NSW Health executives considered testing all cruise ship arrivals for COVID-19 would be “very much overkill” and could cause public relations problems for the department if they got it wrong, a special inquiry into the Ruby Princess heard on Tuesday.
A series of emails revealed by the inquiry showed that NSW Health considered requiring testing of all cruise ship arrivals for COVID-19 but decided against the policy.
The decision was made a month before the Ruby Princess’ disastrous disembarkation in Sydney on March 19, which NSW Health greenlighted despite passengers presenting with COVID-19 symptoms.
Twenty-one people from the Ruby Princess have since died and more than 650 have been infected with COVID-19. The ship has also been linked to further deadly clusters in Tasmania and New Zealand.
The decision also followed the deaths of six people and infection of more than 800 with COVID-19 on the Diamond Princess in Japan, the inquiry heard, at a time when cruise ships had the second most virus cases in the world after mainland China.
“We will be asked why we missed a case and it will look worse for everyone,” NSW Health public health unit director Mark Ferson said in an email to several epidemiologists about a policy for limiting the spread of COVID-19 from cruise ships.
It would also be costly and wear down staff, he said.
In a separate email, Professor Ferson said screening passengers who had not travelled to countries with a COVID-19 outbreak would be “very much overkill”.
It would be enough to ensure doctors on board cruise liners gave out face masks and information about the virus and got the contact details of passengers with symptoms.
Giving evidence before the inquiry on Tuesday, NSW Health chief human biosecurity officer Sean Tobin said he did “not understand the intent” of Professor Ferson’s concerns about reputational damage for the department if it missed a case.
He also confirmed that NSW Health was “very aware of the risk” of coronavirus infection on cruises at the time of the emails.
“These emails reflected that we were taking it very seriously as a major cause for concern for NSW. We were investing a lot of effort to best manage the risk from cruise ships,” Dr Tobin said.
“The Diamond Princess experience made us all very aware of the risk.”
There was disagreement between the experts working on NSW Health’s policy about compulsory testing of symptomatic passengers, the inquiry heard.
“It is a lot of work, but it’s trying to balance the very low risk with the very big problem if we have a [COVID-19] case on a ship,” NSW Health executive director of health protection Jeremy McAnulty replied to Professor Ferson’s emails at the time.
Leena Gupta, director of the Sydney local public health unit, also allegedly repeatedly said that disembarkation should not be allowed on cruise liners if they had test results for potential COVID-19 cases pending.
At the time that the Ruby Princess disembarked, there were 13 COVID-19 test swabs on board that were yet to be processed.
Dr Tobin told the inquiry that the disembarkation of the Ruby Princess could have been handled differently, but stood by NSW Health’s categorisation of the ship as a low infection risk
This categorisation ultimately enabled its disembarkation without intervention from authorities.
Two US lawsuits alleging that Princess Cruises did not adequately screen for COVID-19 on board the Ruby Princess and Diamond Princess were launched on Monday.
The suits, which are among several already filed over the spread of the virus on the company’s cruise liners, seek class action status for passengers aboard both ships.
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