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Japan already had several confirmed coronavirus cases when a giant cruise ship arrived at the port of Yokohama last week.Japan already had several confirmed coronavirus cases when a giant cruise ship arrived at the port of Yokohama last week.
Now, with the disclosure that 64 people from that ship have tested positive for the virus, Japan is scrambling to prevent a larger outbreak even as it prepares to welcome hundreds of thousands of visitors for the Summer Olympics starting in Tokyo in July.Now, with the disclosure that 64 people from that ship have tested positive for the virus, Japan is scrambling to prevent a larger outbreak even as it prepares to welcome hundreds of thousands of visitors for the Summer Olympics starting in Tokyo in July.
[Read: Shinzo Abe, Japan’s political houdini, can’t escape coronavirus backlash.][Read: Shinzo Abe, Japan’s political houdini, can’t escape coronavirus backlash.]
The Japanese government on Monday quarantined the ship, the Diamond Princess, with more than 3,700 crew and passengers aboard, after learning that a man who had disembarked in Hong Kong on Jan. 25 had tested positive for the virus.The Japanese government on Monday quarantined the ship, the Diamond Princess, with more than 3,700 crew and passengers aboard, after learning that a man who had disembarked in Hong Kong on Jan. 25 had tested positive for the virus.
In the days since, it has become a fixture in Yokohama’s harbor, making a slow circuit toward shore for supplies and then back out to sea for quarantine.In the days since, it has become a fixture in Yokohama’s harbor, making a slow circuit toward shore for supplies and then back out to sea for quarantine.
Japanese health workers have screened 279 people from the ship who showed symptoms or who had come into contact with the infected man. The health ministry said on Friday that the people infected with coronavirus had been taken to hospitals across several prefectures.Japanese health workers have screened 279 people from the ship who showed symptoms or who had come into contact with the infected man. The health ministry said on Friday that the people infected with coronavirus had been taken to hospitals across several prefectures.
The remaining passengers and crew members have not yet been tested and will remain quarantined for 12 more days. Some passengers shared concern about the virus’s spread and about the days ahead stuck in their cabins.The remaining passengers and crew members have not yet been tested and will remain quarantined for 12 more days. Some passengers shared concern about the virus’s spread and about the days ahead stuck in their cabins.
Masako Ishida, 61, said Friday that all passengers had been given a thermometer and instructed to report any reading over 37.5 degrees Celsius (99.5 Fahrenheit).Masako Ishida, 61, said Friday that all passengers had been given a thermometer and instructed to report any reading over 37.5 degrees Celsius (99.5 Fahrenheit).
“We were screened on the first day by quarantine officers, but there hasn’t been anything ever since,” she said. “We’re told to report immediately when we feel we have a fever.”Ms. Ishida, who is traveling with her husband and mother, said she was trying to remain calm. But she was also looking forward to leaving her cabin.“Nobody gets out of their room unless they’re in a selected group who get to go out to the deck to breathe fresh air at designated times,” she said, “So I’m hoping that the infection will stop.”Gay Courter, 75, an American, praised the crew but said she was “worried and upset” by the number of coronavirus cases onboard the ship.“I would be happy if they come around and do tests,” she said, referring to the quarantine officers. “They only took our temperature once three days ago, and asked us to fill out a form. They did not swab anybody except for people who had temperatures.”“We were screened on the first day by quarantine officers, but there hasn’t been anything ever since,” she said. “We’re told to report immediately when we feel we have a fever.”Ms. Ishida, who is traveling with her husband and mother, said she was trying to remain calm. But she was also looking forward to leaving her cabin.“Nobody gets out of their room unless they’re in a selected group who get to go out to the deck to breathe fresh air at designated times,” she said, “So I’m hoping that the infection will stop.”Gay Courter, 75, an American, praised the crew but said she was “worried and upset” by the number of coronavirus cases onboard the ship.“I would be happy if they come around and do tests,” she said, referring to the quarantine officers. “They only took our temperature once three days ago, and asked us to fill out a form. They did not swab anybody except for people who had temperatures.”
She also noted the potential consequences of a wider outbreak in Japan. “If people on the ship start dying, nobody’s going to come to the Olympics,” she said.She also noted the potential consequences of a wider outbreak in Japan. “If people on the ship start dying, nobody’s going to come to the Olympics,” she said.
The high rate of coronavirus cases among those tested was a point of concern for some infectious disease specialists.The high rate of coronavirus cases among those tested was a point of concern for some infectious disease specialists.
“That’s a lot of positive cases,” said Dr. Peter Rabinowitz, who is co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security.“That’s a lot of positive cases,” said Dr. Peter Rabinowitz, who is co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security.
Dr. Rabinowitz said that given the relatively low rate of testing among all passengers, it was possible that cases had been missed. “I would think that this would be a very serious situation for the public health department to be evaluating and doing all they can to try to limit the spread,” he said.Dr. Rabinowitz said that given the relatively low rate of testing among all passengers, it was possible that cases had been missed. “I would think that this would be a very serious situation for the public health department to be evaluating and doing all they can to try to limit the spread,” he said.
Other public health specialists said it was difficult to draw too many conclusions yet from what appears to be a high rate of infection on the ship.Other public health specialists said it was difficult to draw too many conclusions yet from what appears to be a high rate of infection on the ship.
“The high ratio might suggest they were very good at first assuming who was most exposed,” said Karen Eggleston, director of the Asia health policy program at the Shorenstein Asia-Pacific Research Center at Stanford University. “On the other hand, if there were others that were equally exposed that were not tested, that would mean it was very troubling.”“The high ratio might suggest they were very good at first assuming who was most exposed,” said Karen Eggleston, director of the Asia health policy program at the Shorenstein Asia-Pacific Research Center at Stanford University. “On the other hand, if there were others that were equally exposed that were not tested, that would mean it was very troubling.”
The Japanese health minister, Katsunobu Kato, said officials were consulting with experts about whether to screen additional passengers. The focus would be on the elderly, those with underlying diseases and those who had come into close contact with the 64 infected passengers.The Japanese health minister, Katsunobu Kato, said officials were consulting with experts about whether to screen additional passengers. The focus would be on the elderly, those with underlying diseases and those who had come into close contact with the 64 infected passengers.
Cruise ships regularly make the news as places where infections spread rapidly.Cruise ships regularly make the news as places where infections spread rapidly.
They bring together thousands of people, concentrating them in small spaces where they share meals, swimming pools and common areas, providing a perfect environment for the spread of infections, said Dr. John Lynch, an infectious disease specialist at Harborview Medical Center in Seattle.They bring together thousands of people, concentrating them in small spaces where they share meals, swimming pools and common areas, providing a perfect environment for the spread of infections, said Dr. John Lynch, an infectious disease specialist at Harborview Medical Center in Seattle.
“It’s like when college students come back to dorm rooms, where we’ve seen the spread of measles and mumps,” he said.“It’s like when college students come back to dorm rooms, where we’ve seen the spread of measles and mumps,” he said.
Though viral respiratory illnesses are primarily spread through droplets when people cough or sneeze in close contact with one another, touching contaminated surfaces and then touching one’s eyes, mouth or nose can also spread viruses, Dr. Lynch said.Though viral respiratory illnesses are primarily spread through droplets when people cough or sneeze in close contact with one another, touching contaminated surfaces and then touching one’s eyes, mouth or nose can also spread viruses, Dr. Lynch said.
The Japanese government has asked another cruise ship, the Westerdam, not to make a scheduled stop in Okinawa. When the Diamond Princess stopped in Naha, Okinawa, last Saturday, about 2,600 passengers left the ship for a few hours and traveled by buses and taxis. Health officials are trying to trace their routes.The Japanese government has asked another cruise ship, the Westerdam, not to make a scheduled stop in Okinawa. When the Diamond Princess stopped in Naha, Okinawa, last Saturday, about 2,600 passengers left the ship for a few hours and traveled by buses and taxis. Health officials are trying to trace their routes.
Japan has also recorded 25 cases of coronavirus infections among citizens who had returned from Wuhan on charter planes over the past 10 days or who had come into contact with tourists from Wuhan. A charter flight that returned to Tokyo on Friday had 198 passengers aboard, including non-Japanese spouses and family members.Japan has also recorded 25 cases of coronavirus infections among citizens who had returned from Wuhan on charter planes over the past 10 days or who had come into contact with tourists from Wuhan. A charter flight that returned to Tokyo on Friday had 198 passengers aboard, including non-Japanese spouses and family members.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Four of those passengers were taken to hospitals after landing in “poor physical condition.” The others are undergoing health checks at the Center Hospital of the National Center for Global Health and Medicine.Four of those passengers were taken to hospitals after landing in “poor physical condition.” The others are undergoing health checks at the Center Hospital of the National Center for Global Health and Medicine.
Experts said Japan’s health care system should be equipped to handle the number of cases in the country right now.Experts said Japan’s health care system should be equipped to handle the number of cases in the country right now.
About 60 facilities across Japan have test kits for the coronavirus, and the hospitals that have accepted patients have specialized isolation units and staff members trained to handle infectious diseases.About 60 facilities across Japan have test kits for the coronavirus, and the hospitals that have accepted patients have specialized isolation units and staff members trained to handle infectious diseases.
So far, among people who have returned from Wuhan, the government is asking those who do not show symptoms or test positive for the coronavirus to isolate themselves voluntarily for 14 days after returning to Japan.So far, among people who have returned from Wuhan, the government is asking those who do not show symptoms or test positive for the coronavirus to isolate themselves voluntarily for 14 days after returning to Japan.
But at least two people who returned on the first charter flight declined to take a test.But at least two people who returned on the first charter flight declined to take a test.
Determining whether to mandate quarantines or simply request voluntary isolation can be a difficult decision for officials.Determining whether to mandate quarantines or simply request voluntary isolation can be a difficult decision for officials.
“Someone is going to have to weigh both the public health consequences of requiring hundreds of people to be in quarantine and the political consequences,” said Timothy Brewer, professor at the schools of medicine and public health at University of California Los Angeles. “Most people who end up in quarantine probably have not been exposed and do not have the disease — so you’re restricting the civil liberties of a lot of people.”“Someone is going to have to weigh both the public health consequences of requiring hundreds of people to be in quarantine and the political consequences,” said Timothy Brewer, professor at the schools of medicine and public health at University of California Los Angeles. “Most people who end up in quarantine probably have not been exposed and do not have the disease — so you’re restricting the civil liberties of a lot of people.”
For now, experts said there was no need to close schools, cancel all concerts and sports events, or order workers to stay home. But such measures should be part of an evolving decision, said Dr. Eggleston, of the health policy program at Stanford.For now, experts said there was no need to close schools, cancel all concerts and sports events, or order workers to stay home. But such measures should be part of an evolving decision, said Dr. Eggleston, of the health policy program at Stanford.
“It’s the responsibility of individuals to consider not only their own well-being but those of others around them,” she added. “Share information, report symptoms, submit to testing and quarantine — and empathize and support those who are doing so on behalf of the community.”“It’s the responsibility of individuals to consider not only their own well-being but those of others around them,” she added. “Share information, report symptoms, submit to testing and quarantine — and empathize and support those who are doing so on behalf of the community.”
Hisako Ueno, Isabella Kwai and Roni Rabin contributed reporting.Hisako Ueno, Isabella Kwai and Roni Rabin contributed reporting.