(Reuters) - On his delivery route through Orange County, California, Joseph Alvarado made 153 stops one day last week for Amazon.com Inc AMZN.O, touching the inside and outside of his van, more than 225 packages, and dozens of customers’ doors and gates.

In a global coronavirus pandemic that has infected about 420,000 people and killed nearly 19,000, delivery drivers like Alvarado have become as essential as first responders, providing food and other basics for millions of people who are isolating themselves under government stay-home directives. But unlike traditional emergency workers, today’s delivery drivers typically have little or no health insurance, sick pay or job security - and many say they lack even the basics needed to stay safe on the job.

Alvarado said the van he drove wasn’t cleaned before or after his 10-hour shift, nor were the bins holding packages handled by warehouse workers and delivery drivers. Yet his company offered no gloves or masks, and only sporadically provided hand sanitizer. Under pressure to meet targets for delivery speed and volume, Alvarado and other drivers say they have little or no time to stop and wash their hands.

“I’m being exposed,” said Alvarado, 38, who has delivered Amazon packages for three years. “I would think that a company like Amazon that is filthy rich, doing great, not going anywhere anytime soon, would want to take care of its employees.”

Alvarado doesn’t actually work for Amazon. He works instead for Pacific Keys Logistics LLC, one of hundreds of companies that compete for coveted delivery contracts with the world’s largest online retailer. The logistics company could not be reached for comment.

To keep the work, such contractors must meet Amazon’s stringent performance standards under compensation schemes that effectively require the delivery companies to keep a tight rein on costs. Often, delivering Amazon packages constitutes their entire business.

Such arm’s-length employment arrangements have insulated Amazon and other companies from liability and the costs of health insurance and other benefits. The business model - also employed by upstart app-based delivery firms such as Instacart, Shipt Inc and Postmates - has proven popular with investors by allowing the companies to avoid nitty-gritty costs like vehicle repair and crash liabilities.

The coronavirus pandemic has revealed the precarious environment that has been a daily reality for these workers as they now take on much greater risks in delivering essential goods, said David Weil, dean of Brandeis University’s school of social policy and management and a former top Labor Department official in the Obama administration.

“It’s totally laid bare how vulnerable they are,” he said. “We are seeing there are millions of workers, who have no social safety net protections, who are now on the front lines of delivering food and delivering packages.”

Contract drivers who deliver for Amazon in the United States are paid an hourly rate starting at $15, according to the company. In written responses to questions from Reuters, Amazon said it requires its delivery contractors to offer healthcare coverage, but didn’t specify how much of the cost, if any, the firms cover.

Some drivers say they opt out of the health coverage because they can’t afford the high out-of-pocket costs. Amazon said it required its contractors to offer drivers an unspecified amount of paid time off, but didn’t say whether they were guaranteed sick pay. The company also has a program known as Amazon Flex, where independent contractors sign up for time slots to take groceries or packages to customers’ doorsteps in their own cars.

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Amazon said it is taking “extreme measures” to protect all workers, including contracted drivers. Such efforts include “tripling down on deep cleaning, procuring safety supplies that are available, and changing processes to ensure those in our buildings are keeping safe distances.”

Amazon said it is giving its contracted delivery companies hand sanitizer and wipes to allow drivers to clean their vehicles. Asked about drivers’ accounts that such supplies were unavailable, the company said some delivery sites “may on occasion see brief shortages.”

App-based delivery firms have partnered with major retailers such as Walmart Inc WMT.N, Kroger Co KR.N and Target Corp TGT.N, which owns Shipt. Instacart and Shipt don’t provide sick pay to drivers but both have said they will offer two weeks of financial assistance for those who test positive for COVID-19 or are placed into quarantine by health authorities.

Reuters interviewed more than a dozen delivery drivers for Amazon, Instacart, Postmates, Uber Eats, a food delivery service from ride-hailing firm Uber Technologies Inc UBER.N, and others, many of whom said they believe the companies did not provide proper protection or support given the risks they are taking.

The lack of sick pay and supplies can also pose a risk to consumers, especially if drivers show up to work sick or can’t frequently wash their hands, said Suzanne Judd, an epidemiologist at the University of Alabama at Birmingham’s school of public health.

“Touching gates, touching door knobs, those are all going to be potential points of exposure,” she said. “Hand sanitizer itself is not enough.”

Despite the risks, many drivers can’t quit as the economy crashes amid relentless daily reports of rising death totals, business closures and government stay-home directives. As the crisis deepened last week, Amazon announced plans for 100,000 new workers to handle surging demand. But those openings will likely be easily filled with the masses of workers laid off from other hard-hit sectors such as restaurants because Amazon is among the few companies that is hiring. The company has temporarily boosted the pay for warehouse workers and contract drivers by $2 an hour in response to the pandemic, but the raises expire at the end of April.

“It’s very sad because three weeks ago we were in a historically tight labor market,” said Matthew Bidwell, a professor at the University of Pennsylvania’s Wharton School who focuses on short-term working arrangements. “It was forcing employers for the first time in a long time to offer more perks and more benefits. They no longer have that pressure.”

Danny Gonzalez also delivers for Amazon in Orange County. After long shifts, his hands are blackened with grime from countless surfaces.

“Where do you go wash your hands when you’re in a vehicle?” said Gonzalez, 33, of Anaheim.

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Dispatchers enforcing Amazon standards track his movements with GPS technology, sometimes questioning the time taken on stops. Realistically, he said, the targets leave no time for hand-washing. He also skips a lunch break and estimates he runs up to 12 miles a day in sprints from the truck to doorsteps.

“There’s no way you will complete a 280-package route in the eight hours or nine hours they want you to,” he said. “We’re just statistics to Amazon.”

The Amazon contractor that employs him, which he declined to name, offers health insurance that employees can purchase, but Gonzalez said he opted out because the costs would have eaten up nearly half his paycheck. Neither Gonzalez nor Alvarado have paid sick leave.

TREATED ‘LIKE A LEPER’

After the pandemic hit, Amazon announced it would set aside $25 million for contracted delivery drivers to apply for up to two weeks paid leave if they are diagnosed with COVID-19 or placed into quarantine by the government or Amazon. Other companies such as Uber, Postmates, Instacart and DoorDash have made similar pledges to help workers.

But the criteria make getting that paid time difficult, drivers said. Jonathan Perales, 25, a driver for Uber and Postmates in Texas, started coughing and feeling feverish earlier this month after picking up an ill passenger. The hospital he visited said he had symptoms of COVID-19, but declined to test him amid a national shortage of kits.

When he sought sick pay from Uber, the company told him he needed a positive coronavirus test or documentation from a medical professional ordering him to self-quarantine. No one at the hospital or the state health department was willing to submit such documentation to Uber on his behalf - which he said the company required - and another clinic refused to examine him when he showed up reporting coronavirus symptoms.

“I was stuck in an impossible situation,” Perales said. “I was trying to get tested, and I was trying to seek financial aid. I was being treated like a leper.”

Despite the illness, he needed the income to avoid an eviction, so he continued to work for Postmates for another two days. Uber shut down his account after he reported the symptoms, he said, which left him unable to pay his bill at the extended-stay motel where he had been living. He now lives in his car. Uber declined to comment on Perales’ case but said in a statement that drivers’ safety is “always our priority.” Postmates declined to comment.

DRIVING 45 MILES FOR HAND SANITIZER

Ron Spigelman delivers for Instacart. The company hasn’t provided training or offered sanitation supplies or protective gear to wear in crowded stores, he said. He recently drove 45 miles to find hand sanitizer at a Dollar General in the countryside near Tulsa, Oklahoma.

He thinks drivers should have access to hand-washing stations. “That way we feel more protected,” he said, “and I think the customers would feel more protected as well.”

In a statement, Instacart said it would soon distribute hand sanitizer and provide access to cleaning supplies in some stores. The company plans to add an additional 300,000 independent delivery contractors to handle skyrocketing demand.

Some drivers have stopped delivering as the crisis worsened. Laura Chelton, 48, drives for Amazon Flex in the Seattle area - site of the first outbreak in the United States. Last week, she noticed that no one was wiping down surfaces in the area at Whole Foods where she picked up orders.

When she saw an older woman cough last week as she assembled grocery bags in that confined space - just eight by 10 feet - she decided that delivering groceries just wasn’t worth the risk.