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A deadly COVID-19 outbreak at Kaiser Permanente San Jose Medical Center has grown to more than 90 cases, the Santa Clara County Public Health Department said Tuesday.

At least 15 patients and at least 77 staff have been infected, with one additional staff member still needing verification on a lab result, the health department said.

On Christmas Day, an employee wearing an air-powered tree costume walked the hallways of the emergency department at the hospital. Kaiser said the costume “likely” is responsible for the employees getting COVID-19, including a registration clerk who later died.

The health department said the source of the outbreak is still under investigation.