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The inside story of Australia’s coronavirus supercluster

Apr 23, 2020 • 15m 30s

Tasmania’s Covid-19 supercluster has forced hospitals to close and lead to thousands of residents being quarantined. Today, we investigate how a severe shortage of protective equipment and the encouragement of dubious practices preceded the deadly outbreak.

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The inside story of Australia’s coronavirus supercluster

208 • Apr 23, 2020

The inside story of Australia’s coronavirus supercluster

RUBY:

From Schwartz Media, I’m Ruby Jones, this is 7am.

With two hospitals shut down and thousands of residents quarantined, Tasmania’s Covid-19 supercluster has brought the state’s health system to its knees.

Now - new evidence has emerged pointing to a severe shortage of protective equipment and the encouragement of dubious safety practices.

Today: Senior Reporter for The Saturday Paper Rick Morton, on the failures that led to Tasmania’s deadly outbreak.

--

RUBY:

So Rick, at the very beginning of this pandemic, Tasmania was one region that did seem to be taking it seriously.

RICK:

Yeah. So, I mean, if you go back to, you know, the 21st of March was a Saturday in Tasmania was actually you know, they jumped out of the gate and they said, we're shutting out border.

Everyone who come to you will have to spend two weeks in quarantine if you do travel here. So they took advantage of the fact that they're an island and they pulled up the drawbridge.

Archival tape -- reporter:

Fortress Tasmania 30 hours from total lockdown.
We are going to introduce the toughest border measure in the country.

RICK:

And, you know, at the time I tweeted and I applauded them, I'm saying, why wouldn't you if you've got a natural moat?

It was one of the last remaining jurisdictions in all of Australia that did not have any record of community transmission. The only cases of Covid 19, they had had entered the state. So they were you know, they would go kicking arse not to put too fine a point on it. And they had all of the natural advantages in their corner. Except it may have kind of paved the way to a little bit of complacency as the cases started to tick up.

RUBY:

So what happened? When did the situation start to change?

RICK:

A passenger from the Ruby Princess cruise ship was actually the first person to die from Covid 19 north west Tasmania.

She died at the North West Regional Hospital, which is based in Burnie. And Burnie,is this beautiful little seaside town on the north west coast, about four and a half hours away from Hobart.

That was kind of ground zero. I mean, she died on March 30 was the first person to die in the state and pretty much over the next two weeks. We just start to see a spiraling super cluster.

a cluster that is attached to two hospitals, but particularly one both located in Burnie. There's the North West Regional Hospital, which is the state public hospital and a private hospital.

Archival tape -- reporter:

Eerie scenes here in Burnie which is the epicentre of Tasmania’s coronavirus outbreak.

RICK:

People from across the workforce at the hospital are affected with diagnoses. That alone should tell you that something didn't go right here

Archival tape -- reporter:

So far around 60 people are linked to this hospital outbreak, 43 are healthcare workers.

RUBY:

That must have had a huge impact on the hospital's capacity.

RICK:

It essentially meant that the hospitals couldn't run. They couldn't keep them open, and ensure that this disease didn't spread even further, faster.

So they closed them. They shut the hospital for two weeks. We suddenly don't have an accident and emergency department anymore. They had to send in Australian medical assistance teams from the federal government. And medically trained Australian Defense Force personnel.

And they put all of the health care workers, almost every single healthcare worker in north west Tasmania to work in a hospital was put into lockdown.

Archival tape -- reporter:

More than 12 hundred staff and at least 4000 family members have been ordered into quarantine for two weeks.

RICK:

That's about five per cent of the north west entire population.

Archival tape -- Jackie Lambie:

We are struggling down here mate, right now we are all holding our breath.

RUBY:

So, Rick, in the space of a few weeks, Tasmania went from no community. community transmission of the virus and sealed borders to 5000 people quarantined and two hospitals shut down. That seems like a dramatic escalation. How did this happen?

RICK:

That's the million dollar question, isn't it? I mean, literally a day after I pitched this story, there were rumors flying around and everyone was like, I heard there was a dinner party.

The chief medical officer, Brendan Murphy, mentioned it in a phone hook up with New Zealand's parliament and said that it was likely a bunch of nurses who got together for an illegal dinner party, which is a word or phrase that will probably enter the lexicon of Australia for all the wrong reasons.

The problem was there in the contact tracing they've done. There is just no evidence at this point that that happened. And it certainly didn't explain the rate at which those illnesses spread through the workforce at the hospital.

And I know it's been a bit of time there, a couple of months, a few months in 2014 reporting on Tasmania. And I knew that there were issues, you know, a decade old issues with the health system. And I did know there was that, you know, how sometimes in journalism you get that spidey sense where you go “there's more to the story here…” and almost inevitably your right anyway, because there's always more to the story.

So after a couple of days of making inquiries, I was shown and given this memo and this memo was drafted by a nurse manager in the infections control unit of Tasmania Health.

So this is the head honchos essentially, and it was sent on March 25th to nurse unit managers and directors of Tasmania's hospitals. And it essentially said, you know, we are going to have to look at reusing P2 masks.

RUBY:

Rick I'm wondering, could you just read out to me what that memo actually says?

RICK:

Yeah, it says, quote, unquote, “during Covid-19, it is important hospitals have adequate resources to deliver services effectively. To assist in this, investigations for the safe decontamination and re-use of P2 masks and the refilling of alcohol hand gel bottles are being undertaken.”

RUBY:

So what does this memo mean in the context of the Covid-19 outbreak in these two hospitals?

RICK:

It means that, you know, the risk of infection among health care workers was dramatically increased.

I mean for the first time anywhere in Australia, we've got in writing what is essentially the admission that they are worried that they do not have enough protective equipment for frontline health care workers in hospitals. This is people with Covid-19 patients on the wards in ICU.

It's a problem because P2 masks, are single use masks. They cannot be reused. There is no safe way to, quote unquote, decontaminate a P2 mask. And there is no health policy in the country that recommends it.

RUBY:

We’ll be back in a moment.

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RUBY:

So Rick, this memo suggests there weren’t enough P2 masks available for frontline healthcare workers managing Covid-19 patients. What about other protective gear? How widespread was this problem?

RICK:

Well I mean, it's not like this memo was the first warning before the crisis escalated. The top levels of the state government were warned. They knew about the fact that there was a severe lack of personal protective equipment in hospitals across the state.

And they knew as this thing was unfolding that staff were kept in the dark about what these procedures were meant to be and why they were being departed from so significantly. And, you know, I spoke to dozens of people on and off the record. And there was a view that maybe a few years of bad hygiene practices and bad infection control practices were coming back to haunt them.

And it wasn't just about protective equipment. You know, I spoke with Dan Jones, who a he was trained as a surgical theater technician at Royal Hobart Hospital. He's currently a kind of a care nurse. He showed me pictures of, you know, ISO wipes what's that had been completely, completely empty outside of certain wards and ISO wipes are what health care workers use to wipe down medical equipment. Sanitiser had gone missing or was just completely stripped from certain wards to put in ICU.

He said that despite years and years and years of being supplied, full length, full sleeve yellow gowns for surgeries and prep work, they were suddenly all taken off and put on the other wards. And so he was doing his job now for the first time against usual best practice without any of these materials. He was given a simple Apron and with short sleeve, which doesn't offer any protection whatsoever to the arm.

And there's another GP in Tasmania who was saying, I'm down to my last five P2 masks and the primary health network, which is the federal government-funded body in each different region around the country, said, oh, no, we've got plenty of masks. But it turned out they were talking about surgical masks. And that's a real important distinction, because surgical masks protect someone else from getting them Covid-19 from you. So if you cough, you don't spread it. But that's of bugger all use to health care workers. P2 masks are the ones that stop a person who is wearing it from getting Covid-19 so that they work in different directions.

RUBY:

Rick, who is responsible here, for making sure that workers have all the protective care they need in a situation like this?

RICK:

These are Tasmanian state health system issues, but the protective equipment goes to an even bigger issue around Australia, and that is that there was a strategic national medical stockpile. It was established for national emergencies in it contained only surgical and P2 masks, but almost nothing of the other items, such as goggles, glove aprons and gowns. And that stockpile failed to meet the basic requirements of a state at the bottom of the country that needed it really badly in late March and early April.

RUBY:

So does that mean that other hospitals in other parts of Australia might be in the same position as these two hospitals and not have enough supplies or enough equipment because this stockpile doesn't have enough?

RICK:

Correct. And it's not just hospitals. It's GP clinic. It's aged care homes. I mean, all of these health care networks, whether they're federal funded or state-funded, are part of the national medical stockpile. And they get their equipment from that stockpile, which is administered by the federal government and divvied out to the states. And, you know, I spoke to a primary health care nurse in regional New South Wales who worked with a bunch of other nurses at a GP clinic. And they'd been told to take their masks home overnight and wash them with metho.

RUBY:

Like methylated spirits?

RICK:

Methylated spirits! Which, by the way, does not work and should not be attempted. But, you know, they’re using the same mask for a week at a time because they do not have enough.

RUBY:

Rick, what about Burnie - and the North West regional hospital. How are things going there now?

RICK:

So we do have more medical supplies and protective equipment coming into the area. And the two hospitals are almost open again. By the time you listen to this, most of the functions of the hospital will be back online, But, they have been shuttered for two weeks now and two weeks is long enough. So, you know, there are a lot of questions that will remain about how this outbreak was allowed to happen to the scale at which it did. And, you know, Tasmania's northwest is historically underfunded.

And it's older, sicker and poorer, as Jacqui Lambie told me. And the rest of the country in many cases, It is a community that was just starting to rebound from years and years and years of just absolute depression. Economically speaking, and now it's been shattered all over again. We really do need some clear answers here. And there will be an inquiry. We don't know exactly what form it will take, but they will be one. And I think we need one.

RUBY:

And Rick, it seems like the people who we've been relying on to help us during this crisis, healthcare workers are the ones that are being let down here.

RICK:

Yeah, unfortunately, that's true. And, you know, there are already people who are not getting paid the most amount of money. You know, they are people who turn up at all hours. They work crazy shifts. And they're being called to expose themselves essentially to this horrific virus, this disease on the frontline. And we can't even give them the basics. And I think that's a really sad state of affairs.

RUBY:

Rick, thanks so much for your reporting on this.

RICK:

Thanks, Ruby.

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RUBY:

Elsewhere in the news…

The Covid-19 death toll in Tasmania currently stands at eight. The most recent fatality was four days ago. The 74-year-old was a patient at the North West Regional Hospital in Burnie.

There have been four new confirmed cases of coronavirus in Australia since Tuesday afternoon, bringing the total to six-thousand-six-hundred-and-49 cases.

Deputy chief medical officer professor Paul Kelly says it’s a sign the country is “doing well in terms of flattening the curve.”

**

The Federal Government has announced it will spend 94 million dollars building a fuel reserve to bolster the national stockpile.

Federal Energy Minister Angus Taylor said it was about taking advantage of historically low fuel prices to build a "strategic fuel reserve"... in case of future “global disruptions”

The reserve will initially be held in the United States.

**

And the senior doctor aboard the Ruby Princess cruise ship has told an inquiry she would not have let passengers disembark when it docked in Sydney last month.

The Special Commission of Inquiry, established by the NSW Government, is investigating the circumstances surrounding the ship’s docking.

Doctor Ilsa WHATS-DAWF told the inquiry that she was surprised passengers were allowed to disembark before test results from sick passengers had been analysed.

More than 600 cases of coronavirus and 21 deaths have since been linked to the Ruby Princess, making it the single biggest source of infection in Australia.

I’m Ruby Jones, this is 7am. See ya tomorrow.

With two hospitals shut down and thousands of residents quarantined, the Tasmanian Covid-19 supercluster has brought the state’s health system to its knees. New evidence has emerged of a severe shortage of protective equipment and the encouragement of dubious practices. Today, Rick Morton on the failures that lead to Tasmania’s deadly outbreak.

Guest: Senior Reporter at The Saturday Paper, Rick Morton.

Background reading:

Tasmanian hospitals caught in coronavirus storm in The Saturday Paper
The Saturday Paper
The Monthly

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7am is a daily show from The Monthly and The Saturday Paper. It’s produced by Ruby Schwartz, Atticus Bastow, and Michelle Macklem. Elle Marsh is our features and field producer, in a position supported by the Judith Neilson Institute for Journalism and Ideas. Brian Campeau mixes the show. Our editor is Osman Faruqi. Erik Jensen is our editor-in-chief. Our theme music is by Ned Beckley and Josh Hogan of Envelope Audio.

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208: The inside story of Australia’s coronavirus supercluster