“We are in a Petri dish”: how the coronavirus devastated a cruise
While the guests on board were nervous, it was the last night of their two-week luxury cruise aboard the Diamond Princess. The party continued as the ship headed for the port of Yokohama, the second largest city in Japan.
The passengers had dinner at Filet Mignon, attended shows in the 700-seat theater and packed the bars and dance floors until the evening. Cruise directors hurriedly distributed a list of activities, including ping-pong, karaoke and Bollywood dance classes, to occupy guests who would have to stay on the ship another day while public health officials examined them for symptoms.
Hoping to soak up the last hours of their romantic journey, Tyler and Rachel Torres, newlyweds from Irving, Texas, attended the performance of a torch singer that night. “We really don’t consider the danger of leaving the room,” said Torres, a 24-year-old occupational therapist. “And since we were on our honeymoon, we refused to waste our last moments on the cruise.”
As the music played, passengers were potentially exposed to the virus. In total, it took Japanese officials more than 72 hours to impose a blockade after they were first notified about the case related to the ship.
The delay of the Japanese government, along with ineffective and ineffective containment measures during the two-week isolation period, would help make the Diamond Princess a floating epidemiological disaster.
Passengers with fever stayed in their rooms for days without being tested for the virus. Health officials and even some medical professionals worked on board without complete protective equipment. Sick crew members slept in cabins with roommates who continued their homework throughout the ship, undermining quarantine.
With 634 infections and two deaths, the cruise represents the largest concentration of coronavirus cases outside of China, and deserves its own category in data collected by the World Health Organization.
Last week, the United States government allowed 14 infected Americans to board evacuation flights with hundreds of passengers who were not. Since then, the Japanese authorities have allowed about 1,000 passengers who were negative to walk free, despite the fact that experts fear that some of them have been exposed and can then develop symptoms. Crew members were expected to start 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 transport after disembarking last week.
Now that the quarantine is over and most of the passengers are gone, the concern is that they can start spreading the virus on land.
The Japanese authorities said they did their best in a fast-moving situation, as they tried to prevent the virus from spreading within the country. After confirming the first cases among those on board, authorities said, they moved to isolate passengers to reduce transmission. The government has said that quarantine was largely effective.
The ship’s operator, Princess Cruises, said the Japanese authorities took the lead in tests and protocols. He added that “the focus has been and continues to be the safety, health and well-being of our guests and crew.”
In the early hours of February 2, before the ship had docked at Yokohama, Hong Kong officials informed the Japanese Ministry of Health about the initially infected passenger.
A spokeswoman for Princess Cruises said the company received a “formal verification” of the Hong Kong infection on February 3 and announced it to passengers on the ship that night.
Only when the parties and the shows ended at around 11 p.m., the guests were advised to stay in their rooms. After the boat docked at Yokohama, medical officers boarded the ship and went door to door taking temperatures, checking the cough and testing the virus to some passengers.
Cruise directors crossed out the planned activities the next day, while the screening continued. People still mixed on board, lining up in large buffets for meals. They used communal buckets and tongs, and shared salt and pepper shakers on the tables.
The passengers thought that their departure would be delayed only one day or so. Many were walking towards breakfast when the captain called back on the intercom on the morning of February 5.
The Japanese Ministry of Health had confirmed 10 cases of coronavirus on the ship, he told them.
Guests had to return to their rooms immediately, where they would have to remain isolated for the next 14 days.
Caught in their cabins, the 2,666 passengers now had time to remember each encounter that could have exposed them to the virus in the days before the ship closed.
There was a buffet on deck 14, where guests were urged to wash their hands before joining the line, although hygiene habits varied widely, some passengers recalled. Now they were wondering why the buffet had remained open even after the ship’s officers learned of the infected host.
Memories of art auctions, snacks, contest nights and mahjong games acquired a sinister tone.
“Everything seems stained in hindsight,” said Sarah Arana, 52, a medical social worker from Paso Robles, California, who left on an American evacuation flight.
A spokeswoman for Princess said the crew had carried out a “routine cleaning and environmental disinfection” using a disinfectant that “is known to quickly kill coronaviruses in 30 seconds.”
Passengers worried about their shore excursions. 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 established a murder mystery on a cruise ship, dwelt at the ship’s last stop, in Naha, the capital of Okinawa. When people landed, public health officials took their temperatures, a measure that was becoming more common as the virus soared in China.
Looking back, Courter wondered if the coronavirus had already begun to spread. With her husband, Philip, and a group of friends, she ate fried noodles and sweet potatoes at an outdoor stand.
“In my heart, I regret having done that,” he said, “because it was a very busy place and there were people from the ship crawling through the city.”
Every day, more cases emerged: 10, another 10, then a peak of 41.
What distressed the passengers most was the feeling that information was being withheld. Hours would pass between the moment the Ministry of Health leaked new cases to the media and the people on board were notified.
Passengers began counting ambulances lined up at the dock to guess how many new infections would be announced that day. The Japanese guests hung banners on the balconies, with a reading: “Serious lack of medicine, lack of information.”
Policies and protocols changed as the quarantine progressed.
On the second day, health officials began to let out those who were in cabins without windows to get fresh air. It was not until the next day that passengers were warned to stay more than 6 feet away from any other person. Torres, a nurse who has since evacuated with his wife, noted that others were not always attentive to wearing masks on the deck.
On the fifth day, passengers received high-strength N95 masks and were advised to use them when they opened their doors to accept deliveries of meals and crew services.
Halfway through the quarantine, the Japanese government announced that some people would be eligible to continue their land confinement: those 80 years of age or older with underlying medical conditions or windowless cabins.
The changes did not inspire confidence. Passengers waited for days to get prescriptions filled for chronic diseases such as 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 the Japanese Ministry of Health complaining that the crew seemed overwhelmed and that quarantine officers were not attending to people with symptoms.
“The ship is out of control,” Chida said, adding that his wife had waited almost a week to receive medication.
“An outbreak is happening,” he said. “We don’t have road maps.”
Yoshihide Suga, chief secretary of the cabinet of Prime Minister Shinzo Abe, said last week that the country’s authorities “had taken the utmost consideration to ensure the health of passengers and crew.”
At first, health officials did not evaluate everyone, saying they lacked the resources. Instead, they focused on high-risk individuals: those who had direct contact with the infected passenger, and later with older and symptomatic people.
Some passengers had trouble getting medical attention, even when they began to show possible symptoms. On the first full day of the quarantine, Carol Montgomery, 67, a retired administrative assistant from San Clemente, Calif., Called the infirmary and said she had a fever and wanted to get tested.
He was told that he depended on the Japanese Ministry of Health and that there was no evidence available on board. After one day, her husband, John, called the United States embassy in Tokyo and tried to convince an official that everyone should be tested.
“We are in a Petri dish,” said John Montgomery. “It’s an experiment. We are her guinea pigs.”
His wife finally persuaded the ship’s medical office to let the couple out of their cabin for an exam. A doctor gave them flu tests, which were negative. The doctor prescribed an antibiotic for Carol Montgomery urinary tract infection.
The coronavirus test was not yet done. The couple later evacuated with the other Americans.
John Haering, a retired railway operations manager from Tooele, Utah, called the doctor’s office when his temperature rose sharply. They told him that if it wasn’t an emergency, he would have to wait.
At one point, someone came to the door with a clipboard, he said, asked his temperature and left. Inside the cabin he shared with his wife, Haering, 63, sweated her, took cold showers and swallowed the last supply of Tylenol while its temperature rose to 104 degrees Fahrenheit.
Four days later, after his fever was gone, officers in hazardous material suits appeared at the couple’s door, ordered Haering to pack a bag and loaded it into an ambulance, leaving his wife on the ship.
The next day, a doctor from a hospital about 40 miles from the port told him he had tested positive for the virus. He remains in the hospital, while his wife, Melanie, is quarantined at an American military base.