Santa Clara County fined Kaiser Permanente San Jose Medical Center $ 43,000 for delays in reporting a coronavirus outbreak that increased from 43 to 60 emergency department employees and killed an employee.
The county sent Kaiser a violation notice after hearing about the outbreak, saying the fine was “one for each employee tested by these 43 employees”. By the time the outbreak was first announced on January 3, 43 people had been infected, but that number has since grown.
Employers are required to report positive cases of coronavirus to the county’s Department of Public Health within four hours of discovering that an employee’s test was positive.
The outbreak is believed to be related to a brief visit on Christmas Day by an employee in an inflatable Christmas costume, which is kept full of air by a battery-powered fan. The employee, who was dressed as a Christmas tree, was asymptomatic at the time, but later tested positive, according to a Kaiser Permanente representative.
However, experts said it was too early to rule out other possible causes behind the outbreak.
“An important question to be discovered is who the index case was,” said Linsey Marr, an aerosol specialist and professor of civil and environmental engineering at Virginia Tech. The index case is the original infected person who spread the virus.
If the index case is the employee in costume, then “it is possible that the ventilator helped to spread the aerosols they were exhaling more,” Marr said. But now, “it is also entirely possible that the fantasy was just a false clue”.
Public health experts would have to rule out the transmission not happening elsewhere, Jose-Luis Jimenez, an aerosol transmission specialist and professor of chemistry at the University of Colorado at Boulder, said by email. Marr and Jimenez investigated a deadly choir outbreak in northwest Washington, in which a choir member infected 53 of the 61 members, two of whom died.
If the person with the fantasy is the index case, Jimenez said he did not expect the fantasy to make a big difference in the spread of the virus.
“That would have spread the aerosols maybe a little more with the fan, but they would have spread anyway,” said Jimenez. “As if the person were smoking, with or without the costume, everyone would have smelled the smoke.”
The emergency department was cleaned and disinfected, and the 70 patients who were present that day were notified of the potential exposure and offered the COVID test, according to a statement from Kaiser Permanente.
As far as they know, the employee has not visited wards other than the emergency department, said a Kaiser spokesman.
The outbreak in Kaiser San Jose coincides with an outbreak of new cases and deaths in Santa Clara County near the holiday. The county reported an average of more than 1,000 new cases per day in the past seven days, an increase of 1.5% over two weeks ago, according to the coronavirus tracker LA Times.
The county said the outbreak was not caused by the most infectious variant of the virus, first identified in Britain.
The Times staff writer Rong-Gong Lin II contributed to this report.