When Vanessa is asked to clean up after patients who have the seasonal flu or measles or MRSA in the Pennsylvania hospital where she works in environmental services, she knows what to do. She knows how to disinfect surfaces, what needs to be thrown away and what she should wear to protect herself. But when she’s asked to clean rooms occupied by COVID-19 patients, she’s flying blind.

“It’s kind of terrifying,” says Vanessa, who TIME is identifying by first name only for professional protection. Her supervisors told her to clean the rooms just as she would for a flu patient, but she says she’s treating them like she would for more serious illnesses—throwing out nearly everything disposable, mopping the walls and scrubbing every inch—to be safe. “No one knows exactly how to clean it. We don’t know how contagious this is.”

At a time when cleaning supplies are invaluable and hand-washing is a national activity, people who clean professionally, like Vanessa, have watched their jobs take on new meaning—and considerable new risks. But what has remained the same, they say, is a lack of respect and, often, inadequate compensation.

Vanessa, for example, makes only about $11 an hour for the unenviable job of disinfecting hospital rooms, often without proper protective gear for herself. The fresh N-95 masks still available in her hospital, she says, are mostly going to doctors and nurses; she and her housekeeping colleagues often have to reuse the ones they have. She says she might have stopped showing up at work if she didn’t need the money, especially since she has underlying health conditions that put her at extra risk of getting COVID-19.

“Because I’m working there,” Vanessa says, “I’m too afraid to go see my family right now.” She lives with her best friend, and is staying away from her parents’ home for now.

Workers across industries are struggling to get the protective equipment they need. Omar, who drives a garbage truck in California, says his company has not even provided hand sanitizer for its workers, even though “we’re dealing with everybody’s trash [and] we don’t know what’s in there.”

When Omar and his coworkers asked for sanitizer, they were given all-purpose cleaner and told to use it on their hands, he says. To stay safe, he’s resorted to asking friends who work in retail to help him find his own sanitizing supplies.

“[Management is] super cheap. In restaurants, do waitresses carry their own [supplies] to clean the tables?” he says, adding that he’s not getting hazard pay. Under his union contract, he makes about $26 per hour.

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K.T., a janitor for a San Francisco office building who asked to be identified by initials only, says her fears have shifted from medical to financial as the outbreak wears on.

“When we [first] heard about coronavirus, we felt like it was something scary,” she says. “We work in a building with a lot of people. We always felt like it was easy for us to get it.” The extra cleaning protocols she was asked to take on—more disinfecting and wiping down high-touch surfaces—didn’t help put her at ease.

But now that the office building in which K.T. works sits empty, she says she’s worried about layoffs or reduced schedules. She has a second job as a plumber and electrician, but she depends on the $21.80 an hour she makes under her 40-hour-per-week union janitorial contract.

Labina Shrestha, the operations manager for environmental services at Boston’s Brigham and Women’s Hospital, is straddling the roles of frontline worker and administrator during COVID-19. She suits up to hold extra cleaning training sessions for her staff, and posts the hospital’s near-daily policy updates in the environmental services lockerroom; she also works with hospital leadership to ensure her team has adequate protective equipment, and that no one feels overworked or unsafe. Communicating openly, she says, helps remind her team why they come in every day.

“We are the first defense when it comes to infection prevention,” she says. “We save lives.”

True as that may be, neither Vanessa nor K.T. believe COVID-19 will change the way the public perceives their work, despite the vital importance it has taken on during the pandemic.

“There are people who really do appreciate [us] and know the janitors are in a big risk,” K.T. says. “But there are a lot of people who…don’t even look at the bottom, and they see us at the bottom.”

The risks cleaning professionals assume might be easier to stomach, Vanessa says, if they were recognized publicly.

“Us housekeepers, we have families, we have health issues, we have people and animals we go home to that we could be giving this to,” Vanessa says. “The doctors and nurses have that too, but they get recognized. No one ever mentions the people who clean it up after they’re gone.”

Please send tips, leads, and stories from the frontlines to virus@time.com.

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Write to Jamie Ducharme at jamie.ducharme@time.com.