Workplaces a major driver of COVID-19 in Sonoma County

The rate of new coronavirus cases continues to soar in Sonoma County as county residents and businesses are again living with drastic limits on their lives from a new stay-home order.

As of Saturday, about 180 people on average have tested positive for COVID-19 each day since Dec. 1, more than double the number during the same time period last month.

The numbers reinforce the trend that Health Officer Dr. Sundari Mase said drove her decision to order county residents stay home and avoid all but essential work and activities, new restrictions that took effect Saturday aimed at limiting the opportunities for people to encounter one another and spread the virus.

Data on where people are contracting COVID-19 show that going to work is one of the riskiest things people do during the pandemic. About 1 in 6 people diagnosed with the coronavirus were exposed to the virus at their jobs, according to transmission data provided to The Press Democrat for cases with information about where they were exposed.

The data suggests people are going to work after they have been infected and efforts to safeguard workers such as emergency paid sick leave and other financial assistance programs are falling short from keeping people home.

“We really want employers to make their employees feel and know that they’re safe when they have COVID and they have to isolate or quarantine — that they have job security,” Mase said.

The stay-home order curtails or closes major business sectors in the county, limiting restaurants to takeout or delivery, halting service at breweries and wineries and diminishing the number of people in retail stories.

The March stay-home orders that shut many businesses proved effective in slowing the spread of the disease, what epidemiologists call flattening the curve of new infections. Mase said she believed it would be highly successful again in slowing the spread of the illness as long as people abide by the rules.

But even with many restrictions reinstated, conditions for most of the so-called essential workforce will be unchanged.

Health care staff, service workers, construction crews and agricultural and field laborers were the top three categories of workers who have contracted COVID-19, although not all of these cases were linked to their workplace.

About half of the 734 health care workers who have tested positive for COVID-19 acquired the virus at their jobs, and they were the most likely category of worker to get infected at work, county data shows. Separately, county officials reported 61 patients at local health care facilities.

More than 1,300 people working in services and sales, such as restaurants, grocery stores, retail and hotels, have contracted the disease, but contact tracers found only 22% are known to have been infected at work.

Among the 598 farm laborers who have tested positive for the virus, contact tracers were able to determine about 34% were infected on the job.

There are 317 public safety employees who have tested positive for the virus, and 122 of those cases were linked to their jobs.

The county is launching some new programs to address workplace outbreaks, such as bringing in a private testing laboratory to conduct surveillance testing with larger employers, according to Mase. The county is hiring someone to serve as a liaison between the public health department and businesses.

Continuing to work

Dr. Jenny Fish, a local family medicine physician who helped found the local health care advocacy group H-PEACE, or Health Professionals for Equality and Community Empowerment, said she believes the county is failing to address the critical role employers play in limiting the spread of the virus for the whole community.

Doctors connected to her organization routinely hear from patients who say they are expected to work even with symptoms of illness or who are too afraid of the financial consequences if they call in sick, Fish said.

Her organization has been compiling stories from their patients with details about these problems to highlight for public officials where improvements need to be made to slow transmission of COVID-19.

One of those stories involves a fast food restaurant employee who confided in his doctor that he was terrified he would contract the virus when his coworker continued coming to work with obvious signs of illness. She would eventually test positive for the virus.

Another case included an older woman with chronic illnesses concerned about her safety because her son worked for a man who insisted on coming to work after testing positive, believing he could be safe by closing the office door. The son tested positive for COVID-19.

A patient who contracted COVID-19 at 36 weeks pregnant told her doctor she continued going to work at a skilled nursing facility out of fear she wouldn’t have enough money when the baby was born.

H-PEACE has heard from patients with COVID-19 who say their employers warned them against informing any colleagues about possible exposure to the virus.

Fear that staying home sick might mean losing a job is particularly strong among Latino workers, Fish said.

“We hear a lot of cases with patients being told they have to come to work or get fired,” Fish said. “Most of them are undocumented workers. They’re less likely to have a voice. They’re less likely to have the power to advocate for themselves.”

Total transparency about workplace outbreaks could be an effective way to force companies to protect their workers and for managers to adhere to those policies, Fish said.

Fish said county residents should be able to know they are supporting restaurants that protect their employees and avoiding places with significant outbreaks.

“To be totally honest I think that’s the only thing that will make a change,” Fish said. “If there’s no transparency, no accountability, nothing will change.”

Looking at workplace

County officials have repeatedly declined to release information about workplace outbreaks, saying that people should be extremely cautious wherever they go.

The transmission statistics also reveal how much the county doesn’t know about the factors contributing to COVID-19 infections.

In nearly 24% of all cases, contact tracers have not determined where the person was exposed to COVID-19, whether it be at work, home or other circumstances, such as travel or social gatherings.

Outside the workforce, 42% of county residents with COVID-19 are getting infected at home by someone else in their household, according to an analysis of more than 9,200 cases, roughly 65% of the total known infections so far.

Nearly 540 people representing nearly 6% of these analyzed cases have been exposed to the disease at group care homes, one of the most critical points of infections because of the risk for grave illness among the elderly and those with chronic health conditions.

Overall, about 8% of cases have been linked to socializing among multiple households, with noticeable spikes after holidays.

Social gatherings around holidays have contributed to spikes in cases after July 4, Labor Day, Halloween and Thanksgiving.

Contact tracers have linked 31 new cases to Thanksgiving gatherings so far, just over half with people who attended gatherings with more than 12 people, according to Sonoma County epidemiologist Kate Pack.

Three of those gatherings involved people who became infected at work, spreading the virus among family and friends at the event. Two of the gatherings were held outdoors, Pack said.

Mase said she expects the actual number of holiday celebrations leading to infections to be greater, but there are limits to how much people recall or admit to when interviewed by contact tracers. Additionally, the full picture of Thanksgiving infections may not yet be clear.

“It’s probably an underestimate because we’re not aware of all the gatherings that lead to cases,” Mase said. “It just depends on what people tell us. Not everybody is giving us a very clear picture of what their factors are, what they’ve done.”

You can reach Staff Writer Julie Johnson at 707-521-5220 or julie.johnson@pressdemocrat.com. On Twitter @jjpressdem.