Ruby Princess inquiry: The real reason passengers were disembarked
A senior NSW Health official has told the Ruby Princess inquiry authorities didn’t delay the cruise ship’s Sydney disembarkation until COVID-19 test results came back for one reason only.
NSW
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Health authorities allowed passengers to disembark the Ruby Princess cruise ship in Sydney despite pending COVID-19 tests because they had flights to catch, and then glossed over failures in a NSW government “spin” report, an inquiry heard.
NSW Health communicable disease senior medical officer Dr Sean Tobin was one of several experts who allowed 2,700 guests to leave the ill-fated liner at Circular Quay without proper health checks on March 19.
Commissioner Bret Walker SC slammed the department’s “apparent tolerance” of the vessel’s dismal COVID-19 testing rates as a serious deficiency.
He grilled Dr Tobin about why his team hadn’t waited for the results of 10 coronavirus swab results, which were taken after more than 100 guests had presented to the ship’s medical centre with acute respiratory illnesses.
“I presently don’t understand why it would have been too much trouble to prevent people from scattering until you at least had results from the very few tests,” he said.
Counsel assisting Richard Beasley SC added: “it seems screamingly obvious from a risk prevention approach that you keep people on board until those test results are known.”
But Dr Tobin said he was concerned with getting people home and onto flights, essentially granting passengers personal liberty to get off what Mr Walker said was often “unkindly called a petri dish of infection.”
When Mr Walker questioned “why nothing was done concerning what I am calling an enormous deficiency” in the number of swabs taken by the ship, Dr Tobin admitted he did not notice the breach of guidelines he’d helped create.
“Can you think of any excuse for not noticing it?” Mr Walker asked.
“No,” Dr Tobin said.
“Do you agree it was deficient in your professional conduct not to notice?” Mr Walker asked.
The state’s chief human biosecurity officer replied that more test supplies would have been preferable but it was “better than nothing”, which Mr Walker said bordered on a “flippant understatement.”
“Nothing would have been an outrageous failure to comply with what was required, yes?” Mr Walker asked.
“Yes,” Dr Tobin agreed.
Dr Tobin agreed there was no mention of the failing in an undated, anonymous and confidential NSW Health report on the scandal that Mr Walker slammed as “distracting PR” and “spin.”
“Did you understand this was supposed to be warts and all? Was this a report that was meant to reveal not conceal shortcomings?” Mr Walker asked.
“It wasn’t my understanding it was meant to conceal shortcomings,” Dr Tobin said.
Dr Tobin, who helped prepare the report, agreed there were omissions and mistakes regarding other aspects of the department’s risk assessment, including a false suggestion the chance of cross-infection had been considered in the decision not to leave passengers on board.
“I don’t think it was a deliberate intention to mislead,” he said.
“Spin is a form of dishonesty, half truth perhaps, weasel words certainly, but all with a bias to producing a particular intended effect on the reader regardless of the merits. Something that an impartial public servant would have nothing to do with, do you agree?” Mr Walker asked.
“Yes,” Dr Tobin said.
Dr Tobin agreed it wasn’t an unreasonable approach to have confined sick passengers to their cabins for up to nine hours pending the swab results, but said his preference would have still been to let everyone leave based on the information he had at the time.
“Would it still be regarded as overkill to quarantine people arriving from overseas now?” Mr Walker asked.
“Not today, but at that time,” Dr Tobin said.
When giving the green light for disembarkation, Dr Tobin had not seen the ship’s acute respiratory disease logs which indicated daily increases in coronavirus symptoms from March 15.
The panel had been given a pre-arrival assessment form which stated 2.7 per cent of passengers and crew had presented with respiratory illness but slightly less than one per cent had influenza-like illness, which just met the state’s low-risk criteria.
Dr Tobin said at the time he understood that the spread of the deadly disease by people who were not showing symptoms was rare.
“Their onward travel would be a lower risk to the community,” Dr Tobin said.
“It’s a risk that did materialise in this case… are you telling me it could not have been prevented by reasonable action?” Mr Walker said.
“No,” Dr Tobin replied.
The Ruby Princess has been linked to around 700 infections nationwide, 22 deaths and cluster outbreaks in northwest Tasmania and New Zealand.
Public Health Unit Director Professor Mark Ferson, who was also on the expert panel, conceded his February comments over a draft policy to prevent the spread of coronavirus in Australia through cruise liners were “stupid.”
In an email sent to several senior physicians, Prof Ferson said the downside of conducting extensive screening before disembarkation was “the cost and wear on staff” while if a passenger was subsequently diagnosed with the deadly disease “we will be asked why we missed a case and it will look worse for everyone.”
On Wednesday Prof Ferson clarified he had not been suggesting that taking such precautions could end up in a PR disaster if a COVID-19 case went undetected.
“This was a stupid thing to say,” Prof Ferson said while giving evidence.
“I was very concerned about what appeared to be my staff having to take on greater work when they were already extremely busy.”
In another email sent on February 13, Prof Ferson added that the proposed requirement for health teams to board every ship and swab all passengers with potential COVID-19 symptoms regardless of their travel history was “very much overkill.”
The inquiry continues.