OTTAWA — For most people, the pandemic has turned border crossing into an impossibility. But for Laurie Dufresne, who lives in Canada and works in the United States, it remains part of her daily commute.
Ms. Dufresne is one of about 1,600 nurses and other health care workers who leave Windsor, Ontario, a city of 217,000, for daily work in Detroit, a metropolitan area of more than four million people. In Windsor, infections remain comparatively under control. Detroit, though, has one of the most severe coronavirus outbreaks in the United States.
For health workers like Ms. Dufresne, fulfilling desperately needed medical duties across the border means being in an uncomfortable position. Canadian officials have been blunt about the risks, and health workers have found themselves under scrutiny at home as potential vectors of the pathogen, not just to Windsor but to all of Canada, which so far has not been hit as hard as the United States.
In other countries, health care workers have also found themselves grappling with a community afraid they will spread the virus when they leave their hospitals to come home.
In Mexico, government officials have reported several instances of discrimination and violence against medical personnel motivated by such fears. Nurses have been kicked off public transportation, doused with chlorine and assaulted.
In Canada over the past few days, Windsor’s border-crossing caregivers have also been used in thinly veiled threats by Prime Minister Justin Trudeau and other Canadian politicians challenging an effort by President Trump to cut off exports of medical supplies to Canada.
The dilemma facing officials in Windsor is how to help a neighbor in crisis while also protecting their citizens.
“I think it is important that we do not abandon our neighbor in this difficult time,” said Dr. Wajid Ahmed, the medical officer of health at the Windsor-Essex County Health Unit.
“But we also need to make sure that we are taking every step that we can to protect our community, protect our health care workers and ensure that we are reducing the risk as much as possible,” he added.
The Canada-U.S. border has been closed to everyone except essential workers, truck drivers and airplane, ship and train crews since March 21.
Detroit sits across the Detroit River from Windsor, just a few minutes’ drive by bridge or tunnel. The current outbreak has created an extraordinary contrast, though: In Detroit and its surrounding counties, there are 17,543 Covid-19 cases, and 926 people have died. Across all of Canada, 20,748 people have been infected, and 509 have died.
Metropolitan Detroit, with about 20 times the population of Windsor, has reported about 67 times the number of infections and 132 times the number of deaths. Dr. Ahmed said about a third of Windsor’s infections had been traced to health care workers returning from the United States.
For Ms. Dufresne, who has worked at various Detroit-area hospitals and as a traveling nurse for 11 years, the shutdown of the border has both eased and complicated her commute.
“The border guards are being much more respectful,” she said. And the Canadian border authorities have given all health care workers special car placards to speed their passage.
But Ms. Dufresne has a new post-work ritual when she gets home: deep disinfection.
After pulling into her garage and closing the door, she immediately takes off and bags all her clothes for laundry, sanitizes the van and then showers.
“It’s scary if you look at the numbers in Windsor compared to the numbers in Michigan,” Ms. Dufresne said. “I’m aware of the risks, and we try to limit them. But I’m not going to not take care of my patients.”
Similarly, Ms. Dufresne is determined not to be separated from her two school-aged children for weeks or months by moving to a hotel in Detroit, as some in Windsor have suggested.
Detroit’s hospitals have long actively recruited in Windsor. Ms. Dufresne said Detroit’s large and sophisticated hospitals offer more and a greater variety of career opportunities than Windsor’s two comparatively small hospitals, which often send patients to a regional hospital about 120 miles away if they need complex treatments or special procedures.
Dr. Ahmed said that despite the large number of health workers who travel daily from Windsor across the border, no agency keeps statistics on these commutes. Numbers posted by The Henry Ford Health System, a nonprofit that oversees six hospitals in the Detroit area, show that 538 of its 6,200 nurses are Canadians.
Ms. Dufresne, a surgical nurse, said she had worked in groups where upward of 40 percent of her colleagues also lived in Windsor.
Dr. Ahmed said Canadian officials should consider limiting the number of times health care workers can cross the border, encouraging more of them to stay in Detroit hotels, barring part-timers from crossing and possibly requiring that international commuters isolate themselves from their families within their homes.
“It’s not about saying, ‘Just stop everything and we shouldn’t provide any service,’” Dr. Ahmed said. “It’s about how do we minimize the risk.”
Ms. Dufresne said that some of her colleagues had been criticized on social media and that at least one had been denied entry to a bank in Windsor. “I think people are scared, and they get a lot of misinformation,” she said.
Many health care workers noted that they are experts at responsibly mitigating risk. And while they understand the fear in Windsor, they say the dangers are overstated.
“Some people are blowing up the negativity,” said Zain Ismail, an administrative health care worker who commutes to a Detroit hospital. “It’s not like these health care workers are hanging out at a mall.”
While back home in Windsor, Mr. Ismail stays inside. Friends handle his grocery shopping.
“When you’re in health care, you’re in the same community no matter what side of the border you’re on,” he said.
Natalie Kitroeff contributed reporting from Mexico City.