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Wednesday, February 12, 2020

Quarantined Cruise Ship in Japan May Now Be The Best Place to Study the Virus

The news broke today that the cruise ship Diamond Princess that has been in the news for being quarantined in Japan now has 175 confirmed infections from the 2019 novel coronavirus (2019-nCoV).  There are 39 new confirmed cases among passengers and crew members and one confirmed case in a Japanese quarantine worker.
Since the outbreak began in December, there have been over 45,000 confirmed cases of COVID-19 worldwide and at least 1,115 deaths. But while 2019-nCoV has spread to at least 24 countries beyond China, nearly all of the COVID-19 cases and all but one death have occurred in China.

According to the latest figures from the WHO, 44,730 cases are confirmed in China, while a remaining 444 are outside the country—including the 175 cases linked to the Diamond Princess. The tally is by far the largest outside of the outbreak’s epicenter; the country with the next-largest COVID-19 outbreak is Singapore, with 50 confirmed cases, according to WHO.
It's reported that the Japanese quarantine worker wasn't wearing highly protective clothing for high biosafety level areas, just wearing a mask and gloves.  He was handing out questionnaires and checking the health of passengers and crew members. 

Assuming passengers don't jump overboard and find ways to get back onshore (always easier at a dock than when miles at sea), this seems like a good opportunity to study the virus.  It could allow study of how long the virus survives on surfaces, and how effectively it spreads.  This is an isolated population, after all.  Patient zero, the first patient to contract the virus on the ship, is known:
Screening for COVID-19 on the ship began after a previous guest tested positive for the virus in Hong Kong on February 1. The man, who is from Hong Kong, boarded the Princess January 20 in Yokohama at the start of a 14-day round-trip voyage. The man sailed a leg of the voyage before disembarking during a stop in Hong Kong on January 25. Meanwhile, the ship sailed on. Upon news that the guest tested positive on February 1, the Diamond Princess returned to Yokohama a day early and has been quarantined ever since, with guests in isolation in their cabins.

It is still unclear when and where the man from Hong Kong became infected and how the virus has spread among people on the ship. It may be that the outbreak involved a so-called “super-spreader,” which means that a single infected patient sheds the virus extremely efficiently and infects an inordinate number of people. But again, it is unclear how many people may have brought 2019-nCoV aboard and how—or if—the 175 cases are all linked.  
I suspect that most of you have been reading what Aesop at Raconteur Report posts about the virus, like this one.  I sure have.  Having an isolated population like this might be a good way to study this virus and perhaps reduce the uncertainties that seem to apply to just about every characteristic.  There are 3,711 people on board the Diamond Princess; Reuters reports that roughly 80 percent of the passengers (over 2,900) are aged 60 or older, with 215 being in their 80s and nearly a dozen over 90. Those age groups have been among the most vulnerable demographics in the outbreak overall.  If those same percentages apply to the 175 cases and 80% of the cases (140 people) are over 60 years old, I'm afraid that will be where the largest number of deaths come from. 


The Diamond Princess at dock in Yokohama.  Getty Images photo.


23 comments:

  1. I swear, there are days it feels like we're living in a Niven/Pournelle novel.

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  2. "Paging Dr. Mengele..."

    It's only "best" in the sense that you're going to kill a given number of persons, to a metaphysical certainty, most of them needlessly.

    The castamays are only as smart as Gilligan, and those 3711 people, passengers and crew, are only as safe as the stupidest person on the ship, because that's the guy who's the 21st century Typhoid Mary, cheerfully spreading infection hither and yon.

    That may also include the ship's air handling system and/or plumbing, which isn't segregated, nor sterile, so keeping everyone in the rooms of a steel ship is tantamount to having the sickest of them coughing on everyone, 24/7/365, and will also probably necessitate the total write-off of the ship to Princess Lines as a permanently colonized Plague Ship.
    It is a certainty that no maritime insurer will ever cover it to set sail again, even if they burned it out from stem to stern.

    At the end of the day, the line, plus the Japanese government, will be liable for billion$ in damages from survivors and heirs' estates, for literally killing people, but given Japanese history regarding the Rape of Nanking, that shouldn't be too troubling to leadership in Tokyo. More like reliving the good old days of the Greater east Asia Co-Prosperity Sphere.

    Basic humanity would dictate that they move people off the ship into individual quarantine tents in the adjacent parking lot, and strictly segregate all their functions, including food and toileting. Doing it like they're doing is going to kill greater numbers, needlessly, who were initially uninfected.

    Including crew members.

    This is ghoul practice, not quarantine, but it accords with the millennia-long eastern tradition of regarding individuals as less worthy than cattle.

    If there were a war on, this would be a war crime. As it is, it's a crime against humanity. With which, yet again, the Japanese have some wee history of familiarity.

    Banzai!

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    1. ...only as safe as the stupidest person on the ship, because that's the guy who's the 21st century Typhoid Mary, cheerfully spreading infection hither and yon.

      The guy got off the ship ob January 25th, and wadn't diagnosed until February 1st. Given that we know there's a long asymptomatic period, what evidence do you have that the guy was "stupid"?

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    2. What evidence do you have from what I wrote here that I was referring with any specificity to anyone who "got off the ship"??

      I'll wait.

      Then ponder that in any group, someone is always the dumbest guy.
      That guy is Gilligan. Always.
      In 100% of all cases. Since Adam, or australopithecus, take your pick.
      Maybe you've seen the morale patch.

      That Guy is the Gilligan on the ship. There may be a 3700-way tie for the position, or he may be all alone at the left edge of the IQ bell curve, but it is nonetheless occupied and staffed, 24/7/365.

      He doesn't wash his hands after he poops. Or most any other time. He coughs without covering his mouth. He double dips the finger food. He serves himself with his fingers. He thinks germ theory and science are witchcraft. Ten times out of nine, he handles food, because those are the lowest-paid positions on a ship, and there's frequently a correlation between salary and intelligence.

      His mental close cousins are passengers who are either rich or famous, because those people tend to think money and fame means the laws of science and reality don't apply to them. That's why Mr. Howell, Mrs. Howell, and Ginger Grant were close runners-up in the category of Stupidest Castaway. As always, just like IRL.

      I didn't think this was an arcane concept.

      Delete
    3. Okay, smartass, I misunderstood what you meant. But at least we know you can be snide, sarcastic, insulting, and an all around inflamed hemorrhoid, albeit a knowledgable one.

      Delete
    4. Not from my reply to you, you don't. What a waste of perfectly good ad hominems for what was overwhelmingly a clear explanation.

      But if you're that butthurt about being caught so wildly mistaken, maybe you shouldn't run around pointing things out that were never said until you've actually read them.

      If I were really as snide, sarcastic, and insulting as you'd alleged, I would have left off explaining things at all, and simply pointed out that you've personally proven the Gilligan Effect better than I could explain.

      Or I could have noted that you tried to sharpshoot me both here, and in comments on my blog, and gone 0 for 2 today.

      If I were really juvenile and going for the easy laugh, I'd ask after Curly and Moe. But that would probably be piling on.

      Feel better now?

      In case it informs your approach, you should know that before my current life, I was professionally involved with field artillery for some good time, where my two personal favorites were white phosphorous, and the "zone and sweep", which continue to have useful applications throughout life.

      Welcome to the majors.

      Delete
    5. You sure showed me.
      Yet again, Larry, thanks for making my point.

      Delete
    6. Keep going, man!
      No second thoughts, just ride it right into the ground!
      Most people, after shooting themselves in both feet, wouldn't keep reloading.
      But you keep on being you!

      Delete
  3. I'm sure that the standard of care is adequate. One unanswered question regarding the fatalities has to do with the standard of care that they received in China. Mainland China has a tradition of poor to non-existent care (by Western standards).

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  4. Allow me to suggest that "a good opportunity to study the virus" under these circumstances is arguably a euphemism for "let's expose a lot of people to a potentially pathogen, without their consent, and see what happens." Given the resources at Japan's disposal, there is nothing to recommend this approach.

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  5. I understand the objections that you raise, Aesop and Retired Mustang. My thought was everyone on board has already been exposed because there were people walking around on board distributing virus for a couple of weeks before they got to Yokohama. It simply never occurred to me that people had not been exposed. I guess my take was that there's a small town's worth of people who have been exposed and continue to exchange the virus. Might as well get as much information from it as we can.

    I like the idea of getting people off the ship and into tents because I was thinking about what you're saying in regard to the ship, Aesop. Exactly how can they decontaminate a ship like that? I live about 25 miles from a cruise ship port and there have been stories about decontaminating after Norwalk virus. Basically giving the ship a bath in bleach. I don't think the people doing the work had to wear space suits, which anyone working on this ship will seem to need.

    One of those news links, Reuters IIRC, had a short video from an Australian woman (again, IIRC) and she seemed pretty OK with it all. I think she felt better about being behind closed doors - as if that's going to matter. How do they handle getting fed? There had better not be the usual open buffets. Deliveries to the door might be OK. Then they have to pick up the dirty dishes, which have to be considered covered in biohazard waste.

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  6. Let me break it down:
    https://raconteurreport.blogspot.com/2020/02/quarantine-math-for-common-core-grads.html

    Pulling the known infected off, at minimum, is at least as bright as Turd-World people do in Sh*tholia, for Ebola.

    Leaving everyone onboard the ship, with common air-handling, ensures that everyone gets it, and hundreds die.

    I repeat, this is Dr. Mengele, back from the grave.

    Quarantining people onboard ships was from millennia past, dozens of centuries before Germ Theory was a thing.

    It's beyond retarded, unless one regards all foreigners as dirty peasants.

    Like Japan does, to this day.

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    Replies
    1. Also "exposure" is vastly different, when it's to a dozen or so active cases, versus keeping everyone in a closed cage, and re-exposing them dozens of times per hour to the same pathogen, as the number of fulminant viral hosts approaches n=Everyone.

      The former is (barely) science, the latter is shark-hunting a virus using 3711 random strangers as live bait.

      We hung Nazis and IJN soldiers for less than that.

      In fact, pulling everyone off and segregating them is the only way to get any data of any real value, unless you want to study viral propagation on a cruise ship with no infection control standards in place, using the most pathogenically fragile population you can get.

      Which, once again, is going right back to using live women and children as bayonet practice targets.

      Delete
  7. Ayup.

    A microcosmic case study until tptb realize the world recognizes that fact too.

    Then the scattering of peoples and info will take root.

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  8. I touched on this on the evening of the 11th:
    https://bigcountryexpatoriginal.blogspot.com/2020/02/the-love-boat-redux.html
    Great Petri dish to follow...
    Also, per CNBC, they ARE now removing the infected from Da Boat:
    "At least 20 of those infected are American, according to the company. The Japanese Health Ministry said all of the infected passengers will be removed from the ship and transported to local hospitals"
    https://www.cnbc.com/2020/02/12/as-coronavirus-spreads-on-ship-princess-cruises-offers-crew-two-months-of-vacation.html

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    Replies
    1. Thanks for the info about passengers being evacuated to local hospitals and link back to your page.

      It's an incubator. Impossible to sterilize the ship and impossible to keep the virus from spreading.

      Delete
    2. My Pleasure... just short (as Aesop said) burning the boat to the ground, ain't no way that thing is bouncing back... Here in FL I've seen them -trying- to decon after a Norovirus Outbreak... wasn't pretty

      Delete
  9. Of possible interest (can't comment as to the science, not a medical-person): https://www.eturbonews.com/542533/coronavirus-risk-for-asians-africans-caucasians-revealed/

    Per the article, susceptibility to the disease varies by race. No one seems to be immune, but some groups are at significantly higher risk than others.

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  10. Keeping the exposed but not yet obvious cases on the ship guarantees that as new cases crop up, the air-handling system will efficiently spread it until everyone left aboard is infected.

    In a hospital, you segregate the infected from everyone else.
    On a ship, they're all stew meat in the same pot, and everyone gets cooked. And day after day, additional cases will keep cropping up, all helpfully assisted by people delivering food, checking on passengers, and the fact that they're all breathing the same air circulated in a non-sterile system.

    This is epidemiological idiocy of the rankest sort.
    It's like only pulling the burned people out of a building on fire, and leaving the uninjured inside as the blaze spreads.

    It's like TPTB were raised on lead paint chips or something.

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  11. This comment has been removed by a blog administrator.

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  12. I am sure they can eventually recover the ship after this mess is over. It will cost a few million to do but that will be far less than building a new ship. The clean up will be extreme to accomplish the ends. Maybe a government can do it to practice biological hazard decontamination.

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  13. Read this a.m. that individual nations are now starting to evac passengers off of the cruise ships.

    They will be repatriated and re-quarantined once they get back.

    Not a complete study, but a lot of data can still be gleaned.

    Official initial reports of containment were bs.

    The rate of transmission is frightening.

    The mortality rate still is shrouded in mystery.

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