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In another twist to the story of the cruise ship at the centre of the largest COVID-19 cluster in Australia, health officials have revealed a doctor’s report arrived AFTER the Ruby Princess docked in Sydney showing more cases.

Had it been filed on time, it probably would have stopped passengers leaving without checks.

According to The Australian newspaper, up to a dozen passengers whose symptoms were not provided to NSW Health authorities were on a doctor’s log not filed until one day after the ship docked.

Health officials told the paper it would have likely raised the ship’s risk profile from “low” to “medium” — mandating a full health screening of passengers.

The Australian reported: “A NSW government official said the extra names would have almost certainly changed the ship’s biosecurity rating from “low” to “medium” risk, a determination that would have mandated health officers boarding the ship to conduct extensive screening.”

Passengers were allowed off the ship without checks, even though 13 passengers were being tested for COVID-19. Some 21 deaths and at least 700 infections nationwide have been connected to the Ruby Princess outbreak.

Today, epidemiologist Kelly-Anne Ressler broke down and apologised for the NSW Health department’s failures at the special inquiry.

“All I can say is that I’m very sorry it turned out the way it did. It was not our intention. Myself and my colleagues at the public health unit were working very hard on this. We did what we could. And if we could do it again, it would be very different.”

The special commission of inquiry heard under guidelines implemented the same day the ship docked, NSW Health had to be informed if there had been a respiratory outbreak of more than 1 per cent of passengers on board.

Counsel Assisting the Inquiry, Richard Beasley SC, said a NSW Health team assessed the vessel as “low risk” before the ship arrived.

The ship’s log used to make that assessment recorded 36 of the 3,795 people on board had presented to the medical centre with relevant symptoms — 0.94 per cent.

As the 1 per cent threshold had not been reached, passengers were allowed to disembark  the next day without teams from NSW Health boarding to ship to make assessments.

The inquiry heard senior physician on the ship Ilse Von Watzdorf first filed one log, but had another in her inbox which was sent a day after the ship docked.

Dr Von Watzdorf received a text from Ms Ressler, on the afternoon of March 20. The text exchange took place in the hours after four positive cases of COVID-19 were confirmed from patient swabs.

“Some of the people swabbed aren’t on the log I have. Did you add any more patients after you sent it to me, and do you have an updated log?” Dr Ressler wrote.

According to The Australian report, Dr Von Watzdorf confirmed there was an updated log and apologised for the oversight.

“I had the final updated log in a draft box,” she said. “It had just – the day just became – I did not have enough hours, I think.”

The Australian reported that it understands the updated patient logs, which recorded the names of sick passengers who presented to the medical centre in the 17 hours after that email was sent but before the ship docked, would have placed the ship at or above that threshold for general passenger checks.

Chief medical officer Brendan Murphy is on record as saying: “In retrospect, there were some decisions made that everyone regrets … clearly there were mistakes made.

“Everyone was doing their best in tricky and tense times at what was probably the peak of the outbreak.”

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