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.
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.
“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.”