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Realistic “Terror Cruise”: How to bring the new crown virus to the world?



How exactly were the hundreds of passengers on the Ruby Princess cruise ship infected with the virus allowed to disembark from Sydney and return to Florida from Tasmania? At around 6 am on March 19, William White, a retired Australian mortgage broker, woke up feeling slightly unwell. He coughs a little and has a runny nose, but it doesn’t look serious. But anyway, there is no time to sleep in bed now. White and his wife Lucia have just finished their ten-day New Zealand cruise, and the cruise ship is now docked in Sydney.

(Picture 1: After the passengers disembarked, the Ruby Princess departed Sydney on March 19.)

(Picture 1: After the passengers disembarked, the Ruby Princess departed Sydney on March 19.)

This is a cruise ship with a length of 950 feet and 1,542 cabins, operated by Princess Cruises, a subsidiary of Carnival Corporation, named “Ruby Princess”. The White couple’s disembarkation time is 8:05 in the morning. Therefore, they quickly packed their luggage, ate breakfast, and then came to the Explorer’s Bar on time, waiting to gather with the tourists who left the ship at the same time, and disembark together.

Unloading passengers on cruise ships is a complex process, and delays are also common. But the Whites only waited a moment before they were told they could leave. They walked through the corridor, and the passing crew waved and high-five goodbye. It only took a few minutes to pass through Sydney’s overseas passenger terminal. Although the spread of the new crown virus pandemic has accelerated, Australian officials have allowed the Ruby Princess to board and disembark passengers without restrictions. Passengers who come down do not need to show their passports, let alone take their temperature. The only document required is the entry form. The border staff only glanced at the form and let the passengers through.

(Picture 2: Passengers leave the Ruby Princess cruise ship in Sydney.)

(Picture 2: Passengers leave the Ruby Princess cruise ship in Sydney.)

At 8:30, the Whites were already walking on the streets of Sydney. The other more than 2,600 passengers had already dispersed, some in taxis, commuter trains, and crowded airport buses. “I often travel abroad by plane and cruise ship,” White said in a statement to investigators later, “but I have never experienced such a short trip.”

Horror Cruise

The decision to allow the Ruby Princess to dock in Sydney will have a profound impact. Facts have proved that this ship is the most important carrier of the Australian coronavirus and once accounted for more than 10% of confirmed cases in the country. In Tasmania, two cruise ship passengers may cause a serious outbreak, resulting in the closure of a major hospital. Other infected passengers flew to the United States, and some eventually died. At the same time, the crew members on the ship were trapped on the Ruby Princess, like prisoners, some of them had difficulty returning home for months.

Although there were a large number of confirmed cases on multiple cruise ships at the beginning of the epidemic, the Ruby Princess was very different. Not only because 28 people on board died from the new crown virus disease-the most of all cruise ships. The other two notorious carnival cruise ships, the Diamond Princess, which was closed for weeks at the docks in Japan, and the Zaandam, which was helplessly wandering on the west coast of South America looking for a country to allow it to dock, never let passengers disembark. But the Ruby Princess was the opposite. Only when the passengers got ashore did people discover that this was an incubator for a devastating outbreak.

In an e-mail statement, the Ruby Princess stated: “Our highest responsibility and our priority is always the safety, health and well-being of guests, crews and community members wherever we go,” and fully comply with the public during the journey. Hygiene guidelines. “After the global health agencies provide new information, we will continue to update and adjust our policies and agreements to reflect the latest developments related to the new crown epidemic.” When the Ruby Princess first set sail, the company said: “It was not seen then. The coronavirus is spreading within the Australian community.”

The situation changed drastically after the cruise ship docked. At that time, Australia, with its isolated geographical location and sound medical system, seemed ready to escape this worst pandemic. The subsequent fiasco prompted the government to take a series of efforts to try to find out the problem and who should be held accountable. The New South Wales government organized a high-profile public investigation, and the police also conducted investigations under the leadership of murder detectives. The passengers’ lawsuits one after another. Everyone is trying to answer a core question: How did hundreds of infected passengers get off the cruise ship and head towards the heart of Sydney when governments around the world are extremely vigilant?

(Picture 3: Group photo of Rosie Gere and Ruby's public account.)

(Picture 3: Group photo of Rosie Gere and the Ruby Official Account.)

Return to Hong Kong early

Circular Quay may be the best place in the world to start sea travel. Located in the foothills of Sydney’s financial district, on one side is the Rock Cultural District-one of the earliest European settlements on the continent. In addition, there are the towering arches of the Harbour Bridge and the famous Sydney Opera House that seems to be set sail.

Thousands of passengers boarded the Ruby Princess from the cruise port at Circular Quay on March 8. The increasingly serious new crown virus epidemic seems to have failed to stop the enthusiasm of passengers. Although Australians are also panicking-hand sanitizers and canned food in Sydney shops are starting to sell out, and people from China, Iran and South Korea are also prohibited from entering the country, the number of confirmed cases in Australia is still quite small. In New Zealand, the destination of this 13-day cruise, fewer confirmed cases.

Stephen and Rosie Gere are two retirees from Tasmania. They arrived at the port at 12:30 in the afternoon, preparing to celebrate Rossi’s 70th birthday with a sea trip. Soon after arriving at the terminal, the Ruby Princess announced that the boarding would be postponed to late afternoon. “We went to Circular Quay and found a nice little bar,” Stephen recalled. “Then we were talking about this virus. Unfortunately, we were always thinking,’This will not happen to us, infection The rate is not high’.” Rossi stood in front of the cruise ship and took a picture; Stephen wanted to edit the name of the ship and change it to “Princess Rossi.”

What they didn’t know was that in the early hours of that morning, after the cruise ship returned from the last voyage, a government epidemiologist named Kelly-Anne Resler and seven other staff members boarded the ship. They carried suitcases full of masks, gloves and test swabs. The New South Wales Department of Health hopes to screen those arriving passengers who may be carrying the new crown virus, whether it is because they have reported respiratory symptoms or have recently been to an affected country. Reisler was shocked by the number of people gathered in the restaurant-more than 300 people. She and her team distributed masks, took their temperature, and asked everyone about their travel history. They decided to test nine people for the virus and then let the others disembark. A doctor told the crew that no new passengers could be boarded until the results came out.

At 5:30 in the afternoon, the test results came out: all were negative. The Ruby Princess can set off for the next voyage. Boarding began. The cruise ship left the berth late at night, slowly passed the opera house and left the port. Some guests watched the city lights gradually disappear from the terrace.

Diane Fish, a travel agent from Delray Beach, Florida, could have had a good night’s sleep on the way to New Zealand for the next two days. Since late February, she has been running around during the journey, leading a group of tourists to play in Australia. But the boat trip is also part of the trip, so she had to shoulder the responsibilities of the tour guide and social manager again to check the entertainment on the boat and make sure everyone had fun.

There is more and more bad news from overseas. Italy has imposed a nationwide blockade on March 9. Soon President Trump issued an unprecedented ban, prohibiting people from Europe from entering the United States. Fish was not so nervous yet, feeling that he was far away from all this. “I didn’t realize at the time that we were not safe anywhere,” she said. But she still prepared a colleague to help her reschedule the tour group if the cruise ship stopped in New Zealand.

On the way across the Tasman Sea, there are many activities for passengers to entertain. The Ruby Princess was launched in 2008. Although it is not the newest or largest cruise ship of Princess Cruises, it is still spectacular. The Ruby Princess has 19 decks, 4 swimming pools, and dozens of restaurants and entertainment venues, most of which surround the atrium called “Piazza”. The captain of the Ruby Princess is an Italian named Giorgio Pomata.

After arriving in New Zealand, the cruise ship passes through Fiordland in the southwestern Fiordland area, and then stops at Dunedin. The Ruby Princess headed north, and the last stop was the Bay of Islands, which was scheduled to arrive on March 18.

On March 15th, the cruise ship docked in Napier on the edge of the wine country in the North Island. Crowds of tourists poured into the town, walked into the souvenir shop, and boarded the tour bus. On the same day, Australian Prime Minister Scott Morrison announced that the country is stepping up efforts to control the coronavirus. Everyone, no matter where they come from, as long as they are from overseas, needs to be isolated for 14 days after arrival. From midnight, cruise ships arriving from foreign ports will be prohibited from docking.

In the Carnival’s regional office, no one knows what this announcement means to the Ruby Princess ships, which carry a large number of Australian passengers. But that night, the public address system of the Ruby Princess issued an announcement: The cruise ship will return directly to Sydney.

Old sailor Stephen Gere has been tracking the Ruby Princess’ itinerary online. He soon discovered that the bridge crew was accelerating, sailing towards New Zealand at 24 or 25 knots instead of 18 knots. After the Diamond Princess, the managers of the Carnival Company are very clear about what the delay means to the cruise ship. “We don’t want you to be trapped anywhere or to be protested at the port,” an executive in Sydney wrote to Captain Pomata.

At the same time, the passenger experience remains basically unchanged. As social distancing is still a relatively new concept except China, restaurants, bars and other entertainment venues on the ship are still open. Moreover, the crowded St. Patrick’s Day celebrations are also going on as usual.

Three confirmed cases

In Sydney, officials are evaluating whether and how to make the Ruby Princess dock. The state government’s criteria for determining whether a cruise ship is carrying the virus is based on the travel history of the passengers on the ship, the current travel location, and most importantly, how many of them have reported “flu-like illness” (ILI)-usually understood as fever or respiratory tract symptoms. If the number of people reported exceeds 1% of the total number of passengers and crew, and the flu virus test on board can prove that the symptoms are not caused by flu viruses, the ship will be considered to be at a higher risk and everyone needs to stay on board until The test swab can be tested in a land laboratory. The Ruby Princess docking on March 8 was a medium-risk docking, partly because some tourists had visited Singapore. Passengers can disembark normally if they dock at low risk.

On the morning of March 18, the day before the Ruby Princess was about to reach shore, government epidemiologist Reisler copied an email from the senior doctor von Wazdorf on the cruise ship. The email answered a series of questions about the passenger’s travel history and condition, and pointed out that medical staff had collected swabs for “a few individuals who had fever but tested negative for the flu”. Von Wazdorf also attached the requested form, listing the names, conditions and temperature of passengers with flu symptoms.

But what to do with the Ruby Princess is left to Lesler’s decision. The decision is made by an independent team of public health experts. They do not think this number is worthy of vigilance. Many patients go to the infirmary for treatment on their way home, but this may also be because the announcement reminds passengers to see a doctor if they have a cough or other respiratory problems, because the virus is spreading. No passengers have been to high-risk countries recently, and the proportion of ILI is slightly less than 1%, but quite a few people have tested positive for influenza. Subsequently, the expert team believed that the Ruby Princess was a low risk, but suggested that some symptomatic passengers should be tested for the new coronavirus just in case.

On the ship, things got stranger. When the cruise ship was approaching ashore, Percy Anderson, a 75-year-old man from Queensland, walked into the elevator and found a strong man in a hoodie with his clothes zippered tightly and tightly blocking his mouth and nose. The woman with him also wore surgical masks, and both seemed to have difficulty breathing. Anderson later told investigators that he and his wife Esther “exchanged glances but said nothing.” Another passenger, Paul Reid, recalled that he went to the clinic because of a cough and sore throat. He said that the doctor wiped his nose and then immediately told him “you are not infected with the coronavirus.” Reid thought that this meant that his coronavirus test was negative, but in fact the medical team on board did not have the ability to do virus testing.

Fish still hopes to relax. She booked a spa treatment and planned to enjoy it when she returned to Florida. After that, she felt something was wrong-muscle soreness, fatigue, “I don’t want to get out of bed the next day”. She thought it was because she was too tired to travel.

Later on March 18, the Office Vessel Traffic Services (VTS), which manages traffic in the Sydney Port, received a call. The other party is a member of the National Ambulance Service and asked for the latest situation on the Ruby Princess. Cameron Butchart, a port manager, thinks the call is weird. To prevent sudden discomfort for the elderly when a cruise ship arrives, ambulances are usually dispatched to the port, but generally no prior notice is given. So Butchart called back again, wanting to know more. “We received Carnival Australia’s booking of two ambulances for the cruise ship arriving in Hong Kong at 2:30 pm. There are two suspected coronavirus patients on board,” the ambulance coordinator told him. “We want to know if this ship will actually Enter the port, and whether passengers can disembark.” Ambulance officials said they tried to get in touch with the Carnival company, but there was no response.

While alert, Butchart hung up the phone and began to contact Carnival Company. But no one answered. He emailed his colleague, telling him to stop the Ruby Princess from docking. “Tell the cruise ship that their docking was denied,” he wrote, “to have their agent contact person contact the Sydney Ship Transport Service office immediately.”

The port staff finally contacted the carnival staff. According to investigation documents, carnival staff said that they did call two ambulances for a passenger with severe leg problems and another passenger with heart disease, but not because of suspected coronavirus infection. Considering this and the decision of the health agency, the port authorities agreed to let the Ruby Princess dock. At 2:30 in the morning, the cruise ship docked at Circular Quay. In the early morning, passengers will leave the ship one after another.

By nine o’clock in the morning, the sidewalk outside the terminal was full of passengers who had just disembarked. Anderson and his wife had to catch a flight back to Brisbane that day, so they got on a bus to Sydney Airport. When they lined up, they noticed a commotion behind them: a woman fell to the ground. Anderson immediately recognized her and the man kneeling beside her. He had seen the couple who were breathing slightly in the elevator of the cruise ship. The medical staff quickly showed up with a stretcher.

Fish boarded the bus to the airport with other passengers. “I sat down and left some space,” she said, “then I heard the lady in front coughing. Two seconds later, the man behind also coughed. Then the one on my right started coughing too. I told my husband, ‘Everyone in this car is sick.'”

At the same time, Reisler is waiting for the results of the Ruby Princess virus test, although most of the passengers on the ship have dispersed. In the afternoon, she logged on to the laboratory’s website to check whether the test results came out. but none. Even the samples are not registered in the system. She called the laboratory and the other party said that they would test as soon as possible.

The next morning, she logged on the website again and saw that three swabs tested positive. One of the swabs came from a staff member on board. Another passenger from Tasmania. The third comes from a woman named Leslie Bacon, who was taken away by an ambulance with a leg problem. (Von Wazdorf once told the health department that both passengers had respiratory symptoms.)

It’s too late

The Ruby Princess is not a low risk at all, it’s just that Raisler knew it too late. The state government hurriedly deployed contact tracking personnel, and government officials also began to hold conference calls to try to find out which link went wrong. But time is getting tighter.

Towards the end of that day, Resler discovered a strange thing: some people tested for coronavirus were not on the list of symptomatic passengers and staff sent on March 18. By this time, four people had tested positive. Resler contacted von Wazdorf and asked: “Do you have an updated ARI list?” (ARI: Acute Respiratory Disease) “Some people who have been tested are no longer on the list I got. After sending the list, have you added new patients?”

Six minutes later, Von Wazdorf sent a reply. “I will send it to you now. I’m really sorry, the latest list is from the last morning, but I forgot. This is crazy.” The updated list did not increase significantly, but this change is very critical: The updated ILI ratio reached 1.3%, exceeding the 1% threshold that implies a higher risk. The Ruby Princess also updated passengers’ illness information on another government platform until the early morning of March 18. But Lesler later testified that she was not aware of the data.

“I keep asking myself if I can do more to protect everyone,” Von Wazdorf told Reisler that night.

(Picture 4: The Ruby Princess docked at Circular Quay, March 19.)

(Picture 4: The Ruby Princess docked at Circular Quay, March 19.)

The passengers on the ship were already scattered across Australia and around the world, and some had caught up with the last flight before the international border was closed. The Carnival Company provided government officials with a list of passengers’ contact information, but the details were not accurate. Some passengers do not answer the phone at all. By March 20, contact tracking personnel only contacted 44 international tourists, leaving 526 international tourists with no news. That weekend, Qantas reported that 170 “close contacts from the Ruby Princess” flew to the United States on March 21. The government is one step too late. It is enacted that the next night, the Australian Border Agency will put passengers on the Ruby Princess on a special list-a “do not board” reminder will be issued during registration.

On March 19, when he boarded the flight to the United States, Fish had no idea about the confirmed case. She realized that the situation had changed when she was changing planes in San Francisco. Some people in her tour group received contact tracking calls. As it happened, she started to feel uncomfortable, very uncomfortable. The airport was almost empty. She found an empty bench and was about to lie down and sleep for a while. “I know I have a fever. So I found a place to sit away from people, and I want to be tested as soon as possible,” she said.

After returning home, Fish slept for 12 hours as soon as he slept. After waking up, she found a nearby emergency care center that could be tested. The test results confirmed her suspicion: positive. Her husband is also positive.

Confirmed cases from the Ruby Princess have also appeared in Australia. When White, the former mortgage broker, first returned to his home in southern Sydney, he thought he had just caught a cold. Two days later, a friend who was also on the same cruise ship called and said that her husband was taken to the hospital due to complications from the new crown virus. Later, the Whites also went for a test and both were positive. Today, they have recovered.

The other two passengers, 72-year-old Vietnamese veteran Graham Lake and his wife Carla, are in self-isolation at their homes near Brisbane. They heard that someone on the ship was diagnosed on March 20. Although there were no special symptoms, the couple went to the hospital for testing. The doctor did not test Lake because he had no symptoms; but his wife stayed in the hospital because of a dry cough and fever.

The next morning, Carla called to tell her husband that she was diagnosed. Soon, Lake felt uncomfortable himself. A week later, an ambulance took Rekla to the hospital. He was also diagnosed. He was sent to a ward with his wife. Not long after, Kara entered the intensive care unit. Lake was also by her side. In the early morning of March 29, he found that Carla had no breath. He stood in front of his wife’s bed for a while, then returned to his bed, not knowing what to do next. “Watching my wife die, but I can’t do anything,” he said.

In Hobart, Tasmanian retiree Keele also tested positive for the virus. One day after returning home, he was taken to the hospital and admitted to the intensive care unit.

In Hobart, Tasmanian retiree Keele also tested positive for the virus. One day after returning home, he was taken to the hospital and admitted to the intensive care unit. His wife Rossi and his daughter almost thought he was going to die, so they went to the hospital in protective clothing to see him “last time”. Fortunately, 11 days later, Keir finally recovered. A few months later, he still felt ill. “Of the six people in the same group, I think I am the one with the best health,” he said, “but it turned out that I got sick.”

Five-star mobile prison

On the Ruby Princess, only a group of people were considered potential carriers of the virus from the beginning. That is the more than 1,000 staff on board. Most of them came from countries such as Indonesia and the Philippines. They were not allowed to disembark in Sydney but were asked to return to the port of departure. But for a financially complex company like Carnival, this is more difficult. The nominal home port of the Ruby Princess is Bermuda. Right now, the crew can only stay on board until the company is not sure where the ship can go.

After the passengers left, the crew on board began their carnival. On the evening of March 19, they held a “sail party” by the pool. But the next departure was a voyage without a destination. The medical staff on board found that more and more people had respiratory symptoms. A Filipino crew member who requested anonymity said that more and more colleagues are being sent to the cabin for isolation. Only those who are seriously ill are allowed to return to Sydney for treatment.

As dissenting politicians and unions became increasingly uneasy about the situation aboard the Ruby Princess, Australian officials finally allowed the cruise ship to dock in early April—but not at Circular Quay. The cruise ship finally docked at the remote port of Kambra. There, the cruise ship truly became “a five-star mobile prison.” Almost everyone can only move around in their dormitories and are only allowed to open the door to collect food or receive treatment. Police and soldiers stationed at the pier.

The state government is eager to solve this problem. However, it is obviously unreasonable to let the ship full of patients with the new coronavirus continue to return to the sea to wander at sea. By mid-April, more than 10% of crew members had been diagnosed. It was not until the end of April that people came up with a solution. Everyone on board is tested for the virus, and those with negative results can leave by plane.

(Picture 5: On April 23, the Ruby Princess departed from Port Kamba.)

(Picture 5: On April 23, the Ruby Princess departed from Port Kamba.)

The situation for crew members from poorer countries is even more difficult. Although compassionate organizations believe Australia should help them return home, there are still more than 500 crew members from developing countries (the capacity of these countries to organize repatriation work is limited) stranded on the Ruby Princess, sailing all the way to Manila, the capital of the Philippines. . The Philippine crew were relatively lucky and got off the ship on April 23. After arriving in the Philippines for two weeks at sea, other crew members still had to wait several weeks before being allowed to go ashore.

(Picture 6: The Ruby Princess (left), docked in Manila Bay with other ships, May 7.)

(Picture 6: The Ruby Princess (left), docked in Manila Bay with other ships, May 7.)

The Ruby Princess is now docked off the coast of Malaysia. It is not clear whether anyone will be held responsible for what happened on board. In total, at least 663 passengers and 191 crew members on board were infected with the new crown virus. Of the 28 dead, 20 were in Australia and 8 were in the United States-causing twice as many deaths as on the Diamond Princess. As a result, a “most deadly marine epidemic” was brewing on the Ruby Princess.

Catastrophe

The New South Wales Police Department is still conducting a long-term investigation, while the lawsuits in Australia and California are still in the early stages. A public investigation led by prominent Sydney lawyers released their report on August 14. The results of the report show that the medical staff on Carnival and the Ruby Princess have complied with public health requirements. But the report did suggest that if von Wazdorf sent the initial patient list and informed public health officials of the latest number of sick passengers on board, the results might be different.

The report made the sharpest criticism of the government’s process of allowing the Ruby Princess to dock, calling it a “serious error.” The report pointed out that the government process regarded the cruise ship as a low risk “extremely unreasonable.” After the report was released, the Ruby Princess issued a statement expressing “deep condolences” to the dead. The Governor of New South Wales, Chen, hopes to apologize for the “mistakes” of the health personnel.

The northwestern part of Tasmania, which has suffered the most tragic consequences, is economically backward. After the cruise ship arrived in Sydney, soon the first sick passenger from the Ruby Princess was admitted to the Northwest Regional Hospital (NWRH) in Burnie Town. A week later, another patient was admitted to the hospital. By the beginning of April, an investigation by the national health department found that one or both of the two patients were very likely to be the original spreader, causing the virus to spread rapidly in the hospital. On April 12, the Tasmanian government announced that the hospital was closed, requiring employees and their families to immediately isolate themselves for 14 days. The military doctor had to fly to the area to deal with the emergency. In the end, 138 people in this area were infected and 10 of them died.

The cruelty of the epidemic is random. Bill and Adrienne Crist have lived in the northwest of the island for more than 40 years. They raised three daughters and lived by the sea, facing the sea. Their home is about an hour away from Burnie Town.

In early April, Bill told his wife that he was not feeling well and wanted to go to the hospital for a visit. Adrienne is responsible for driving. On the way, she asked Bill whether to go left or right-left to Burnie Town and NWRH, and right to the hospital in another town. In the end, Bill chose to go to the left because of the beautiful scenery on this road.

Bill was admitted to the hospital immediately. At first, “no obvious epidemic prevention measures were taken in the hospital,” Adrienne recalled. A few days later, Bill’s condition deteriorated and Adrienne was told that he had to leave. But Adrienne refused.

On April 10, Bill passed away, the day after their 57th wedding anniversary. It was not until the last minute that the doctor told Adrienne that Bill was infected with the new crown virus. It is almost certain that he contracted the virus in the hospital — “maybe from a second or third transmission on the Ruby Princess,” Adrienne said. At first, she didn’t understand how the virus spread to her little place that was almost isolated from the world. Now, she said: “The virus came from a cruise ship. And we never even approached a cruise ship.”