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As Passenger Angst Grows, Japan to Let Some Off Ship, but Fewer Than Hoped As Passenger Angst Grows, Japan to Let Some Off Ship, but Fewer Than Hoped
(3 days later)
TOKYO — For a moment on Thursday, John and Carol Montgomery thought they might be departing early from the cruise ship quarantined in Yokohama, Japan, where new cases of the coronavirus have been confirmed almost daily.TOKYO — For a moment on Thursday, John and Carol Montgomery thought they might be departing early from the cruise ship quarantined in Yokohama, Japan, where new cases of the coronavirus have been confirmed almost daily.
Japan’s health minister said a few categories of passengers could spend the remainder of the two-week quarantine ashore. The Montgomerys thought they qualified because they share a cabin without windows or a balcony and Mr. Montgomery, 68, has diabetes.Japan’s health minister said a few categories of passengers could spend the remainder of the two-week quarantine ashore. The Montgomerys thought they qualified because they share a cabin without windows or a balcony and Mr. Montgomery, 68, has diabetes.
Their hopes were quickly dashed. The health minister’s statement, it turned out, had been ambiguous. The captain of the vessel, the Diamond Princess, announced narrower criteria for offshore quarantine: passengers 80 or older with underlying medical conditions or windowless cabins.Their hopes were quickly dashed. The health minister’s statement, it turned out, had been ambiguous. The captain of the vessel, the Diamond Princess, announced narrower criteria for offshore quarantine: passengers 80 or older with underlying medical conditions or windowless cabins.
“Looks like we’re not going anywhere,” said Ms. Montgomery, 67.“Looks like we’re not going anywhere,” said Ms. Montgomery, 67.
The misunderstanding punctuated what critics call Japan’s bungled communications during the crisis, reinforcing how the nation has been vexed by an epidemiological challenge that grows each day. With more and more of the Diamond Princess 3,400 anxious passengers and crew getting sick — possibly infecting one another — health officials have even raised the possibility of prolonging the quarantine, now set to expire next Wednesday.The misunderstanding punctuated what critics call Japan’s bungled communications during the crisis, reinforcing how the nation has been vexed by an epidemiological challenge that grows each day. With more and more of the Diamond Princess 3,400 anxious passengers and crew getting sick — possibly infecting one another — health officials have even raised the possibility of prolonging the quarantine, now set to expire next Wednesday.
Precisely how the coronavirus has been spreading aboard the ship is just one of many unknowns in the affliction’s reach into Japan. The country also announced its first death from the coronavirus, of a woman in her 80s in Kanagawa Prefecture, which includes Yokohama.Precisely how the coronavirus has been spreading aboard the ship is just one of many unknowns in the affliction’s reach into Japan. The country also announced its first death from the coronavirus, of a woman in her 80s in Kanagawa Prefecture, which includes Yokohama.
The authorities said the woman did not appear to have traveled to China, the center of the epidemic, before falling ill. Her death was the third so far outside mainland China; the others were in the Philippines and Hong Kong.The authorities said the woman did not appear to have traveled to China, the center of the epidemic, before falling ill. Her death was the third so far outside mainland China; the others were in the Philippines and Hong Kong.
Japan’s health ministry also announced 44 new coronavirus cases from the ship, raising the total to 218. Counting those from the vessel, total cases in Japan have surpassed 250, the most of any country other than China.Japan’s health ministry also announced 44 new coronavirus cases from the ship, raising the total to 218. Counting those from the vessel, total cases in Japan have surpassed 250, the most of any country other than China.
The clumsy messaging aside, the move by the health ministry to begin letting some people off the Diamond Princess was clearly a response to mounting stress on board as the quarantine slogs toward its planned conclusion in less than a week. The step also reflected the particular risk that the virus appears to pose to the elderly.The clumsy messaging aside, the move by the health ministry to begin letting some people off the Diamond Princess was clearly a response to mounting stress on board as the quarantine slogs toward its planned conclusion in less than a week. The step also reflected the particular risk that the virus appears to pose to the elderly.
“People in the ship’s surroundings are kind of in a cesspool of probability of being infected,” said Dr. Peter Katona, an infectious disease specialist at the University of California, Los Angeles.“People in the ship’s surroundings are kind of in a cesspool of probability of being infected,” said Dr. Peter Katona, an infectious disease specialist at the University of California, Los Angeles.
“We don’t really understand the transmission of this virus very well,” he added. “So I think that keeping people in their rooms and letting them out briefly is about as good as you are going to be able to do on a ship, but the psychological impact of that is hard to measure.”“We don’t really understand the transmission of this virus very well,” he added. “So I think that keeping people in their rooms and letting them out briefly is about as good as you are going to be able to do on a ship, but the psychological impact of that is hard to measure.”
The health minister, Katsunobu Kato, said the government would consider expanding the criteria to include passengers under 80 years old in the coming days.The health minister, Katsunobu Kato, said the government would consider expanding the criteria to include passengers under 80 years old in the coming days.
According to a document distributed to several embassies by Japan’s foreign ministry and seen by The New York Times, the Japanese government is discussing plans to administer coronavirus tests to people aboard the ship in tranches to determine if more can be quarantined onshore. Some passengers have been calling for testing of everyone on board, a step the government has called impractical.According to a document distributed to several embassies by Japan’s foreign ministry and seen by The New York Times, the Japanese government is discussing plans to administer coronavirus tests to people aboard the ship in tranches to determine if more can be quarantined onshore. Some passengers have been calling for testing of everyone on board, a step the government has called impractical.
Their psychological stress worsened on Thursday as the health ministry announced the new cases. The authorities have said that a small number of the 218 infected are in serious condition.Their psychological stress worsened on Thursday as the health ministry announced the new cases. The authorities have said that a small number of the 218 infected are in serious condition.
“I have worked hard to stay calm, but now it’s getting so much harder,” Sarah Arana, 52, a medical social worker from Paso Robles, Calif., said in a text message. “It appears that we are put at risk daily by staying on the ship.”“I have worked hard to stay calm, but now it’s getting so much harder,” Sarah Arana, 52, a medical social worker from Paso Robles, Calif., said in a text message. “It appears that we are put at risk daily by staying on the ship.”
Some epidemiologists said it was possible that the bulk of the people receiving diagnoses now had contracted the virus before the quarantine began on Feb. 4. The outbreak has been traced to a man who disembarked from the ship on Jan. 25 in Hong Kong and later tested positive.Some epidemiologists said it was possible that the bulk of the people receiving diagnoses now had contracted the virus before the quarantine began on Feb. 4. The outbreak has been traced to a man who disembarked from the ship on Jan. 25 in Hong Kong and later tested positive.
For more than a week after his departure, passengers shared buffets, sat close to each other in theater performances and played mahjong on deck.For more than a week after his departure, passengers shared buffets, sat close to each other in theater performances and played mahjong on deck.
“The curve you’re seeing is a natural epidemiological wave,” said Dr. Allen Cheng, an infectious disease specialist at Monash University in Melbourne, Australia. “The first person may have infected a number of people, and those secondary cases have caused tertiary cases, and what we’re seeing now is the natural incubation of those tertiary cases.”“The curve you’re seeing is a natural epidemiological wave,” said Dr. Allen Cheng, an infectious disease specialist at Monash University in Melbourne, Australia. “The first person may have infected a number of people, and those secondary cases have caused tertiary cases, and what we’re seeing now is the natural incubation of those tertiary cases.”
With crew members living and eating in close quarters, the chances for new infections rises the longer everyone stays on the ship. The danger was underlined on Wednesday when the health ministry announced that one of its own officials had been infected after helping to evaluate passengers and crew members for symptoms. The official had been wearing a mask and gloves but not a hazardous materials suit.With crew members living and eating in close quarters, the chances for new infections rises the longer everyone stays on the ship. The danger was underlined on Wednesday when the health ministry announced that one of its own officials had been infected after helping to evaluate passengers and crew members for symptoms. The official had been wearing a mask and gloves but not a hazardous materials suit.
“There is a possibility that infections have spread despite the fact that passengers have been isolated on board,” said Mitsuyoshi Urashima, a professor of molecular epidemiology at Jikei University Hospital in Tokyo. “It’s better to let them off, as we don’t know the cause of infection at this stage.”“There is a possibility that infections have spread despite the fact that passengers have been isolated on board,” said Mitsuyoshi Urashima, a professor of molecular epidemiology at Jikei University Hospital in Tokyo. “It’s better to let them off, as we don’t know the cause of infection at this stage.”
Passengers were growing concerned that the longer they stayed on board, the longer the quarantine could be extended for passengers who are potentially exposed to confirmed infections.Passengers were growing concerned that the longer they stayed on board, the longer the quarantine could be extended for passengers who are potentially exposed to confirmed infections.
“The logic and the basis for the quarantine is that if people do not have a fever or show signs of sickness after 14 days, that they don’t have the virus,” Mr. Montgomery, the passenger, said. “But the problem is, on this petri dish of a ship, is that three days prior to the 19th, we may have an interaction with somebody in the hallway or on the deck” who is infected.“The logic and the basis for the quarantine is that if people do not have a fever or show signs of sickness after 14 days, that they don’t have the virus,” Mr. Montgomery, the passenger, said. “But the problem is, on this petri dish of a ship, is that three days prior to the 19th, we may have an interaction with somebody in the hallway or on the deck” who is infected.
On Wednesday, he said, when the couple went out for a prescribed fresh air break, another passenger was coughing in the hallway as they returned to their cabin.On Wednesday, he said, when the couple went out for a prescribed fresh air break, another passenger was coughing in the hallway as they returned to their cabin.
“So this whole thing is based on a false logic,” he said.“So this whole thing is based on a false logic,” he said.
In a briefing earlier this week, Masami Sakoi, a health ministry official, said it was possible that people exposed to infected passengers would have to effectively reset the clocks on their quarantine periods.In a briefing earlier this week, Masami Sakoi, a health ministry official, said it was possible that people exposed to infected passengers would have to effectively reset the clocks on their quarantine periods.
Updated June 12, 2020Updated June 12, 2020
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.
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.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.
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.
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.
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.
Ms. Montgomery suggested that the governments of the countries with passengers or crew members on the Diamond Princess should offer to house people in quarantine facilities on land.Ms. Montgomery suggested that the governments of the countries with passengers or crew members on the Diamond Princess should offer to house people in quarantine facilities on land.
“If the U.S. embassy took the Americans off and took us away from here and quarantined and tested us and they did that with every nationality, I think that would be more effective,” she said.“If the U.S. embassy took the Americans off and took us away from here and quarantined and tested us and they did that with every nationality, I think that would be more effective,” she said.
Even so, finding space where such a large number of people could be safely isolated and given proper medical care could be a challenge, especially as Japan is now seeing fresh cases elsewhere. On Thursday, the health ministry announced three new cases, involving a taxi driver and a doctor, in addition to the death from the coronavirus.Even so, finding space where such a large number of people could be safely isolated and given proper medical care could be a challenge, especially as Japan is now seeing fresh cases elsewhere. On Thursday, the health ministry announced three new cases, involving a taxi driver and a doctor, in addition to the death from the coronavirus.
“With those waves of new infections every day, that would challenge the most resilient person’s sense of security,” said Benjamin Cowie, an infectious disease physician at the Peter Doherty Institute for Infection and Immunity in Melbourne. “But that’s a very substantial number of people to then try to have to quarantine anywhere on the shore.”“With those waves of new infections every day, that would challenge the most resilient person’s sense of security,” said Benjamin Cowie, an infectious disease physician at the Peter Doherty Institute for Infection and Immunity in Melbourne. “But that’s a very substantial number of people to then try to have to quarantine anywhere on the shore.”
Even with the rising stress, some passengers were making the best of their time trapped on board. Aun Na Tan, 43, an administrator from Australia who is sharing a windowless cabin with her husband, 44, and two teenage children, said they were playing card games and watching movies together while her husband works remotely and her children keep up with homework online.Even with the rising stress, some passengers were making the best of their time trapped on board. Aun Na Tan, 43, an administrator from Australia who is sharing a windowless cabin with her husband, 44, and two teenage children, said they were playing card games and watching movies together while her husband works remotely and her children keep up with homework online.
In such close quarters, Ms. Tan said, “my daughter hops into my bed for a cuddle every now and then. I’m just enjoying the opportunity. They get less and less as she gets older.”In such close quarters, Ms. Tan said, “my daughter hops into my bed for a cuddle every now and then. I’m just enjoying the opportunity. They get less and less as she gets older.”
Even some who might be eligible to quarantine off shore said they would stick it out on the ship.Even some who might be eligible to quarantine off shore said they would stick it out on the ship.
“Luckily, we’re staying in a stateroom that’s slightly larger, so we’re fine with it,” said Masako Ishida, 61, who is traveling with her mother and stepfather, who are in their 80s. “We wouldn’t mind at all if we’re the last ones to disembark, as long as those in need can leave the ship. It would be easier if we stayed here until the 19th and relax.”“Luckily, we’re staying in a stateroom that’s slightly larger, so we’re fine with it,” said Masako Ishida, 61, who is traveling with her mother and stepfather, who are in their 80s. “We wouldn’t mind at all if we’re the last ones to disembark, as long as those in need can leave the ship. It would be easier if we stayed here until the 19th and relax.”
Reporting was contributed by Eimi Yamamitsu, Hisako Ueno, Makiko Inoue and Ben Dooley.Reporting was contributed by Eimi Yamamitsu, Hisako Ueno, Makiko Inoue and Ben Dooley.