Abstract
BackgroundJapan implemented a large-scale quarantine on the Diamond Princess cruise ship in an attempt to control the spread of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in February 2020.ObjectiveWe aim to describe the medical activities initiated and difficulties in implementing quarantine on a cruise ship.MethodsReverse transcription–polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 were performed for all 3711 people (2666 passengers and 1045 crew) on board.ResultsOf those tested, 696 (18.8%) tested positive for coronavirus disease (COVID-19), of which 410 (58.9%) were asymptomatic. We also confirmed that 54% of the asymptomatic patients with a positive RT-PCR result had lung opacities on chest computed tomography. There were many difficulties in implementing quarantine, such as creating a dividing traffic line between infectious and noninfectious passengers, finding hospitals and transportation providers willing to accept these patients, transporting individuals, language barriers, and supporting daily life. As of March 8, 2020, 31 patients (4.5% of patients with positive RT-PCR results) were hospitalized and required ventilator support or intensive care, and 7 patients (1.0% of patients with positive RT-PCR results) had died.ConclusionsThere were several difficulties in implementing large-scale quarantine and obtaining medical support on the cruise ship. In the future, we need to prepare for patients’ transfer and the admitting hospitals when disembarking the passengers. We recommend treating the crew the same way as the passengers to control the infection. We must also draw a plan for the future, to protect travelers and passengers from emerging infectious diseases on cruise ships.
Highlights
Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in China on December 31, 2019, it has rapidly spread all over the world and 230,104 people have died from coronavirus disease (COVID-19) in 215 countries as of May 3, 2020 [1]
Japan implemented a large-scale quarantine on the Diamond Princess cruise ship, and all passengers including asymptomatic patients were tested for SARS-CoV-2 by using reverse transcription–polymerase chain reaction (RT-PCR); valuable http://publichealth.jmir.org/2020/2/e18821/
JMIR Public Health Surveill 2020 | vol 6 | iss. 2 | e18821 | p. 1 lessons can be learned from the steps taken for quarantine implementation on the cruise ship
Summary
696 (18.8%) tested positive for coronavirus disease (COVID-19), of which 410 (58.9%) were asymptomatic. We confirmed that 54% of the asymptomatic patients with a positive RT-PCR result had lung opacities on chest computed tomography. There were many difficulties in implementing quarantine, such as creating a dividing traffic line between infectious and noninfectious passengers, finding hospitals and transportation providers willing to accept these patients, transporting individuals, language barriers, and supporting daily life. As of March 8, 2020, 31 patients (4.5% of patients with positive RT-PCR results) were hospitalized and required ventilator support or intensive care, and 7 patients (1.0% of patients with positive RT-PCR results) had died
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