By: Laura Entis
As the rest of the country locked itself inside during the early days of COVID-19, frontline workers reported for duty day in and day out. Doctors and nurses, meatpackers and corrections officers, transit operators and grocery store clerks — they continued to go about their business despite the advanced risk of exposure. As a result, hundreds of thousands were infected and thousands died, including more than 1,700 healthcare workers.
News reports have drawn attention to these deaths, as well as to what Adia Wingfield, a sociology professor and associate dean at Washington University in St. Louis, describes as “the challenges frontline workers have been facing even before the pandemic, in terms of burnout, stress and the hours and amount of work.” However, whether this extends to influence is another matter.
The shameful reality is that, 11 months after the discovery of the novel coronavirus, essential workers across industries continue to contend with unsafe conditions. Stunningly, healthcare facilities in the U.S. still lack adequate personal protective equipment (PPE).
“Nurses are more visible and their stories are more present. But are we actually listening to what they are telling us?” asks Christopher Friese, a professor of nursing, health management and policy at the University of Michigan. “That’s the open question.”
The pandemic has forced many frontline workers into an impossible situation, with many facing pressure on multiple fronts. “It’s a life and death issue,” explains Kate Bronfenbrenner, the director of labor education research at Cornell University’s School of Industrial and Labor Relations. “They are being forced to work, they are being threatened with the loss of their jobs and they are also being laid off in large numbers.”
For workers nervous about layoffs, demanding safer working conditions can be an unrealistic proposition. Under the Trump administration, the Occupational Safety and Health Administration has “literally become dysfunctional,” Bronfenbrenner says. “There is no enforcement.”
Safety records are no longer public, while inspections have been significantly scaled back, leaving workers at the mercy of their employers’ ability — and willingness — to enforce existing standards. “You can be as careful as you want to be,” Friese adds, but going to work often means entering an environment outside your control.
Some fare better than others
Certain frontline workers are more likely to face unsafe working conditions than others — a reality that cuts across industries, but is similarly true within them. For example, healthcare workers at large, nonprofit hospitals, which generally serve more affluent patient populations, have fared relatively well, in part because they have access to protective measures such as testing, adequate staffing and PPE, says Patricia Davidson, dean of the School of Nursing at Johns Hopkins University.
Meanwhile, workers at smaller facilities and nursing homes are often more vulnerable due to less developed systems. “We are seeing support and resources going to communities and patient populations that are already well-off and relatively comfortable,” Wingfield explains. Meanwhile, historically underserved communities that have been disproportionately hit by the virus continue to lack adequate equipment and staffing.
Indeed, COVID-19 taps into existing, deeply ingrained health inequities that affect healthcare workers as well as patients. While writing and researching her book Flatlining: Race, Work, and Health Care in the New Economy, Wingfield spoke with physicians, nurses and health technicians at multiple health organizations. Before the pandemic, Black healthcare workers at under-resourced public facilities reported soaring levels of stress and alienation. They also felt exploited: Their willingness to go above and beyond for their patients, many of whom reminded them of friends and family, was being taken advantage of by a healthcare system unwilling to provide the resources to truly equalize care.
The result, not surprisingly, has been high levels of burnout and, in some cases, turnover. “That was the case five years ago,” Wingfield says. “I would imagine it only has gotten significantly worse in the wake of the pandemic.”
In the absence of federal, state and local regulations, unions have provided workers with some protections — not to mention a certain degree of influence. To that end, the United Food and Commercial Workers International Union, the country’s largest meatpacking union, held press conferences and released information about infections and deaths among its ranks. “If the union weren’t there, no one would even know what was happening in the industry,” Bronfenbrenner notes.
A strong union, one that stands up to officials and employers on behalf of its workers, can force significant concessions. Following pushback from the United Federation of Teachers (UFT), New York City delayed the start of in-person learning by nearly a month, giving public schools more time to prepare. The rollout was chaotic and mired in controversy, yet multiple New York City teachers shared that, without the support of the union and the influence it wields, the process would have felt even more out of control.
Given the absence of comprehensive, up-to-date government health data, some unions have stepped up to fill important blind spots. In September, National Nurses United released a report revealing that more than 200 registered nurses have died from COVID-19. Addressing infection spikes and deaths allows the profession to identify “where the problems are,” Friese says, and allocate resources to better protect its members.
Unfortunately, many workers don’t just lack a strong union — they also lack any semblance of an organization that advocates for their interests.
Take the gig economy, which has swelled during the pandemic thanks to dwindling traditional jobs and an increase in on-demand delivery orders. Gig workers aren’t classified as employees, but as independent contractors, a group that lacks benefits and other protections. “They are extremely vulnerable,” Bronfenbrenner says.
Taking the first step
For these and other workers making minimum wage or close to it, real influence starts with policy changes that favor workers’ rights. It also means pressuring private and public employers alike to address pre-existing inequities in the workforce, which have only been amplified by COVID-19.
For workers of color, the first step in addressing these disparities is getting organizations and systems to acknowledge they exist in the first place. “One of my hopes is that healthcare facilities will make the issues facing their workers of color, and Black workers in particular, a central priority,” Wingfield says.
This requires a recognition that healthcare workers are likely to experience the pandemic differently based on a variety of factors, including their race and gender. “We know this is taking an enormous toll on providers across the board,” Wingfield continues.
But she adds a caveat: “Black workers are going to have to navigate a particular puzzle of trying to save and cure people with whom they often have some sort of familiarity and connection, in an environment where that connection hasn’t always been recognized, rewarded or respected.”
In the bigger picture, more equitable influence for frontline workers stems from stronger social support networks, and the creation of models that put people over profit. “We, as a society, in some ways need to be held accountable for people who died — and who did not have to die,” Davidson explains. This means investing in a robust, integrated public health system capable of providing high-quality data so the same mistakes aren’t made the next time our health system faces a crisis. “A safe working environment is something we are all entitled to,” she adds.
Frontline workers clearly agree. Bronfenbrenner notes that, despite a depressed economy, “We’ve seen more strikes than we’ve seen in a long time.”
As 2020 has proved in spades, it’s anyone’s guess what the short-, immediate- or long-term future holds. But for her part, Bronfenbrenner is hopeful that COVID-19, not to mention the stark disparities it has laid bare, will usher in an age of increased organizing activity. This, she notes, was true of the Great Depression, another period marked by rising inequality.
Because, of course, not everyone is suffering financially. Large corporations have seen their profits surge. The stock market continues to climb, expanding the fortunes of the country’s wealthiest people.
Meanwhile, at the other end of the economic spectrum, more and more people are being asked to choose between feeding their children and keeping their homes. As Bronfenbrenner puts it, “That’s when you see people saying, ‘I’m going to organize and I’m going to go on strike. When it’s my children’s health or my children’s home, I am not going to let my employer put my life at risk.’”