SAN JOSE (CBS SF) — The outbreak of COVID-19 at a Kaiser Permanente emergency room in San Jose linked to a staffer wearing an inflatable costume on Christmas has worsened, with the outbreak spreading to patients at the hospital, according to health officials.

A statement from Santa Clara County Public Health said 78 staffers at Khad now tested positive, with one still needing verification of the positive test. There are now 15 patients at the hospital who have also contracted the virus, according to the statement.

One emergency room employee has died because of COVID-19 complications following of the outbreak, the county said.

Kaiser Permanente officials have blamed a staffer wearing an inflatable Christmas tree costume on December 25th for triggering the outbreak.

Last week, Kaiser’s San Jose Medical Center was issued a public health order violation for failing to timely report the original 43 COVID cases, which it reported on January 3.

According to the county’s public health order, employers are legally required to submit information about confirmed positive cases and close contacts within four hours after learning about the positive cases. Kaiser indicated the original outbreak involved staffers testing positive between December 27, 2020 and January 1.

The penalty for each violation is $1,000 for a total of $43,000, the county said.

The county said it has been determined that the virus that caused the outbreak was not the new variant of the COVID-19 virus first identified in the United Kingdom.