Covid 19 coronavirus: Big Read: One last normal day - why the Ruby Princess and its passengers were allowed out in Napier

Hawke's Bay has four cases linked to the Ruby Princess cruise ship with one being a tour guide and the other three residents of Gladys Mary Care Home in Napier. Photo / File

Elisa McCafferty stepped off the Ruby Princess cruise ship in Napier with pure excitement. She'd been waiting for a long time for this part of the itinerary.

She visited the MTG and saw the stories of horror unleashed on the region by the Hawke's Bay Earthquake, before heading off on a wine tour.

It was to be the last "normal" day for her, and the 2600 passengers around her.

McCafferty, who is now back in her UK home battling a case of coronavirus that she likely contracted on the ship, had no idea she too would become part of a horror story.

At the moment, the horror story is mostly confined to what happened after the boat, which is stricken off the coast of Sydney with 1000 or so crew aboard, left New Zealand waters.

Its arrival and the subsequent disembarking of infected passengers in New South Wales (the boat has since been linked with roughly 550 Covid-19 cases) has been roundly condemned in Australia.

In Napier, it wasn't quite as serious, but the docking of the cruise ship has created a cluster of cases.

Thirteen people, not all of them being treated in the region, have been, as at Friday identified as having likely caught coronavirus because of the docking of the Ruby Princess in Napier, seven of them since Thursday.

A Hawke's Bay DHB spokeswoman said not all 13 cases are based in Hawke's Bay, although they may have contracted it here are receiving healthcare in another part of the country.

Of that cluster the DHB's main concern based in the region is Gladys Mary Care Home which has a group of five residents – three confirmed and two probable cases - of Covid-19.

Medical Officer of Health Dr Nick Jones said the five cases were doing well and none of them had required additional medical assistance, at this stage.

McCafferty, from London, said the day in Napier with her husband was one of the highlights of the trip.

But when the pair got back on board, things changed quickly. Whispers spread around passengers and four hours after leaving Napier Port it was announced they would not be heading to Tauranga but instead back to Sydney.

McCafferty said during the entire trip across the Tasman, nothing was said at any time about anyone being sick on board.

The ship along with seven other cruise liners with 8500 crew members on board are now stricken in New South Wales waters with the fear of containing infected people on board.

About a third of the cruise ship was international passengers and were told they could travel overseas immediately or self-isolate in Sydney for a fortnight.

McCafferty said she made the decision to head home to London, only learning when they arrived home that there were confirmed cases on board.

In the early stages of her isolation she developed symptoms and tested positive for the virus.

At the moment she is still at home but said that she has been close to having to be hospitalised.

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She said that their day in Napier was no different to any other days and they spent the time going to the MTG in Napier and taking part in Winery Tours Hawke's Bay before having lunch and heading back to the ship.

Napier Port CEO Todd Dawson said that while a nationwide cruise ship ban was announced the day before by Jacinda Ardern the ship was still permitted to enter the port.

"As of midnight March 14 all cruise ships were banned from coming into New Zealand waters until at least June 30 2020," he said.

"But ships already in New Zealand waters were permitted to conclude their itinerary, subject to clearance by the DHB prior to each port call, which the Ruby Princess did and was allowed to enter."

He said it was an unprecedented situation.

Elisa McCafferty from London, England was one of the 2600 passengers, along with her husband, on board the ship when it arrived at Napier Port on March 15. Photo / Supplied

"Following the Hawke's Bay DHB's announcement last week of a Covid-19 case in Hawke's Bay linked to the Ruby Princess, we made sure that everyone who was on the wharf that day (Sunday 15 March), including contractors, tour operators and volunteers, was made aware of the development," he said.

"Following the announcement, all Napier Port personnel who had contact with the ship were in touch with the Ministry of Health.

"The Ministry of Health advised a number of our people to go into self-isolation as a precautionary measure.

"All of these people have now completed their 14-day self-isolation period in good health."

A DHB spokeswoman said Hawke's Bay Public Health staff receive pre-arrival public health declaration forms, from cruise ships before they dock.

This was the case for the Ruby Princess, when it docked in Napier March 15.

The declaration noted sickness on board and the ship provided a list of all persons on board with influenza like symptoms.

The Medical Officer of Health requested the ship's doctor make contact as soon as possible to discuss the reported illness aboard.

A discussion with the Medical Officer of Health and the ship's doctor took place, while the ship was still docked in Wellington.

In the intervening time there was an announcement that New Zealand ports were to be closed to all passenger vessels from midnight the following day.

The Medical Officer of Health alerted Ministry of Health officials and the National Health Co-ordinating Centre to the presence of a person aboard who had respiratory illness that now met the new case definition.

The Ministry of Health border protection advisor on call confirmed that the border closure did not apply to vessels already within New Zealand waters.

The DHB spokeswoman said that meant the only grounds for not granting clearance would be if there was evidence of Covid-19 aboard.

On the call, with the ship's doctor, it was agreed that although there was evidence of an influenza outbreak aboard the possibility of a Covid-19 case could not be excluded without a test being conducted on the person testing negative for influenza.

The Medical Officer of Health advised the ship's master that if Covid-19 could not be excluded the vessel would not be granted clearance to disembark in Napier.

The vessel was still in Wellington port but was due to leave at 6pm.

On the request of the ship's doctor the Medical Officer of Health requested urgent Covid-19 testing of all influenza like illness cases including the suspect Covid-19 case with the assistance of the Wellington Regional Public Health service and the ESR laboratory in Wellington.

The ship was advised not to leave port if the test samples had not been transferred to Wellington Regional Public Health Service staff.

ESR reported all tests were negative for Covid-19 and Public Health agreed to clear the vessel for disembarkation in Napier at 7am the following morning.

The Ministry of Health's border team were advised later that night.

Laura Vodanovich, director at MTG, one of the places many passengers visited, said prior to the ship's visit MTG already had good practices in place for keeping the team and visitors safe.

"This included physical distancing, increased hygiene practices and ensuring no staff who were unwell were coming to work," she said.

"When knowledge of the on-board cases was known, my immediate concern was for the welfare of the team and I spoke to the staff who were working that day.

"They felt reasonably comfortable that the level of risk to them was low, but I also received advice from the DHB, who also deemed the risk as low for the museum team."

They continued to monitor the team that worked that day and are pleased that the two-week period has passed, with no staff showing any signs of illness.

Winery Tours Hawke's Bay did not wish to comment on the Ruby Princess situation.

Linden Estate Winery is part of a special cruise ship winery tour the operators offer but the winery's CEO Wayne Walford said he could not confirm if they had passengers tour the site.

He did say though that the Estate followed strict health and safety restrictions by bleaching equipment, hand sanitiser and social distancing rules but confirmed no staff had to self isolate.

Napier Mayor Kirsten Wise said if everyone follows the rules it will help the public health teams who are actively contacting anyone who came into contact with the passengers and crew from the Ruby Princess.

"My job as mayor is to reinforce the messages from the Government - stay home - and those of the district health board and encourage anyone who may have symptoms of Covid-19 to contact their GP or health line so they can be referred for assessment if necessary."

• Covid19.govt.nz: The Government's official Covid-19 advisory website