020; Cohen 2020). This forces HHAs to either pay out of pocket for their own PPE, if they can find it, reuse PPE, or not use any at all. Without PPE, HHA put themselves, their families, their clients, and their clients’ families at risk. Most lack paid sick leave, a barrier to self-isolating after possible exposure (Gleckman, 2020). Some clients are firing their HHAs, fearful of COVID-19, resulting in HHAs’ income loss (Woods, 2020).
Beyond the risks of viral exposure, care-giving work always has the potential to be exhausting because it requires more than rote performance of assigned tasks. Done well, caregiving calls for empathy, connection, and prioritizing others’ needs. At times, essential care-giving work may call for emotional ingenuity, but it does not typically present the opportunities for creative expression that many sought-after professions offer. Thus, this work always demands an element of self-sacrifice. Perhaps this acute public health crisis will draw attention to the longstanding crisis of care — the systemic undervaluing of all work involved in social reproduction (Fraser, 2016) — and the cultural and economic forces that lead to the undercompensation of caregiving work, including the work of HHAs who help sustain life and manage its end.
Many essential workers were taken for granted long before COVID-19 forced a nationwide admission of their value. Now that it has become impossible to ignore or underplay their contributions, we should protect, dignify, and provide post-COVID support to them. Immediate measures might include: provision of PPE and other protections in the workplace; participation in decision-making about workplace safety; paid sick leave; hazard pay; free access to telemedicine, including emotional and mental health support services; and opportunities to be temporarily relieved from duty by replacement workers. Additionally, if a “Heroes Fund” to provide disability and death benefits takes shape, hidden essential workers should be explicitly included. The COVID-19 pandemic, terrible as it is, presents an opportunity to set some things right through improvements in the wages and benefits of hidden essential workers, resistance of their social marginalization, and celebration of their contributions to society.
Allen, “Funeral Homes Overwhelmed with COVID-19 Cases”, National Public Radio (NPR) News, April 5, 2020 https://www.npr.org/2020/04/05/826972795/funeral-homes-overwhelmed-with-covid-19-cases
Amario and G. Solano, “In Ecuador, families wait with their dead as bodies pile up”, AP News, April 2, 2020, https://apnews.com/ccf626dfa46e62da38cb7faa938aa3b8
Bush and M. Obama, “Laura Bush and Michelle Obama Celebrate Essential Workers,” One World: Together At Home, April 20, 2020, https://www.youtube.com/watch?v=wUdveqZj0Iw&feature=youtu.be
Cohen, “Home Health Care Workers Are Taking Care of America’s Most Vulnerable- And They’re Doing it Without PPE, CBS News, April 3, 2020. https://www.cbsnews.com/news/home-health-care-workers-are-taking-care-of-americas-most-vulnerable-and-theyre-doing-it-without-ppe/
S.S. Davidson and W.H. Benjamin Jr, “Risk of infection and tracking of work-related infectious disease in the funeral industry”, American Journal of Infection control 34, no.10 (2006), 655-660.
Faden, “Treat Health-Care Workers Like the Heroes They Are,” Washington Post, April 22, 2020.https://www.washingtonpost.com/opinions/2020/03/20/coronavirus-is-upending-society-here-are-ideas-mitigate-its-impact/?arc404=true#Faden
Fraser, “Contradictions of Capital and Care” New Left Review 100 (2016) 99-117.
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Workers’ Rights Under Threat in US Meat and Poultry Plants,” September 2019. https://www.hrw.org/report/2019/09/04/when-were-dead-and-buried-our-bones-will-keep-hurting/workers-rights-under-threat
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Kessler, “Working With Dead People Has Its Own Special Kind of Job Stress,” Vice, November 2017. https://www.vice.com/en_us/article/wjgznw/funeral-director-compassion-fatigue
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Mirabella, “Nearly 2 million chickens at Eastern Shore Farms set to be destroyed because of coronavirus related plant shortages,” The Baltimore Sun, April 24, 2020. https://www.baltimoresun.com/coronavirus/bs-md-poultry-producers-coronavirus-20200424-hufdfzs24zhqpeptx4w6yngztm-story.html
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Riga, “‘Last on The Food Chain’: Equipment Shortages, Coronavirus-Infected Bodies Shaking Funeral Industry”, Talking Point Memo (TPM) News, March 27, 2020 https://talkingpointsmemo.com/news/funeral-homes-coronavirus-masks-ppe
Robertson and R. Gebeloff, “How Millions of Women Became the Most Essential Workers in America,” New York Times, April 18, 2020 https://www.nytimes.com/2020/04/18/us/coronavirus-women-essential-workers.html
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Sandel, “Are We All in This Together?,” New York Times, April 13, 2020 https://www.nytimes.com/2020/04/13/opinion/sunday/covid-workers-healthcare-fairness.html
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Woods, “Home Health-Care Workers in the US at Tipping Point Amid Coronavirus Outbreak”, CNBC, April 14, 2020. https://www.cnbc.com/2020/04/14/home-health-care-workers-at-tipping-point-amid-coronavirus-outbreak.html