Borenstein: Kaiser keeps COVID, non-COVID patients in same units.

Unbeknownst to family and patients, Kaiser has been keeping COVID and non-COVID patients in the same hospital nursing units when bed space runs short. Kaiser refuses to say how widespread the practice has been or how many patients consequently contracted the deadly virus.

I learned of the practice when an elderly, immunocompromised relative hospitalized in Kaiser’s Oakland facility for an unrelated reason tested positive for the virus on the ninth day of her stay. She had tested negative on the first, third and sixth days in the hospital and had been permitted no outside visitors. The positive test was reconfirmed on the 10th day.

The relative, after being diagnosed Jan. 20 with COVID-19, was moved to an isolation room across the hall — on the same eighth floor she had been staying. Medical personnel told me that, because of staffing shortages, doctors shuttled between rooms in the unit with COVID-19 patients and those with uninfected patients.

In this case, the potential for virus spread was exacerbated because the patient was taken elsewhere in the hospital for surgery on that ninth day, just hours after being tested and before the positive COVID-19 result was received.

A Kaiser spokeswoman, responding to questions by email, said nursing units are split between COVID and non-COVID patients when hospitals are full. She declined to say how many patients have caught the virus as a result or which Kaiser facilities are affected.

But her answer suggests the practice was not limited to Oakland. “The number of mixed units varies depending on the status of the surge and the number of COVID-19 positive patients hospitalized at a given time within a Kaiser Permanente hospital,” wrote spokeswoman Kerri Leedy.

Nurses do not care for both types of patients on the same shift, Leedy wrote, but it is “possible” some doctors and housekeeping staff do, “depending on the individual’s assignment.”

Anyone entering COVID-19 patients’ rooms must don appropriate personal protective equipment and take it off and practice hand hygiene when exiting, Leedy wrote. Staff are required to always wear masks.

Dr. Nicholas Moss, Alameda County’s health officer, said he thinks state regulations permit the practice. He said he could not discuss COVID-19 case numbers or outbreaks at individual facilities.

It’s understandable Kaiser had to resort to extreme measures to handle the latest surge of patients, which tapped out many Bay Area and California hospitals. What’s troubling is the lack of transparency.

Kaiser and other hospitals have a responsibility to tell patients and their families about COVID-19 risks — starting with notification to uninfected patients that others in the same unit have the virus.

Kaiser’s approach to disclosure is circular. Asked if Kaiser warns COVID-free patients about the nearby infected people, Leedy responded, “This is certainly information that is available to patients and families if requested, and we have no intent to withhold it.”

Of course, one would have to know to ask. This same health care operation earlier in the pandemic was assuring patients that COVID and non-COVID patients were being kept separate.

There’s a balancing going on here. Kaiser, understandably, doesn’t want people with serious medical conditions avoiding needed treatment because they fear contracting the coronavirus. There’s ample evidence that people are forgoing care. But the best way to build trust is to be forthcoming with patients and staff.

Unfortunately, Kaiser keeps pushing the envelope. In January alone, the health care giant was fined or cited for the failure to timely report the Christmas Day coronavirus outbreak in San Jose that affected about 90 staff and patients; for allegedly failing to investigate and notify employees in Walnut Creek who had been exposed to the virus; and for allegedly requiring employees in San Leandro to use respirators with defective face shields and cracked helmets.

Now comes the issue of keeping COVID and non-COVID patients in the same nursing area. Kaiser doesn’t acknowledge that there might be a potential problem here.

In the case of my relative, whose COVID-19 case fortunately has been very mild after receiving an infusion of monoclonal antibodies, Kaiser repeatedly notes correctly that it’s not certain when the virus was contracted. But the negative test on the sixth day, followed by the positive test on the ninth day of hospitalization, indicates there’s a great likelihood the transmission occurred inside the hospital.

If the health care system won’t acknowledge there’s a potential problem, it’s sure not to fix it. That’s perhaps the biggest problem.