The Carnival Cruise Ship That Spread Coronavirus Around The World Coronavirus Around The World

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At about 6 a.m. on March 19, William Wright, a retired Australian mortgage broker, woke up feeling a little off. He had a cough and his nose was running, though it didn’t seem too bad. In any case, there was no time to linger in bed. Wright and his wife, Lucia, had just docked in Sydney after a 10-day journey around New Zealand on the , Australian officials had cleared the Ruby to disembark without restrictions. Passengers didn’t even need to show their passport, let alone get their temperature checked. The only paperwork was an immigration form that border guards glanced at before waving people through.

Passengers in Sydney disembark from a February cruise aboard the Ruby Princess.

Photographer: Don Arnold/Getty Images

By 8:30 the Wrights were on the street, where 2,600-plus passengers had begun filtering into taxis, commuter trains, and densely packed airport buses. “I am a regular traveler overseas by flights and cruises,” Wright later said in a statement to investigators. “I have never experienced something so fast.”

The decision to allow the Ruby to dock would have profound consequences. The ship turned out to be the single most important vector for the coronavirus in Australia, accounting at one point for more than 10% of the country’s cases. In Tasmania two cruisers were the probable source of an outbreak so severe it forced a major hospital to shut down. Other infected passengers flew to the U.S., where some ultimately died. The crew, meanwhile, became virtual prisoners on their own vessel, some unable to return home for months.

Although multiple cruise ships recorded large numbers of Covid-19 cases in the early stages of the pandemic, the Ruby was unique, and not simply because 28 people died of the illness, the most of any voyage. Two other notorious Carnival ships—the had been banned—the country had only a handful of cases. In New Zealand, where the 13-day cruise was heading, there were even fewer.

Stephen and Rosie Keal, retirees from Tasmania, arrived around 12:30 p.m. to start a voyage celebrating Rosie’s 70th birthday. Shortly after they reached the terminal, Princess made an announcement: Boarding would be delayed until at least the late afternoon. “We went up to Circular Quay and found a nice little pub,” Stephen recalls. “The whole discussion, as you can imagine, was about this virus. And we unfortunately took the attitude, ‘Oh, this won’t happen to us, the rates are very low.’ ” Rosie posed for photos with the Ruby’s bow overhead; Stephen wanted to edit them so the hull would read “Princess Rosie.”

What they didn’t know was that at dawn that morning, just after the ship pulled in from its previous cruise, a government epidemiologist named Kelly-Anne Ressler had boarded with seven other staff. They carried suitcases full of masks, gloves, and testing swabs. The New South Wales health agency wanted to screen arriving passengers who appeared to be at risk of having Covid-19, whether because they’d reported respiratory symptoms or had recently been in an affected country. Ressler was shocked by the number she found gathered in a dining room—more than 300, in all. She and her team handed out masks, took temperatures, and asked about travel histories. They decided to test nine people for the virus and allow the others to disembark. Until the results came in, a doctor told the crew, new passengers shouldn’t be allowed on board.

At 5:30 p.m., the tests came back: all negative. The Ruby was cleared to depart on its next cruise. Boarding proceeded, and the ship left its berth late in the evening, easing past the Opera House and out of the harbor. Some guests watched from their balconies, the lights of the city fading as they reached the open Pacific.

Diane Fish, a travel agent from Delray Beach, Fla., would have been content to spend the two-day passage to New Zealand sleeping. She’d been on the road since late February, leading a group of clients through a packed itinerary around Australia. But the cruise was part of the trip, so she settled into her usual roles as tour director and social convener, checking out the onboard entertainment and making sure everyone was having a good time.

The Ruby’s opulent “piazza.”

Source: Stephen Keal

The bad news from overseas was mounting. Italy had imposed a to the United States. Fish wasn’t too anxious, given that she was thousands of miles from any known outbreak. “It just did not occur to me that we weren’t safe where we were,” she says. But she did ask a colleague to be prepared to help rearrange her group’s travel if the cruise was halted in New Zealand.

There was plenty to occupy passengers on the way across the Tasman Sea. Launched in 2008, the Ruby was far from Princess’s newest or biggest ship, but it was still impressive. It had 19 decks, four swimming pools, and dozens of restaurants and attractions, many of them arrayed around a central atrium called the Piazza—inspired, as Princess’s marketing copy optimistically put it, “by the vibrant squares of Europe.” The Ruby’s Italian captain, Giorgio Pomata, was the commodore of the entire Princess fleet.

After arriving in New Zealand, the ship passed first through Fiordland, a region of spectacular mountain bays in the far southwest, before stopping in Dunedin. The Ruby then began port-hopping northward, with the final stop, in the Bay of Islands, planned for March 18.

On March 15, the Ruby stopped in Napier, on the edge of North Island wine country, and throngs of passengers spilled into town, hitting souvenir shops and piling onto tour buses. The same day, Australia’s prime minister, Scott Morrison, announced that his country was significantly stepping up its efforts to keep out the coronavirus. Everyone arriving from overseas would have to spend 14 days in isolation, no matter where they were traveling from. Cruise ship arrivals from foreign ports would be banned as of midnight.

No one at Carnival’s regional office was sure what the announcement meant for vessels such as the Ruby, which was carrying a large number of Australian passengers. But that evening an announcement went out over the ship’s public-address system: The cruise would head straight back to Sydney.

Stephen Keal, an accomplished sailor, had been tracking the Ruby’s progress online, and he soon noticed the bridge crew was flooring it, traveling at 24 or 25 knots instead of the 18 or so on the way to New Zealand. In the aftermath of the Diamond Princess, Carnival managers were well aware of what could happen to the ship if it was delayed. “We don’t want to get yourselves stranded anywhere or have a protest at a port due to cruise ships in the region,” a Sydney-based executive wrote to Commodore Pomata.

The passenger experience, meanwhile, remained largely unchanged. With social distancing still a novel concept outside of China, restaurants, bars, and other attractions stayed open. Crowded St. Patrick’s Day celebrations went ahead.

Back in Sydney, officials were assessing whether and how to let the Ruby dock. The state government’s criteria for determining whether a cruise ship could be carrying the virus were based on where passengers had traveled previously, where they’d been on their current trip, and, crucially, what share of them had reported “influenza-like illness,” or ILI—generally understood to refer to a fever and respiratory symptoms. If the number exceeded 1% of the guests and crew, and if onboard tests for influenza showed that not to be the culprit, a vessel might be deemed high-risk and everyone kept on the ship until coronavirus swabs could be tested by an onshore lab. A medium-risk landing—such as the Ruby’s March 8 arrival, flagged in part because some passengers had been in Singapore—involved a more flexible menu of responses, whereas in a low-risk scenario passengers could disembark normally.

On the morning of March 18, the day before the Ruby was due to arrive, Ressler, the government epidemiologist, was copied on an email from the ship’s senior doctor, Ilse von Watzdorf. It answered a list of questions about passenger travel histories and conditions, noting that medical staff had collected swabs for “a few cases of ‘febrile, influenza test negative’ individuals.” Von Watzdorf had attached the required spreadsheet listing the names, conditions, and temperatures of passengers with flu-like symptoms.

The decision on how to treat the Ruby lay not with Ressler, but with a separate panel of public-health experts. They didn’t find the numbers alarming. Many patients had come to the medical clinic during the journey back, but that might have been explained by announcements instructing passengers with coughs or other respiratory issues to get checked, rather than because the virus was spreading. No one had recently been to the highest-risk countries, and the ILI ratio was a bit below 1%, with a considerable number of people testing positive for the flu. The panel determined that the Ruby was low-risk but advised that swabs from some of the symptomatic passengers be tested for coronavirus, just in case.

On board, things were getting weird. As the boat neared port, Percy Anderson, a 75-year-old from Queensland, entered an elevator to find a heavyset younger man in a hoodie zipped all the way up to cover his mouth and nose. The woman with him was wearing a surgical mask, and both appeared to be having trouble breathing. Anderson and his wife, Esther, “exchanged a glance but didn’t say anything,” he later told investigators. Another passenger, Paul Reid, recalled going to the clinic with a cough and sore throat; he said a doctor swabbed his nose and soon told him “you don’t have corona.” Reid assumed that meant he was negative for Covid-19, but the medical team had no ability to perform such a test.

Fish was still hoping to relax. She booked a treatment at the spa in anticipation of the long journey back to Florida. Afterward she felt strange—stiff and so tired that “I didn’t want to get up the next day.” She figured it was the fatigue of the trip catching up to her.

Late on March 18, a call came in to Vessel Traffic Services (VTS), the office responsible for managing movements in Sydney Harbor. Someone from the state ambulance service was on the line, requesting an update on the Ruby. A port manager, Cameron Butchart, found the call unusual. Ambulances were frequently dispatched to cruise arrivals, given the medical problems that could befall elderly passengers, but the office rarely got a heads-up. Butchart called back to find out more. “We’ve got two bookings here for Carnival Australia for a cruise ship that’s coming in at 2:30 with two suspected corona patients on board,” an ambulance coordinator told him. “We just wanted to know if the ship was actually coming into port, and if [they’re] allowed to disembark.” The ambulance official said they’d reached out to their contact at Carnival but got only voicemail.

Alarmed, Butchart hung up and started calling people at Carnival. No one answered. He emailed a colleague and asked him to stop the Ruby from docking. “Advise the ship that their booking is denied,” he wrote. “They’re to have their agent contact Sydney VTS urgently.”

Port officials ultimately reached Carnival staff. According to investigative documents, they said they’d requested the ambulances for a passenger with severe leg pain and another with cardiac trouble, not because of suspected coronavirus infections. Given that and the health agency’s designation, the port authority agreed that the Ruby was clear to land. At 2:30 a.m., it moored at Circular Quay. Disembarkation would begin first thing in the morning.

 

By 9 a.m. the sidewalk outside the terminal was dense with passengers. Anderson and his wife had a flight later that day to Brisbane, so they took a packed bus to Sydney Airport. They were in the check-in queue when they noticed a commotion behind them: A woman had collapsed. Anderson immediately recognized her and the man kneeling at her side as the pair he’d seen laboring to breathe in the Ruby Princess elevator. Paramedics soon arrived with a stretcher.

Fish had also boarded a bus to the airport with other passengers. “I sat down, leaving some space,” she says. “And I hear the lady in front of me cough. Two seconds after that, the guy behind me coughs. Then the guy to my right. And I said to my husband, ‘Everyone on this bus is sick.’ ”

Meanwhile, Ressler was waiting for the results of the swab tests from the Ruby—most of them for passengers who’d already scattered. That afternoon she logged on to an online lab portal to check if they were done. They weren’t. They hadn’t even been registered in the system. She phoned the lab and was told they’d be tested soon.

Early the next morning she logged in again. Three of the swabs, she saw, were positive. One was from a crew member still on board. Another was from a Tasmanian guest. The third was from a woman named Lesley Bacon, who’d been one of the patients taken off in an ambulance, suffering from leg pain. (Von Watzdorf had told health authorities that both passengers also had respiratory symptoms.)

The Ruby, Ressler was learning too late, had been anything but low-risk. The state government rushed to deploy contact tracers while officials convened conference calls to figure out what had gone wrong. Time was growing short to contain the spread.

Toward the end of the day, Ressler noticed something odd: Some of the people who’d been tested for coronavirus weren’t on the list of symptomatic passengers and crew sent on March 18. By this point there were at least four positive results, including one for the other patient who’d left in an ambulance. Ressler sent a WhatsApp message to von Watzdorf. “Do you have an updated ARI log?” she asked, referring to acute respiratory illness. “Some of the later people swabbed aren’t on the one I have. Did you add any more patients after you sent it to me?”

Von Watzdorf responded six minutes later. “I’ll send it now. Sorry, I forgot that the last one was from the morning. It was so crazy.” The updated numbers weren’t drastically higher, but they did differ in one crucial respect: The ILI ratio was almost 1.3%, well above the 1% threshold that indicated a higher level of risk. The Ruby had also been updating a separate government platform with information on reported passenger illnesses until early evening on March 18, but Ressler later testified that she wasn’t aware of that data.

“I keep on asking myself what I could’ve done better to protect people,” von Watzdorf wrote to Ressler that night.

Ressler replied almost immediately. “Yeah, there will be more cases. Probably a lot.”

 

The Ruby docked at Circular Quay on March 19.

Photographer: Steven Saphore/Anadolu Agency/Getty Images

The Ruby’s passengers were all over Australia and beyond, having in some cases caught the final flights before international borders closed. Carnival had provided officials with a list of emails and phone numbers so everyone could be reached, but the details weren’t all correct, and some passengers didn’t pick up their phones or had turned them off. By the evening of Friday, March 20, contact tracers had managed to reach only 44 of the 570 international guests they’d tried. Over the weekend,

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