In the closing submissions of the Ruby Princess inquiry, NSW Health was criticised for making three crucial mistakes when handling the arrival of the ship, when it docked in March.
After more than a dozen days of hearings since April, the inquiry into the cruise ship’s COVID-19 outbreak heard health officials should have prioritised the rapid testing of the initial swabs when the Ruby docked.
Those passengers who tested positive on the morning of March 19, should have transferred to quarantine, which would have resulted in limiting the spread of the virus.
But what happened instead was a series of mistakes from an incorrect assessment of the ship as “low risk”, a decision, Richard Beasley, counsel assisting the inquiry, said was a “serious mistake”.
He also told the inquiry that permission for the ship to dock should not have been granted before COVID-19 swabs taken on board had been tested and results returned immediately. Mr Beasley also said that a NSW Health team should have boarded and tested everyone with symptoms.
Mr Beasley said NSW Health made a “group mistake” in not fully updating an arrival form handed out on 18 March. The form asked passengers to report if they had been in “mainland China, Italy, Iran, South Korea, Cambodia” and other then-Covid-19 hotspot countries in the past 14 days.
However, by that date, the policy had changed to include all international travel, but this was not reflected on the arrival card.
NSW Health should have requested an updated log, Mr Beasley said, and the ship’s doctor Ilse Von Watzdorf should have provided one, or at least made a phone call to inform NSW Health that a large number of passengers had presented with acute respiratory illness in the 24 hours before the ship docked at Circular Quay.
“She could have done that and in my submission, without saying more about it, she should have,” Mr Beasley said. However, he said: “she did what she was asked to do.”
Commissioner Bret Walker said NSW Health’s risk assessment process, in particular, the use of low, medium and high-risk categories, was a distraction from the important question: “what precautions are necessary?”
“Everything I’ve understood from health submissions is, regardless of what the thinking should have been, is ‘this is low risk and the only reason we’re taking swabs is to be ultra-cautious’,” Mr Beasley said.
NSW Health did not receive the results of the swabs removed from the Ruby Princess at 3am on the 19th until 10am the following day, a length of time Mr Beasley said was “unacceptable.”
“The swabs weren’t taken for fun,” he said. “The process should have been, these tests were taken as soon as possible.”
It was also heard that the Ruby Princess’ doctor had emailed a NSW Health representative about not having enough swabs to test passengers.
“There is evidence of email exchanges between [the ship’s senior doctor] Dr Ilse von Watzdorf and [NSW Health senior epidemiologist Kelly-Anne] Ressler, about difficulties Von Watzdorf was having in sourcing a sufficient number of swabs,” said Mr Beasley.
“Ms Ressler provided Dr Von Watzdorf with about 25 swabs but Von Watzdorf was told by Ms Ressler to make sure she has enough swabs. The evidence is Von Watzdorf was attempting to source swabs.
“This was not ignored by NSW Health, was not ignored by Princess or Carnival or Dr Von Watzdorf.”
However, Walker noted: “I think there is room for criticism that such a large enterprise was not able in a timely fashion to meet a global emergency with basic supplies.”
Either way, Mr Beasley said that passengers “should not have under any circumstances” disembarked.
He said, instead, what should have happened is “the swabs that went off the ship at 3am should have been immediately tested. Health assessment panel should have boarded the ship and taken swabs from everyone who was a suspect case of COVID-19, immediately. All passengers should have been confined to their cabins.”
“As soon as a positive result was known, which would have been still in the early hours of the morning of the 19th of March, the only practical course then is that all passengers and crew are securely removed from the ship because they are all suspect cases of COVID, and they are taken into what I’ll just call quarantine” Mr Beasley said.
The inquiry will hear further submissions on today, with Mr Walker due to hand down his report on August 14.