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Brigham and Women's Hospital in Boston is being lauded for its transparency in reporting a cluster of nosocomial COVID-19 cases, but the hospital also serves as a cautionary tale for clinicians on becoming lax about precautions.

As of September 26, there were 34 people involved in the cluster (11 patients and 23 employees), according to a . Some 400 employees and 54 patients have undergone COVID-19 testing overall, and it's believed that more than 650 people may be connected to the cluster.

An investigation by the hospital's infection control team found numerous contributing factors, including a lack of physical distancing among staff who were unmasked while they were eating, and a "staff member with mild symptoms, consistent with historical seasonal allergies, [who] did not appreciate those symptoms as potentially related to COVID-19 and continued to work."

Also, many patients weren't masked during their interactions with staff, and providers weren't consistent in their use of eye protection, investigators found.

Finally, the first patient who tested positive had an aerosol-generating procedure before getting a positive test result.

While the exact source of the cluster remains undetermined, the infection control team said it believes the cluster has been contained within two inpatient units in the hospital's Braunwald Tower. Patients were moved off unit 16A which was closed for deep cleaning and an evaluation of its heating, ventilation, and air conditioning (HVAC) system. Unit 14CD was thoroughly cleaned and the infection control team documented a clear chain of transmission.

"This cluster is not impacting any other areas of the hospital or our outpatient clinics," according to the press release.

Clinicians on Twitter put in their two-cents worth.

"Gotta stay vigilant, folks," , of the University of Utah in Salt Lake City. "We are going to see more of these [incidents] if people get lazy about hygiene practices in hospital."

"I applaud Brigham & Women's on the transparency & sharing the investigation which reminds us all to keep our [guard] up in nosocomial settings," , an infectious diseases specialist at Boston University.

Bhadelia added that both hospitals and staff must remain vigilant: "Hospitals need to work with staff to figure out solutions to gaps that lead to outbreaks when expected human mistakes happen," she told 木瓜直播.

, a surgeon at Brigham and Women's, tweeted that she was "Proud to work at a transparent and accountable organization."

Brigham and Women's said it's offering free and voluntary testing for all employees who've been working on the main hospital campus since Sept. 14. The hospital also is testing all current inpatients, in addition to its current policy of requiring testing of all patients at admission and daily screening for symptoms.

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