Another care worker I interviewed, Shelly Hughes, a certified nurse’s aide at North Cascades Health and Rehabilitation Center, in Bellingham, near the Canadian border, was in a similar position. She had public health insurance but only a few hours of accrued sick leave. She hoped her union might be able to get its members some version of short-term disability coverage if they contract an infection at work.

Nurse’s aides and licensed practical nurses like Ms. Hughes and Ms. Bridges do exhausting, often tedious work for the four million people in residential long-term care, in return for low pay and meager benefits. America’s long-term care system is already fragile, because of staffing shortages and a growing population of elderly people. The addition of an epidemic makes the situation even more perilous — for nursing staff as well as for patients.

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