Over 3,500 people quarantined on Diamond Princess cruise

[Starwind]

HAL has requested a new test for the American passenger who tested positive in Malaysia, as she didn't test positive in Cambodia.

HAL has issued an updated statement on their website confirming the passenger has tested positive and also providing a timeline and additional information:

https://www.hollandamerica.com/blog/ships/ms-westerdam/statement-regarding-westerdam-in-japan/
QUOTE

Update: 2/16/2020 5:24 am Pacific Time
Testing done in Malaysia on a Westerdam guest who disembarked the ship to fly home was reported positive for COVID-19, as confirmed by a statement by Malaysian Deputy Prime Minister Dr. Wan Azizah Wan Ismail at a press conference. The guest departed Westerdam February 14 and later reported feeling ill at the Kuala Lumpur, Malaysia airport. The guest was taken to the hospital and is reported to be in stable condition. The guest’s traveling companion tested negative for COVID-19.

Holland America Line is working closely with government and health officials in Malaysia and Cambodia and experts in the U.S. Centers for Disease Control (CDC) and the World Health Organization (WHO). At this time, no other guests or crew, either on board or on their way home, have reported any symptoms of the illness. Guests who have already returned home will be contacted by their local health department and be provided further information.

“We are in close coordination with some of the leading health experts from around the world,” said Dr. Grant Tarling, Chief Medical Officer for Holland America Line. “These experts are working with the appropriate national health authorities to investigate and follow-up with individuals who may have come in contact with the guest.”

On Feb. 10, 2020, all 2,257 passengers and crew on board Westerdam were screened for illness including the taking of individual temperatures. No individual was identified with an elevated temperature. Also during disembarkation in Cambodia guests underwent an additional health screening including the completion of a written health questionnaire. Furthermore, the passports of everyone on board were reviewed to ensure no one had traveled through mainland China in the 14 days prior to the cruise. During the voyage there was no indication of COVID-19 on the ship. The guest who tested positive did not visit the ship’s medical center to report any symptoms of illness. An additional 20 guests who reported to the medical center during the cruise were tested by health officials for COVID-19, and all results were confirmed negative.

Westerdam is alongside at Sihanoukville, Cambodia, with 747 crew and 233 guests who are awaiting their final travel arrangements. The remainder of guests from the voyage departed Sihanoukville via charter flights to Phnom Penh and are in various stages of transit home.

Holland America Line will provide a further update once we have more information.

END QUOTE

 

[noonew]

That Cambodia only has one case seems unlikely in that it is sandwiched between two countries that have lots of cases and porous borders, and many thousands of know potential exposure under home quarantine. She tested negative, then positive, then positive. It is possible she incubated for the full 14 days or even 15 and then popped a (+) result, that is, she could be an outlier on either end. But everyone onboard would also have to be an outlier because they were at sea and unable to dock for 14 days. No one else on the ship, has had a positive result, yet. Leaning toward Cambodia.

Latest I've heard, the incubation period can last as long as 24 days. Also, Westerdam docked and picked up 600+ passengers from Hong Kong on Feb 1 and the first group of passengers disembarked on Feb 14. They were not at sea for the full 14 days. The symptom may appear as early as 2 days of the first contact, but since the woman was tested positive on the 15th, it's less likely that she contacted the virus in Cambodia, more likely on the Westerdam.

Correction: According to the US Embassy Cambodia's twitter account, the woman was tested positive after arriving in Malaysia on Feb 14, the same day she disembarked from the ship. That means she only spent several hours ashore in Cambodia, thus nearly impossible for her to get the virus from Cambodia.

 

[QueenElinor]

Some of the Americans are now getting off Diamond Princess. Flights back to the US happen very soon. This tweet is from an American is who is not leaving.

https://twitter.com/x/status/1229037215184932865

I will be very interested to see how things go for him. Hope he keeps tweeting. There's a British couple right now who would take his place on the American flight out in a heartbeat.

Latest I've heard, the incubation period can last as long as 24 days. Also, Westerdam docked and picked up 600+ passengers from Hong Kong on Feb 1 and the first group of passengers disembarked on Feb 14. They were not at sea for the full 14 days. The symptom may appear as early as 2 days of the first contact, but since the woman was tested positive on the 15th, it's less likely that she contacted the virus in Cambodia, more likely on the Westerdam.

Correction: According to the US Embassy Cambodia's twitter account, the woman was tested positive after arriving in Malaysia on Feb 14, the same day she disembarked from the ship. That means she only spent several hours ashore in Cambodia, thus nearly impossible for her to get the virus from Cambodia.

My vote is definitely for her picking it up on the Westerdam. We've seen how it spread quickly through the Diamond Princess. 600 passengers from HK could easily have someone with coronavirus, or it could be someone else entirely who's not been identified yet. Someone with just cold symptoms.

I still think the long incubation times that have been reported are actually people who were exposed to others with minimal to no symptoms more recently than 24 days. It's going to take a bit of work to sort those two issues out.

As far as HAL stating they screened all the passengers, data from the SARS outbreak suggest they'll only pick up about half the people who are infected. It's better than nothing, but far from effective.

 

[QueenElinor]

I am very impressed with how quickly (relative to other countries) the US evacuates their citizens. Always the first to react and respond.

Well, we have the capacity. And it's good to see that all the money we spend on the military has humanitarian benefits, as well. I have a feeling we'll be calling on them more for things like this as time goes by- right now around 600 people are under quarantine at 11 military bases around the country.

Also, much to my surprise (considering the never-ending parade of negative news about our government) I found out today that America is the most prepared for a pandemic, with the UK not far behind. I think our geography will help us out, too. So we'll see how all of those factors play out over the next few months/years.

At a local level, I think we have very strong public health departments and disaster preparedness. I know my community does. Honestly, they're the ones I have the most faith in. I know these people well, and they are ON it.

 

[Starwind]

A US couple video'd coming off the Diamond and onto the buses:

 

[QueenElinor]

A US couple video'd coming off the Diamond and onto the buses:

I'd like to see them when they get off the plane in the US. I'd be kissing the tarmac!

 

[Adventurelawyer]

Latest I've heard, the incubation period can last as long as 24 days. Also, Westerdam docked and picked up 600+ passengers from Hong Kong on Feb 1 and the first group of passengers disembarked on Feb 14. They were not at sea for the full 14 days. The symptom may appear as early as 2 days of the first contact, but since the woman was tested positive on the 15th, it's less likely that she contacted the virus in Cambodia, more likely on the Westerdam.

Correction: According to the US Embassy Cambodia's twitter account, the woman was tested positive after arriving in Malaysia on Feb 14, the same day she disembarked from the ship. That means she only spent several hours ashore in Cambodia, thus nearly impossible for her to get the virus from Cambodia.

I was unaware they took on passengers there. However, that 24 day number is out of China which can no longer tell when anyone was exposed and have to rely on memory of the infected. CDC and others in the West are questioning that number, as are the Singapore health authorities. Even if they took on passengers on Feb 1 and at least one of them were exposed, but not symptomatic, at least one of them would have tested positive in addition to the woman who tested positive in Malaysia. So it is still unlikely. As I said before, statistical outlier is possible, either on the front or the back end of the incubation period. CDC has said the same, but it is unlikely. Asymptomatic carriers are still unverified. Most of these people are taking other medications which could reduce fever, or symptoms. Since she initially was not symptomatic on the ship, or in Cambodia, its unlikely anyone else is at risk.

If the fear is that these people will somehow end up in the general population of their home countries, without being under even the minimum self quarantine rules, it is doubtful. At least here in the US, they may even be facing an escort to official quarantine on presentment to US customs. CDC is erring on the side of aggressive caution.

 

[Adventurelawyer]

Well, we have the capacity. And it's good to see that all the money we spend on the military has humanitarian benefits, as well. I have a feeling we'll be calling on them more for things like this as time goes by- right now around 600 people are under quarantine at 11 military bases around the country.

Also, much to my surprise (considering the never-ending parade of negative news about our government) I found out today that America is the most prepared for a pandemic, with the UK not far behind. I think our geography will help us out, too. So we'll see how all of those factors play out over the next few months/years.

At a local level, I think we have very strong public health departments and disaster preparedness. I know my community does. Honestly, they're the ones I have the most faith in. I know these people well, and they are ON it.

Even on a state and local level, we jointly with the Feds practice table top exercises for disasters. The last one I did before going into private practice was for Pandemic Flu. The response you are seeing is right in line with the playbook. The order was sent to DoD well before February 1 to prep for Pandemic Flu measures, so we are actually on it and it's why I am not as worried as most seem to be and why I am following the response closely. As of now, containment is working and we are holding the line. The incident in Hawaii could undo all the hard work so far and if it does, and containment is breached, then the evacuations will stop. Unless you are on a US mission (and sometimes even if you are) you will be on your own wherever you happen to be in the world.

 

[noonew]

I was unaware they took on passengers there. However, that 24 day number is out of China which can no longer tell when anyone was exposed and have to rely on memory of the infected. CDC and others in the West are questioning that number, as are the Singapore health authorities. Even if they took on passengers on Feb 1 and at least one of them were exposed, but not symptomatic, at least one of them would have tested positive in addition to the woman who tested positive in Malaysia. So it is still unlikely. As I said before, statistical outlier is possible, either on the front or the back end of the incubation period. CDC has said the same, but it is unlikely. Asymptomatic carriers are still unverified. Most of these people are taking other medications which could reduce fever, or symptoms. Since she initially was not symptomatic on the ship, or in Cambodia, its unlikely anyone else is at risk.

If the fear is that these people will somehow end up in the general population of their home countries, without being under even the minimum self quarantine rules, it is doubtful. At least here in the US, they may even be facing an escort to official quarantine on presentment to US customs. CDC is erring on the side of aggressive caution.

The fact that the ship docked in HK on Feb 1 was the main reason Westerdam was denied docking by 5 different international ports before Cambodia.

The key word here is "test". According to HAL's latest statement and tweets from several passengers onboard, the only test they did on Feb 10 were the temperature checks. That is not enough to confirm or deny whether a person has the virus. The health screen they did when they disembark in Cambodia on Feb 13/14 were temperature check (again) and passport check to see whether anyone were in Mainland China during the previous 14 days. According to the Cambodia and HAL official statement, they only tested 20 passengers out of 2,257 passengers and crews. Again, I'm interested in what kind of "test" they did on these 20 passengers. It took hours or, in some cases, days for other countries (Japan, Thailand, Singapore, etc) to perform an extensive test to confirm/deny whether a person has this virus, but it took less than 12 hours for Cambodia to speed up and test these 20 cases. The woman who was tested positive in Malaysia wasn't one of those 20 passengers tested by the Cambodia.

As for the asymptomatic cases being verified, the Japanese official said out of the 355 confirmed cases from the Diamond Princess, 111 are asymptomatic.

And after weeks of testing, Japan only finished 1,219 cases out of total 3,711 people on the Diamond Princess. That's how long it took an advanced country like Japan to perform the actual test, not just temperature checks and health/passport screening like HAL and the Cambodia official did.

 

[Adventurelawyer]

The fact that the ship docked in HK on Feb 1 was the main reason Westerdam was denied docking by 5 different international ports before Cambodia.

The key word here is "test". According to HAL's latest statement and tweets from several passengers onboard, the only test they did on Feb 10 were the temperature checks. That is not enough to confirm or deny whether a person has the virus. The health screen they did when they disembark in Cambodia on Feb 13/14 were temperature check (again) and passport check to see whether anyone were in Mainland China during the previous 14 days. According to the Cambodia and HAL official statement, they only tested 20 passengers out of 2,257 passengers and crews. Again, I'm interested in what kind of "test" they did on these 20 passengers. It took hours or, in some cases, days for other countries (Japan, Thailand, Singapore, etc) to perform an extensive test to confirm/deny whether a person has this virus, but it took less than 12 hours for Cambodia to speed up and test these 20 cases. The woman who was tested positive in Malaysia wasn't one of those 20 passengers tested by the Cambodia.

As for the asymptomatic cases being verified, the Japanese official said out of the 355 confirmed cases from the Diamond Princess, 111 are asymptomatic.

And after weeks of testing, Japan only finished 1,219 cases out of total 3,711 people on the Diamond Princess. That's how long it took an advanced country like Japan to perform the actual test, not just temperature checks and health/passport screening like HAL and the Cambodia official did.

And people lie about what they may have taken in order to skirt the quarantine system. The Japanese also won't admit that their system contributed to the spread of the virus onboard the Diamond and elsewhere in their country. They are a timebomb. Until a peer reviewed study confirms true asymptomatic spread ( think "Typhoid Mary," not masked symptoms), I am not even a little worried about the HAL incident. Again, 14 days is the current norm. Feb 1, to Feb 14 and no other passengers are symptomatic or positive. Again, even IF she were a freak of nature, a statistical outlier, at least one of those Hong Kong passengers would also be sick. 14 Days, and only 1 passenger. Additionally, her husband isn't sick. This is a nothing burger.

 

[QueenElinor]

Unless you are on a US mission (and sometimes even if you are) you will be on your own wherever you happen to be in the world.

From a practical viewpoint, as harsh as it sounds, it may not make a lot of difference then, either. Nowhere would be safe, why bother. So is that their logic, or is it rather that resources would be needed here at home?

And people lie about what they may have taken in order to skirt the quarantine system.

And that, in fact, already happened. A Utah couple KNEW the wife was sick and hesitated to call the ship's medics because they feared they'd be separated. https://www.abc4.com/news/second-utahn-quarantined-on-cruise-ship-tests-positive-for-coronavirus/ She later tested positive.

This is why quarantines have too be designed by the experts, and not cruise lines. Although this was a really tough spot for them to be in.

 

[Dreams&wishes]

Well, we have the capacity. And it's good to see that all the money we spend on the military has humanitarian benefits, as well. I have a feeling we'll be calling on them more for things like this as time goes by- right now around 600 people are under quarantine at 11 military bases around the country.

Also, much to my surprise (considering the never-ending parade of negative news about our government) I found out today that America is the most prepared for a pandemic, with the UK not far behind. I think our geography will help us out, too. So we'll see how all of those factors play out over the next few months/years.

At a local level, I think we have very strong public health departments and disaster preparedness. I know my community does. Honestly, they're the ones I have the most faith in. I know these people well, and they are ON it.

Please tell me where you read that the UK is prepared for a pandemic I'm here atm and I desperately need reaurance! Until now they have not stopped the flights from China. They have sent people back home after testing them while waiting for the results, which in the last London case was positive. They have said that they will stop testing when they will reach 100 cases. They have said to headmasters that students that have been in contact with coronavirus cases can keep going to school untill tests results come back positive. They havesaid that if you get symptoms , you can stay at home and ride it out.They have this blind trust in self quarantine which, as the last case demonstrated doesn't work as people don't respect it. Finally they only have four Airborne High Consequences Infectious Disease Centres (HCIDs) in England which are equipped to receive people with illnesses such as coronavirus.

These are Guy's and St Thomas' NHS Foundation Trust, Royal Free London NHS Foundation Trust, Royal Liverpool and Broadgreen University Hospitals NHS Trust, and Newcastle upon Tyne Hospitals NHS Foundation Trust.

You can see how 4 hospitals for a population of 66.44 million might not be enough. Furthermore these centers are quite far from alot of other major cities and they count on having to transport people there by ambulance which may not be practical and certainly impossible if numbers start to ramp up.

 

[QueenElinor]

Please tell me where you read that the UK is prepared for a pandemic I'm here atm and I desperately need reaurance! Until now they have not stopped the flights from China. They have sent people back home after testing them while waiting for the results, which in the last London case was positive. They have said that they will stop testing when they will reach 100 cases. They have said to headmasters that students that have been in contact with coronavirus cases can keep going to school untill tests results come back positive. They havesaid that if you get symptoms , you can stay at home and ride it out.They have this blind trust in self quarantine which, as the last case demonstrated doesn't work as people don't respect it. Finally they only have four Airborne High Consequences Infectious Disease Centres (HCIDs) in England which are equipped to receive people with illnesses such as coronavirus.

These are Guy's and St Thomas' NHS Foundation Trust, Royal Free London NHS Foundation Trust, Royal Liverpool and Broadgreen University Hospitals NHS Trust, and Newcastle upon Tyne Hospitals NHS Foundation Trust.

You can see how 4 hospitals for a population of 66.44 million might not be enough. Furthermore these centers are quite far from alot of other major cities and they count on having to transport people there by ambulance which may not be practical and certainly impossible if numbers start to ramp up.

Here you go:

https://www.weforum.org/agenda/2020/02/these-are-the-countries-best-prepared-for-health-emergencies

I understand your concern, and I suspect there are reasons for the policies they have, reasons which deal with local issues I don't know anything about. On the travel ban, they were probably guided by the WHO. And regarding the hospitals, if they need to convert entire hospitals to serve virus patients, they will.

The main thing is for YOU to be prepared. Your own behavior can really make a difference. There are a whole bunch of guidelines out there to look at to see what you can do. Do those things, and that's most of the battle right there. The people in China were completely caught unaware, and we are not. That's a huge advantage. Don't think you're helpless, because you definitely are not. For one thing, you're reading and learning.

 

[Dreams&wishes]

Here you go:

https://www.weforum.org/agenda/2020/02/these-are-the-countries-best-prepared-for-health-emergencies

I understand your concern, and I suspect there are reasons for the policies they have, reasons which deal with local issues I don't know anything about. On the travel ban, they were probably guided by the WHO. And regarding the hospitals, if they need to convert entire hospitals to serve virus patients, they will.

The main thing is for YOU to be prepared. Your own behavior can really make a difference. There are a whole bunch of guidelines out there to look at to see what you can do. Do those things, and that's most of the battle right there. The people in China were completely caught unaware, and we are not. That's a huge advantage. Don't think you're helpless, because you definitely are not. For one thing, you're reading and learning. That's better than most folks out there right now.

Thanks.
They seem to not want to create panic and everyone is very unworried about it, but I think that that creates even more panic! A council from Brighton, where the big spreader was from. Was worried and he said that the heath department advised him not to speak to the press anymore. If you look on the guardian website the don't even speak about the coronavirus anymore!

Anyway yes we all wash our hands constantly and my husband is still in quarantine in the spare bedroom he had to go to work the other day, but his colleagues weren't very happy to see him! Even though he has no symptoms and there is no advice for peoole who visit Singapore to stay at home! And they have over 75 cases now

 

[Dreams&wishes]

Apologies last thing. It's school holiday here in the UK atm and there are many many international students that will travel back home to the far East for the holidays. With no travel ban in place that it's not a very comfortable situation to be in.

 

[QueenElinor]

Thanks.
They seem to not want to create panic and everyone is very blazed about it, but I think that that creates even more panic! A council from Brighton, where the big spreader was from. Was worried and he said that the heath department advised him not to speak to the press anymore. If you look on the guardian website the don't even speak about the coronavirus anymore!

Anyway yes we all wash our hands constantly and my husband is still in quarantine in the spare bedroom he had to go to work the other day, but his colleagues weren't very happy to see him! Even though he has no symptoms and there is no advice for peoole who visit Singapore to stay at home! And they have over 75 cases now

There are other things you can do, too, like buying cheap knit gloves to wear outside, and switching them out to wash everyday, staying out of crowds and avoiding public transport. Some things border on the "prepper" side of things, like having enough food to get through a 2 wk quarantine, always having a tank of gas and some cash. On the other hand, those things don't seem all that hard to do, either.

 

[Adventurelawyer]

From a practical viewpoint, as harsh as it sounds, it may not make a lot of difference then, either. Nowhere would be safe, why bother. So is that their logic, or is it rather that resources would be needed here at home?


And that, in fact, already happened. A Utah couple KNEW the wife was sick and hesitated to call the ship's medics because they feared they'd be separated. https://www.abc4.com/news/second-utahn-quarantined-on-cruise-ship-tests-positive-for-coronavirus/ She later tested positive.

This is why quarantines have too be designed by the experts, and not cruise lines. Although this was a really tough spot for them to be in.

I agree, it’s impractical, but we don’t leave our people behind. Its why we reclaimed Bo Bergdahl who we tried for dissertation and just as easily could have ended up executing and why we will evac anyone on a diplomatic or military assignment. That first flight out was meant for diplomats and their families, everyone else flew as space was available. We will do it on principle until we cannot. They will always prioritize officials on official business over civilians on leisure. These people being offered transportation and quarantine at home are lucky. But you’re right, that policy isn’t always logical. You hope we never get to that point. Thats for sure. Table topping that exercise was bleak indeed. I didn’t walk away with a good feeling.

 

[Dreams&wishes]

There are other things you can do, too, like buying cheap knit gloves to wear outside, and switching them out to wash everyday, staying out of crowds and avoiding public transport. Some things border on the "prepper" side of things, like having enough food to get through a 2 wk quarantine, always having a tank of gas and some cash. On the other hand, those things don't seem all that hard to do, either.

Yes, but the thing that concern me the most are my 4 kids they are young their ages are from 1 to 8. They wash their hands, but they are kids and I don't want to start giving them phobias either. I also worry that if we, parents get it, we don't have family here I the UK to be with them or if they get it they will be in isolation and we won't be able to see them. This is what worries me of this disease.

 

[MarkLT1]

Yes, but the thing that concern me the most are my 4 kids they are young their ages are from 1 to 8. They wash their hands, but they are kids and I don't want to start giving them phobias either. I also worry that if we, parents get it, we don't have family here I the UK to be with them or if they get it they will be in isolation and we won't be able to see them. This is what worries me of this disease.

In terms of the phobias for your kiddos.. I would try not to worry too much about that. I find that kids "get it" a lot more than we give them credit for. Saying something like "It is always good to wash your hands, but from time-to-time, there are some particular germs that start to spread, and we have to be extra careful, and right now there is one of those that could make us sick.. now say those ABCs while you wash your hands!" gets the message across that there is a reason we are being extra diligent, and that it is not a normal situation.

And the most likely outcome if you and/or your kids catch it, is that it really has gotten out all over the place, and the kinds of isolation, etc.. will probably not be as important (e.g.- you probably dont have to worry about being separated from your children). AND, keep in mind that it looks like 80% of people who contract it, get the equivalent of a mild cold, and only about 5% end up with serious issues. And those 5% are typically older individuals who have additional health issues that compound things. At that point, it needs to be thought more like the flu. But a funny bi-polar flu, where on a few people have significant symptoms (versus the flu, which has a low mortality rate, but almost everyone who gets it, gets knocked out for a week).

 

[mmmears]

Even on a state and local level, we jointly with the Feds practice table top exercises for disasters. The last one I did before going into private practice was for Pandemic Flu. The response you are seeing is right in line with the playbook. The order was sent to DoD well before February 1 to prep for Pandemic Flu measures, so we are actually on it and it's why I am not as worried as most seem to be and why I am following the response closely. As of now, containment is working and we are holding the line. The incident in Hawaii could undo all the hard work so far and if it does, and containment is breached, then the evacuations will stop. Unless you are on a US mission (and sometimes even if you are) you will be on your own wherever you happen to be in the world.

I heard about that exercise and the outcome didn't sound great, so yes, I'm worried. Also concerned about what you said (not that I don't believe you) about not bringing UC citizens home at some point (have a DD doing a year abroad right now, but through the US Govt). I may PM you more details if that's ok.