Health authorities in Australia have been heavily criticised in an official inquiry into the Ruby Princess cruise ship coronavirus outbreak. The inquiry found “serious errors” by New South Wales Health in its handling of suspected cases on board. All 2,700 passengers were allowed to disembark in Sydney in March without sufficient screening. More than 100 of them felt unwell. A total of 914 later tested positive. Twenty-two died.The ship, carrying mostly Australian passengers, had completed an 11-day cruise from Sydney to New Zealand and back when it docked on 19 March. The passengers – some seen coughing and spluttering – were allowed to leave the ship at Sydney Harbour, catching trains, buses and even overseas flights to get home.But despite officials’ fears, the virus did not spread far beyond those who had been on board.Excluding a cluster in the island state of Tasmania which spread through a hospital, only 34 people in Australia caught the virus through secondary transmission.But it was Australia’s worst coronavirus episode before the current lockdown in Victoria.What are the findings?The Commission of Inquiry said all passengers with “acute respiratory illness” or “influenza-like illness” should have been tested for Covid-19, in line with new guidelines issued on 10 March. “NSW Health should have ensured that cruise ships were aware of the change to the definition of a ‘suspect case’ for Covid-19 made on 10 March,” its report says.”This would have resulted in the identification of such cases on the Ruby Princess. 101 persons fell within the suspect case definition by 18 March, and 120 by the time the ship docked.”The inquiry describes these as “serious mistakes by NSW Health”. It also describes as “inexcusable” a failure to obtain results immediately from coronavirus swab tests taken on 19 March – the day the vessel docked. The decision by an expert panel of New South Wales Health to classify the Ruby Princess as “low risk” is condemned as “inexplicable as it is unjustifiable”. A directive on 17 March meant all ship passengers disembarking after arriving from another country should have isolated themselves for 14 days once on land.
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The NSW government, the report says, “should have arranged suitable accommodation for all passengers who were not residents of the state”.Passengers were incorrectly informed that once disembarked, they could travel elsewhere, the inquiry found, despite having been in contact with a Covid-19 case.Though the advice was corrected by NSW Health on 21 March, it was too late to prevent many travelling onward, “including some passengers who were symptomatic during transit”. The report makes several recommendations, but says that mistakes and failures in decision-making have already been largely recognised by the expert panel and NSW Health. There are no “systemic” failures that need tackling and those involved are said to recognise “they would do things differently if they had their time again”.What has the reaction been?New South Wales government leader Gladys Berejiklian said she would read the report over the weekend before responding.The owner of the Ruby Princess, Carnival Corp, said the report had backed its position that none of its employees had misled the authorities. “In our more than 20 years in Australia, we have always sought to co-operate honestly and professionally with officials in accordance with the regulatory environment,” it said.
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New Zealand Prime Minister Jacinda Ardern has announced a 12-day extension of the country’s Covid-19 restrictions, after a cluster of cases grew to 29.There are four “alert levels” in New Zealand, and Auckland has been on Level 3 since Wednesday.The rest of the country is on Level 2, and Ms Ardern said both would be extended.New Zealand has had success containing coronavirus, and went 102 days without a community transmission. The origin of the cluster in Auckland – New Zealand’s largest city with a population of 1.5 million – is still being investigated.Why 12 days?The PM said the decision to extend the restrictions was “in keeping with our cautionary approach and New Zealand’s philosophy of going hard and going early”.She said that, in 12 days’ time, she thought “the cluster will be identified, will be isolated, and we can move to Level 2 in Auckland with confidence”.All 29 cases “remain linked to one cluster centred in Auckland”, Ms Ardern said, adding that 38 people are in government quarantine.How New Zealand went ‘hard and early’ to beat Covid-19But she said that, although the first cases of the new outbreak were confirmed in Auckland on Tuesday, contact-tracing had uncovered an earlier case, involving a shop worker in the Mt Wellington district of Auckland who became sick on 31 July.“In terms of the ongoing investigation to identify where the virus originated from, there are still no clear connections at this point,” Ms Ardern said.But she said genomic testing and contact-tracing suggested the current outbreak was not linked to border entry points or New Zealand’s previous outbreak in March. New Zealand could expect to see more cases from the cluster, she said, adding: “It will grow before it slows.”And it may continue to be linked to schools, churches and social gatherings, as it has done to date. We also know, based on overseas experience and our own, that it is possible to contain a cluster or outbreak without ever being able to identify its origin.” What are the restrictions?Under Level 3, which is now in place in Auckland, all public places – such as libraries, museums, cinemas, food courts, and playgrounds – must be closed.People must work from home where possible, and children are encouraged to “learn from home”. Residents have been told to stay in their “household bubbles” when not at work or school if they have to attend.Supermarkets and petrol stations can open, but other “close contact” businesses must shut.
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Level 2 – which applies to the rest of the country – is less severe. People can still go to workplaces and schools, but they must keep their distance and wear a mask if possible. Gatherings of more than 100 are banned.The final game of the Super Rugby Aotearoa competition between the Auckland Blues and Canterbury Crusaders at Auckland’s Eden Park has been cancelled due to the restrictions. What is the background?Four people tested positive on Tuesday in Auckland. A three-day lockdown was brought in the following day, now extended by 12 days. Aside from the lockdown measures, the outbreak also prompted Ms Ardern to postpone until Monday the dissolution of parliament so that September’s election can take place. In her latest address, she said no decision had been taken on the election 19 September date yet – she would decide in the next 48 hours. The opposition National Party say the election should be delayed as restrictions on campaigning mean Ms Ardern has an unfair advantage. Before Tuesday, New Zealand was one of only a handful of countries to go so long without recording a locally transmitted case of Covid-19. All 22 active cases of the virus before Tuesday’s announcement were among returning travellers quarantined in isolation facilities.The government had lifted almost all of its lockdown restrictions, which were first imposed in March. An early lockdown, tough border restrictions, effective health messaging and an aggressive test-and-trace programme had all been credited with virtually eliminating the virus in the country.
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