The Guardian (USA)

Coronaviru­s: cruise ship held near San Francisco as US ramps up response

- Vivian Ho in San Francisco and Hallie Golden in Seattle

Passengers on a Grand Princess cruise ship linked to the first death from coronaviru­s in California remained off the coast on Thursday as the first two cases were confirmed in San Francisco.

A coast guard helicopter was delivering test kits to the cruise ship waiting to dock in the port of San Francisco before flying them back to a laboratory. While the ship has 2,422 passengers and 1,111 crew onboard, according to the cruise line, fewer than 100 have thus far been identified for testing.

“The ship will not come on shore until we appropriat­ely assess the passengers,” said Gavin Newsom, California’s governor, in a news conference Wednesday.

The death of a 71-year-old man on Wednesday was the first US fatality reported outside of Washington state, bringing the total number to 11 and prompting the California governor to declare a state of emergency. The state is battling the virus on multiple fronts, with 60 confirmed cases.

Meanwhile, national efforts to contain the virus are ramping up. The US Senate on Thursday passed an $8.3bn measure to help tackle the outbreak in hopes of reassuring a fearful public and accelerati­ng the government’s response. At an event in Pennsylvan­ia on Thursday evening, Donald Trump said the US economy might take a hit from the outbreak, but he defended his handling of the crisis.

The vice-president, Mike Pence, who has been leading the administra­tion’s response to the spread, admitted earlier on Thursday there were probably too few testing kits to meet demand.

At a later press conference, held with the Washington state governor,

Jay Inslee, Pence said that 1.2m test kits would be delivered in the next few days and 4m by next week. He said in the “not too distant future”, the public could also expect to get tests from their doctor and local pharmacy.

In response to a question about Trump’s remarks on Wednesday, in which he disputed the coronaviru­s death rate presented by the World Health Organizati­on, Pence said he supported the president’s judgment and that the number might prove to be lower than previously reported.

Inslee, who has often condemned Trump, said they didn’t have the luxury of debating this issue right now.

“I have had more than a very robust disagreeme­nts with the current president but I want to focus today on the work we need to do in partnershi­p,” he said. “And I can tell you that I think this is a good partnershi­p moving forward.”

The two cases in San Francisco – a man in his 90s with underlying health conditions who is in serious condition, and a woman in her 40s who is in fair condition – had no history of travel. One of the cases prompted a pre-emptive school closure, as the patient is a relative of a student at the school.

The man who died was one of three individual­s who tested positive for coronaviru­s after traveling on a roundtrip Grand Princess cruise from San Francisco to Mexico last month.

After the ship docked in San Francisco on 21 February, thousands more passengers boarded and thousands disembarke­d. The vessel then began a roundtrip voyage to Hawaii.

Another previous passenger has also been hospitaliz­ed. The cruise line said that no cases of the virus had been confirmed among those still on the ship but that some passengers had experience­d flu-like symptoms.

On the return leg of the Hawaii trip, 11 passengers and 10 crew members reported flu-like symptoms, Newsom said in a news conference. One additional crew member who had served on the Mexico trip was medically disembarke­d in Hawaii with flu-like symptoms and tested negative for coronaviru­s, according to San Francisco public health officials.

In addition to the 21 people reporting flu-like symptoms, officials planned to test the 62 passengers from the Mexico trip who remained on board for the Hawaii journey, as well as an unknown number of crew. Those guests were instructed by the cruise line to stay in their staterooms until they were cleared by medical personnel.

By one estimate, more than 50% of the passengers that disembarke­d from the cruise ship on 21 February were California­ns, Newsom said, not including the crew. In total the state and the CDC are working to track down about 2,500 people throughout the state who disembarke­d from the ship and could be at risk.

Keane Li, who said his parents were aboard the cruise ship, tweeted a video that his parents sent him of the helicopter­s delivering the test kits on Thursday morning.

Li’s parents declined to be interviewe­d but told Li that while there was no strict order to remain in their staterooms, passengers were instructed to maintain a distance of 6ft from each other. The buffet option was no longer available, and passengers were told to leave a seat between each diner at meals.

The helicopter­s that arrived in the morning were set to return in the evening to pick up the samples to bring to a laboratory for testing, Li said. Results would be available, at the earliest, on Friday morning, meaning the ship would remain off the coast until at least then.

The decision to hold the ship offshore came as federal health authoritie­s announced an investigat­ion of the Life Care nursing home in Kirkland to determine whether it followed guidelines for preventing infections.

Last April, the state fined Life Care $67,000 over infection-control deficienci­es following two flu outbreaks that affected 17 patients and staff.

At least 70 coronaviru­s cases have been reported in Washington state. Researcher­s say the virus may have been circulatin­g in the Seattle area undetected for weeks.

On Thursday, US health officials said they expected a far lower death rate than the World Health Organizati­on’s internatio­nal estimate of 3.4% – a rate admittedly too high because it doesn’t account for mild cases that go undetected.

Brett Giroir, assistant US health secretary, instead cited a model that included mild cases to say the US could expect a death rate somewhere between 0.1% – like seasonal flu – and 1%.

The New York governor, Andrew Cuomo, confirmed the number of cases in the state had doubled to 22. “We are trying to contain as much as possible the spread of each case we find – but we expect more cases,” he said.

The risk is highest for older people and anyone with high-risk conditions such as heart or lung disease, diabetes or suppressed immune systems, such as from cancer treatments.

Meanwhile, public officials in Washington came under pressure to take more aggressive steps against the outbreak, including closing schools and canceling large events.

Many major Seattle-area businesses and some schools have begun acting on their own, including the the 22,000student Northshore district north of Seattle, which announced it would close for up to two weeks as a precaution.

 ?? Photograph: Scott Strazzante/AP ?? The Grand Princess cruise ship near San Francisco.
Photograph: Scott Strazzante/AP The Grand Princess cruise ship near San Francisco.
 ?? Photograph: Ted S Warren/AP ?? Mike Pence, right, arrives with Washington’s governor, Jay Inslee, second from right, and John Wiesman, Washington state’s secretary of health, for a news conference on Thursday.
Photograph: Ted S Warren/AP Mike Pence, right, arrives with Washington’s governor, Jay Inslee, second from right, and John Wiesman, Washington state’s secretary of health, for a news conference on Thursday.

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