Aug. 4 (UPI) -- New York City home healthcare workers interviewed during the height of the COVID-19 outbreak in March and April said they "felt invisible" and "were forced to make difficult trade-offs in their work and personal lives," according to a report published Tuesday by JAMA Internal Medicine.
The workers, who typically assist older adults and people with disabilities, also expressed concern that they could spread the virus to their families or their clients due to a lack of personal protective equipment, or PPE, the researchers said.
"Home healthcare workers have been on the front lines, [and] they did so ... often at physical, emotional and financial risk to themselves," report co-author Dr. Madeline R. Sterling told UPI.
"Interventions and policies to better support these front-line health care professionals are urgently needed," said Sterling, assistant professor of medicine at Weill Cornell Medicine.
The findings by Sterling and her colleagues are based on interviews with 33 home healthcare workers affiliated with 24 agencies in New York City.
The interviews were conducted during the spring, when COVID-19 ravaged the nation's largest city, infecting more than 100,000 people and killing more than 20,000, the researchers said.
PPE shortages have been an issue for healthcare workers and first responders in all settings globally since the start of the pandemic, according to the World Health Organization.
Just under 90% of medical personal across the country lacked sufficient supplies of PPE as of early April, a survey of medical personnel in more than 200 cities conducted by the U.S. Conference of Mayors found.
An April report in the industry journal Home Health Care News suggested that many workers were purchasing their own PPE from department stores and tattoo parlors.
The home healthcare workers who participated in the assessment reported in JAMA Internal Medicine were, on average, 48 years old and had about 11 years' experience working in the field, Sterling and her colleagues said.
Of the 33 study participants, 32 were women, 21 were Black and six were Hispanic, according to the researchers.
The researchers reported that four participants became ill with suspected or confirmed COVID-19 during the study period and stopped working once they experienced symptoms.
Many participants said that, even though their clients had chronic conditions putting them at risk for infection, they were considered essential workers and continued to work and care for their patients despite social distancing measures.
Many participants also had conflicting feelings about continuing to work, reporting that they needed to for financial reasons but felt guilty and worried about spreading COVID-19 to others.
The workers indicated that they received little guidance from their agencies regarding appropriate precautions and often relied on media reports for information. Similarly, many were forced to purchase their PPE, including face masks and gloves, researchers said.
Overall, the study participants said that they felt the need to balance the risks to their health with their obligations to the people for whom they are caring, the researchers said.
"Unfortunately, as this study suggests, home healthcare workers feel undervalued by the medical community and society at large, and the lack of necessary medical supplies only reinforced this impression," Sterling said.