Ruby Princess ‘ground zero’ in Tas outbreak: official probe

Official investigation finds the coronavirus outbreak in Tasmania’s northwest was likely sparked by two Ruby Princess cruise passengers.

The Ruby Princess leaves Port Kembla. Picture: AAP.

An official investigation has found the deadly coronavirus outbreak in Tasmania’s northwest was likely sparked by two returned Ruby Princess cruise passengers and fuelled by inadequate hospital practices.

The state government accepted the recommendations – designed to address the failures identified - in full, with Premier Peter Gutwein urging the public not to blame cruise ship passengers or health workers who unwittingly spread the virus.

“The report confirms that most likely ground zero for the outbreak at the North West Regional Hospital was the Ruby Princess,” Mr Gutwein said. “No passenger is to blame and no health care worker is to blame….This is simply a case of people going about their lives, going about their jobs, while this dreadful set of circumstances has ensued and wreaked havoc on so many people.”

Ruby Princess: Origins of a cluster. Source: Health Department

A Public Health Services preliminary report into the ongoing outbreak, which has infected 127 and killed 11 in the state’s northwest, was released on Thursday, finding the original source of the cluster was one or both returning cruise passengers.

“The original source of infection was most likely to have been one (or both) of two inpatients who were admitted to the North West Regional Hospital (near Burnie) with COVID-19 acquired on a cruise ship, the Ruby Princess,” the report concludes.

“Of the initial cases amongst staff at least one was a healthcare worker who had provided care directly to one of these patients. Following these initial infections, multiple potential chains of direct person-to-person transmission were apparent … between staff, or between staff and patients (in both directions).

“These transmission events occurred within the different northwest healthcare facilities through either the transfer of infectious patients or through infectious staff working in multiple locations including aged care facilities.”

The report found factors fuelling the infection spread included staff continuing to work despite experiencing respiratory systems, in most cases because they attributed these to allergies, asthma or other illnesses.

Other factors included regular staff meetings, such as shift handovers, occurring in confined spaces, potential shortcomings in infection control practices, and incomplete or delayed identification of close contacts of confirmed COVD-19 cases for immediate isolation.

As well, the highly anticipated report found infection was spread by “high levels of staff mobility between different healthcare facilities” and the transfer of undiagnosed infectious or incubating patients between different hospitals.

Statewide, there have been 219 COVID-19 cases and 12 deaths, the latest being an 86-year-old woman from the state's northwest confirmed on Thursday morning.

Director of Public Health Mark Veitch, the report’s chief author, suggested the scale of the northwest outbreak was down to late detection. “By the time we saw cases we were already into a second wave or perhaps a third wave of cases,” he said.

Chief Medical Officer Tony Lawler’s response to the report included recommendations to increase resources to prevent and deal with infection outbreaks in the region.

Professor Lawler also called for cultural changes to address medical staff “presenteeism”. “A significant proportion - 20 per cent - of COVID-positive healthcare workers worked while symptomatic,” he said.

“Reasons include the desire of staff to not let colleagues down, mistaking the symptoms of COVID-19 for other conditions, or concerns over perceived resource constraints.”

Professor Lawler also found a continued reliance on paper records, including clinical records and staff rosters, “hampered the timely management of potential close contacts”.

State Labor called for a royal commission into the outbreak. Mr Gutwein has promised a further expert inquiry once the crisis had eased.