A COVID-19 outbreak at St. Michael Medical Center in Bremerton has health care workers there ringing alarms after public health and hospital officials delayed notifying them of the virus spreading in several units.

The Bremerton outbreak comes amid dropping statewide COVID-19 infection rates.

The Spokane Regional Health District confirmed 37 new cases on Tuesday and no new deaths. There are now 5,125 cases in county residents, with more than half of those cases considered recovered. There are 43 people hospitalized with COVID-19 in Spokane hospitals, and 34 of them are Spokane County residents.

In Bremerton, the medical center alerted the Kitsap Public Health District that an employee had tested positive for COVID-19 on Aug. 4. After completing a case investigation, the health district found no close contacts at the hospital, however, according to the health district’s timeline.

Then on Aug. 13, based on other positive COVID-19 cases, the health district found five cases connected to one particular unit at the hospital. On Aug. 14, the Kitsap Public Health District declared an outbreak.

Workers there, represented by UFCW 21, say they were not notified of any employees testing positive or an outbreak until Aug. 17, however.

Cindy Franck, a nurse at St. Michael Medical Center for 20 years and a union member, told reporters Tuesday that she was not alerted to the outbreak until Aug. 17, at the earliest, if not later.

Rob Shauger, a certified nursing assistant at St. Michael Medical Center, said he learned about the outbreak from his brothers who saw local news reports.

At first, only close contacts on the unit with confirmed cases of COVID-19 were tested for the virus.

“Realistically with the resources we’ve been allocated towards this, we tried to do what contacts would have the biggest bang for our buck, so to speak,” Dr. Michael Anderson, chief medical officer at CHI Franciscan which operates the medical center, told reporters Monday.

On Aug. 14, the Kitsap Public Health District recommended testing all patients and staff on the unit, but by Aug. 18, the virus had spread to another unit.

As of Monday, the Kitsap Public Health District had confirmed 45 cases connected to the outbreak, with 30 cases in staff members and 15 cases in patients at the hospital. The virus has spread to at least three units, which are not admitting additional patients. Patients who were on those units have stayed, however, and they are being monitored and tested regularly, Anderson said.

Now all hospital staff members and patients are being tested, but workers say the test results are coming back slowly, preventing them from either returning to work or forcing them to make a difficult choice about going to work even if they aren’t experiencing symptoms.

Shauger and Franck were both tested on Thursday of last week. Both hospital employees got their test results back on Tuesday, including Franck who got a text saying her test came back negative during the press briefing. While waiting for results, as long as they are not displaying symptoms, employees are still able to go to work, however, depending on their risk evaluation.

Anderson told reporters Monday that the risk to each staff member returning to work differed and was evaluated using criteria from the Centers for Disease Control and Prevention.

For Shauger, that meant he was told to use his “best judgment” in evaluating whether or not he should return to work before his test results came back. He experienced no symptoms and passed the screening at work for the overnight shift on Monday evening. His test came back negative Tuesday morning after he worked overnight. The hospital has temperature and symptom check screenings for all employees.

Certain employees that have had direct exposures to those who tested positive are placed on administrative leave and out for 14 days. Shauger said that with so many employees out due to the 14-day exposure quarantine, staffing is tight.

UFCW 21 is calling for rapid testing for workers so that the results come back between 24 and 48 hours, as they do for hospital patients tested for the virus.

One of Shauger and Franck’s coworkers, who was supposed to be a part of the union’s press briefing on Tuesday, is instead in the emergency room fighting to breathe with COVID-19, they said.

”Our coworker that was positive was not even notified that he was exposed, and now he’s sick and in the ER today,” Franck said on Tuesday.

St. Michael Medical Center restricted visitation to just one visitor for end-of-life care scenarios when the outbreak was identified, and Anderson said they will continue to monitor and retest patients regularly.

Outbreaks at medical facilities have persisted throughout the pandemic, Department of Health data show. As of Aug. 15, there have been 117 outbreaks in health care settings, which are not long-term care settings. An outbreak in a health care setting is one or two cases confirmed and connected to that shared location, depending on whether it is an inpatient or an outpatient setting.

The Department of Health was on-site at St. Michael Medical Center on Tuesday. The Centers for Disease Control and Prevention has also conducted an on-site visit, UFCW 21 members said on Tuesday, which they were not notified about.

Dr. Gib Morrow, public health officer at the Kitsap Public Health District, said he expects more cases will be confirmed from the outbreak in the coming days.

The hospital is testing all staff members, and Shauger said there is now scheduled drive-up testing available to hospital workers.

Local and state health officials traced the outbreak to one employee.

Kitsap Public Health District officials reached out to the state health department for additional recommendations as the outbreak widened.

”This is not the first hospital to have one of these outbreaks, and we feel confident we will be able to help them control this,” Lindquist said.