I don't want to mention names or places, but I remember a MA who, after multiple problems, refused any session involving the hot tub. I guess that says it all.
There's only place that I was comfortable to do the hot tub thing. It wasn't a real hot tub as we know it, it was an oversized bath with water jets. Shower was mandatory and the bath was filled while I was receiving light massage. When ready, we went in the tub. Water was drained and It was sanitized after every client. (And that was way before covid)