When commissioner Bret Walker SC suggested there had been a “reprehensible shortcoming” by NSW Health in allowing people to disembark.

On March 17, the ship’s medical logs showed about 50 people had presented for acute respiratory symptoms, with another 54 people presenting in the following 24-hours, the inquiry heard.
When questioned about the increase, Ms Ressler said she assumed it was due to announcements being made on the ship for people with symptoms to present to the doctor.
Ms Ressler, who is the coordinator of the department’s cruise ship health program, said the increase would qualify as an outbreak, but the health department thought it to be an influenza outbreak due to the number of positive flu tests.
Counsel assisting the commission Richard Beasley SC said NSW Health deemed the ship “low risk” on March 18, the day before it docked.
The assessment was based on the log which indicated 36 of 3795 people aboard, or 0.94 per cent, had presented to the medical centre with relevant flu-like symptoms.
Under the state government’s draft guidelines developed by NSW Health on February 19, if the number of flu-like cases presented was equal to or greater than 1 per cent, it would indicate an outbreak had occurred and the ship would be deemed a higher risk. If two more people had presented, the ship would have met the one per cent threshold, the inquiry heard.
“[But] by 19 March when the ship docked, the 1 per cent level had been reached, although that data was not before the health assessment panel when their determination was made,” Mr Beasley said.
In opening remarks, he said the outbreak of COVID-19 on cruise ships surprised no one given the transmissibility of the disease.
“These ships are very large and they have the capacity to carry thousands of passengers and crew,” he said.
“On these cruises, in close proximity to each other, people eat together, drink together, danced together and watch entertainment together. Outbreaks of gastroenteritis and influenza are not uncommon.”
An updated medical log was sent to NSW Health on March 20, which showed a significant increase in the number of passengers with acute respiratory or influenza-like illnesses.
Ms Ressler said if that data had been available when NSW Health was making its risk assessment, it would have pushed the ships risk level to medium and an onboard risk assessment would have been carried out.
We would have conducted the assessment, worked out who fit our criteria for testing, we then would have allowed everyone to disembark, we possibly would have kept those people on board until those results were received, she said.
On March 19, Ms Ressler messaged the ship’s doctor Ilse Von Watzdorf to confirm several passengers had tested positive for COVID-19.
Dr Von Watzdorf said she was thinking what could have been done better and Ms Ressler responded that there would probably be a significant increase in cases.
“Coronavirus on a cruise ship is a big problem. It is very transmissible,” Ms Ressler told the inquiry.
The inquiry continues on Wednesday.
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