Two senior bureaucrats who oversaw hotel quarantine in Victoria have admitted they didn't know who was in charge of the program.
About 99 per cent of the state's second wave of COVID-19 can be traced back to returned overseas travellers who quarantined at two hotels.
Pam Williams and Merrin Bamert from the Department of Health and Human Services shared the role of commander of Operation Soteria, the taskforce that ran the program.
Appearing before the state's hotel quarantine inquiry on Friday, both were asked who was in charge at each hotel.
"The terminology 'in charge' is somewhat loaded in the context of this inquiry," Ms Williams said.
"We were working as a team. It was a difficult team to manage. This was an environment where the usual things that you do to develop a team weren't possible."
Ms Williams said the DHHS and the Department of Jobs, Precincts and Regions took responsibility for their own staff and contractors.
Hotel managers, meanwhile, looked after their staff and security companies managed their guards.
"It was a collaborative approach," she added.
The inquiry was shown an email written by Ms Bamert in which she said she was "not sure who you would say was in charge" of the program.
"This operation was being managed out of a range of sites with no clear operational structure," Ms Bamert wrote in the email on May 21.
She was replying to an email from Safer Care Victoria, an authority investigating the death of a man in hotel quarantine in April.
Ms Williams said more than 20,000 people went through the quarantine program from March 29 until it was suspended in June.
"Of those, seven people in three rooms were implicated in the spread. So in fact, 96.8 per cent of the people who were positive in hotel quarantine did not go on to spread the virus," she said.
The inquiry also heard from Ikon Services Australia, who had been contracted by the Jobs department to perform a deep clean of rooms at the Rydges on Swanston hotel.
The hotel exclusively hosted returned travellers who had tested positive to COVID-19, and in late May it became the site of a major outbreak after a family of four who stayed at the hotel somehow infected hotel staff and security guards.
Ikon Services general manager Michael Girgis told the inquiry they were instructed to perform cleans on May 15 and 18, about the time the family tested positive to the virus.
"When Ikon went in to clean those rooms on the 15th and 18th of May, had Ikon been told that the Rydges Hotel had been designated as a COVID-positive hotel?" counsel assisting the inquiry Ben Ihle asked.
"No we weren't. We weren't informed," Mr Girgis said.
Ikon was later called in to clean common areas on May 28, after a staff member at the hotel tested positive to COVID-19 on May 26, and on June 3 and 4 after the hotel had been shut down because more workers had tested positive.
Ms Williams denied the hotel was a dangerous place to work.
"There were a number of things that were done to ensure staff were as safe as they can possibly be," she said.
"Is it possible with COVID in the environment to be 100 per cent safe? No, and our experience in the hospital system at the moment indicates that."
Deputy Chief Health Officer Annaliese van Diemen did not appear before the inquiry as scheduled.
She will appear next week, alongside Chief Health Officer Brett Sutton, Emergency Management Commissioner Andrew Crisp, current Chief Commissioner of Victoria Police Shane Patton and former top cop Graham Ashton.
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