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2020 coronavirus pandemic on cruise ships

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Passengers and crew who travelled on several cruise ships during the 2019–20 coronavirus pandemic were found to be infected with the novel SARS-CoV-2 virus that caused the pandemic. Although most ships involved did not have substantial spread of the disease, on the British-registered Diamond Princess, there was substantial spread of the virus amongst the passengers and crew. The ship was quarantined in February 2020 for nearly a month with about 3,700 passengers and crew on board; around 700 people were infected in the incident, and eight died.

The crisis management team of the German federal government said on 4 March 2020, following several actual and suspected outbreaks on cruise ships, "The Federal Foreign Office has included in its travel advice that there is an increased risk of quarantine on cruise ships."[1] On 11 March 2020, Viking Cruises suspended operations for its 79-vessel fleet until the end of April, cancelling all ocean and river cruises, after it was revealed that a passenger on a cruise in Cambodia had been exposed to the virus while in transit via plane, placing at least 28 other passengers in quarantine.[2][3] Similarly, on 12 March, Princess Cruises, owner of virus-stricken ships Diamond Princess and Grand Princess, suspended operations for all future cruises on its 18-ship fleet for 60 days.[4][5] The Federal Transport Minister of Canada announced on 13 March that ships carrying more than 500 people cannot dock in Canada through 1 July 2020.[6]

Average age of cruise passengers

A report from Cruise Lines International Association from 2019 is quoted to indicate the average age of cruise passengers as 46.9 years, with a median age between 60 and 69 years.[7] Research from 2001 studying the epidemiology of passenger mortalities on cruise ships, indicated a median age of 65 years of cruise participants. It also stated, that between April 1995 to April 2001 "there was an average of one death every six months per ship", with an average of 800 passengers on each ship.[8]

Incidents

Cruise ship incidents with confirmed positive cases on board
Ship Passengers Crew People Docked date Location ship was allowed to dock Owner/operator
Diamond Princess 2,666[9] 1,045[9] 3,711[10] 4 February 2020[9] Port of Yokohama, Yokohama, Japan[9] Princess Cruises (a subsidiary of Carnival Corporation)[9]
World Dream 1,871[11] 1,820[11] 3,691 5 February 2020[11] Kai Tak Cruise Terminal, Hong Kong, China[11] Dream Cruises (part of Genting Hong Kong)[12]
Westerdam 781[13] 747[13] 1,528 13 February 2020[13] Sihanoukville, Cambodia[13] Holland America (a subsidiary of Carnival Corporation)[13]
Nile River cruise ship
(MS River Anuket or MS A'sara)
101[14] 70[14] 171[14] 7 March 2020[14] Luxor, Egypt[14] Gate 1 Travel[15]
Voyager of the Seas[16] 7 March 2020[16] Sydney Harbor, Sydney, Australia[16] Royal Caribbean[17]
Grand Princess 2,422[18] 1,111[18] 3,533[18] 9 March 2020[18] Port of Oakland, Oakland, California[18] Princess Cruises (a subsidiary of Carnival Corporation)[18]
Silver Shadow 318[19] 291[19] 609 12 March 2020 Recife Port, Recife, Brazil[19] Silversea Cruises (part of Royal Caribbean)[20][21]
Silver Explorer 111[22] 120[22] 231 14 March 2020[22] Castro (Chiloé Island) Cruise Port, Castro, Chile[22] Silversea Cruises (part of Royal Caribbean)[20][23]
Braemar 682[24] 38[24] 1,063 17 March 2020[22] Port of Mariel, Mariel, Cuba[25] Fred. Olsen Cruise Lines[26]
Voyager of the Seas[27][16] 18 March 2020[27] Sydney Harbor, Sydney, Australia[27] Royal Caribbean[17]
Ovation of the Seas[27][16] ~3,500 18 March 2020[27] Sydney Harbor, Sydney, Australia[27] Royal Caribbean[28]
Costa Luminosa[29] 1,370[30] 410[31] 1,780 19 March 2020[32] Marseille-Fos Port, Marseille, France[32] Costa Cruises[33] (a subsidiary of Carnival Corporation)[30]
Ruby Princess ~2,700[34] 1,100[34] 19 March 2020[34] Sydney Harbor, Sydney, Australia[34] Princess Cruises[35] (a subsidiary of Carnival Corporation)
Celebrity Solstice[27] 20 March 2020[27] Sydney Harbor, Sydney, Australia[27] Celebrity Cruises[36]
Costa Magica[29] 2,309[37] 960[37] or 930[38] 3,269 Costa Cruises (a subsidiary of Carnival Corporation)[39]
Costa Favolosa 1,009 Costa Cruises (a subsidiary of Carnival Corporation)[40]
Costa Victoria 726[41] 25 March 2020[41] Civitavecchia, Rome, Italy Costa Cruises (a subsidiary of Carnival Corporation)[42]
Zaandam 1,243[43] 586[43] 1,829[43] Holland America (a subsidiary of Carnival Corporation)[43]

Diamond Princess

2020 coronavirus pandemic on board Diamond Princess
Diamond Princess (ship, 2004) - cropped.jpg
Diamond Princess, seen from Mount Asama (Ise and Toba) in Toba, Mie Prefecture, Japan, December 2019
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationPacific Ocean
First outbreakWuhan, Hubei, China
Index caseDiamond Princess
Arrival date5 February 2020
(1 month, 3 weeks and 2 days)
Confirmed cases712[44]
Recovered587[44][45]
Deaths
11[46][47][48][49][50][51][52][53][54]
Itinerary[55]
Date Arrive Depart Port 80 y/o index case
20 January 17:00 Yokohama, Japan embarked
22 January 7:00 21:00 Kagoshima, Japan
25 January 7:00 23:59 Hong Kong, China disembarked
27 January 7:00 16:00 Chan May, Vietnam
28 January 8:00 18:00 Hạ Long Bay, Vietnam
31 January 7:00 17:00 Keelung, Taiwan
1 February 12:00 23:00 Okinawa, Japan tested positive
3 February Yokohama, Japan

Confirmed cases on Diamond Princess ()

Date
(JST)
Tested
(cumulative)
Confirmed
(cumulative)
Notes and ref(s)
3 February Berthed at the Port of Yokohama
5 February 31 10 [56]
6 February 102 20 Calculated from reports[56][57]
7 February 273 61 [57]
8 February 279 64 [58]
9 February 336 70 [59]
10 February 439 135 [60]
12 February 492 174 Calculated from reports[60][61]
13 February 713 218 [61]
15 February 930 285 Includes 73 asymptomatic cases[62]
16 February 1,219 355 Includes 111 asymptomatic cases[63]
17 February 1,723 454 Includes 189 asymptomatic cases[64]
18 February 2,404 542 Includes 254 asymptomatic cases[65]
19 February 3,011 621 Includes 322 asymptomatic cases[66]
20 February 3,063 634 Includes 328 asymptomatic cases[67]
26 February 4,061 705 Includes 392 asymptomatic cases[68]
5 March 3,618*1 696*2 Includes 410 asymptomatic cases[69]
*1: Actual number of individuals tested. *2: Excluding cases found after disembarkation.
title=Cumulative number of people infected by coronavirus on Diamond Princess

Diamond Princess is a cruise ship registered in Britain owned and operated by Princess Cruises (incorporated in Bermuda and with headquarters in Santa Clarita, California, US), a brand of Carnival Corporation & plc.

SARS-CoV-2 was confirmed on 4 February 2020 to have spread within Diamond Princess during cruise M003,[70] which had departed on 20 January 2020 from Yokohama (in Tokyo Bay near Tokyo) for a round trip.[71] By the time passengers disembarked into quarantine, the number of confirmed cases on the ship was more than in most countries.

On 20 January 2020, an 80-year-old passenger from Hong Kong, China, embarked in Yokohama, and disembarked in Hong Kong on 25 January. On 1 February, six days after leaving the ship, he visited a Hong Kong hospital, where he tested positive for SARS-CoV-2.[72][73] The ship was due to depart Yokohama for its next cruise on 4 February, but announced a delay the same day to allow Japanese authorities to screen and test passengers and crew still on board. On 4 February, the authorities announced positive test results for SARS-CoV-2 for ten people on board, the cancellation of the cruise, and that the ship was entering quarantine.[72][74]

A total of 3,700 passengers and crew were quarantined by the Japanese Ministry of Health, Labour and Welfare for what was expected to be a 14-day period, off the Port of Yokohama.[75] On 7 February, the total number of people on board with confirmed SARS-CoV-2 infections grew to 61.[76] Another 3 cases were detected on 8 February, bringing the total to 64.[77] On 9 February 6 cases were detected,[78] while another 65 were detected on 10 February, bringing the total to 135.[79]

On 11 February, 39 more people tested positive for the virus, including one quarantine officer, bringing the total to 174.[80] Passengers with confirmed cases were reported to be taken ashore for treatment.[81] On 13 February, 44 more people tested positive for the virus, bringing the total to 218.[82] On 15 February 67 more people were reported to be infected, bringing the total to 285.[83] On 16 February 70 more people were reported to be infected, bringing the total to 355. The next day on 17 February, the Ministry of Health, Labour and Welfare confirmed 99 more cases, raising the total to 454, 33 of whom were crew members;[64][84] on 18 February, another 88 cases were confirmed, bringing the total to 542.[85] By late March it was stated that 712 of 3,711 people on the Diamond Princess, or 19.2% had been infected by COVID-19.[86][87]

Kentaro Iwata, an infectious diseases expert at Kobe University who visited the ship, strongly criticised the management of the situation in two widely circulated YouTube videos published on 18 February.[88][89][90][91] He called Diamond Princess a "COVID-19 mill".[92] He said that the areas possibly contaminated by the virus were not in any way separated from virus-free areas, there were numerous lapses in infection control measures, and that there was no professional in charge of infection prevention—the bureaucrats were in charge of everything.[93] Japanese officials denied the accusations.[94][93] While the U.S. Centers for Disease Control and Prevention commended the efforts to institute quarantine measures, their assessment was that it may have not been sufficient to prevent transmission among people on the ship.[95][96] Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said that the quarantine process had failed.[90] A day later, Yoshihiro Takayama, an acquaintance of Iwata and a doctor working on Diamond Princess, pointed out what he described as errors in Iwata's description of the situation in a Facebook post that went viral.[97] The next day on 20 February, Iwata removed his videos and apologised to those involved, but still insisted the situation on the ship had been chaotic.[97][94]

A preliminary report based on the first 184 cases by Japan's National Institute of Infectious Diseases (NIID) estimated that most of the transmission on the ship had occurred before the quarantine.[97] The cruise line, Princess Cruises had first assumed there was only minimal risk and had initiated only the lowest-level protocols for outbreaks before the quarantine.[98] By 27 February, at least 150 of the crew members had tested positive for the virus.[99][100] Dr. Norio Ohmagari, top government adviser and director of Japan's Disease Control and Prevention Center admitted that the quarantine process might not have been perfect.[99] A crew member reported that many of the crew had been expected to still work and interact with passengers even under the quarantine.[101][102] Princess Cruises stated that Japan's ministry of health was the lead authority defining and executing quarantine protocols, yet Japan's ministry of foreign affairs stated that a criteria of behavior was presented but the ultimate responsibility for safe environment rested with the ship operator.[101] Food service workers were found to have likely been the main early route of spread.[103] 46.5% of the infected passengers and crew members had no symptoms at the time of testing.[104][86][87]

By 1 March, all passengers and crew members had disembarked from the ship.[105] On 8 March, an Indonesian, a former crew member of Diamond Princess, tested positive for SARS-CoV-2 during the mandatory quarantine period in Indonesia.[106]

Deaths

Two passengers died on 20 February[107] and a third on 23 February, all three of whom were Japanese citizens in their 80s.[108] A fourth passenger, an elderly Japanese man, was reported on 25 February to have died.[109] The fifth fatality, a Japanese woman in her 70s,[49] and the sixth fatality, a British national in his 70s, both died on 28 February.[110][50] A 78-year-old Australian national, who was evacuated from the ship, died on 1 March in Australia, making him the seventh.[51] A Hong Kong national from the ship died on 6 March, making him the eighth.[111] A Canadian man in his 70s died on 19 March, making him the ninth coronavirus-related death from the ship.[112][53] Two Japanese passengers in their 70s died on 22 March making them the 10th and 11th death.[54]

World Dream

World Dream

The cruise ship World Dream (registered in the Bahamas, operated by Dream Cruises) was on a journey from Nansha Port, Guangzhou, Guangdong, China to Nha Trang and Da Nang in Vietnam during 19–24 January 2020 with 6903 persons on board including 108 from Hubei, in which 28 were from Wuhan.[113]

On 24 January 2020, the ship returned to Nansha Port. Port customs performed a temperature check for all disembarking passengers and crew, with 31 people sampled and tested for the virus, including those who had fever during the cruise and those who were in close contact with confirmed cases before they boarded for the cruise. All the test results were negative though some of them were later confirmed to be infected.[114]

Between 24 January 2020 and 2 February 2020, the ship made three additional cruises out of Guangzhou or Hong Kong, including two "cruises to nowhere" and one to the Philippines, although passengers from the journey were not disembarked at Manila due to local resident protests over fear on the virus.[115]

Confirmed cases

On 2 February 2020, the ship departed from Hong Kong for Taiwan with around 3,800 persons on board. On the same night, the cruise company was notified that there were confirmed cases from the ship's former passengers. On the next day, the Guangdong government officially announced that three former passengers from the Vietnam journey had been confirmed infected by the novel coronavirus after they were disembarked. Former passengers from the cruise in China were told to contact local health authority and observer quarantine.[116]

As of 11 February 2020, 12 cases associated with the cruise were confirmed, including 1 ground worker who had temporarily worked on the ship, and 4 relatives of passengers.[117]

Quarantine and preventive actions

After the Guangdong government official announcement of confirmed cases among former passengers, on 4 February 2020, Taiwan blocked the ship's port of call in Kaohsiung due to concern on the virus. On 5 February 2020, World Dream returned to Hong Kong and all 3,800 passengers and crew on board the ship at the time were put under quarantine at Kai Tak Cruise Terminal.[118] The quarantine was lifted on 9 February 2020 after all 1,800 crew members tested negative for the virus. The majority of the passengers were not tested as they had had no contact with the infected Chinese passengers who had been on the ship during 19–24 January.[119]

MS Westerdam

MS Westerdam pictured on 24 November 2015

In February 2020, Netherlands' ship MS Westerdam, departing after a stop in Hong Kong on 1 February, was not allowed to call in the Philippines, Japan, and Guam over concerns regarding coronavirus infections.[120][121] After initially receiving approval on 10 February to let the passengers disembark in Thailand, as the ship was heading to Laem Chabang port near Bangkok, permission to dock was refused the next day. However, the ship was still maintaining its course to Bangkok and at around 10:30 am CET on 11 February, Westerdam sailed around the southern tip of Vietnam.[122][123][124] According to Flip Knibbe, a Dutch passenger on the ship, all the passengers had their temperatures checked a second time. Speaking to NOS on 11 February, Knibbe said "Dit schip is virusvrij": 'This ship is virus-free'. Unlike Diamond Princess, those on board were not in quarantine. Everyone could move freely, shops and restaurants were open and the entertainment programme continued.[124]

After Westerdam was refused at several points of call, on 13 February, the ship was allowed to dock in Sihanoukville, Cambodia.[125] At this point, only the 20 passengers who reported feeling ill were tested, and all of them tested negative.[126][127]

On 15 February, Malaysia reported that an 83-year-old US citizen who disembarked from Westerdam and flew into Malaysia on 14 February had tested positive for SARS-CoV-2.[128][129][130] In a second test, requested by both the Holland America Line and Cambodian authorities the woman tested positive again.[131][126][127][129][132] Despite these findings, Cambodian Prime Minister Hun Sen visited the ship, discouraged use of masks, and encouraged the passengers to tour the city, sparking concerns that another spoke was being added to the contagion network.[133] Further cruise passengers were denied entry to Malaysia from Cambodia as a result.

On 22 February, after treatment with antiviral medications that were speculated to have an effect against COVID-19, the woman's medical condition improved and she was tested negative for SARS-CoV-2. The United States Centers for Disease Control and Prevention (CDC) initially stated that the woman had never been infected by SARS-CoV-2, but withdrew the claim, clarifying that the CDC "[has] no visibility on whether the initial test of the woman was anything other than positive".[134] Due to possible background politics, it is uncertain whether these results were a false negative,[135] or whether the passenger cleared the virus from her system after 72 hours of intensive treatment.[136]

Grand Princess

Grand Princess in Split, Croatia, 2011
A member of the Maryland National Guard before transporting passengers from Grand Princess

Public health officials from Placer County, California reported that an elderly resident with underlying health conditions who had died on 4 March 2020 had tested positive for SARS-CoV-2 after returning from a cruise from San Francisco to Mexico and back on Grand Princess between 11 and 21 February.[137][138][139] This marked the first death in California attributable to the virus.[140][141] The source of the new case's infection appeared to be the same as that of a resident of Sonoma County who tested positive on 2 March and who was also aboard Grand Princess on the same dates.[142][143]

Consequently, Princess Cruises, the owner and operator of Grand Princess, working with the Centers for Disease Control and Prevention (CDC), the government of California, and public health officials in San Francisco, terminated a port call in Ensenada, Mexico planned for 5 March and ordered the ship to return to San Francisco over concerns about the potential for an outbreak on board.[144]

After Grand Princess docked in San Francisco on 21 February, 62 passengers who had been on the previous cruise to Mexico reboarded the ship as it set sail for Hawaii, making stops at Kauai, Oahu, Maui, and Hilo (on the Big Island) between 26 and 29 February.[145][146] These passengers, who may have made been exposed to the same environment as were the Placer or Sonoma County cases during the previous cruise, were quarantined in their own on-board staterooms on 4 March by order of the CDC.[144] In addition, eleven passengers and ten crew members were exhibiting potential symptoms, and Grand Princess was ordered by the government of California to remain offshore while the California National Guard's 129th Rescue Wing airlifted test kits by helicopter to the ship.[147][148][149]

On 5 March, Princess Cruises confirmed that there were 3,533 people on board the ship—2,422 passengers and 1,111 crew members—representing 54 nationalities in total.[150]

On 6 March, U.S. Vice President Mike Pence announced that of the 46 tests run on selected passengers and crew members on Grand Princess, 19 crew members and two passengers had tested positive, 24 had tested negative, and one test was inconclusive.[151] Pence announced at a White House Coronavirus Task Force briefing that the ship would be brought to a non-commercial port, and that everyone on the ship would be tested and quarantined as necessary.[151] On 6 March, President Trump said that, despite what experts told him about limiting the spread of COVID-19, he wanted those on board Grand Princess to stay on the ship so that they would not be counted as American cases, which would otherwise "double because of one ship that wasn't our fault."[152]

On 7 March, Princess Cruises confirmed that Grand Princess was still at sea roughly 50 miles (80 km) from San Francisco, and that it was scheduled to dock in Oakland on 9 March, with its passengers to be transferred to facilities on land while the crew would be quarantined and treated on board.[150][153][154][155] The United States Coast Guard had airlifted supplies, including personal protective equipment, to the ship, and had medivacked a critically ill passenger and his travel companion for treatment unrelated to COVID-19.[150]

On 9 March, the ship docked at the Port of Oakland and passengers started disembarking.[156] More than 3,000 people on board were to be quarantined, with passengers at land facilities and the crew on board.[157][157] As of 22:00, 407 people had disembarked.[150]

Princess Cruises confirmed on 10 March that 1,406 people had disembarked from Grand Princess,[150] increasing to 2,042 on 12 March.[150]

Disembarked cases

2 March

  • California: The Sonoma County Department of Health confirmed that a former passenger of Grand Princess, on the cruise from San Francisco to Mexico, was a (presumptive) case.[158]

3 March

  • California: Placer County officials confirmed that a former passenger of Grand Princess, also on the cruise from San Francisco to Mexico, was a (presumptive) case.[159] Officials confirmed the next day that the passenger had died.[137][138][140]

5 March

  • Canada:
    • Alberta: Alberta reported its first presumptive case, a woman in her 50s who lives in the Calgary area, was on board Grand Princess and returned to Alberta on 21 February.[160]
  • United States:
    • California:
      • Placer County: Officials reported an additional three presumptive positive cases, with all three having travelled on the same cruise on the same dates.[161]
      • Sonoma County: Health officials announced another positive presumptive case who was a passenger on the same cruise between 11 and 21 February.[162]
      • Sunnyvale: Department of Public Safety officers reported that they performed CPR on an unconscious 72-year-old patient who was not breathing, but were ultimately unsuccessful in reviving him.[163] After the man died, a family member informed officials that the victim had been a passenger on Grand Princess with two other people currently suspected of being infected.[163]
    • Nevada: The Washoe County Health District announced that a presumptive positive patient, a male in his 50s, has been linked to Grand Princess.[164] He self-isolated at home.[164] An elementary school in Reno was closed because one of the man's family members is a student there.[164]

6 March

  • Canada:
    • Ontario: Health officials confirmed that two new cases, a married man and woman in their 60s, were aboard Grand Princess from 11–21 February and returned to Canada on 28 February.[165]
  • United States:
    • California:
      • Alameda County: Officials confirmed that a former passenger of Grand Princess, an older patient with underlying health problems, has tested positive.[166] The former passenger was on the ship during the trip to Mexico from 11–21 February 2020. The patient was hospitalised and family members were quarantined.
      • Contra Costa County: Health officials announced that two new cases have been identified, with both having traveled on the same cruise on the same dates.[167]
      • Marin County: The health department announced that two Marin County residents that were on the cruise and displayed symptoms have also been tested, but Governor Gavin Newsom has prioritised the testing of the passengers currently aboard Grand Princess, and all the tests are going through the same lab.[168]
    • Hawaii: Governor David Ige announced the state's first case, a male Oahu resident who was a passenger on Grand Princess.[169][170] Although the ship stopped in Hawaii in late February, the man disembarked Grand Princess in Mexico earlier in February (before it returned in San Francisco on 21 February) and flew back home to Honolulu from Mexico.[169][170][171]
    • Illinois: The Illinois and Chicago public-health departments announced that a former passenger of Grand Princess tested (presumptive) positive. The passenger, a woman in her 50s, had traveled on the same cruise to Mexico and disembarked at San Francisco on 21 February. She was hospitalized and isolated in stable condition. She is a special education assistant in the Chicago public school system, and the school where she worked was to be closed the following week, with all at-risk staff requested to self-quarantine for 14 days.[172]
    • Utah: The Department of Health confirmed that the first (presumptive) case in Utah is a former passenger of Grand Princess living in Davis County.[173]

7 March

  • Canada:
    • British Columbia: Health officials announced that two cases are former passengers of Grand Princess. Both in their 60s, the two patients rode the ship to Mexico and back to California.[174]
  • United States:
    • California:
      • Fresno County: Officials confirmed that a former passenger of Grand Princess had tested positive.[175] The former passenger was on the ship during the trip to Mexico from 11–21 February 2020. The family of the patient is reported to be self-monitoring.

21 and 23 March

Two passengers from Grand Princess died from complications of coronavirus: one on 21 March and the other on 23 March. Both were in their early sixties. Of the 1,103 passengers who elected to be tested, 103 tested positive, 699 tested negative. The remaining results are pending, the Department of Health and Human Services (HHS) said.[176]

MS River Anuket

MS River Anuket, pictured March 2018

A Taiwanese-American tourist, who had been a passenger on a Nile River cruise ship variously known as MS River Anuket[177] or Asara,[178] discovered that she was positive for SARS-CoV-2 after she returned to Taiwan. World Health Organization officials informed Egyptian authorities of the situation, and all crew members and 150 passengers aboard the cruise ship were tested for SARS-CoV-2.[177] On 7 March 2020, health authorities announced that 45 people on board had tested positive despite being asymptomatic,[179] and that the ship had been placed in quarantine at a dock in Luxor.[177]

MS Braemar

On 13 March 2020, five passengers tested positive for the COVID-19 virus aboard MS Braemar. As a result, the ship was denied entry into its destination, the Bahamas. The infected patients were discovered after a former passenger of the cruise tested positive in the Canadian province of Alberta. The infected passenger disembarked off the cruise in Kingston, Jamaica, but it was unknown where they contracted the disease.[180]

Sint Maarten also denied a request from the cruise to allow passengers to fly out.[181]

Cuba finally allowed the ship to dock and evacuated all travelers to the United Kingdom.[182]

Ruby Princess

From 15 March 2020, Australia banned cruise ships arriving from foreign ports. However, exemptions were granted to allow four ships, already en route to Australia, to dock and disembark its passengers. On 19 March 2020, Ruby Princess, which was one of the four ships given the exemption, docked at the Overseas Passenger Terminal in Sydney, Australia, after a cruise to New Zealand. On 20 March, it was announced that three passengers and a crew member of Ruby Princess had tested positive for the virus.[183] The ship had docked in Sydney Harbour, and the passengers had disembarked before the results came back positive.[184] The ship had returned to Sydney with 1,100 crew members and 2,700 passengers, and 13 people that were sick were tested for the virus.[185]

On 24 March, one person who was a passenger on the 8–19 March cruise aboard Ruby Princess died after a coronavirus diagnosis.[186] As of 28 March, 284 passengers (162 in New South Wales, the rest elsewhere in Australia) had tested positive for the virus.[187]

Other ships with confirmed cases on board

Costa Magica

On 12 March, two passengers aboard Costa Magica were reported to be tested positively for COVID-19 while quarantined in Martinique. The ship that departed from Guadeloupe with 3,300 people on board had been disallowed entry in several sea ports including in Grenada, Tobago, Barbados and Saint Lucia, due to over 300 Italian nationals on board.[188]

All the passengers were disembarked, and 930 crew members stayed aboard.[38] Eventually, the ship stopped three miles offshore from Miami, and on 26 March, the U.S. Coast Guard reported evacuation of six sick crew members from Costa Magica.[189][190][38]

Costa Favolosa

Costa Favolosa departed from Guadeloupe. Six of the disembarked occupants of the ship were tested positive for COVID-19.[38] On 26 March, as the ship stopped three miles offshore from Miami, the U.S. Coast Guard reported evacuation of seven sick crew member, out of 1,009 who stayed aboard.[189][190][38]

Costa Luminosa

On 8 March, an Italian woman was quarantined in the U.S. Territory of Puerto Rico while being tested for the virus. She had arrived there via Costa Luminosa, a cruise ship that had departed from Fort Lauderdale, Florida, U.S..[191] On 13 March she, her husband and a third person's tests came back positive for the virus.[192]

On 21 March local news in Puerto Rico reported the death of the woman, aged 68.[193]

Costa Victoria

Costa Victoria left Dubai on 7 March, 2020. A female Argentine national was tested positive and disembarked in Crete. 726 passengers were quarantined and managed to leave only after the ship docked in Civitavecchia, near Rome, Italy on 25 March.[41][194]

Silver Shadow

Silversea Cruises ship Silver Shadow was blocked from disembarking its 608 passengers and crew at the port of Recife in Brazil, as a 78-year-old Canadian aboard had been suspected of having the virus.[195] Two passengers were later medically disembarked, and one of them tested positive for the virus.[22]

Silver Explorer

Silver Explorer docked in Castro, Chile, with 111 passengers and 120 crew, after an 83-year-old man fell ill and tested positive for the virus.[22]

Zaandam

The Holland America cruise ship Zaandam was stranded off the coast of Chile after being denied entry to ports since 14 March. Of the 1,829 people (1,243 passengers, 586 crew) aboard, 13 passengers and 29 crew members fell ill with "flu-like symptoms".[43] The vessel is sailing for Port Everglades, Florida hoping to dock on 30 March with a total of 77 sick persons aboard as of 24 March.[196] Four passengers died while waiting for permission to transit the Panama Canal, while the number of sick aboard climbed to 148.[197] Two passengers tested positive for COVID-19.[198] However, on 27 March, the ship was denied transit through the Panama Canal due to the number of sick people on board.[199]

Ships without confirmed cases on board

Suspected cases

  • AIDAmira: Six passengers on the ship were isolated, after flying on a plane with a sailor who later tested positive with the virus. More than 1,700 are now trapped on the cruise ship, docked at Cape Town, South Africa.[200]
  • Costa Diadema: On 24 March 2020, the ship docked at Limassol, Cyprus, and a crew member suspected of suffering from the coronavirus was taken to hospital. Several other crew members were also reported to be ill. Costa Diadema was sailing from Dubai to Savona, Italy, without passengers.[201]
  • Golden Princess: At least three passengers have been quarantined by the ship's doctor, according to local health officials. It is en route for Melbourne.[202]
  • Mahabaahu: Several passengers and crew members were quarantined after an American passenger who have traveled in the ship in Brahmaputra River in Assam, India was tested positive in Bhutan.[203][204]
  • MSC Magnifica: More than 250 suspected cases are on board. As of 23 March 2020, the ship is heading for Fremantle, Australia to disembark patients to hospitals and isolation.[205] Later that day, the cruise ship was denied entry into Australia.[206]

No currently suspected cases

  • AIDAaura: The German cruise ship AIDAaura, with about 1,200 people on board, was held on 3 March 2020 in the harbour of Haugesund, Norway, while two asymptomatic German passengers were tested who had been in contact with a person who subsequently developed COVID-19; their test results were negative.[1][207]
  • Carnival Panorama: On 7 March 2020, the Centers for Disease Control and Prevention (CDC) halted passengers disembarking from the cruise ship Carnival Panorama docked at Long Beach Cruise Terminal in California when a female passenger was reported to be sick.[208] The sick passenger was transported to a hospital to be tested, and all passengers were held on board the ship pending test results.[209][210] The test came back negative late that evening, and disembarkation was scheduled to resume the next morning.[208] Carnival Panorama was returning from a trip to Mexico with scheduled stops at Cabo San Lucas, Mazatlán and Puerto Vallarta, which were also scheduled stops for Grand Princess during the previous month.[208][211][171]
  • Costa neoRomantica: On 26 March 2020, the ship with no passengers on board, previously quarantined at Nagasaki, Japan, anchored at the roadstead of Vladivostok, Russia to refresh the ship with water, fuel, and food. However, it was denied entrance as the Russian sanitary officials stipulated the dock workers to be quarantined for 14 days. No COVID-19 cases on board were reported.[212][213]
  • Costa Fortuna: The Italian cruise ship Costa Fortuna attempted to dock at Phuket, Thailand, on 6 March 2020, but was denied by Thai officials because it was carrying passengers who had left Italy within the past two weeks.[214] On 7 March, the ship attempted to dock at Penang in northern Malaysia, but was denied pursuant to a complete ban on cruise ships.[214] The vessel docked in Singapore on 10 March and the passengers disembarked, with some being bused directly to the airport. There were no confirmed cases of COVID-19 aboard the ship.[215]
  • Costa Serena: Fifteen passengers aboard Costa Serena on 24 January were suspected to have SARS-CoV-2. The ship arrived at its destination, Tianjin, China, on 25 January. With 17 suspected cases, and 146 (of 3,706) passengers from Hubei province where the disease originated, an emergency was declared. The cruise ship was locked down for 19 hours before the passengers were allowed to disembark; no confirmed cases were found.[216]
  • Costa Smeralda: In January, Costa Smeralda and her 6,000 passengers were quarantined at the port of Civitavecchia in Rome, Italy, following two suspected cases.[217] A spokesperson from Costa Cruises stated that a 54-year-old woman aboard the ship was suffering from a fever and that she and her husband were both being tested. They were found to be uninfected, and passengers were allowed to go on shore the next day.[218]
  • Grandeur of the Seas: On 12 March 2020, Grandeur of the Seas was denied a request to berth at the Austin "Babe" Monsanto Marine Terminal in the United States Virgin Islands because a crew member had travelled to Japan within the previous two weeks, even though no confirmed cases of coronavirus were on board.[219][220] The ship, however, was eventually allowed to return to transport a seriously-injured passenger to a hospital for treatment.[219]
  • Maasdam: 842 guests and 542 crew members from Holland America Line's Maasdam were not allowed to disembark in Honolulu on 19 March 2020.[221]
  • MS Monarch: On 14 March, Panama repatriated 1,504 Colombian tourists from the cruise ship Monarch. Since the port of Cartagena, Colombia is closed, the people have to fly from Colón, Panama. About 300 people were still waiting to buy tickets.[222]
  • MSC Meraviglia: On 26 February, Mexican authorities granted permission for MSC Meraviglia, registered in Malta, to dock in Cozumel, Quintana Roo, because she carried a passenger presumed to be infected with the coronavirus. The ship was previously denied access to ports in Jamaica and the Cayman Islands.[223] Two cases of common seasonal flu were found.[224]
  • Norwegian Jewel: The cruise ship was stranded in the middle of the Pacific Ocean, after being denied entry into Papeete, French Polynesia and Lautoka, Fiji, due to fears of possible infection.[202] On 19 March the 1,700 passengers were prevented from disembarking in Honolulu.[221] On 23 March, the passengers were allowed to disembark in Honolulu in order to catch chartered flights to return to the home locations. There were no confirmed cases of COVID-19 aboard Norwegian Jewel.[225]
  • Pacific Princess: Though there have been no confirmed cases on board, the ship has been rejected to dock at numerous destinations including Bali, Singapore, Phuket, Thailand, and Sri Lanka. The ship is currently en route to an uncertain future for Fremantle, Australia.[202]
  • Regal Princess: On 7 March, two crew members of Regal Princess were tested and the docking of the ship at Port Everglades in Fort Lauderdale, Florida, U.S., was delayed for about a day while waiting for test results. The tests were negative, and the crew did not have respiratory complications, so the ship was allowed to dock.
  • Royal Princess: As a crew member from Grand Princess had transferred to Royal Princess fifteen days earlier, the CDC issued a "no-sail order" for Royal Princess on 8 March 2020, prompting Princess Cruises to cancel the ship's seven-day cruise to Mexico before it departed Los Angeles.[171][226][227]
  • Sun Princess: Princess Cruises ship Sun Princess was not allowed to dock at a port in Madagascar on 13 February 2020, as it had visited Thailand less than 14 days before. The ship docked at the French island of Réunion on 1 March, but passengers were met by a crowd of about 30 who insisted that the passengers be tested and tried to prevent them from leaving the port area. Objects were thrown at passengers, and the police deployed tear gas. Princess Cruises said that there was no evidence of SARS-CoV-2 on the ship.[138]

Hazard controls

According to the U.S. Centers for Disease Control and Prevention, proper hazard controls for cruise ships and other commercial vessels include postponing travel when sick, and self-isolating and informing the onboard medical center immediately if one develops a fever or other symptoms while on board. Ideally, medical follow-up should occur in the isolated person’s cabin.[228]

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