Across California, thousands of health care workers have tested positive for the deadly coronavirus. Yet, a new report from the Centers for Disease Control and Prevention (CDC) suggests that transmission is relatively rare when a doctor, nurse or other worker has brief contact with a patient and is wearing appropriate protective gear.
As of April 15, local health departments in the state reported 2,974 confirmed cases of COVID-19 among health care workers — a little more than 10 percent of all reported cases. Nationally, by April 9, 9,282 cases involving health care providers had been reported out of more than 300,000 total cases.
About 67 out of every 100,000 California residents have tested positive so far compared to about 178 out of every 100,000 health care workers in the state.
Those numbers likely don’t reflect all infected health care workers, and they may be slightly skewed since health care workers may have better access to testing. Still, they offer valuable insight into a disease that is attacking the very workforce charged with beating it.
While some workers likely picked up the disease while traveling or interacting with family, other were exposed on the job.
Locally, an outbreak of the virus among at least four nurses with ties to a single unit at Santa Clara Valley Medical Center prompted a whistleblower complaint about the hospital’s handling of the virus. The county is investigating.
According to the CDC report, workers appear to have been especially vulnerable early on in the pandemic — before community transmission was common. The agency looked at a case in Solano County at NorthBay VacaValley Hospital in mid-February that was the first to come from an unknown source.
The patient exposed 121 health care workers there to the coronavirus, the CDC said, but just three tested positive.
“The number was low,” said John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley.
The trio had close, prolonged contact — multiple hours — with the woman and weren’t wearing enough protective gear. The 40 other workers who exhibited symptoms of the disease but ultimately tested negative spent less time with the patient and were not as close as those who tested positive.
“They weren’t geared up for this,” said George Rutherford, professor of epidemiology at UC San Francisco.
After the patient was transferred to another hospital, UC Davis, where she was on a closed-system ventilator, no workers reported testing positive.
One major takeaway from the report is that personal protective gear [PPE] — which has been in short supply across the country — is key to stopping the spread of the virus. The report recommends that in high-risk situations — such as when a patient is being intubated — workers should wear N95 masks.
Now, the wearing of masks and protective gear is standard, Swartzberg said, so the report “was reassuring” in the sense that it suggests the practices currently in use to protect workers are effective.
“Health care facilities should emphasize early recognition and isolation of patients with possible COVID-19 and use of recommended PPE to minimize unprotected, high-risk [health care personnel] exposures and protect the health care workforce,” the CDC said.
Still, across the Bay Area, from Oakland to San Jose, nurses have protested what they say is a lack of such appropriate protective gear, saying they’re having to rewear masks they would ordinarily throw away and running short on face shields and other tools that can provide an extra layer of protection from the infectious droplets that transmit the disease.
The agency noted that as community transmission has increased, it has become harder to tell exactly where each person gets infected. The Solano County case “presented a unique opportunity,” the CDC said, to study how transmission occurs in a health care setting.
The case also highlights the importance of testing. The CDC didn’t agree to test the VacaValley patient for several days after she was admitted, meaning health care workers who treated her during that time did not know she had the disease. As public health officials look to ease shelter-in-place requirements for the Bay Area, they say testing will be crucial because it’s the only way to know who has had the virus — and who is still at risk of becoming infected.
As with the rest of the community, most health care workers who have gotten the virus have not needed to be hospitalized. But, as in the broader population, some cases have been severe or deadly, primarily among those older than 65.
Moving forward, the CDC warns, “the total number of COVID-19 cases among [health care personnel] is expected to rise as more U.S. communities experience widespread transmission.”
Staff writer Harriet Blair Rowan contributed to this report.
