NSW Health is seeking all passengers who came off the Ruby Princess cruise ship, which is now "somewhere off the coast of Wollongong", after a COVID-19 outbreak was discovered on board.
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Health minister Brad Hazzard said the government was now trying to contact 2700 people who disembarked in Sydney on Thursday, due to fears for their health and the need for strict self-isolation.
He said 13 swab tests were done on board before people disembarked due to some "flu activity", even though there was no evidence of COVID-19 on the ship.
However, due to increased cautionary measures, these were checked for COVID19 and three returned a positive result.
One of these was in a crew member who remains on board the ship, along with around 1000 other crew members.
Another was a passenger who is in a serious condition in Sydney, and another has travelled on to Tasmania.
Dr Kerry Chant said a fourth passenger has been confirmed as having the disease, and one other case is already under investigation.
"That is a cause for us to have some concern," Mr Hazzard said.
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"Why it is so urgent for us now, is that those people indicate that there may be the possibility of other passengers on board that ship who could have had the covid virus."
"If they are following instructions given to them by border force then they will be at home in quarantine for 14 days and that ... shouldn't present any major concerns."
"The very big concern is that those people came off their ship with no knowledge of the virus being on their ship."
He said this highlighted the importance of self isolating after travelling.
Dr Chant said the Ruby Princess was managing the case of the crew member on board the ship, isolating other crew members, ramping up cleaning measures and using doctors on board the ship to treat the affected staff member.
"They are very confident they can control a further spread of the virus," she said.
Ship locaters show the ship is well away from the Illawarra, located about 90 nautical miles out to sea, well past the horizon.
It is not one of the ships anchored off the coast of Wollongong.
Dr Chant and Mr Hazzard also reported NSW biggest 24-hour spike in case numbers: 75 new cases since 11am yesterday.
The total number of NSW numbers is at 382 and the death toll stands at six, after an 81-year-old died.
In his media conference, Mr Hazzard also issued a public warning for many people who are outside enjoying the hot summer weather.
He noted reports that "many thousands" of people had been gathering at Bondi Beach and said "we are in different times, we need to behave in different ways".
"Whether you are in Bondi or whether you are in a church, you need to separate by 1.5 metres," he said.