How the bungled plan to quarantine a cruise ship led to the biggest coronavirus outbreak outside China
EXPERTS today questioned how a cruise ship under quarantine in Japan became the site of the biggest coronavirus outbreak outside of China.
Authorities ordered 3,711 passengers and crew to remain on board the Diamond Princess - but instead of stopping the spread it created a "boiling pot of transmission" leading to 543 cases on board so far.
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Not all passengers will be freed from the Diamond Princess liner on Wednesday, which has been docked in Yokohama since February 3.
A number of scientists say the ship served as an incubator instead of a quarantine facility meant to prevent the worsening of an outbreak.
In fact, three Japanese health officials who helped in the quarantine checks on the ship were also infected.
Despite this, authorities in the country have defended quarantine processes.
Around 1,000 crew members were told to wear surgical masks, wash their hands, use disinfectant sprays and stop operations at restaurants, bars and other entertainment areas after February 5.
Now, experts are questioning the possibility of environmental spread and a lack of understanding around the importance of “deep-cleaning” the entire ship to prevent people from touching contaminated surfaces.
Dr Nathalie MacDermott, an outbreak expert at King’s College London, said further investigations on how the virus was being transmitted was needed.
She said: “Obviously the quarantine hasn’t worked, and this ship has now become a source of infection.
"We need to understand how the quarantine measures on board were implemented, what the air filtration on board is like, how the cabins are connected and how waste products are disposed of,” she said.
“There could also be another mode of transmission we’re not familiar with."
People in the quarantine zone described the ship as a floating prison, with confirmed cases revealing how while were confined to their rooms and cabins, they were allowed to walk on the decks every day while wearing a mask.
Dr Paul Hunter, a professor of medicine at the University of East Anglia, said: “I suspect people were not as isolated from other people as we would have thought.
“It’s difficult to enforce a quarantine in a ship environment and I’m absolutely sure there were some passengers who think they’re not going to let anyone tell them what they can and cannot do,” he said.
Dr Hunter also said it was a disappointment that the quarantine hadn't worked - and how some people returning home would be placed in further isolation for another two week period.
“Given how the virus has continued to spread, we have to presume everyone leaving the ship is potentially infected, and therefore they have to go through another two-week quarantine period.
"Not to do so would be reckless."
Due to the large amount of people on board, the bungled quarantine ship will take until at least Friday to empty, because of the large amount of passengers.
Other scientists said the passengers should have been removed from the boat from the beginning.
“Boats are notorious places for being incubators for viruses,” said Arthur Caplan, a professor of bioethics at the New York University School of Medicine.
“It’s only morally justified to keep people on the boat if there are no other options.
He said of a second quarantine: “It’s never good to lose your civil liberties and your rights of movement, but two more weeks of quarantine is not an undue burden if you’re trying to protect spread of a disease."
'Highly transmissible'
Speaking to global health lawyer Dr Roojin Habibi said shutting all the passengers in together had created a "boiling pot of transmission" for the virus.
Dr Jimmy Whitworth, a disease expert at the London School of Hygiene and Tropical Medicine,: "Obviously keeping all the people in one place increases the risk for them.
"Cruise ships are crowded and people are very close to each other.
"This is a respiratory virus so it's going to be spreading by droplet spread [breathing/coughing], close contact and contaminated surfaces about the place.
"This virus is highly transmissible and is tough to control in this circumstance. It was worth a go [the ship quarantine] but it's simply not worked."
Backing up the sentiment, Dr Anthony Fauci, director of America's National Institute of Allergy and Infectious Diseases, told that the quarantine process had "failed".
"I'd like to sugarcoat it and try to be diplomatic about it, but it failed. People were getting infected on that ship."
"Something went awry in the process of the quarantining on that ship. I don't know what it was, but a lot of people got infected on that ship."
The lockdown officially ends on Wednesday, but Japanese health officials expect that only around 500 passengers will leave the ship in Yokohama on Wednesday.
