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iii) In 3 (21%) clusters, diagnosis of the earliest case was delayed which may have facilitated transmission. Nosocomial cases decreased to low levels (0-2 per day) despite continuing high numbers of admissions of community-onset SARS-CoV-2 cases (40-50 per day) and before the impact of introducing universal face-masks or banning hospital visitors. Genomics was necessary to accurately resolve transmission clusters Our data supports unidentified cases, such as healthcare workers or asymptomatic patients, as important vectors of transmiss