Lack of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission from a healthcare worker to a cohort of immunosuppressed patients during the SARS-CoV-2 omicron variant surge, California, 2022

The risk of an HCW acquiring COVID-19 from another HCW is reportedly 3 times higher than contracting it from patients.1 Given that not all infections are detected, it is critically important that during surges, all infection controls (administrative, engineering, and personal protective equipment [PPE]) are optimized to protect patients and HCW colleagues.2 We report a case in which a highly infectious HCW working with profoundly immunosuppressed patients did not transmit SARS-CoV-2 to patients despite multiple close interactions. Patient Characteristics, Timing of Exposure, and Follow-Up Test Results for 9 Transplant Patients Cared for by an Infectious Healthcare Worker Wearing a Fit-Tested Respirator for Source Control, California, January 2022 Patient Age, Years, and Sex Diagnosis (Date of Transplant) Day of Exposurea Day of Follow-Up Test(s) Type of Test Test Result(s) 1 56 F Pre-heart 0 3 and 5 Nasopharyngeal Negative 2 62 M Lung (8/2021) 0 3 and 5 Nasopharyngeal and midturbinate Negative 3 46 F Liver (4/2021) −1 and 0 5 Nasopharyngeal Negative 4 62 F Liver (2/2021) −1 5 and 5 Nasopharyngeal and midturbinate Negative 5 60 F Kidney (4/2019) −1 and 0 5 Midturbinate Negative 6 65 M Heart/Liver (12/2020) −1 3 and 5 Nasopharyngeal Negative 7 70 M Lung (11/2021) −1 5 Midturbinate Negative 8 55 M Heart (10/2021) −1 and 0 5 Nasopharyngeal Negative 9 56 F Redo lung (8/2019 and 12/2021) −1 4 and 5 Nasopharyngeal and nasal Negative This report is important for several reasons. [...]these patients were immunocompromised, putting them at higher risk of severe infection and death (as high as 13%–20%) if they were to contract SARS-CoV-2.4,5 We hypothesize many possible reasons why the index case did not transmit to patients or other HCWs.