Ellis is among the estimated 75,000 home health aides in Pennsylvania, many of whom are working through the pandemic out of compassion, financial pressures, or both. Pre-pandemic, the job was labor-intensive and thin on rewards. Pay is generally poor in a field overwhelmingly staffed by women; paid time off and employer-provided health care are rare, said Ali Kronley, director of the United Health Care Workers of Pennsylvania. The coronavirus has exacerbated workers’ challenges.