San Francisco Chronicle - (Sunday)
Disclosing business outbreaks raises fear
Is it safe to go to the grocery store? Why did that restaurant close its doors for a day?
A year after officials identified the first case of the coronavirus in the Bay Area, local health departments mostly aren’t saying which businesses have seen infections at work. A patchwork of rumor, employee notifications and media reports have taken the place of the systematic reporting seen elsewhere.
The Bay Area’s approach stands in stark contrast to Los Angeles County, which has been transparent about workplace outbreaks well before a state law requiring some reports on outbreaks, AB685, took effect on Jan. 1.
Of the 10 local health departments, only one divulged the names of businesses that had seen outbreaks. Some cited policies protecting medical privacy for withholding it. Experts said health officials must balance public safety benefits with the risks of tarnishing businesses’ reputations or discouraging them from reporting infections.
The backers of
AB685 sought to push for more transparency, requiring public reporting by the state health department on coronavirus outbreaks at workplaces by industry. The state health department has not yet made the information available, and it would not give the public the kind of detailed information available in Los Angeles and Oregon, which began a statewide disclosure system in May.
It is unclear whether publicly revealing the specific names and locations of affected businesses and the number of infections, as Los Angeles does, has helped slow the spread of the disease. The pandemic remains more severe in Southern California than in the Bay Area, while Oregon has been one of the bestperforming states in fighting the pandemic.
“The gravity of the pandemic and the need to share information is an important factor that can help protect the public,” an L.A. County Department of Public Health spokesperson said in an email, adding that the county shares outbreak and contact tracing information to protect the public.
L.A. County does not attach dates to its outbreak information, which makes it unclear where the virus is currently circulating.
“Providing this sort of data could mislead the public.” San Francisco spokesperson
“There are so many confounders, it’s hard to ascertain what role releasing the data in L.A. County has had,” said John Swartzberg, an epidemiologist at UC Berkeley. “There’s a lot of noise in the system. I don’t know how you would identify that this particular intervention works, and that study would be impossible to do.”
But spotlighting businesses with direct interaction with customers could keep people safer, Swartzberg and other health experts said.
The California Department of Public Health would not say what information it is collecting from county departments on coronavirus outbreaks at businesses, or when it will begin publishing the AB685mandated information on its website. The department does publish data about cases at skilled nursing facilties by county, including business names, which is also available on some local health department websites.
The law doesn’t prevent health departments from listing business names as long as they protect sensitive information, like employee names, said Pam Dixon, a privacy expert and executive director at the nonprofit World Privacy Forum. AB685 prohibits the release of personally identifiable information about employees.
Listing outbreaks across the state by industry is the minimum requirement under the new law, Dixon said, and counties could do more if they chose to. “That’s the floor and then there’s wiggle room above that,” she said of the new disclosure requirements.
Oregon limits its weekly workplace outbreak disclosures to ones involving at least five people at sites with at least 30 employees.
In California, reporting outbreaks is largely left up to businesses, with only a few hundred state workplace safety inspectors spread out statewide.
Business groups like the California Chamber of Commerce are worried that even general information about outbreaks could hamper economic recovery.
“Any time an industry is labeled as having a COVID19 outbreak … that’s not good for business,” said Erika Frank, the trade group’s general counsel. Industryspecific numbers also don’t reflect steps a business has taken to curb the spread of the virus, or whether someone got it at work, Frank added.
Already struggling businesses could face enduring damage to their reputation and revenues if outbreaks, regardless of their cause, become public knowledge, said Rodney Fong, CEO of the San Francisco Chamber of Commerce.
Legislation and executive orders signed by Gov. Gavin Newsom last year expanded a presumption in certain professions that workers infected with the virus got it on the job for workers’ compensation cases. Without those changes, workers might have struggled to prove where they got infected.
Many frontline workers in food and agriculture work in crowded conditions where social distancing is difficult but also live in cramped housing and share transportation to work, blurring the origins of viral spread. Studies have shown that essential workers passing the virus to one another at work is a significant risk, not just to themselves but their families.
Labor groups and unions have pushed hard for more transparency from employers during the pandemic.
Unions and workers advocated successfully last year for emergency regulations at the state’s Occupational Safety and Health Standards Board. Those rules, which partly overlap with the new law, took effect last year. They require businesses to tell employees about outbreaks, along with creating plans to curb the virus, among other requirements. Regulators can issue fines and citations against companies that do not follow the new requirements. They do not require broad public disclosure, however.
Last week the U.S. Department of Labor also released guidance for businesses on creating infection prevention plans. That guidance is similar to the new California rules but is not binding
Groups including the state chamber opposed the new rules, calling them unclear and a burden on businesses.
Employees may be getting more information about the virus at work, but the public is still largely in the dark about outbreaks at businesses.
Only one Bay Area county, Contra Costa, released information on workplace coronavirus outbreaks to The Chronicle on request. That list showed almost 70 businesses with confirmed ongoing outbreaks as of Jan. 22. Fewer than 20% of recorded virus exposures happened in the workplace, according to an email from a county spokesman. Gatherings at homes or elsewhere made up about 70% of exposures while 1015% happened at longterm care facilities.
Other health agencies declined to release names of businesses, offering varying justifications that some experts said did not always stand up to legal or logical scrutiny.
San Francisco said it does not provide public data on workplace infections.
“Due to asymptomatic transmission and incomplete data, providing this sort of data could mislead the public,” a spokesperson said.
Santa Clara County said it did not have workplace outbreak information to share and could not explain how it planned to comply with the new law requiring them to collect that information.
Napa County said that that since Jan. 1 there have been eight workplaceassociated outbreaks reported affecting 34 workers, but declined to provide specifics, including the industry breakdown required by AB685. Alameda County claimed HIPAA, a federal medicalprivacy law, limited what they could disclose. Dixon, the privacy expert, said that law likely did not apply to the situation.
Solano County specified outbreaks at nursing homes and other assistedliving facilities but declined to provide names, citing ongoing health investigations. Officials said the responsibility of notifying employees about positive cases at work rests with employers.
Sonoma County declined to provide the names of businesses that had experienced outbreaks.
Laine Hendricks, a spokesperson for Marin County, said it was not required to by law to disclose detailed information and chose not to release it. Marin has seen at least 54 workplace coronavirus outbreaks since the start of the pandemic, she said, and nearly 1,400 employees who tested positive for the coronavirus have been referred for investigation to the county. San Mateo County did not respond to requests seeking comment.
Berkeley, which has its own health department, tracks and investigates workplace outbreaks and cases, but does not disclose business names. “Our primary goal for public health information has been to notify the public when there is actionable information that can protect public health and save lives,” City Communications Director Matthai Chakko said in an email. “We have publicized incidents, such as measles, when that information can help the public take action,” he added.
Outing and punishing companies that knowingly and negligently put their workers, and by connection the public, at risk of infection could be a more effective approach than the blanket disclosure practiced in L.A., said Dr. John Balmes, a professor at UC Berkeley and UCSF and a workplace health expert.
He pointed to meatpacking plants that allowed the virus to run rampant through cramped facilities in California and elsewhere in the U.S. as examples of businesses the public should be made aware of.
The lack of a centralized approach to releasing and acting on such information posed public health risks, he added.
Grocery store outbreaks could also be crucial information for people in deciding where to shop, said Swartzberg, the epidemiologist. But even then, more information would be necessary, like how many workers were affected. What if only a single employee got sick, and they got infected at home? Swartzberg said he could see businesses viewing disclosure in such cases as unfair.
He pointed out that health departments disclose other health and safety violations: “I certainly appreciate public health announcements of salmonella outbreaks or rats at restaurants.
“Health departments are trying to thread a needle between doing everything they can to protect the public but at the same time, trying not to harm businesses that are hanging on by their fingernails,” he said.