1920. Lack of SARS-CoV-2 transmission from a Healthcare Worker to a Cohort of Immunosuppressed Patients during the Omicron Surge, California, 2022

Abstract Background The Omicron surge caused a significant strain on the healthcare system, particularly as it relates to healthcare worker (HCW) infections. Occult infection transmission from HCWs to patients is an important area upon which infection control programs can continue to improve. Methods We conducted a retrospective chart review of 9 patients on the immunocompromised solid organ transplant service who were exposed to a highly infectious vaccinated and boosted healthcare worker across 2 days during the Omicron surge in January 2022. Results The index healthcare worker began to show symptoms shortly after rounds on the second day of clinical service. Nasopharyngeal rtPCR testing for SARS CoV 2 was positive, Ct value 15.9; a routine screening Covid19 test the day prior using an anterior nares swab had been negative. All 9 patients who were exposed and received follow-up testing on days 3-5 since exposure were negative for SARS CoV 2. One additional healthcare worker who was also exposed tested negative on follow-up testing despite several hours of close contact across 2 days. Both HCWs wore N95 respirators during all patient care and in breakrooms. Patient exposures were less than 15 minutes in duration, but also less than 6 feet in distance. Conclusion The index healthcare worker did not transmit SARS CoV 2 to a cohort of immunocompromised patients or to a fellow HCW despite being very infectious. The index HCW wore an N95 respirator during all patient encounters which could have reduced the chance for transmission. Disclosures All Authors: No reported disclosures.