‘We’re in a petri dish’: how coronavirus ravaged a cruise ship

0

A general views shows busses parking in front of the cruise ship Diamond Princess, at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 20, 2020. (Reuters)

(Written by Motoko Rich)

The captain came over the intercom early in the evening: A passenger who had left the ship nine days earlier had tested positive for the new coronavirus sweeping through China.

While the guests on board were unnerved, it was the final night of their two-week luxury cruise aboard the Diamond Princess. The revelry continued as the ship headed toward the port in Yokohama, Japan’s second-largest city.

Passengers dined on filet mignon, attended shows in the 700-seat theater and crowded the bars and dance floors into the night. Cruise directors hastily distributed a slate of activities, including Ping-Pong, karaoke and Bollywood dance lessons, to occupy guests who would have to remain on the ship another day while public health officials screened them for symptoms.

A bus carrying passengers from the quarantined Diamond Princess cruise ship leaves a port in Yokohama, near Tokyo, Thursday, Feb. 20, 2020. Passengers tested negative for COVID-19 started disembarking since Wednesday. (AP)

Hoping to soak up the final hours of their romantic voyage, Tyler and Rachel Torres, newlyweds from Irving, Texas, took in a performance by a torch singer that evening. “We didn’t really consider the danger of leaving the room,” said Torres, 24, an occupational therapist. “And since we were on our honeymoon, we refused to waste our last moments on the cruise.”

As the music played on, passengers were potentially exposed to the virus. In all, it took Japanese officials more than 72 hours to impose a lockdown after they were first notified about the case connected to the ship.

The delay by the Japanese government, along with slapdash and ineffective containment measures during the two-week isolation period, would help turn the Diamond Princess into a floating epidemiological disaster.

Feverish passengers were left in their rooms for days without being tested for the virus. Health officials and even some medical professionals worked on board without full protective gear. Sick crew members slept in cabins with roommates who continued their duties across the ship, undercutting the quarantine.

With 634 infections and two deaths, the cruise ship represents the largest concentration of coronavirus cases outside China, meriting its own category in the data compiled by the World Health Organization.

The U.S. government this past week allowed 14 Americans who were infected to board evacuation flights with hundreds of passengers who weren’t. Japanese officials have since let close to 1,000 passengers who tested negative walk free, even though experts fear some of them have been exposed and could later develop symptoms. Crew members were expected to start leaving this weekend.

On Saturday, the health minister admitted that 23 passengers had been released from the ship without taking a valid recent test and had traveled by public transit after disembarking this past week.

Now that the quarantine has ended and most of the passengers have left, the concern is that they could start spreading the virus on shore.

Japanese officials said they did the best they could in a fast-moving situation, as they tried to keep the virus from spreading within the country. After confirming the first cases among those on board, the authorities said, they moved to isolate passengers to reduce transmission. The government has said the quarantine was largely effective.

The ship operator, Princess Cruises, said Japanese authorities took the lead in testing and protocols. It added that the “focus has been and remains the safety, health and well-being of our guests and crew.”

In the early hours of Feb. 2, before the ship had even docked in Yokohama, Hong Kong officials informed the Japanese Health Ministry about the initial infected passenger.

A spokeswoman for Princess Cruises said the company received “formal verification” of the infection from Hong Kong on Feb. 3, and announced it to passengers on the ship that evening.

Only as the parties and shows ended around 11 that night were guests advised to stick to their rooms. After the boat docked in Yokohama, medical officers boarded the ship and went door to door taking temperatures, checking for coughs and testing some passengers for the virus.

The cruise directors scratched the planned activities the next day, while the screening continued. People still mingled on board, lining up at large buffets for meals. They used communal ladles and tongs, and shared salt and pepper shakers on tables.

Passengers figured their departure would be delayed by only a day or so. Many were walking up to breakfast when the captain came over the intercom again on the morning of Feb. 5.

The Japanese Health Ministry had now confirmed 10 cases of the coronavirus on the ship, he told them.

Guests needed to return to their rooms immediately, where they would have to stay, isolated, for the next 14 days.

Tainted Memories

Trapped in their cabins, the 2,666 passengers now had time to recall every encounter that might have exposed them to the virus in the days before the ship’s lockdown.

There was the buffet on Deck 14, where guests were urged to wash their hands before joining the line, though hygiene habits varied widely, some passengers recalled. Now they wondered why the buffet had remained open even after the ship’s officers learned about the infected guest.

Memories of art auctions, afternoon high teas, quiz nights and mahjong games all took on a sinister hue.

“Everything looks tainted in retrospect,” said Sarah Arana, 52, a medical social worker from Paso Robles, California, who left on an American evacuation flight.

A Princess spokeswoman said that the crew had carried out “routine environmental cleaning and sanitizing” using disinfectant that is “known to quickly kill coronaviruses in 30 seconds.”

Passengers worried about their excursions on shore. The infected passenger had taken a bus tour in Kagoshima, a city in southern Japan.

Gay Courter, 75, an American novelist from Crystal River, Florida, who once set a murder mystery on a cruise, dwelled on the ship’s last stop, in Naha, the capital of Okinawa. As people disembarked, public health officials took their temperatures — a measure that was becoming more commonplace as the virus spiraled in China.

Looking back, Courter wondered if the coronavirus had already started to spread. With her husband, Philip, and a group of friends, she ate noodles and fried sweet potatoes at an outdoor stall.

“In my heart, I regret doing that,” she said, “because it was such a crowded place and there were people from the ship crawling around the town.”

Each day, more cases emerged: 10, another 10, then a spike of 41.

What distressed passengers most was a sense that information was being withheld. Hours would pass between when the Health Ministry leaked new cases to the media and the people on board were notified.

Passengers took to counting ambulances lined up on the pier to guess how many new infections would be announced that day. Japanese guests hung banners off balconies, with one reading, “Serious lack of medicine, lack of information.”

‘No road maps’

Policies and protocols shifted as the quarantine wore on.

On the second day, health officials began letting those in windowless cabins out for fresh air breaks. It wasn’t until the next day that passengers were warned to keep more than 6 feet away from anyone else. Torres, a nurse who has since evacuated with his wife, noticed that others were not always vigilant about wearing masks on deck.

On the fifth day, passengers were issued heavy-duty N95 masks and advised to wear them when they opened their doors to accept deliveries of meals and amenities from the crew.

Halfway into the quarantine, the Japanese government announced that some people would be eligible to continue their confinement onshore — those 80 or older with underlying medical conditions or windowless cabins.

The changes didn’t inspire confidence. Passengers were waiting days for prescriptions to be filled for chronic conditions like diabetes and high blood pressure. People were running out of toothpaste and clean underwear.

Tadashi Chida, a passenger in his 70s, sent a handwritten letter to Japan’s Health Ministry complaining that the crew seemed overwhelmed and that quarantine officers were not attending to those with symptoms.

“The ship is out of control,” Chida said, adding that his wife had waited nearly a week for medication.

“An outbreak is happening,” he said. “We have no road maps.”

Yoshihide Suga, the chief Cabinet secretary to Prime Minister Shinzo Abe, said this past week that the country’s authorities had “made the maximum consideration to secure the health of passengers and crew.”

At first, health officials didn’t test everyone, saying they lacked the resources. Instead, they focused on high-risk individuals: those who had direct contact with the infected passenger, and later older and symptomatic people.

Some passengers had trouble getting medical attention, even when they started to show possible symptoms. On the first full day of the quarantine, Carol Montgomery, 67, a retired administrative assistant from San Clemente, California, called the infirmary, saying she had a fever and wanted to be tested.

She was told that it was up to the Japanese Health Ministry, and that no tests were available on board. After a day passed, her husband, John, called the U.S. Embassy in Tokyo and tried to convince an official that everybody needed to be tested.

“We’re in a petri dish,” John Montgomery said. “It’s an experiment. We’re their guinea pigs.”

His wife eventually persuaded the ship’s medical office to let the couple leave their cabin for an exam. A doctor gave them flu tests, which came back negative. The doctor prescribed an antibiotic for Carol Montgomery’s urinary tract infection.

They still did not get tested for the coronavirus. The couple later evacuated with the other Americans.

Source Article