An inquiry into the Ruby Princess debacle has cleared the Australian Border Force but found “inexplicable”, “unjustifiable” and “inexcusable” errors by NSW Health.

Bret Walker SC last week released the Report of the Special Commission of Inquiry into the Ruby Princess, which examined the circumstances which allowed 2,700 passengers, many of whom were infected with COVID-19, to disembark at Sydney Harbour on March 19 and scatter.

That event resulted in 62 secondary and tertiary coronavirus cases with 28 deaths linked to the ship, including 20 Australians.

The report concludes that “neither the ABF nor any ABF officers played any part in the mishap”.

However, it found serious errors in the public health response, including the risk assessment process by the NSW Health expert panel.

In light of all the information the Expert Panel had, the decision to assess the risk as “low risk” – meaning, in effect, “do nothing” – is as inexplicable as it is unjustifiable.

Brett Walker SC

“In light of all the information the Expert Panel had, the decision to assess the risk as “low risk” – meaning, in effect, “do nothing” – is as inexplicable as it is unjustifiable,” Mr Walker said.  “It was a serious mistake.”

The errors included a failure to take into account updated CDNA guidelines about what should be considered a suspected COVID case, which applied to 120 people by the time the ship docked in Sydney.

NSW also failed to ensure infected passengers were confined to their cabins, he said.

‘Fly in the ointment’

The report also criticised testing processes, including a failure to follow procedure regarding the collection of swabs from onboard the Ruby Princess, a failure to supply backup dockside swabbing, and a delay in getting results.

“The failure to ensure that swabs were collected by an onboard health assessment team …. was a serious failure by NSW Health,” it says.

“The delay in obtaining test results for the swabs taken from the Ruby Princess on the morning of 19 March is inexcusable.

“What can confidently be concluded is that we – New South Wales and the broader community – would have been very likely considerably better off with respect to COVID-19 had those mistakes not been made.”

Mr Walker had a special mention for the federal government, which he described as the “fly in the ointment” for its refusal to allow a Commonwealth officer to attend and give evidence.

“Quite how this met the Prime Minister’s early assurance of full co-operation with the Commission escapes me,” Mr Walker said.

Premier apologises

NSW Premier Gladys and health minister Brad Hazard have apologised “unreservedly” and promised that the state government will learn from the mistakes identified in the report.

“The NSW government extends its heartfelt apology to anyone who experienced any additional hurt, stress and trauma due to the mistakes made by NSW health,” Ms Berejiklian.

She said NSW Health acted immediately to address the failure identified by Mr Walker to ensure the errors aren’t repeated.

Ms Berejiklian said the report identified a number of concerning mistakes.

“It’s clear there were mistakes made by NSW health and others,” the Premier said.

Ms Berejiklian said all recommendations would be adopted, however she noted the report did not identify any systemic failures.

Mr Walker said on a whole, state public health officials adequately attempted to protect public health against COVID-19 on cruise ships, but their attempts “sadly miscarried” in what he described as “this sorry episode”.