Greg Dowis, a sanitation worker in an Atlanta suburb, where coronavirus infection rates have soared in recent days, arrived to work on Tuesday and surveyed the cleaning supplies available for roughly 35 garbage truck drivers: one face mask and a couple boxes of blue nitrile gloves. He took a photo and texted it to Motherboard. Dowis and his team collect waste from hospitals and apartment complexes.

“Still no cleaning supplies or hand sanitizer,” he wrote in the text. “We are still having to pick up trash by hand...even at businesses that have confirmed cases.”

Waste collection, which has long been one of the deadliest jobs in the country, has suddenly became a lot more dangerous for the 467,000 sanitation workers in the United States as coronavirus spreads throughout the country.

Workers handle trash and liquids from hospitals and apartment complexes that flow out of trash bags. This can include needles, broken glass, and medical waste. They clean behind the blade that compacts trash after each garbage dump—handling loose trash and “garbage juice” that gets caught in the body of the truck. Garbage from New York City and New Jersey is hauled by subcontractors out to landfills in the Midwest, and sanitation workers often walk through these landfills, coming into contact with debris. And often they make face-to-face contact when collecting signatures from businesses to confirm that trash has been collected.

Scientists say that the novel coronavirus can survive on surfaces for up to 72 hours, raising fears among workers that they’re handling contaminated waste. Last week, sanitation workers in Pittsburgh walked off the job calling for more protective gear.

“Sanitation was already the fifth most dangerous job in the world,” Sean Campell, the president of Teamsters Local 813, which represents commercial sanitation workers in New York City, told Motherboard. “The virus adds a new element to that. It’s a very stressful time for sanitation workers in the public and private sector. People are out in the elements. To have this virus out there is really unsettling.”

Workers say conditions are particularly bad at Republic Services, which is the second largest private waste collection company in the US, employing some 35,000 sanitation workers nationwide. Microsoft founder Bill Gates, whose private investment firm owns more than a third of the company’s stocks, is Republic Services' largest shareholder.

Motherboard spoke to five Republic Services workers, including Dowis, who has worked there for 22 years. Each said that the company has failed to provide adequate supplies and basic protective gear to sanitation workers, many who collect waste from hospitals and residential buildings.

Republic Services told Motherboard that it is closely following OSHA guidelines and CDC recommendations for waste management and is providing workers with protective gear, including soap, hand sanitizer, tissues, puncture-proof gloves, and face protections.

“We are confident that we have the necessary plans and protocols in place for protecting employees from coronavirus,” a spokesperson for Republic Services told Motherboard. “Given our higher state of vigilance due to Covid-19, in all of our locations we are reminding our employees to follow existing OSHA-directed personal hygiene and safety protocols and providing them with necessary personal protective equipment. We carefully review our inventory of all such supplies, and we are maintaining adequate levels at all locations.”

Dowis told Motherboard that his crew was not offered any protective gear or anti-bacterial wipes until last week. On Thursday, he said he arrived at work to find one canister of antibacterial wipes and one small package of hand wipes for 35 workers, but no masks or rubber gloves.

“We’ve been trying to get them to get us Covid-19 protections. We still don’t have appropriate cleaning material. I had to buy my own wipes and I constantly wipe down my truck during the day, especially after I pick up from hospitals or apartment complexes,” Dowis, who is also a union steward, told Motherboard. “It’s not sufficient what they’ve given us. A lot of fellow coworkers are worried.”

“This may sound crude but I would say Republic Services has a profiteer type of attitude when it comes to this epidemic,” Chuck Stiles, director of solid waste and recycling division at the Teamsters, which represents 7,000 Republic Services employees told Motherboard. “They have sent out their supposed plan of mitigation of what they’re willing to offer their workers, but it falls extremely short of what’s needed. Workers are saying that everything is in short supply.”

Paul Auxer, an industrial driver for Republic Services, says the situation is just as dire at his worksite in Columbus, Ohio, where supplies of face masks and hand sanitizer have been depleted and he frequently comes into direct contact with customers to get signatures. (Republic told Motherboard it made “extensive changes at all of our facilities several weeks ago to help ensure proper social distancing for all our employees.”)

“We had a masks and hand sanitizer the first day the governor shut down the state, but we haven’t really had much since,” Auxer, who picks up waste at hospitals and apartment complexes, said. “No wipes. No disinfectant. No hazard pay. No rubber gloves. Everybody is absolutely concerned.”

Auxer said that he has only been offered 10 days of paid sick leave, which isn’t enough if he gets sick.

“I’m in the bracket that you would consider higher risk,” he said. “I smoked for 14 years. My lungs are definitely compromised. I’m 50. My job puts me more at risk. If I’m going to be in the hospital for a month, you’d think they’d pay for more than 10 days. I’d think after 25 years, the company I work for would like to take care of me. I’d like to think I’m worth that.”

Last week, OSHA updated its guidelines for handling waste, recommending that sanitation workers treat medical waste including materials contaminated with Covid-19 materials "like any other non-contaminated municipal waste."

But Stiles, the Teamster official, worries that without proper gear, sanitation workers are coming into contact with hospital and residential waste contaminated with Covid-19.

“My main concern is that workers do come into contact with waste from hospitals and doctor’s offices,” he said. "Stuff just gets thrown into dumpsters. It doesn’t get incinerated. What Republic has offered to drivers is so weak. The bottom line is: it’s a bad situation that’s going to get a lot worse.”

“We are afraid. We service at least six hospitals in this area,” said Kevin Clark, a Republic Services worker in Memphis, Tennessee. “You’re dealing with medical waste from the hospital. You might see vials, blood, needles, body parts that you’re walking on top of in the landfill.”

It's not just Republic, of course. Sanitation work is essential and dangerous even at the best of times. Now, with a pandemic, workers would be at some risk even with proper PPE. But sanitation workers say there are steps companies and cities could take to make them safer. These concerns about equipment and safety led sanitation workers employed by the city of Pittsburgh to walk out on March 25, demanding face masks and increased healthcare benefits.

Stiles says that workers need face masks, puncture proof gloves, rubber nitrile gloves, heavy duty boots, hand sanitizer, and social distancing policies to stay safe. He says that Republic has refused to provide extra protections like Tyvek suits and face masks for drivers cleaning behind the blade that compresses trash inside sanitation trucks, a cleaning process workers must complete after each trash dump.

Sanitation workers at several sanitation companies told Motherboard that while health care and grocery stores workers are often seen as the frontline workers of the pandemic, sanitation workers feel like their work is overlooked and invisible—despite the fact that they frequently come into contact with contaminated waste.

“A lot of people don’t understand what we do. They see first responders and health care workers getting recognition, but we’re behind the scenes,” Auxer said. “We’re doing the same important job as those healthcare workers and we’re not nearly as protected.”

While some sanitation workers at other waste management companies told Motherboard that they have been provided with ample protections, the entire commercial waste industry is bracing for mass layoffs as large swaths of business that have shut down also suspend their trash collection.

“Companies can’t handle the level of decline,” said Sean Campell, the president of the Teamsters Local 831, which represents private sanitation workers in New York City. "In the commercial sector, the office buildings, bars, and restaurants, there’s maybe a skeleton crew. Outside of that, there’s no one in there. The only place you have waste is hospitals, food facilities, and places that deliver essential supplies.”