Andrew Lithwin, Assistant Professor at Cornell University, studies relationships between labor and germ transmission and has been writing for years on the problems with contracted or outsourced labor for hospital sanitation. “When employers ‘externalize’ work—replacing conventional employees with contractors or temps, they are giving up on relationships vested with trust and reciprocity, choosing instead to simply ‘transact.’ I know in times of trouble, I would much rather rely on those with whom I have a relationship, not those with whom I merely transact" (Cornell University, 2020).