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Santa Clara County has fined Kaiser Permanente San Jose Medical Center $43,000 for delays in reporting a coronavirus outbreak that has swelled from 43 to 60 emergency department staffers and killed one employee.
The county sent Kaiser a notice of violation after it learned about the outbreak, saying the fine was “one for each of personnel that these 43 personnel tested.” At the time the outbreak was first announced on Jan. 3, 43 people had been infected, but that number has since grown.
Employers are required to report positive coronavirus cases to the county Public Health Department within four hours of finding out an employee has tested positive.
The outbreak is thought to be linked to a brief Christmas Day visit from an employee in an inflatable holiday costume, which are kept filled with 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 soon to rule out other possible causes behind the outbreak.
“An important question to figure out is who was the index case,” said Linsey Marr, an aerosols expert 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 costumed employee, then “it’s possible the fan could have helped spread the aerosols they were breathing out farther,” Marr said. But right now, “it’s also entirely possible the costume was just a red herring.”
Public health specialists would have to rule out that transmission didn’t happen elsewhere, Jose-Luis Jimenez, an expert in aerosol transmission and professor of chemistry at the University of Colorado 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 in the costume is the index case, Jimenez said he didn’t expect the costume would have made a huge difference in spreading the virus.
“It would have spread the aerosols maybe a bit more with the fan, but they would spread anyway,” Jimenez said. “Like if the person was smoking, with or without the costume, everyone would have smelled the smoke.”
The emergency department has been cleaned and disinfected, and the 70 patients who were present that day have been notified of the potential exposure and offered COVID testing, according to a statement from Kaiser Permanente.
To their knowledge, the employee did not visit other wards besides the emergency department, a Kaiser spokesperson said.
The outbreak at Kaiser San Jose coincides with a surge of new cases and deaths in Santa Clara County around the holidays. The county has reported an average of more than 1,000 new cases each day over the last seven days, a 1.5% increase from two weeks ago, according to the L.A. Times coronavirus tracker.
The county said the outbreak was not caused by the recent, more infectious variant of the virus first identified in Britain.
Times staff writer Rong-Gong Lin II contributed to this report.
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