Report into the North-West outbreak highlights 17 recommendations for change
Symptomatic hospital staff mingling with patients and meetings in confined spaces are some of the contributors to the deadly North-West outbreak, a report has revealed. SEE THE TIMELINE
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SOME staff at the North West Regional Hospital continued to work while showing symptoms of coronavirus, a report by health officials into the deadly outbreak of the virus at the facility has revealed.
The interim report into what caused the cluster, released on Thursday morning, also revealed the Ruby Princess cruise ship was likely “ground zero” for the outbreak.
But people should not use the findings to apportion blame for the outbreak, Premier Peter Gutwein and health officials said.
A further probe into the outbreak — in a region which has seen 12 of the 13 Tasmanian deaths from coronavirus — will be done by independent experts in coming months.
SEE THE OUTBREAK TIMELINE BELOW
As at April 21, 114 people had been diagnosed with COVID-19 in the NWRH outbreak – 73 staff, 22 patients and 19 others including household contacts.
Among staff diagnosed, the report found 77 per cent attended work while infectious but many of them did not yet know they had the virus.
However, 29 per cent had symptoms on the same day as their last day at work and one fifth attended work on one or more days after the onset of symptoms.
READ MORE:
Infected staff mingling with other workers and treating patients
Ruby Princess ground zero for North-West outbreak
The rapid spread among staff was worsened by meetings in confined spaces and by health workers working across multiple facilities in the region.
The report found the likely source of infection was one or both patients admitted to the NWRH who acquired the virus on the Ruby Princess that docked in Sydney in mid-March.
They were admitted to the hospital on March 20 and March 26 respectively, and three cases among healthcare workers were confirmed between April 3 and 4.
One of the initial cases was a healthcare worker who had provided direct care to one of the patients from the cruise ship.
The number of confirmed cases spiked significantly in the following days, leaving authorities playing catch-up to bring the outbreak under control.
But Mr Gutwein said the report should not be used to point the finger at groups of people.
“No [cruise ship] passenger is to blame and no healthcare workers are to blame,’’ he said.
“This is just simply a case of people going about their lives, going about their jobs, while this dreadful set of circumstances has ensued and has wreaked havoc and misery on so many people.”
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Mr Gutwein said the strong work ethic of Tasmanians “can be our own worst enemy” and that those experiencing symptoms of illness should not turn up to work.
Health Minister Sarah Courtney said it was important lessons were learned from the North West outbreak to avoid similar situations were not repeated.
“What is clear is that COVID-19 is unlike any other health threat that we have faced in living memory,’’ she said.
“COVID-19 is a highly infectious, potentially deadly disease and Tasmania is not alone in falling victim to devastating hospital outbreaks.”
Tasmania’s chief medical officer Tony Lawler said it was “understandable” health workers had turned up to work despite displaying symptoms, but said addressing this issue was a priority.
“Often as healthcare workers seeing patients in their extreme states, we underestimate our own symptoms,’’ he said.
“People come to work when they feel they must because they don’t want to let their colleagues down and our patients down. We need to work to address this.”
Prof Lawler said health workers had experienced a “torrid time” in recent weeks and he had seen “troubling and disturbing” correspondence about negative treatment suffered by workers in the region’s communities.
Director of Public Health Mark Veitch said the outbreak progressed quickly after the first confirmed cases in staff members.
“Our impression was that by the time we saw cases, we were already into a second wave of cases and perhaps a third wave of cases that peaked towards the weekend of the 11th and 12th [of April],’’ he said.
Department of Health secretary Kathrine Morgan-Wicks said the report highlighted the importance of people being aware of their own health and to isolate themselves from their workplace if they have “even the mildest symptom”.
TIMELINE:
MARCH 19: The Ruby Princess cruise ship docks in Sydney.
MARCH 20: A Ruby Princess passenger is admitted to the medical ward of the North West Regional Hospital in Burnie. They are diagnosed with COVID-19.
MARCH 26: Another passenger from the ill-fated cruise ship is admitted to the same ward at the hospital, becoming the second person infected with the virus to be treated there.
MARCH 29-APRIL 2: Several healthcare workers at the NWRH experience onset of symptoms of coronavirus. Some work while symptomatic for up to six days.
MARCH 30: An elderly woman dies from coronavirus at the NWRH. That night, a man from the state’s South, who was also a passenger on board the Ruby Princess, dies in the Royal Hobart Hospital.
APRIL 3: Two cases of COVID-19 in healthcare workers at the NWRH are diagnosed.
APRIL 4: A further single case of coronavirus is confirmed in a healthcare worker at the hospital. An Outbreak Management Team is set up to respond to the outbreak.
APRIL 6: Cases among staff and patients within the NWRH and related facilities continue to increase. Two more cases are diagnosed. Police assistance is called in to support contact tracing efforts.
APRIL 7: The North-West records its second death from coronavirus, with a man in his 80s dying at the NWRH. It is the third death statewide from the virus, with all linked to travel on the Ruby Princess.
APRIL 7-8: A further nine cases are confirmed. A decision is made to transfer Ambulance Tasmania presentations from Devonport eastwards to the Launceston General Hospital. Visitor restrictions to hospitals and aged care facilities are extended statewide.
APRIL 8: The medical and surgical wards at the NWRH are closed to all new admissions.
APRIL 9: Guidelines relating to the definition of a close contact are reinterpreted, impacting the number of close contacts captured in tracing for notified cases.
APRIL 10: A man in his late 70s with COVID-19 dies at the NWRH, the state’s fourth death from the virus.
APRIL 11: Public Health Director Mark Veitch orders all household members of quarantining staff to be quarantined for the same time period as the staff member. Patients discharged since March 27 are told to stay in their homes for 14 days following discharge.
APRIL 12: The state’s fifth COVID-19 death, and fourth in the North-West, is announced. A woman in her 70s dies at the NWRH. The decision to close the NWRH and NWPH and related medical services is made. All staff who have worked in these areas since March 27 (about 1300) and their household members (a further 3000-4000) are put into quarantine for 14 days.
APRIL 13: An Australian Medical Assistance Team (AUSMAT) is tasked to fly into Tasmania, with expert cleaners engaged to carry out a deep clean of the hospital. Patients from the NWRH are transferred to the Mersey.
APRIL 14: A 91-year-old woman who was being treated at the MCH becomes the state’s sixth coronavirus death.
APRIL 17: A 72-year-old man dies from coronavirus at the MCH. The NWRH emergency department is reopened and is initially staffed by Australian Defence Force personnel under the leadership of AUSMAT.
APRIL 18: Tasmania records its eighth death from coronavirus, a 74-year-old man. He had been a patient at the NWRH and was later cared for at the MCH.
APRIL 24: A ninth death from coronavirus is announced, a 79-year-old North-West woman who was being cared for at the Launceston General Hospital.
APRIL 25: The death of a 90-year-old man from coronavirus is announced. He was being cared for at the MCH.
APRIL 26: Another life is lost due to COVID-19, with a man in his 90s at the MCH succumbing to the disease.
APRIL 27: Premier Peter Gutwein announces an independent review into the circumstances of the North- West outbreak. He also says a report prepared by state health officials has been completed and will be released to the public in full.
APRIL 30: A report by Tasmanian health officials on the COVID-19 outbreak in the region is released. It comes as the state records its 12th death from coronavirus, an 86-year-old woman who was being treated at the MCH. Later in the day, another death was confirmed, an 86-year-old woman who was being cared for at the same facility. It brought the number of COVID-19 deaths in the state to 13, 12 of them in the North-West.
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