As a police probe begins into the Ruby Princess, details emerge about other gaps in Australia’s quarantine response, including the use of isolation declaration cards. By Karen Middleton.
The other holes in Australia’s quarantine
A gap in quarantine processes meant airline passengers potentially infected with coronavirus were able to fan out across the country last month without immediate follow-up in some places, as details from the government’s isolation declaration cards were not universally passed on.
The federal government introduced its new isolation declaration cards for incoming international passengers in late March, soon after it began requiring that people arriving in Australia self-isolate at their destinations for 14 days.
But The Saturday Paper has confirmed some state and territory governments had to demand the information contained on the cards – names, addresses and contact details – upon discovering it was not automatically being sent to them after the Australian Border Force (ABF) and the federal Health Department had collected it.
Without the details, it was much harder to locate and monitor people who had arrived from overseas and travelled on to other cities and towns, and to trace the contacts of any who reported feeling unwell.
“Those cards should have been handed over straight away,” one official tells The Saturday Paper. “I don’t know why they weren’t.”
Detail of this communication breakdown involving federal agencies and the states and territories emerges amid ongoing federal–state brawling over the handling of the cruise liner Ruby Princess, which was allowed to dock in Sydney in the early hours of March 19, with its passengers disembarking unchecked.
That incident is the single largest and deadliest spreader of Covid-19 in Australia. At time of writing, the cruise ship was responsible for 15 deaths – about 30 per cent of all virus-related fatalities across the nation.
It is now the subject of a New South Wales Police Force investigation.
When the Ruby Princess docked in Sydney last month, passengers arriving in Australia by sea and air were already required to follow mandatory self-isolation rules, although the ship’s 2700 passengers were not advised of that directly as they spilled out into the harbour city and beyond.
The isolation declaration cards were introduced the next day.
Officials from several jurisdictions have told The Saturday Paper the delay in transferring isolation declaration card information slowed the processes for monitoring – and, where necessary, tracking contacts of – incoming overseas passengers.
They say it potentially undermined Australia’s quarantine measures at a crucial time in the battle to smother infection rates, with arriving international passengers posing the greatest threat.
At least one affected jurisdiction became aware of the issue within a few days of the cards being introduced, and pressed federal authorities until the problem was rectified. For others, it appears to have taken longer.
Several jurisdictions say they were unaffected, including NSW, which has the greatest number of international arrivals by air. A spokesperson for NSW Health says it received the information from the cards as soon as they were introduced.
The Northern Territory introduced its own cards when it closed its borders to visitors on March 24. Tasmania also introduced its own arrival cards for all incoming passengers.
The national cards were part of a series of escalating measures to try to stop the spread of Covid-19 in Australia.
This week, the Department of Home Affairs, within which the ABF is located, declined to respond to questions about the cards, saying they should be directed to the Health Department.
A Health Department spokesperson suggested the state and territory authorities in the arrival locations were responsible for transferring the information to destination jurisdictions. They said ABF officers collected the completed cards and hand-delivered them to “the state and territory healthcare workers present at the international airports”.
If none were present, the cards were then collected by secure courier and delivered to the health authority in that first-port jurisdiction.
“How the completed card is then used by state and territories for follow-up is at the discretion of the relevant jurisdiction,” the spokesperson said.
The introduction of isolation declaration cards followed a decision of the federal cabinet’s national security committee, requiring by law that arriving international passengers undertake 14 days of self-isolation.
Until then, self-imposed quarantine had effectively been voluntary.
Following the security committee meeting, and a separate meeting of the newly created special coronavirus decision-making body known as the national cabinet, Morrison announced that self-isolation of arrivals would become mandatory from midnight on March 15.
The next day, ABF commissioner Michael Outram explained his organisation had been working with the airlines on how the change would be implemented.
“They’ve also been fantastic, the airlines, in getting advice to passengers overnight who were landing in Australia so that we could implement the measure as of midnight – and that was done very effectively,” Outram told Sky News on March 16.
“We’ve also managed to reprogram our SmartGates for midnight last night so that all travellers coming into Australia using a SmartGate are being asked a question about … the quarantine provisions and their consent to do them. And then our officers at the back of the baggage hall who collect those inbound passenger cards are actually engaging with passengers, asking the question about ‘Is that the address?’ and ‘Do they understand the provisions?’ ”
But it seems there was less collaboration between federal agencies and the enforcing jurisdictions.
The process of confirming passengers’ agreement to self-isolate was formalised when the declaration cards were introduced on March 20, five days after the regime became mandatory.
At a news conference following another national cabinet meeting a week later, on March 27, Morrison held up a copy of the coronavirus isolation declaration card.
“Everyone who has been coming into Australia now for some time has had to fill this out,” the prime minister said. “On this, they make a declaration. They say who they are, they say where they are going to self-isolate, they tell us what their phone number is, their passport numbers, and they sign up to self-isolation.”
He emphasised that the self-isolation was now enforceable by law, with strong penalties for those who failed to comply.
“If you have come back into Australia, you need to live up to this pledge,” Morrison continued. “And the state and territory governments are going to make sure you do.”
But some of them were struggling to establish if people were living up to the pledge.
It was only when Morrison showed the leaders the cards during that day’s national cabinet meeting that some smaller jurisdictions discovered the information was clearly being collected but not passed on.
“Information is critical to quarantine and isolate and contact-trace,” says one official from an affected jurisdiction.
“[That] is an essential part of the health response and we need a consistent flow of information to be able to stay on top of it.”
Quarantine arrangements were stepped up that same day after self-isolation arrangements had failed to adequately stem the spread of infection.
One example was the now-prominent case of a Victorian couple who returned from a trip to the United States ski resort town of Aspen in early March and were later diagnosed with Covid-19. The husband and wife had ignored quarantine advice both before and after that diagnosis.
They are allegedly responsible for a cluster of infections in and around Melbourne and the Mornington Peninsula, where they have a holiday house, after attending social functions, shopping and playing golf in defiance of restrictions.
In both Melbourne and Sydney, the highest rates of infection are in some of the wealthiest suburbs, home to large numbers of returned international travellers and their families, friends and other contacts.
Subsequently, federal Health Minister Greg Hunt issued a public rebuke, saying police should “throw the book” at the couple.
At his news conference on March 27, Morrison went on to announce the ramp-up of the measures, this time placing all arriving passengers into mandatory quarantine at designated locations, beginning just before midnight on March 28, and not allowing them to continue with onward travel for 14 days.
The first of those subject to the compulsory quarantine arrangement were released and allowed to travel to onward destinations late this week, at their own expense.
A small number of people have been granted exemptions from the full duration of hotel quarantine on medical and compassionate grounds and are being required to complete their time at home or in another designated location.
While most jurisdictions have granted very few exemptions, the Tasmanian government confirmed it had granted 140 to date.
The NT government is charging passengers for the 14-day compulsory hotel stay to discourage them from disembarking in the territory.
Airline crew and maritime crew, other than those on cruise liners, have been exempt from the 14-day enforced quarantine system to date.
But that changed late this week, following the news that four Qantas staff tested positive to coronavirus this week after a flight from Santiago, Chile, but were allowed to quarantine at home.
The national cabinet revised the exemption on advice from chief health officers in light of the potential risk of flight crew infecting others.
International air crew will now be required to self-isolate at home or a hotel for 14 days between flights. Domestic crew are exempt, except where states ban entry by visitors.
Hunt said on Wednesday it was vital not to disrupt the flow of medical and other supplies into the country.
“To maintain the airbridge, to maintain the bringing into Australia of essential supplies, we have to have both the maritime and aviation crew, so this is about making sure that we are able to bring Australians home, bring essential supplies in,” Hunt said. “… So our focus is on protecting the flight crew and they will be considering what additional measures [are required].”
The NSW Police Force investigation into the Ruby Princess is also now under way, with officers boarding the ship on Wednesday night to begin interviewing witnesses. The ship is docked temporarily at Port Kembla, south of Wollongong, with at least 18 members of its more than 1000 crew having tested positive to coronavirus and another 200 displaying symptoms.
The public blame-shifting continues between NSW and the federal ABF over who allowed the Ruby Princess passengers to disembark in Sydney unchecked.
In a private briefing to her Coalition MPs recently, NSW Premier Gladys Berejiklian reportedly insisted NSW Health was not to blame and that fault lay with the ABF.
Media reports of that briefing prompted the ABF’s Commissioner Outram to hold a news conference, laying out the time line of the ship’s journey and saying the senior doctor on board had notified NSW Health on March 18 that several passengers had been swabbed for “febrile influenza” but had tested negative and had been isolated.
He said NSW Health had responded the same day that the ship had been assessed as “not requiring on-board health assessment in Sydney”. It had determined, instead, that the 15 relevant swabs should be sent to a lab for Covid-19 testing.
“You are free to disembark tomorrow,” Outram quoted the NSW Health message as saying.
The ABF has confirmed this week that one of its officers received a phone call from the NSW Port Authority about the health of six people on the ship early on March 19 but had been advised that NSW Health had cleared it for arrival.
Maritime quarantine procedures have been tightened dramatically since then, and some other cruise ships have been refused permission to dock.
Overall, physical distancing rules and measures to restrict people’s movements in Australia are succeeding in slowing the spread of coronavirus infection.
Minister Hunt reported this week that the three-day average transmission rate was now about 2 per cent.
“That could spike, that could lift at any one time,” he said. “But what it really says is we are consolidating the gains in terms of flattening the curve. We’re not there yet. We’re not there until we have eradicated community transmission. But as a country, all of this hard work and sacrifice has meant that we are saving lives and protecting lives. And I want to say to Australians, thank you for what you have done.”
The national effort required to maintain that success is colossal, involving the temporary and permanent closure of businesses, loss of potentially millions of jobs and enormous social stresses on families and individuals.
That makes every small, counterproductive lapse in the system all the more concerning.
This article was first published in the print edition of The Saturday Paper on Apr 11, 2020 as "The other holes in Australia’s quarantine".
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