21 POSITIVE TESTS ON STRICKEN SHIP
Quarantine likely, but where? Fate of 2,422 in limbo as they await testing
Stranded in their rooms while floating miles off the California coast, the passengers of the Grand Princess learned of their distressing fate from Washington, D.C., via television: 21 people aboard the cruise ship have tested positive for the coronavirus, and the ship’s destination is unknown.
Of those who tested positive, 19 are crew members and two are passengers, said Vice President Mike Pence in a surprise news conference to announce the results. He did not describe the severity of their illnesses, but the ship’s captain later announced that they would be hospitalized.
Everyone else on the ship now will be tested, said Pence. Only 46 people among the 3,500 passengers and crew were tested in the first round. And rather than docking in San Francisco as planned, the vessel will head to an unspecified noncommercial port some time this weekend.
“We will be quarantining as necessary,” he added. “Those who need to be quarantined will be quarantined.”
Startled by the news, the ship’s 2,422 guests were glued to the televisions in their rooms, where they have been isolated since Thursday night. Earlier in the day, they had been assured that the captain would offer an update on Friday afternoon.
They have not been told where and when they will be tested or where they’re being taken.
“Getting the news online prior to the captain’s announcement really shakes my confidence in the entire system — the long wait, then dismissing the captain and the passengers by telling the world prior to advising the people directly involved — that was lame,” said passenger Suzanne Suwanda, of Los Gatos.
“But getting tested will be a relief, so when I get home I don’t have to worry about being contagious,” she said.
In a later broadcast to the passengers, ship officials apologized and said that the federal government had not given them advance notice of the announcement.
The ship’s captain also revealed that the infected people on board had not been told of their status before Pence’s news conference.
“These individuals will be notified as quickly as possible,” the captain said.
The White House said it is working with Gov. Gavin Newsom to plan a strategy for the vessel’s newly planned arrival in a noncommercial port. California’s only active military port is based in San Diego. But there are closed naval bases in Alameda, Vallejo and other locations that could potentially accommodate the ship. The military also maintains a small port on the Delta near Concord. Officials have not said whether they might also anchor offshore.
President Donald Trump on Friday said he preferred that the passengers and crew remain on board the ship — “I don’t need to have the numbers (of infections) double because of one ship” — but that appears unlikely.
U.S. health officials are seeking to avoid the disastrous experience of the Diamond Princess, where six people died and 706 of 2,666 passengers and 1,045 crew were infected last month. Japanese health officials’ decision to quarantine those aboard the docked ship drew widespread criticism that it likely helped spread the disease among them.
“Let me assure the American public, as we did so with Americans returning from China and those from the other cruise ship, we are taking all measures necessary to see to the health of all those involved and to protect the health of the American public and prevent the spread of the disease,” Pence added.
It is essential to get passengers and crew off the infected ship, said epidemiologist Dr. Michael J. Mina of the Harvard Medical School and Brigham and Women’s Hospital.
“I think one of the major lessons we learned from the Diamond Princess is not to leave people on board under quarantine with the hopes that they will not spread infection and will, as a population, remain healthy,” he said. He also advised followup testing on land, as well as self-quarantines.
“Ultimately, the right thing to do is to remove the individuals from the cruise ship, test them and find a place for them where they can truly self-isolate and self-quarantine safely,” he said.
California now has 69 confirmed cases and one death, not including the new Grand Princess cases, the California Department of Public Health announced on Friday. More than 9,900 people are currently selfmonitoring after returning to the U.S. through San Francisco or Los Angeles international airports.
On Friday, Santa Clara County added four new cases, all unrelated to each other. Of these new cases, one is a man who shares a home with a previously confirmed case. Another is a man who recently traveled from India. For the other two, a man and a woman, the risk factors are unknown. Two of the four are hospitalized. This brings the county’s total number of cases to 24.
Also on Friday, Contra Costa County officials identified three new cases, bringing its total to four, and Alameda County announced its second case.
There are at least 148 confirmed U.S. cases, and a hospital in Washington state Friday announced a 12th person had died there from the coronavirus, bringing to 15 the total deaths from the respiratory illness in the country.
The concern over the Grand Princess surfaced Wednesday after the state’s first fatality, an elderly Rocklin man who was on the earlier leg of the cruise.
The cruise ship has made two San Franciscobased round-trip loops in February and March. The first voyage went to Mexico from Feb. 11-21. The second and current voyage left for Hawaii on Feb. 21, and some crew and passengers from the Mexico trip stayed aboard.
That first trip now is believed responsible for six infections. In addition to the dead Rocklin man, two Sonoma County residents are sick, two of the Contra Costa cases also are linked to that cruise, as is Alameda County’s new case.
Bay Area health departments now are monitoring dozens of passengers who were on the ship’s February Mexico trip. On Thursday, Sunnyvale police said they unsuccessfully attempted to revive an unconscious 72-year-old man who had been aboard the cruise ship and has since died. Sunnyvale Department of Public Safety confirmed the man tested negative for COVID-19.
The challenge facing the Grand Princess is daunting, health experts said.
At sea, “running 35 tests is different than running 3,500 tests,” said Dr. Art Reingold, Division Head of Epidemiology and Biostatistics at Berkeley Public Health and director of the CDCfunded California Emerging Infections Program.
Could its passengers — now symptom-free — be incubating the virus and become positive over the next several days?
“The answer is, potentially, yes,” said Reingold.
Even if every passenger tested negative, there’s no assurance that some might not go on to develop the disease, said Dr. John Swartzberg, a specialist in infectious disease and clinical professor emeritus at UC Berkeley’s School of Public Health.
The test isn’t sufficiently sensitive to detect very early infections, he said. It seeks viral RNA — and early in a coronavirus infection, there’s just not that much RNA to find.
“If I got off that boat, I’d go into quarantine regardless of what the tests show,” he said. “I would assume I had been infected.”
“If it’s positive, I’d quarantine. If it’s negative, I’d quarantine,” he said. “I would avoid loved ones and everybody else until I’m sure I’m not. That’s the safest thing to do.”