NSW Health official apologises in teaful Ruby Princess inquiry
A government health official has been brought to tears during a tense inquiry into the handling of the Ruby Princess fiasco which the commissioner has branded a "reprehensible shortcoming in NSW Health".
A NSW Health official has broken down in tears while apologising for her department’s failures in dealing with the notorious Ruby Princess cruise ship coronavirus bungle.
Epidemiologist Kelly-Anne Ressler cried as Commissioner Bret Walker SC questioned why he shouldn’t rule that there had been a “reprehensible shortcoming in NSW Health” over the fiasco.
“All I can say is that I’m very sorry it turned out the way it did. It was not my intention. Myself and my colleagues in the public health unit were working very hard on this,” she said.
“If we could do it again it would be very different.”
Ms Ressler agreed it was “unsatisfactory” that more sick passengers onboard the ship were tested for influenza than were tested for COVID-19. She said she was not aware of any discussions within NSW Health about the lower rate of coronavirus tests.
“Until you raised it with me now I wasn’t aware that it was so unsatisfactory,” she told Mr Walker.
“It appears to have been routine that on these cruises more people would be tested for influenza than were tested for COVID-19. I don’t understand how that fits within the protocols,” Mr Walker said.
“The purpose this protocol had to protect the Australian community against future contagion doesn’t sound very difficult or complicated in its principles… and yet seems most imperfectly not to have been observed, is that correct?”
“Yes,” Ms Ressler said.
A key aspect of Ms Ressler’s evidence involved questions about whether doctors on the Ruby Princess had ensured passengers went into isolation after developing either respiratory illness or fever.
Ms Ressler said previously in her career, cruise doctors had “resisted having to isolate people with a cough and people who had mild respiratory illness".
"I've worked with ships for a long time and I understand their internal protocols and I understood they required people to be isolated for influenza like illness, and so that is what I was used to," she said.
Mr Walker also slammed the South Eastern Sydney Local Health District worker for claiming she only had power to ensure the liner was following its own health policy.
“Actually, you could find out whether they were following Australian protocol, and if they did not, deal with them accordingly. That’s simply incorrect,” he said.
“I’m very concerned that you may have tried to mislead me with that answer.”
“It was not my intention commissioner,” Ms Ressler said.
“What I am trying to figure out is what lies behind this image you have just given us of little old NSW and great big cruise companies, which if I may say so sounds both unrealistic and offensive,” he said.
When asked whether the state government policy was deficient, Ms Ressler said “the practice was extremely challenging.”
“What is challenging about suggesting to a ship… they will have to show compliance with a NSW protocol, what’s challenging about that?” Mr Walker asked.
“It’s difficult for me in my role as an epidemiologist, in a local public health district, to insist on the practices of massive cruise ship companies,” she said.
Ms Ressler agreed that the requirement for guests to isolate on board only if they had both respiratory illnesses and fevers would have been calculated to reduce the number of passengers having to stay in their cabins, adding it was a barrier to reporting symptoms.
Updates
Text messages between cruise doctor and NSW Health revealed
Jessica McSweeney
When test results proved some Ruby Princess passengers had COVID-19 one day after 2700 passengers disembarked in Sydney, the cruise ship’s senior doctor messaged the NSW Health official who’d announced they’d been given the green light to leave.
“I keep asking myself what I could have done better to protect people,” Dr Ilse Von Watzdorf texted via Whatsapp.
“There will be more cases, probably a lot,” epidemiologist Kelly-Anne Ressler warned.
The notorious vessel has since become the single biggest source of infection nationally, and during emotional testimony at a commission of inquiry, Ms Ressler admitted mistakes were made by her state government department.
“It looked like a flu outbreak, and everybody was being told to go into 14-day isolation, and there were no new cruises happening,” she said.
“And we just had to get everybody home and the cruising stopped. And this was the last day that passengers were arriving.”
A patient log given to health authorities one day before the liner docked in Sydney on March 19 showed 0.95 per cent of those on board had flu-like symptoms.
Under state government protocols, a respiratory outbreak of more than one per cent of guests was an important criteria allowing a higher biosecurity risk rating which would have mandated health officers to board the ship and conduct extensive screening.
Commissioner Bret Walker SC asked Ms Ressler why that figure wasn’t close enough to the arbitrary threshold to trigger a more serious response, considering the risks involved with the deadly disease.
“We should have had a buffer. I acknowledge that,” she said.
“I was nervous about the decision but I was okay with the decision, because we had 24 of 36 (people test) positive for flu.”
Ms Ressler said she gave weight to Dr Von Watzdorf’s opinion that the cruise ship had an influenza outbreak, and passed that on to the NSW Health assessment panel.
–Lucy Hughes Jones
MISSED CHANCE!
Kyle Pollard
Commissioner Bret Walker SC has said a NSW Health official's answer was "unrealistic and offensive".
Epidemiologist Kelly-Anne Ressler said that she was only able to ensure cruise ships follow their own plan for virus outbreaks, rather than the NSW Health standards.
Commissioner Walker said the picture Ms Ressler painted of health authorities as "little old NSW and big cruise ship companies" was "unrealistic and offensive".
Ms Ressler later amended her answer to agree that NSW Health could compel cruise ships to comply with state protocols.
QLD TRY! HARRY GRANT
Kyle Pollard
Anglicare has announced today the tragic death of a 16th resident at Newmarch House aged care facility in Penrith.
It comes as a worker for the federal government contractor Aspen Medical was stood down for breaching infection controls at the virus plagued Newmarch House. The home’s operator Anglicare confirmed in a statement it had asked Aspen Medical to stand down the care worker because they incorrectly used Personal Protection Equipment.
“The reason why the person was stood down was for breaches of the PPE protocol. We take our PPE protocols seriously. It’s vital to protect those we’re caring for from this terrible virus,” the statement said.
Picture: Richard Dobson
However the private contractor hit back this afternoon, saying they were still waiting for critical information on the incident from Anglicare more than a day after the worker was stood down.
“We are still waiting on a detailed incident report from Anglicare in relation to a member of our surge support agency staff who was stood down yesterday morning. Once we have the facts, we will investigate the matter thoroughly and provide our staff member with a fair and balanced hearing. We continue to support the residents of Newmarch House with a team of 35 healthcare professionals on a roster reporting to the facility management team,” the statement said.
“Aspen Medical was asked to provide surge staff to support to Anglicare during this outbreak of COVID-19 at Newmarch House with effect from 20 April 2020 .”
Federal aged care minister Richard Colbeck sent Aspen Medical into the facility last month to help backfill some of the 75 per cent of the normal workforce who were in isolation.
–Nick Hansen
16th death at Newmarch House as worker stood down
Anglicare has announced today the tragic death of a 16th resident at Newmarch House aged care facility in Penrith.
It comes as a worker for the federal government contractor Aspen Medical was stood down for breaching infection controls at the virus plagued Newmarch House. The home’s operator Anglicare confirmed in a statement it had asked Aspen Medical to stand down the care worker because they incorrectly used Personal Protection Equipment.
“The reason why the person was stood down was for breaches of the PPE protocol. We take our PPE protocols seriously. It’s vital to protect those we’re caring for from this terrible virus,” the statement said.
Picture: Richard Dobson
However the private contractor hit back this afternoon, saying they were still waiting for critical information on the incident from Anglicare more than a day after the worker was stood down.
“We are still waiting on a detailed incident report from Anglicare in relation to a member of our surge support agency staff who was stood down yesterday morning. Once we have the facts, we will investigate the matter thoroughly and provide our staff member with a fair and balanced hearing. We continue to support the residents of Newmarch House with a team of 35 healthcare professionals on a roster reporting to the facility management team,” the statement said.
“Aspen Medical was asked to provide surge staff to support to Anglicare during this outbreak of COVID-19 at Newmarch House with effect from 20 April 2020 .”
Federal aged care minister Richard Colbeck sent Aspen Medical into the facility last month to help backfill some of the 75 per cent of the normal workforce who were in isolation.
–Nick Hansen
PRESSURE BUILDS
Kyle Pollard
A NSW Health official says she was concerned the Ruby Princess cruise ship failed to test nearly 200 sick passengers on a previous voyage in March who showed possible coronavirus symptoms.
Commissioner Bret Walker SC grilled epidemiologist Kelly-Anne Ressler about an earlier docking of the ship on March 8, where authorities delayed disembarkation in Sydney while unwell travellers and crew were assessed.
Government health authorities had rated the vessel’s biosecurity level as medium, primarily because two ill guests had recently been to Singapore.
They’d come onboard expecting to assess 170 people, but instead more than 360 passengers and crew who identified as suffering respiratory symptoms were assembled following a call out.
Ms Ressler said 240 of those gathered had some kind of symptoms, while the rest presented for assessment due to previous travel history.
The passengers and crew gathered for assessment were sitting close together, a fact which concerned Ms Ressler, the inquiry heard.
The inquiry heard the ship’s medical team had only swabbed 30 people for influenza, while there weren’t any swabs available for COVID-19 testing.
“Doesn’t that, on its face, indicate that this is a ship with deficient compliance… regarding swabs?” Mr Walker asked.
“Yes… the ships were having trouble finding swabs,” Ms Ressler replied.
“Do you recall that quite striking deficiency – zero when there perhaps should have been 170, 30 when there perhaps should have been 170 – do you recall that being the subject of any discussion between you and your colleagues?” he asked.
“Yes, it was a concern and why I kept pushing for some information to come from the state level or the commonwealth level to cruise ships about doing this,” Ms Ressler said.
When the ship’s doctor sent the patient log to NSW Health on March 7 before docking, the authorities asked the Ruby Princess to test only the two people who’d visited Singapore and anyone else who subsequently presented with worrying symptoms at the infirmary.
“As an epidemiologist you understand testing is done in order to achieve some kind of public health outcome. Did you understand what public health outcome would be achieved by not taking swabs from 170 people?” Mr Walker asked.
“We were applying a testing criteria that was looking for positive travel history plus respiratory symptoms,” Ms Ressler said.
Once on board, NSW Health assessors took COVID-19 swabs from nine passengers which all came back negative, the inquiry heard.
–Lucy Hughes Jones
NSW Health official concerned over testing failure
A NSW Health official says she was concerned the Ruby Princess cruise ship failed to test nearly 200 sick passengers on a previous voyage in March who showed possible coronavirus symptoms.
Commissioner Bret Walker SC grilled epidemiologist Kelly-Anne Ressler about an earlier docking of the ship on March 8, where authorities delayed disembarkation in Sydney while unwell travellers and crew were assessed.
Government health authorities had rated the vessel’s biosecurity level as medium, primarily because two ill guests had recently been to Singapore.
They’d come onboard expecting to assess 170 people, but instead more than 360 passengers and crew who identified as suffering respiratory symptoms were assembled following a call out.
Ms Ressler said 240 of those gathered had some kind of symptoms, while the rest presented for assessment due to previous travel history.
The passengers and crew gathered for assessment were sitting close together, a fact which concerned Ms Ressler, the inquiry heard.
The inquiry heard the ship’s medical team had only swabbed 30 people for influenza, while there weren’t any swabs available for COVID-19 testing.
“Doesn’t that, on its face, indicate that this is a ship with deficient compliance… regarding swabs?” Mr Walker asked.
“Yes… the ships were having trouble finding swabs,” Ms Ressler replied.
“Do you recall that quite striking deficiency – zero when there perhaps should have been 170, 30 when there perhaps should have been 170 – do you recall that being the subject of any discussion between you and your colleagues?” he asked.
“Yes, it was a concern and why I kept pushing for some information to come from the state level or the commonwealth level to cruise ships about doing this,” Ms Ressler said.
When the ship’s doctor sent the patient log to NSW Health on March 7 before docking, the authorities asked the Ruby Princess to test only the two people who’d visited Singapore and anyone else who subsequently presented with worrying symptoms at the infirmary.
“As an epidemiologist you understand testing is done in order to achieve some kind of public health outcome. Did you understand what public health outcome would be achieved by not taking swabs from 170 people?” Mr Walker asked.
“We were applying a testing criteria that was looking for positive travel history plus respiratory symptoms,” Ms Ressler said.
Once on board, NSW Health assessors took COVID-19 swabs from nine passengers which all came back negative, the inquiry heard.
–Lucy Hughes Jones
Commissioner brands health official's testimony as "offensive"
Jessica McSweeney
Commissioner Bret Walker SC has said a NSW Health official's answer was "unrealistic and offensive".
Epidemiologist Kelly-Anne Ressler said that she was only able to ensure cruise ships follow their own plan for virus outbreaks, rather than the NSW Health standards.
Commissioner Walker said the picture Ms Ressler painted of health authorities as "little old NSW and big cruise ship companies" was "unrealistic and offensive".
Ms Ressler later amended her answer to agree that NSW Health could compel cruise ships to comply with state protocols.
BACK UNDER WAY!
Kyle Pollard
The Ruby Princess inquiry commissioner has blasted the wording of a draft NSW Health policy for cruise ships docking amid the COVID-19 pandemic as “very poorly chosen.”
The draft procedure for risk assessing cruise ships entering Australia calls for liners to flag any respiratory illness outbreak affecting at least one per cent of people on board that aren’t explained by positive influenza results.
But Commissioner Bret Walker SC said coronavirus can’t be ruled out simply due to a positive flu test, stating “coinfection means that having one doesn’t preclude you from having the other.”
He questioned a NSW Health official about that aspect of the document, which was prepared on February 19 – one month before 2700 passengers disembarked the ill-fated liner in Sydney.
“This is a screening protocol for public health to protect the Australian community,” he said.
“It strikes me that language… is very poorly chosen.”
“I think it was very, very difficult to know how to find cases of COVID on cruise ships and this document could have done it better,” NSW Health epidemiologist Kelly-Anne Ressler said.
NSW health doesn’t require cruise ships to keep a respiratory diseases log – but most vessels including the Ruby Princess do.
Ambulance workers and officials from the NSW Port Authority, Carnival Australia and NSW Health will give evidence at the hearings this week.
But members of the expert NSW Health panel which categorised the Ruby Princess as having a low biosecurity risk, before COVID-19 test results for sick travellers came back, will not testify this week.
Passengers on both Ruby Princess cruises departing Sydney for New Zealand on February 24 and March 8 cruises have been invited to contact the inquiry by end of this month.
–Lucy Hughes Jones
Screening protocol for ships 'poorly chosen'
The Ruby Princess inquiry commissioner has blasted the wording of a draft NSW Health policy for cruise ships docking amid the COVID-19 pandemic as “very poorly chosen.”
The draft procedure for risk assessing cruise ships entering Australia calls for liners to flag any respiratory illness outbreak affecting at least one per cent of people on board that aren’t explained by positive influenza results.
But Commissioner Bret Walker SC said coronavirus can’t be ruled out simply due to a positive flu test, stating “coinfection means that having one doesn’t preclude you from having the other.”
He questioned a NSW Health official about that aspect of the document, which was prepared on February 19 – one month before 2700 passengers disembarked the ill-fated liner in Sydney.
“This is a screening protocol for public health to protect the Australian community,” he said.
“It strikes me that language… is very poorly chosen.”
“I think it was very, very difficult to know how to find cases of COVID on cruise ships and this document could have done it better,” NSW Health epidemiologist Kelly-Anne Ressler said.
NSW health doesn’t require cruise ships to keep a respiratory diseases log – but most vessels including the Ruby Princess do.
Ambulance workers and officials from the NSW Port Authority, Carnival Australia and NSW Health will give evidence at the hearings this week.
But members of the expert NSW Health panel which categorised the Ruby Princess as having a low biosecurity risk, before COVID-19 test results for sick travellers came back, will not testify this week.
Passengers on both Ruby Princess cruises departing Sydney for New Zealand on February 24 and March 8 cruises have been invited to contact the inquiry by end of this month.
–Lucy Hughes Jones
HALFTIME: QLD 12 - NSW 6
Kyle Pollard
The ship’s chief doctor Ilse Von Watzdorf forgot to send an updated log detailing which guests had been tested for coronavirus, forcing NSW Health workers to chase up the final data.
Counsel assisting Richard Beasley said an update provided after passengers had left the vessel revealed “many more passengers who had identified as having attended the medical centre with both acute respiratory disease and influenza-like illness”
NSW Health epidemiologist Kelly-Anne Ressler messaged Dr Von Watzdorf on the afternoon of March 20 – 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 texted via WhatsApp.
Dr Watzdorf apologised for the oversight, and later told the hearing logs were not updated in real time, and often had to be adjusted hours later because of intense workload demands.
“I had the final updated log in a draft box, the day just … did not have enough hours,” Dr Von Watzdorf said.
