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Japanese expert warns of alarming state inside Diamond Princess

Passengers begin to disembark amid fears that virus containment is insufficient

Buses were on hand at Yokohama port to carry Diamond Princess passengers to the nearest train station, where they are being asked to take public transit to their next destination. (Photo by Kai Fujii)

TOKYO -- Remaining Diamond Princess passengers who have tested negative for the new coronavirus on Wednesday began disembarking the cruise ship despite warnings their 14-day quarantine period was poorly handled and they could take the virus off the ship with them.

Approximately 500 people were to leave the ship, docked in Yokohama, on Wednesday. All of the nearly 3,000 passengers are expected to set foot on land by Friday.

They are being bused to the nearest train station and asked to return home by public transit. There will be no further restrictions.

The ship has been providing nightmarish headlines since Feb. 1, when a coronavirus test on an elderly passenger who had disembarked in Hong Kong one week earlier came back positive. The result spread fears that more aboard the Diamond Princess could have contracted the disease.

The ship returned to Yokohama port a day early, on Feb. 3, but was put on lockdown so Japanese authorities could test passengers and crew.

Initially, the Ministry of Health, Labor and Welfare only tested passengers and crew who were showing symptoms as well as those who were in close contact with infected people. It blamed this on limited testing capabilities.

The first day, 10 tests came back positive, and the ship was put on lockdown for 14 days. By Tuesday, a total of 542 passengers and crew had been diagnosed with the virus.

Despite the quarantine coming to an end, experts warn that the process was not nearly sufficient to prevent transmission among passengers, who the experts say pose ongoing viral risks.

Kentaro Iwata, an infection prevention specialist and professor at Kobe University on Tuesday went aboard the ship as part of Japan's Disaster Medical Assistance Team. He later published a YouTube video. In his post, Iwata says the ship did not take standard precautions, such as distinguishing between free-of-infection green zones and potentially contaminated red zones.

(A screenshot of Kentaro Iwata YouTube page)

While aboard, Iwata said he witnessed a feverish crew member go to the ship's medical center while wearing an N95 mask but no other protective gear. "The medical officer," he said, "was not protecting herself. She [said] she was already infected, 'I'm sure about that.' So she was completely giving up protecting herself.

"I've dealt with a lot of infections," he went on, listing Ebola, cholera and SARS. "I never had fear of getting infection myself... because I know how to protect myself and how to protect others... But inside the [cruise ship] I was so scared of getting COVID-19 because there was no way to tell where the virus is. No green zone. No red zone. Everywhere could have the virus, and everybody was not careful about it. There was no single professional infection control person inside the ship and nobody in charge of infection prevention as a professional. The bureaucrats were in charge of everything."

Iwata, who speaks in English on the video, said he has isolated himself away from his family in a single room and will not go to work for the next 14 days. He lamented that there were no professional infection control specialists on the ship and that the DMAT team consisted of doctors and nurses "who might go back to their hospitals and might infect their patients -- I can't bear with it."

Japan's National Institute of Infectious diseases said the quarantine helped to slow the rate of infection. It is clear, it said in a release, "that substantial transmission of COVID-19 had been occurring before implementation of quarantine on the Diamond Princess."

Experts in the U.S. voiced skepticism about the process.

The Centers for Disease Control and Prevention, better known as the CDC, released a statement on Tuesday saying Japan's efforts "may not have been sufficient to prevent transmission among individuals on the ship" and that "the rate of new infections on board, especially among those without symptoms, represents an ongoing risk."

The CDC said all passengers and crew have been placed under travel restrictions and that the Americans among them are prevented from returning to the U.S. for at least 14 days after they disembark.

Days earlier, the U.S. flew some American passengers to California and Texas, where they will be quarantined for another two weeks.

Other countries are also helping their citizens return home.

Japan's health ministry said it will coordinate with the Diamond Princess operator to help crew leave the ship.

All passengers disembarking have tested negative for the virus.

The cruise initially had 3,711 people, including 1,045 crew, from 56 countries and regions.

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