Diamond Princess passenger "tested positive for Wuhan coronavirus"

[Wehwalt]

3 minutes ago, rich_cathybrock said:

https://www.usatoday.com/story/travel/cruises/2020/02/21/coronavirus-diamond-princess-cruise-evacuees-test-positive-nebraska/4829248002/

"However, more than 100 American passengers elected to finish their quarantine on the ship rather than leave on one of last weekend's evacuation flights. According to a letter from the Centers for Disease Control and Prevention, they must remain symptom-free and continue to test negative for two weeks before re-entering the United States." 

 

I believe this was also cited in one of the letters delivered to pax onboard from CDC prior to disembarkation.  I can't imagine how this gets managed, but assume it would be coordinated with Princess' team who are arranging flights home for everyone.  Since US is requiring a negative test to clear pax whose passports are now flagged, they probably need a negative test to fly.

 

I don't know if Princess will pay for flights if you wait it out in Japan, considering you had the opportunity for a repatriation flight.

[cherylandtk]

11 minutes ago, bluesea321 said:

 

Can you or anyone give me a source for the "presumably will be tested"?  I know they are banned from returning to the US prior to March 4 (at the earliest) but I have not been able to verify that a COVID-19 retest is being demanded. Hope they don't just test temperature, it is better than nothing but not reliable.

I don’t think they have yet decided.  Since this is a rapidly changing set of knowledge, I doubt if a specific decision will be made until March 4 or later; after we see if any of the ‘free to wander’ pax turn up ill or not.  The current embassy status page makes a distinction in cohort groups, but does not specify what the requirements to return will be for that group.

https://japan2.usembassy.gov/pdfs/alert-20200221-diamon-princess.pdf

[bluesea321]

6 minutes ago, rich_cathybrock said:

https://www.usatoday.com/story/travel/cruises/2020/02/21/coronavirus-diamond-princess-cruise-evacuees-test-positive-nebraska/4829248002/

"However, more than 100 American passengers elected to finish their quarantine on the ship rather than leave on one of last weekend's evacuation flights. According to a letter from the Centers for Disease Control and Prevention, they must remain symptom-free and continue to test negative for two weeks before re-entering the United States." 

 

I believe this was also cited in one of the letters delivered to pax onboard from CDC prior to disembarkation.  I can't imagine how this gets managed, but assume it would be coordinated with Princess' team who are arranging flights home for everyone.  Since US is requiring a negative test to clear pax whose passports are now flagged, they probably need a negative test to fly.

 

 

This is the letter from HHS that the passengers staying behind received and it does not say "retest". However I hope you are right and they do retest them.

 

[ceilidh1]

3 hours ago, Colo Cruiser said:

How do you know this?  

It is the couple who owns KHTS Radio - many of us on here have been following them. They have done some well-written blogs as well as videos on the radio FB page. One of the 4 was found positive a day or so before the evac flight and was transferred to hospital in Japan. The other 3 were tested due to close contact. Her husband was negative. The other couple  had not received their test results prior to going on the evac flight. The husband of this couple developed a fever on the flight and was flown behind the plastic sheet. He was tested on arrival in US and next day confirmed positive. His wife still shows negative, as does the husband of the other lady who is still in Japan.

[kathy49]

1 hour ago, phil the brit said:

https://www.state.gov/joint-statement-by-u-s-department-of-state-and-u-s-department-of-health-and-human-services-on-repatriation-of-american-passengers-from-the-diamond-princess-cruise-ship/

 

Scroll right down to full transcript at the bottom and read questions from various media. They were only allowed to ask one question each and not allowed any comebacks.

This is going to blow up, one of the most pertinant questions was how long were (known) infected people sitting on the busses with non infected people. The answer was "there was a 40 minute ride to the airport and busses were emptied as soon as it was safe to do so".

THAT WAS NOT THE QUESTION, HOW LONG WERE BOTH INFECTED AND NOT INFECTED PEOPLE ON THE BUSSES MIXED UP?

This was NOT answered...............It WILL be asked again I am sure.

botched in so many ways and so many answers unknown....families and passengers will first want to get home and sort thru this and you can expect this will be the topic of some serious review.

[npcl]

11 hours ago, hal2008 said:

 

"If Japan was not willing" is a long stretch just to justify decisions of unprofessionals in the admistration to overrule professional CDC experts.

 

Japan had already taken 600+ people in hospitals. Both before and after. There is no reasonable rationalization to believe that they will oddly refuse only this 14 people. "Paperwork was already done" is a very weak excuse against possibility of exposing so many other US citizens.

 

Most probably delay was not in negotiating with Japan and then losing that negotiation but in arguing with CDC and then overruling them.

 

 

The representative from State are also professionals, just a different category of professional.  It is State not CDC that would have negotiated the departure agreement.  It is State not CDC that bears any responsibility for failing to live up to that agreement.  I would expect that CDC would have, in consultation with State, approved the departure list.  In hind sight maybe they should have only included on the list those that had already tested negative (keeping in mind that not all of those tests were recent), but they did not.  However, the agreement was for anyone that wanted to leave that had not tested positive and the planes manifest was established using that criteria.

 

They could have delayed taking anyone, until test results were back for everyone.  Of course that did not occur until the quarantine was over and people were being released from the ship.

 

As the saying goes no good deed goes unpunished.

[npcl]

10 hours ago, seapals2 said:

Honestly .. I would have wanted to know the minute they discovered the passenger who had been onboard was tested positive. I would have wanted quarantine to prevent the spread of the virus ... but.. on finding out that crew were among those tested positive I would have been extremely worried and wanted to get off the ship and quarantine on land .. preferably in my home country.  Of course the numbers effected prevented this.  The logistics of doing all the tests and waiting for the results prevented the ‘ideal’.  So .. and this was my point .. I don’t want to be on a ship while the risk of this virus exists.  I don’t want to be one of thousands and not in control of my own health and treatment. 

None tested positive until they arrived in Yokohama and the ship was quarantined.  The ship had no way to test for COVID-19.  It was only suspected based on the symptoms a number of passengers were exhibiting.  

[npcl]

10 hours ago, seapals2 said:

For me it’s more about the numbers involved.  Suddenly you are in a group of thousands and not an individual.  We have always cruised aware that we are putting ourselves at risk of contacting illness but this virus is new and life threatening demanding testing and quarantine.  
Makes me wonder what happened back in the day of SARS .. how did the cruise industry cope with that outbreak.  
 

off to do some research.  

 

 

 

SARS was a much different situation.  Shorter incubation time, pretty much all cases serious, higher fatality rate.  Bottom line less hidden spread.   This with asymptomatic cases being able to spread the disease, high percentage of mild cases that might not seek treatment, longer incubation time to spread the illness.  If one was doing a paper on the characteristics of an illness to turn into a pandemic this one has them.

[bluesea321]

46 minutes ago, rich_cathybrock said:

https://www.scmp.com/week-asia/health-environment/article/3051845/could-coronavirus-crisis-sink-cruise-industry  An interesting look at the reaction to potential infection in the ports visited by DP before the quarantine.

 

Yeap.  The Diamond is at the moment scheduled to return to service in late April however its only ports through May are in Japan and S. Korea. And with S. Korea now at the highest alert level I anticipate that the Busan port will be scratched. So where can they cruise now? Asian ports are clamping down and for good reason.

[npcl]

4 hours ago, kathy49 said:

thanks to all for the updates and thoughts here ...helpful as we watch the fallout from this cruise.  In years to come experts will review this "quarantine" and probably do things very very differently.  Really a failure and far from over.

Actually if you take a look at the situation and the data the quarantine was far from a failure.  And even though there are some ways it could be improved.  Many things went well.

 

 

First take a look at the situation. It is pretty much of a worst case scenario.

 

A cruise ship shows up with over 3000 on board with an infectious illness that has had time to spread.

 

At this time, unlike what the researcher would have wanted, there are no red and green zones, because unlike a hospital, it must be assumed that the virus everywhere on board. There are often big differences between what one wants in an ideal world and what one must deal with in the real world. 

 

Because the virus is new there is limited testing capability and because there has not been large scale quarantines in Japan since the Cholera outbreaks in the 1920's there are not established quarantine centers to handle that number of people. Not only that but there are insufficient cabins on board to isolate both the crew and the passengers.  Also since it is a working ship some of the crew must continue to do their jobs.

 

With that in mind the goals would be to 1. Prevent the spread from ship to shore  2. Reduce risk as much as possible for those on the ship. 3. Structure the quarantine such that the people on the ship can eventually get off and that it doesn't turn into months and months of waiting and new cases develop.

 

So with that in mind the decision was to isolate the passengers (who by the way were the highest risk for serious/fatal outcomes because of age and medical history). 

 

Consider the passengers to be Cohort 1. The treatment of Cohort 1 was if they did not develop the disease and tested negative AFTER the end of the 14 day period they would be considered to be free of disease and released, with the exception of those in cabins where others developed symptoms or tested positive.  Those would be transferred in Cohort 2 and would need longer quarantine period.

 

The Quarantine period did come and go.  The report referenced earlier, that actually showed detailed passenger information certainly supported that the isolation of the passengers on board was effective.  The tests were conducted and the majority of the passengers were released. As of this time there is 1 out of over 2000 that went through the quarantine and later tested positive.  There might be more, but as the days pass that risk reduces.

 

That leaves Cohort 2  - those passengers with cabin mates that tested positive.  who remain in isolation and Cohort 3 which is the crew which was not in isolation.  Now the demographics of the crew are such that while they might contract the illness that fatality rates are very low in the  same range as the flu, so unlike the passengers where numerous fatalities could be expected, you would not expect it to occur in the crew.

 

Are there things that could have been done differently?  Certainly.  But when one considers the timing, the number of people, the space on board the ship.  The ability of the illness to spread prior to isolation, I am of the opinion that it went surprisingly well. 

 

Quarantines are never fun. It is not their purpose to be so.  Their purpose is to protect as many as possible and to lower the risk as much as possible.

 

 

 

[kathy49]

18 minutes ago, bluesea321 said:

 

Yeap.  The Diamond is at the moment scheduled to return to service in late April however its only ports through May are in Japan and S. Korea. And with S. Korea now at the highest alert level I anticipate that the Busan port will be scratched. So where can they cruise now? Asian ports are clamping down and for good reason.

i can't imagine trying to sell a cruise in Asia for the foreseeable future...one port after another having outbreaks. It just makes no business sense...who is going to book?

[npcl]

17 minutes ago, bluesea321 said:

 

Yeap.  The Diamond is at the moment scheduled to return to service in late April however its only ports through May are in Japan and S. Korea. And with S. Korea now at the highest alert level I anticipate that the Busan port will be scratched. So where can they cruise now? Asian ports are clamping down and for good reason.

I suspect that Diamond will not be cruising in Asia. Don't see either Korea or Japan wanting to deal with any more cruise ships at this time.

[bluesea321]

19 minutes ago, npcl said:

I suspect that Diamond will not be cruising in Asia. Don't see either Korea or Japan wanting to deal with any more cruise ships at this time.

 

I would have anticipated the same but Princess so far is sticking to its plans. I would not want to board the Diamond and in particular in Asia.

Edited February 23, 2020 by bluesea321

[npcl]

4 minutes ago, bluesea321 said:

 

I would have anticipated the same but Princess so far is sticking to its plans. I would not want to board the Diamond and in particular in Asia,

I think they are hoping that the outbreaks slows down and gets controlled before they have to make more decisions.

[rich_cathybrock]

Thank you @npcl for being a voice of reason.  I also believe Princess did the best they could in an impossible situation.

 

While the lessons learned will be voluminous when all is said and done, the decisions made are now water under the proverbial bridge.

[Pushka]

3 hours ago, rich_cathybrock said:

@JennAngel9I agree wholeheartedly.  I cannot imagine being one of the "unlucky 14", getting all the way to the plane, and being told I had to be removed.  I keep thinking it was terribly "convenient" for those results to be made known to the US gov't only after they took custody of them.  Either way, at the point this was discovered, the exposure had already transpired on that bus and the only humane thing to do at that point was bring them all home, and I, for one, wouldn't have had that play out any other way, since they are now isolated here, and there have been no reports of others in the facilities where the US pax are quarantined getting sick, which I take as a positive sign.

 

Now Italy is having a surge and meantime, we still don't know where everyone who got off Diamond is headed, nor how many remain onboard.  In ~ 2 weeks, those who did disembark on their own are presumably to be tested and, if cleared, can return home.   That, if 2 weeks is even enough time....

 

This is a mess.   Boarding the Anthem a week from today, and on Majestic in Sydney in Jan of 2020.

 

And being packed up ready to board the bus to come back to home country then being refused the flight is exactly what happened to an Australian family when their daughter tested positive just before departure. On the other hand at least one person developed the virus on the flight. 

[Kmkub]

4 hours ago, em-sk said:

 

They were trying to do both.  

 

If they were only trying to quarantine the ship as a whole they would not have restricted passengers to their cabin. 

Well, sort of. They were in isolation, which is not a quarantine. They were hoping to mitigate.

[Psoque]

41 minutes ago, Kmkub said:

Well, sort of. They were in isolation, which is not a quarantine. They were hoping to mitigate.

I hope this one sticks.

As I have already said many times for the past week or so, the only goal of the quarantine is to seal off the virus within the ship.  This was slightly modified in the case of Diamond Princess by a) sending the sick to the hospital on land for better care b) providing supplies to the ship c)receiving test samples, etc from the ship d)sending people to the ship to check in.

The quarantine was performed because WHO/CDC/and the Japanese government has a responsibility to prevent this from contributing to a worldwide disaster.  Can you imagine both Haneda/Narita airprts and Yokohama/Tokyo stations to be teeming with people sick with the virus, as well as potentially thousands of asymptomatic but infectious carriers flying home from Tokyo to hundreds of locations overseas?  Quarantine affect all who are potentially exposed to the virus, which is the entire population on the ship.  It does not distinguish who is infected/not ifected/tested positive/tested negative/symptomatic/asymptomatic.  That's how the quarantine works.

 

Since Princess/CDC/Japanese Government/WHO also has a strong interest in keeping passengers and crew away from harm, they ran a lockdown/isolation protocol on the ship, to hopefully reduce the spread of the virus among those who might be still uninfected.  600+ people onboard still tested positive for the virus.  How could that be?  I don't think anybody can really answer this question now, because we don't know how many of these people were infected before vs. after the quarantine/lockdown/isolation began.

 

But one this we know for sure, the mass evacuation, first led by the US State Department, though perhaps well intended (to manage the political pressure and hysteria), did mix up those who were infected with the others, and broke the quarantine beyond repair.  After that, the quarantine became a bit of a moot point, because (a lot of) cats are out of the bag.

 

Below is a good explanation about the differences between quarantine, isolation.

 

https://www.cdc.gov/quarantine/index.html

 

CDC does not have a good write-up on lockdown, but lockdown is essentially a limit on movement/gathering of people (whether they are sick/infected/infectious or not) to reduce the spread of the disease.  This is different from isolation because isolation is separation of those who are ill from not ill.  However in practice, act of isolation and lockdown invariably overlap, as it was in the case with Diamond Princess.

 

 

[Jetstreamer]

2 hours ago, bluesea321 said:

 

I would have anticipated the same but Princess so far is sticking to its plans. I would not want to board the Diamond and in particular in Asia.

 

This ship is going to be the cleanest ship out there when it enters back into service so no worries there.

 

In Japan there is no reason to worry any more than there would be anywhere else. The Diamond outbreak was nothing to do with Japan - that was just where the ship was when it was discovered. The per capita cases are still fairly low and I feel the perception outside Japan is far removed from the reality in it. People are just getting on with their lives.

 

Other countries with a bigger cruise industry footprint are developing more cases too. It is possible that soon there will be no safe havens for cruise ships and what then, stop all cruises? 

 

So, while I fear that further upcoming Diamond cruises will be cancelled, I hope not. Part of this is personal as we are due to sail in May, but I certainly wouldn't be hoping the sailings go ahead if I had concerns. 

[glam mistress]

An Israeli national from DP is positive now. 

 

 

[bluesea321]

The number of infected on the Diamond has now been raised to 691 with 3 deaths.  This likely includes newly diagnosed crew members.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

[sprinkles]

5 minutes ago, bluesea321 said:

The number of infected on the Diamond has now been raised to 691 with 3 deaths.  This likely includes newly diagnosed crew members.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Thanks for posting the link blue sea, you posted while I was typing.

[npcl]

6 hours ago, kathy49 said:

i think conventional wisdom would say it was two fold...to keep them apart from the country of Japan and its citizens...and secondly to keep them from each other ie to not spread the virus on board. failure.

If you look at the detailed data on the passengers that was published before Japan ended the passenger quarantine, which indicated details about symptom onset dates.  The isolation looked like it was very effective. The only apparent transmission during isolation appears to be in cabins where one tested positive.  So not sure what you are using for a source that the passenger isolation failed.

 

https://www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html

Edited February 23, 2020 by npcl

[bluesea321]

2 minutes ago, sprinkles said:

Thanks for posting the link blue sea, you posted while I was typing.

My pleasure.

[Wizpharm2]

10 minutes ago, bluesea321 said:

The number of infected on the Diamond has now been raised to 691 with 3 deaths.  This likely includes newly diagnosed crew members.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

This site provides a wealth of information,  and updated a lot more frequently.
https://www.worldometers.info/coronavirus/?source=122648