service industry worker poses outside with a mask on.
Essential worker poses for photo for a campaign the state chapter of United Electrical staged. Photo credit: North Carolina Public Service Workers Union, UE Local 150.

By Liora Engel-Smith

Twice a week, Tiffany Patterson drives herself to BioLife Plasma Services where a phlebotomist threads a needle into a vein in her arm. Then the Charlotte resident waits around — sometimes for an hour, sometimes less — for the plasmapheresis machine to extract the yellowish fluid from her body.

The center pays for her time: $20 for the first visit of the week, $35 for the second.

That $55 buys her groceries, feeding her two teenagers. The money also supports her father, who has multiple myeloma, cancer of the plasma cells.

Patterson, a customer service representative, said she stopped working in March, shortly after coronavirus arrived in North Carolina. Her employer allowed some of her coworkers to do their job from home, but Patterson, who was in the middle of training, said her work was suspended. Since then, Patterson has been scrambling to make ends meet.graphic including an image of coronavirus

“I try to focus on my dad and my family right now,” she said. “Cause if I focus on that and COVID-19, I don’t know where I’d be.”

By recent count, more than 570,000 North Carolinians have applied for unemployment because of coronavirus since the crisis began in mid-March.

Social distancing measures have altered nearly every aspect of daily life — schools, salons, bars and libraries are closed. Restaurants are limited to takeout and delivery services. People can’t congregate. For service-industry workers like Patterson, this coronavirus response isn’t just an inconvenience. It threatens an already fragile existence.

Meanwhile, others in the service-industry workforce who were lucky enough to keep their jobs now face a different challenge: the threat of getting sick.

Many fronts 

The pandemic is playing out on many fronts. Hospitals and health clinics come to mind immediately, but other venues may not be as obvious. Coronavirus transmits through contact between people and is likely often transmitted by virus-laden droplets on surfaces where they can live for days.

This puts grocery store workers at risk. Bus drivers, too, come in contact with many people in close quarters and the seats and poles they may have touched or coughed on.

Those who work in facilities where groups of people live — mental health hospitals, prisons, nursing homes and more — are also vulnerable. Beyond the medical staff in such facilities, the threat of coronavirus extends to cooks, cleaners and laundry staff. None of these jobs can be done remotely, so one of the most important ways to minimize the risk of exposure — staying home — isn’t available for these essential workers.

“We get up and put our lives on the line every single day,” said Nichel Dunlap, paratransit operator at the Charlotte Area Transit System.

Dunlap, who is also the recording secretary at the Charlotte chapter of the United Electrical, Radio and Machine Workers of America, said she does what she can to protect herself from coronavirus. Management told drivers that buses are getting cleaned more often now, but Dunlap begins each shift by cleaning the bus she’s assigned to.

Officials have taken some measures to protect her and other drivers, she said. She’s been given gloves and an N95 mask and officials have asked passengers to wear face masks when they board a bus. Transit officials also divided the workforce into two groups and each works on alternate weeks. A spokeswoman from Charlotte Area Transit System did not respond directly to a question about the number of COVID-19 cases among workers, but the organization said earlier this month that an employee who isn’t a driver tested positive. At least two bus drivers across the state, one in the Raleigh area and the other from Greenville have also tested positive.

The CATS spokeswoman said the organization took protective measures such as limiting the number of passengers on buses and providing gloves, hand sanitizers and masks for drivers. CATS also waived bus fares and asked passengers to exit through the back door of the bus to limit contact with passengers.

“The COVID-19 crisis is an ever-changing situation,” the spokeswoman wrote in an email Tuesday. “As we learn more, CATS responsively adjusts the way we operate, allowing us to continue to provide this essential service to those who need it most.”

Some of the measures Charlotte Area Transit System officials have put in place affected the drivers’ pay, Dunlap added. Drivers can no longer work overtime, meaning their take-home salary is smaller, even though their base pay remains the same. The union has been pushing for hazard pay for the city’s bus drivers and other essential employees, she said.

“At the end of the day, nobody wants to bring this home to their families,” Dunlap said.

‘In harm’s way’

The prospect of bringing COVID-19 home looms large in the minds of many workers in congregate living facilities. As of Friday, 73 outbreaks in prisons, residential care facilities, nursing homes and similar settings accounted for roughly 2,100 of the approximately 8,000 coronavirus cases in the state.

“There’s no way to do that work without close contact, there’s no way to social distance,” said Ardis Watkins, executive director of the State Employees Association of North Carolina, an organization that counts many DHHS staff among its members.

Even with protective measures, employees may come in contact with an asymptomatic case and unknowingly become exposed to the virus, she added.

Darrion Smith, a therapeutic support specialist at Central Regional Hospital, a state psychiatric facility in Butner, sums up that worry in one question: “Do you know how hard it is to explain social distancing to psych patients?”

“You tell them and you stress, you sound like a broken record,” he said, answering his own question.“Just repeat, repeat, repeat, repeat, repeat. Some get it. Some, they just don’t.”

Smith, who works with inmates serving their prison terms in the hospital, said his unit has changed markedly since coronavirus became a threat. Everyone wears masks now. Staff stands far apart from patients when possible. Chairs and couches are spaced out, in line with social distancing guidelines. But coronavirus infections tend to spread where people congregate, so just coming to work is a risk, said Smith, who is also United Electrical’s eastern region vice president.

Both SEANC and United Electrical have been demanding hazard pay for all frontline employees. SEANC’s Watkins said that while the state health department has taken steps to protect its workers, employees can use the extra money they receive from hazard pay to make other accommodations that keep them from coming in contact with vulnerable family members during the pandemic. She said SEANC will bring the proposal to the General Assembly when the session begins next week.

Kody Kinsley, deputy secretary for behavioral health and intellectual and developmental disabilities at DHHS, said the state health department has been using the limited funds it was allotted to extend hazard pay to workers who are in facilities with coronavirus outbreaks. DHHS has taken measures such as daily temperature screenings and dividing patients and staff into smaller groups to prevent infections, in addition to providing workers with masks. It also modified guidelines to allow workers who are sick to take emergency sick leave, not vacation or other sick times.

With these and other protections in place, Kinsley said he is confident the department is doing everything it can to protect staff and patients at its 14 facilities.

A variable risk

For Sekia Royall, a cook at the state-owned O’Berry Neuro-Medical Treatment Center in Goldsboro, the fear of coronavirus is magnified because her daughter has sickle cell anemia. But Royall, who is also statewide vice president for United Electrical, has to work. O’Berry residents — people with complex medical and cognitive needs — have to eat and someone’s got to feed them.

“It’s a constant fear, really,” she said. “A constant fear of going to work.”

Royall said she’s been allotted one surgical mask for five days. Employees have been instructed to keep their masks in a plastic bag between uses, she said, but the masks get dirty quickly. Royall comes in contact with residents for up to three hours a day during meal times, and as part of her job, Royall sets the tables and pours drinks for them.

Some staff, she said, began bringing cloth masks to work, but they were recently told they cannot wear masks they bring from home. The facility has some N95 masks, which provide more protection from the virus, but they’re reserved for active outbreaks, she added.

“We’re considered essential staff, but we’re not treated as such,” Royall said. “We’re in harm’s way without the proper protection.”

Kinsley said that the state health department purchased surgical masks for employees to use, and that cloth masks are too variable in quality to be used alone. He said that staff can use cloth masks in conjunction with the masks they are provided.

As for staff whose family members or themselves have underlying health conditions, it’s a question of fitness to work in a clinical environment where other infectious diseases, not just coronavirus, are a risk.

“We’re doing everything we can on a case-by-case basis,” he said. “At the same time, if we were to start pulling people off units just because of generalized risk, first and foremost we wouldn’t have any staff that would be able to serve the people [in our care].”

Work after the outbreak

April Whitted worked as a medical assistant for a few years, but last October, she decided to switch careers. The Greensboro resident got her aesthetician’s license and found a job at a local salon. After six months in the field, she had just begun to build a steady stream of clients. Then all of that came to a halt in mid-March, as COVID-19 hit and the salon she works for closed.

“I was just starting to see the light,” she said. “I was just starting to live beyond check to check and then, here we are.”

Whitted said she receives unemployment. Her husband, who stocks the shelves at Lowe’s, has been able to maintain his job. As things go, she said, her financial situation is better than most. But Whitted misses her clients. With no definitive end to the crisis, Whitted worries about keeping her new skills sharp.

And when the restrictions lift, she said, there’s no telling how long it’ll take for clients to return.

“About a week or two before we closed, people were starting to cancel appointments anyway,” she said. “Business slowed down drastically because people were already on edge, so I think we’re going to go back to people still being on edge.”

For Whitted, fewer clients coming through the door means fewer tips and less income. In the meantime, Whitted is working on boosting her savings and learning a new skill that she hopes will help her expand her customer base: she’s getting eyelash extensions training, a service she could probably offer outside of the salon she works for.

Maybe by summer the coronavirus outbreak will blow over, she added. It’ll be just in time for bikini season.

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Liora Engel-Smith joined NC Health News in July 2019 and covers policies, programs and issues that affect rural areas. She has previously worked for the The Keene Sentinel in New Hampshire and the Muscatine...