How the 'failed' quarantine of the Diamond Princess cruise ship started with 10 coronavirus cases and ended with more than 630
- The Diamond Princess cruise ship went from 10 cases of the new coronavirus to more than 630 over the course of its two-week quarantine.
- Experts and officials have criticized the decision to keep people on the ship and poor hygiene practices onboard.
- Here's how the cruise ship ended up with more than half of all novel coronavirus cases outside China.
- For the latest case total, death toll, and travel information, see Business Insider's live updates here.
- Visit Business Insider's homepage for more stories.
Passengers on the Diamond Princess cruise ship got their first piece of bad news on February 4: Ten people onboard had tested positive for the novel coronavirus.
It was the beginning of a two-week ordeal of quarantine orders and disease response that has been widely criticized as a failure. On Friday, Japan's Ministry of Health reported that 634 people from the ship had tested positive for the virus. The US Centers for Disease Control and Prevention (CDC) reported an additional 18 cases from the ship, with an expectation that more will arise.
Two people have died.
"The quarantine was not justified, and violated the individual rights of the passengers while allowing the virus to literally pick them off one-by-one," Dr. Amesh Adalja, who works at the Johns Hopkins Center for Health Security, told Business Insider in an email.
Adalja and other experts have criticized the decision to keep passengers and crew on the ship and said poor hygiene practices helped spread the virus.
"I'd like to sugarcoat it and try to be diplomatic about it, but it failed," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told USA Today. "People were getting infected on that ship. Something went awry."
Here's how it got so bad.
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On February 1, a man who'd been on the Diamond Princess tested positive for the new coronavirus six days after leaving the ship. It docked in the port of Yokohama, Japan, three days later.
By the following morning, 10 people on the ship had tested positive for the virus. Japan's Ministry of Health placed the entire boat under a 14-day quarantine.
Japanese health officials continued testing passengers and transported those who tested positive to health facilities on land.
From the beginning, those quarantined on the ship reported confusion and a lack of information.
Fehrenbacher told Business Insider that he stood very close to a woman who was clearly sick when he got his medical screening.
Ishida also reported concerns about the screenings: "They didn't put the thermometer into our ears properly," she said.
Three days into the quarantine, people on the ship began unfurling signs that read "Lack of medicine!" and "Thank you, media."
Passengers were confined to their rooms, the least expensive of which have no windows or balcony.
Honeymooners Alan and Wendy Steele told The Washington Post that they were going "stir crazy" on February 5.
Passengers tweeted pictures of their meals and gave the room service mixed reviews.
In addition to food and drinks, passengers were given face masks.
Those in the interior, windowless cabins were allowed to walk around the deck for a few minutes each day, wearing face masks.
Experts have criticized the decision to keep people on the ship.
Keeping people in a confined space may have helped the virus spread.
"Cruise ships are made of surfaces that are really sticky for viruses," Kelly Hills, a bioethicist and Rogue Bioethics co-founder, told Business Insider.
Infectious-diseases expert Kentaro Iwata said poor hygiene practices on the ship made him "so scared" of contracting the virus when he visited.
As the case count continued to rise, some Indian crew members begged their government to rescue them.
Crew members brought meals to passengers' rooms, but the workers continued to eat together in the ship's mess hall.
"We all are really scared and tense," Sonali Thakkar, a worker on the cruise ship, told CNN.
As the case count rose past 200, passengers expressed fear.
"The 14-day stipulation was meaningless in a context with new infections and new transmission episodes," Adalja said.
On February 12, the Japanese Ministry of Health announced that some passengers over 80 years old could finish their quarantine on land.
On Valentine's Day, passengers were gifted roses, chocolates, and (courtesy of the Japanese Health Ministry) new iPhones featuring a special app for medical support.
After nearly a month on board, the remaining passengers finally began to leave the ship after the quarantine ended on February 19.
By then, the number of people infected with coronavirus on the ship had skyrocketed to 621 — more than half of all cases outside China.
Fourteen US citizens who tested positive for the virus flew home in an isolation box on the back of the plane with other Americans from the ship.
But on Thursday, the CDC said 22 of the other US evacuees who had been on the flight had either tested positive for the coronavirus or shown symptoms.
CDC officials had argued against the decision to have sick and healthy people fly on the same plane.
Two people who were on the cruise ship — an 87-year-old Japanese man and an 84-year-old Japanese woman — died on Tuesday, Japanese officials said.
Princess Cruises is preparing the ship to set sail again on April 29.
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