Aboard the Ruby Princess: how one cruise spawned a COVID-19 outbreak

The emptying of 2700 passengers from the Ruby Princess cruise liner was quicker than the spread of a global pandemic.

"We got off the ship so fast, they didn't even look at our passports," said Janet Dixon-Hughes, who found herself standing out on the footpath with her daughter and 95-year-old mother half an hour before her husband was due to collect them from Circular Quay on Thursday morning.

"I've never come into the country that quickly. I was just astounded."

The Ruby Princess docked in Sydney on Thursday.Credit:Kate Geraghty

The next night, Ms Dixon-Hughes flicked on the news to see a passenger being evacuated from her home of 11 days on a stretcher.

That passenger, aged in her 70s, has now died from coronavirus while the number of people from the cruise to test positive is at 133 and counting. They have dispersed through NSW, Tasmania, the ACT, Western Australia and as far away as the United States, in what might be Australia's first instance of exporting the virus overseas. The Ruby Princess has spawned more cases than some entire states.

"When we got off, none of us were aware there was anyone on the ship who had symptoms, we were not aware there was a suspected case of COVID-19 and not until we saw people stretchered off into an ambulance did we have any idea that we were possibly exposed to the virus," Ms Dixon-Hughes said.

The passengers are angry. The states that imported the cases are aghast. And authorities at every level of government are distancing themselves from the decision to allow 2700 people off the ship when 13 were awaiting the results of coronavirus tests.

It was up to the states to manage the arrival of cruise ships, federal Health Minister Greg Hunt said on the weekend.

Trevor Spencer, 75, and his wife Julie Spencer, 71, with their luggage after disembarking from the Ruby Princess.Credit:Kate Geraghty

But when the ship reached Napier on March 15, the captain announced that the rest of the itinerary would be scrapped and the ship would return to Sydney immediately. NZ Prime Minister Jacinda Ardern had announced the 14-day isolation period for international arrivals a day earlier and it was due to take effect that night. Some passengers, including New Zealand nationals, wanted to disembark at Auckland and return home by plane but this was kiboshed by the captain. There was no real protest.

"The cruise director said he couldn't believe how well everyone was handling everything," Mrs Spencer said. "He kept saying, 'I don't believe I've ever travelled with such a happy bunch of people'."

They are not happy now.

Ms Dixon-Hughes said although the passengers had been warned to expect health checks to be conducted, these never took place and nobody took their temperature or asked about their health when they disembarked. She is now suspicious about the speed with which they were unloaded from the boat.

"Who rushed us out that fast?" she said. "Was it the health department or the cruise liner? Their experience after the Diamond Princess [where 700 passengers contracted coronavirus after the ship was refused entry to Japan] was to get people off as fast as possible, ask them to self-isolate and it's better to ask for forgiveness than permission."

Each passenger was told to isolate for 14 days in accordance with the new protocols for international travellers. By the time they learnt four passengers had tested positive for coronavirus, a full day later, many passengers had travelled back to their home towns unknowingly afflicted by the virus.

One passenger was a resident at the Uniting Arrunga aged-care home in Sydney's north-western suburbs. The facility was only told the resident was on the ship when NSW Health officials asked that they self-isolate for a fortnight.

The Ruby Princess now accounts for one in eight of the 818 coronavirus cases in NSW, and 26 cases interstate. The Herald can reveal a woman who travelled from Salt Lake City, Utah, to join the Ruby Princess has since tested positive to coronavirus.

Marjorie Willardson said she and her husband had raised concerns with two passenger service representatives, expressing that they felt the cruise "should not be continuing", but they were told all was well.

In an email to Princess Cruises, Mrs Willardson said its crew had assured her “we are taking all precautions and our passengers [are] completely safe on the ship”. Mrs Willardson told a crew member that she believed the cruise was “very unsafe”.

“Large groups are meeting together in concerts, eating areas and on crowded bus tours. The people coughing and sneezing all around us,” she said. “However the cruise just kept cruising as if nothing was going on around us. It was crazy. I couldn’t believe it.”

Western Australian Premier Mike McGowan is citing the Ruby Princess as the reason he will not allow a cruise ship full of sick passengers off the coast of Fremantle to disembark. "I will not allow what happened in Sydney to happen here," he said.

Carnival Australia said there was "no substance" to the allegation that disembarking was rushed.

"It now appears clear that when Ruby Princess began its cruise on March 8 in Sydney, the incidence of COVID-19 in the general community was higher than might have been apparent at the time," a spokesman said. "Based on our own experience and on knowledge of the behaviour of the virus, the most likely explanation is that, in such a dynamic and rapidly evolving environment, the illness was introduced unwittingly to the ship following embarkation in Sydney."

NSW Health has tightened its protocols to test any passenger with a respiratory-related illness before they embarked on a cruise ship. The federal government has banned foreign cruise ships from entering Australia, with Mr Hazzard saying they would hold a ship until Covid-19 tests were returned, even if passengers or crew would miss connections.

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