‘The place is a mess’: St Basil’s inquiry reveals heart-wrenching email from health staffer

Nov 16, 2021
The coronial inquest into the deaths at St Basil’s Homes for the Aged has begun. Source: Getty

The coronial inquest into the handling of Covid-19, and the subsequent Covid-19 deaths at St Basil’s Homes for the Aged in Fawkner, has been presented with a heartbreaking email about the ‘horrific’ conditions that prevailed at the beginning of the month-long outbreak.

“I cried several times on-site and I’m pretty tough,” wrote the Victorian Department of Health consultant employee who visited St Basil’s on July 23. “Clients not being fed, meds missed, hygiene unattended, in their nappies for hours and hours. Bed sores …” The emotional email (in full below) was tendered at the inquest which began on Monday, November 15, 2021, before State Coroner John Cain.

The inquest revealed that Federal Chief Nursing Officer Alison McMillan visited St Basil’s in July 2020, the day after its first coronavirus death, and signed the aged care home off as “fit for purpose”.

Professor McMillan visited St Basil’s at the recommendation of Australia’s then-chief medical officer Brendan Murphy, after the possibility was mooted of removing all of the home’s 117 residents for their safety. McMillan reported that there was “no need for a significant evacuation of positive residents to hospital”. Over the next month, 45 St Basil’s residents died from Covid-19. The average age of the deceased was 85.

In his opening statement, Peter Rozen, QC, counsel assisting Judge Cain, said that when Professor McMillan visited St Basil’s on July 22, 2020, the conditions for residents at the home were so grim that a complete evacuation was being considered, however, it was still marked as “fit for purpose”, and “the question of transferring a significant number of Covid-19 positive residents out of St Basil’s was deferred”.

However, by July 24, “the true extent of the neglect became apparent to those at the highest levels of the Commonwealth and Victorian governments”, Mr Rozen said.

Before Professor McMillan’s visit to St Basil’s on July 22, Victoria’s Chief Health Officer Brett Sutton stood down the home’s entire staff due to the outbreak of positive cases, marking all staff as close contacts. Professor Sutton previously said that this direction was given in the interests of both residents and staff. He will take the stand next week.

The relief staff, employed by Aspen Medical, a private contractor, entered the home on July 22, after Professor McMillan visited, and as they entered, chaos reportedly ensued.

According to the email, very few of the replacement workers understood the systems established to look after residents, many of whom had complex medication and dietary needs. Many residents at the Greek Orthodox aged care home only spoke Greek, and subsequently, a communication barrier deeply impacted the effective running of the facilities. St Basil’s chairman Kon Kontis and the home’s nursing director, Vicky Kos, warned that standing down all staff was dangerous.

Visiting doctors noted “genuine concern about residents starving to death and dying of dehydration from basic care needs not being met,” Mr Rozen told Judge Cain.

“A number of senior Commonwealth public servants in Canberra, none of whom had set foot in St Basil’s, were making decisions on July 21, 2020, about the residents in the teeth of very clear warnings from doctors who were caring for the same residents,” said Mr Rozen during the inquest’s first day.

Mr Rozen added to this, saying that from this tragedy there is a lesson to be learned by the Federal Government, “to heed the warnings of the experts on the ground in such crises”.

The St Basil’s hearing continues over the next six weeks.


Email from a Victorian Department of Health employee

Sent at 4.41am, July 24, by Kirsten Congerton, a consultant employed by the state Department of Health, who volunteered to visit St Basil’s on July 23

St Basil’s was horrific. I cried several times on-site and I’m pretty tough.
We had one person pass away, we expect two or three more overnight. They have written many residents off as palliative.
The place is a mess. It is not stable or improving.
No doffing stations were set up on the floors, and I mean none. A lot of don [put on PPE] but no doff [take off PPE] in clinical areas. PPE was constantly being worn.
We had no bins to put yellow waste bags into, we had to resort to tying bags outside residents rooms so the very young, inexperienced, terrified and overwhelmed agency staff could doff.
We had to manage the staff, none were capable of standing up as a leader and were in no condition psychologically to do so. [We] did our best to help them survive the night, but we had to call it at 2am.
Personal Care Assistants in tears, registered nurses in over their heads and obviously frightened.
Clients not being fed, meds missed, hygiene unattended, in their nappies for hours and hours. Bed sores …
[Another employee] and I have seen a lot in our time and experience but this is horrific for everyone involved.
We will write a proper report but this me spitting a few things out at 4am.
[We] will go to [another aged care home with an outbreak] tomorrow afternoon as we need the morning to rest and some time to process what we saw and dealt with.


Timeline of a Tragedy: Those who died at St Basil’s

  • 21/07/2020

    Athanasios SAMARAS, Age:91

  • 22/07/2020

    Konstantinos DAKOURIS, Age: 86

    Dimitrios ROUSSOS, Age: 83

  • 23/07/2020

    Georgina MITSINIKOS, Age:87

    Boro PETKOVIC, Age: 82

    Maria VASILAKIS, Age: 81

  • 24/07/2020

    Ilias TAKIS, Age: 81

  • 25/07/2020

    Dimitrios FOTIADIS, Age: 79

  • 25/07/2020

    Maria KARAVIAS, Age: 93

    Theodoros MAKRIDIS, Age: 91

    Christos VARVARIS, Age: 93

  • 26/07/2020

    Paul BARBOUSSAS, Age: 79

    Christos MIHELAKOS, Age: 88

    Archondia SAVVA, Age: 98

  • 27/07/2020

    Theodoula ANDREOU, Age: 85

    Gina ANDRIKOPOULOS, Age: 84

    Efthalia CHRISTOFILOS, Age: 85

    Marija RUKAVINA, Age: 86

  • 28/07/2020

    Alexandra LA ROCCA, Age: 88

  • 29/07/2020

    Fotini ATZARAKIS, Age: 77

    Barbara KARASAVIDIS, Age: 77

  • 31/07/2020

    Orea BOURNOXTSIS, Age: 86

    Fortunata CARDINI, Age: 98

    Nicolina PINGIARO, Age: 90

  • 01/08/2020

    Hrisoula TRIMBOS, Age: 78

  • 03/08/2020

    John DIMITRIOU, Age: 73

    Vasilios TZOULIS, Age: 80

  • 04/08/2020

    Pavlos DIMOTAKIS, Age: 72

    Lemonia IOANNOU, Age: 75

  • 05/08/2020

    Con COUTLAKIS, Age: 88

    Michael DIMITRIADIS, Age: 94

    Renato NUNZIATO, Age: 96

    Zisis SKENDERIS, Age: 83

  • 06/08/2020

    Maria PATSALIS, Age: 87

  • 07/08/2020

    Malama VALKANIDIS, Age: 83

  • 08/08/2020

    Chryssi MANOLAS, Age: 82

    Ilias TRIMBOS, Age: 76

  • 09/08/2020

    Anna BARBOUSSAS, Age: 81

    Efraxia TSALANIDIS, Age: 84

  • 10/08/2020

    Androula PIERIDOU, Age: 72

  • 11/08/2020

    Vasiliki PATSAKOS, Age: 85

    Jakov PUCAR, Age: 90

  • 12/08/2020

    Margarita KARAHALIOS, Age: 85

  • 14/08/2020

    Filia XYNIDAKIS, Age: 77

  • 15/08/2020

    Slavka PUCAR, Age: 82

    Dimitrios TSINTZIROPOULOS, Age: 92

  • 17/08/2020

    (Con) Konstandinous POULAKOS, Age: 86

  • 18/08/2020

    George AKRITIDIS, Age: 83

  • 22/08/2020

    Basile GINIS, Age: 83

  • 23/08/2020

    Afroditi KAZAKO, Age: 94


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