Over the next five days, Japan faces the daunting task of testing thousands of passengers aboard a quarantined cruise ship, evacuating them and transporting those who test positive for the coronavirus — or who may have come in contact with someone who has — to medical facilities on shore.
With the health ministry yet to announce a plan to address these issues or to extend the quarantine, which is scheduled to end Wednesday, the task of getting everyone off the Diamond Princess by the deadline grows increasingly improbable.
The whole situation is like “a game with no end in sight,” said Koji Wada, a professor of public health at the International University of Health and Welfare.
“As the time limit gets closer, the question now is whether it’s possible to send everyone home in time,” he said. “It’s entirely possible that not all passengers will be evacuated by the end of the quarantine period.”
So far, those infected with COVID-19 start to show symptoms anywhere between two and 14 days after contracting the virus. Thus a two-week quarantine was placed upon the cruise ship, which was carrying more than 3,700 passengers and crew, after an 80-year-old man who left the ship in Hong Kong tested positive for the virus.
But if secondary infections are occurring on the ship, as many experts suspect, the 14-day quarantine — which began on Feb. 5 when the Diamond Princess arrived at Yokohama Bay — will prove meaningless.
Still, the health ministry has not officially changed its plan to end the quarantine on Feb. 19 nor explained to the public what strategies it will take to contain the outbreak after the deadline.
“The cruise ship is almost completely infested,” Wada said.
“The world is watching Japan,” he continued, adding that Japan is the only country in the world — besides China —that has had to deal with so many coronavirus patients all at once.
He said that, depending on the outcome, Tokyo’s response could serve as a model for other countries struggling to contain the outbreak.
The ship made port in Yokohama Bay last week following a 16-day cruise that included stops in Japan, Hong Kong, Vietnam and Taiwan.
A total of 2,666 passengers, including those staying in small, windowless rooms, were asked to stay inside their compartments to prevent transmission during the quarantine period.
Since then, 218 passengers and crew members have tested positive, as well as one of the quarantine officers administering the tests.
On Friday, high-risk passengers 80 or older who tested negative for COVID-19 were allowed to disembark amid growing concerns over the physical and mental conditions of those aboard.
The elderly passengers were transported by bus to a government facility in Wako, Saitama Prefecture.
The central government has called on doctors, academics and other experts to help devise a plan to safely and securely evacuate the Diamond Princess. Wada is part of this collaborative effort. He raised the idea of using tents near Yokohama Bay as a preliminary testing ground for the passengers.
Moving forward, he added, the government needs to put forth a plan that lays out how all passengers and crew will be evacuated, tested and treated, all while containing the virus.
Further doubt was cast upon efforts to evacuate the Diamond Princess by Shigeru Omi, president of the Japan Community Healthcare Organization and former regional director of the World Health Organization’s Western Pacific Regional Office, during a news conference on Thursday.
Omi, who served as WHO regional director during the 2002-2003 outbreak of SARS, questioned the reliability of the test results and the ability of onshore medical facilities to accept coronavirus patients.
“The tests aren’t necessarily picking up the virus 100 percent of the time,” he said. “And if coronavirus patients are taken to a local hospital, where should the patients who were already there go? How do we know the medical staff are prepared for these circumstances?”
The Diamond Princess was quarantined by the government in an attempt to contain the novel coronavirus and prevent a domestic epidemic. However, reports of new cases of infection aboard the ship continue to emerge almost daily and passengers seem to be growing weary as the quarantine continues.
Omi pointed out that quarantine periods typically reset every time an additional case is reported.
Health minister Katsunobu Kato said on Wednesday that he wants to test everyone aboard the ship but the lack of testing kits and logistical difficulties are complicating matters. As of Wednesday, 492 samples had been collected, but that figure includes specimens collected from the same people more than once.
“Keeping the passengers in a place with such high risk of infection is questionable, not only from a virus prevention standpoint, but ethically as well,” Omi said. “We need to move quickly to get them off the ship as soon as possible.”
Meanwhile on Friday, a female taxi driver in Okinawa was confirmed to be infected with the novel coronavirus, the first patient in the prefecture.
She was among about 200 people in the prefecture being monitored by the Okinawa government who had close contact with passengers on the Diamond Princess when the ship made port in Naha during its trip.
On Friday, at the request of the health ministry, SoftBank delivered iPhones preloaded with medical advice to passengers aboard the Diamond Princess.