Enlarge /. SAN ANTONIO, TX – FEBRUARY 17: American evacuees from the Diamond Princess cruise ship arrive at the San Antonio-Lackland Joint Base on February 17, 2020 in San Antonio, Texas. The Diamond Princess cruise ship, from which passengers were evacuated and docked in the Japanese city of Yokohama, is believed to be the highest concentration of novel coronavirus cases outside of China, where the outbreak began.
Fourteen Americans were tested positive for the new corona virus when they started returning from Yokohama, Japan to the United States, where they were caught in a quarantine aboard the luxury cruise ship Diamond Princess, which began on February 3.
To date, February 17, Japanese health authorities have confirmed 454 cases of COVID-19 on the ship, including 99 cases reported since yesterday. The cluster is by far the largest of all COVID-19 relapses outside of China, where the outbreak started and has caused the vast majority of infections and deaths.
The new cases of returning Americans will almost double the current number of COVID-19 cases in the United States and increase the total number from 15 to 29 at present.
Originally, no American cruise passengers infected with the new corona virus were to leave Japan. When the US government announced plans to evacuate the approximately 400 Americans stuck on the cruise ship on Saturday, February 15, it determined that sick passengers would stay in Japan for treatment.
Evacuation plans for over 300 other Americans, however, were questioned as they disembarked the ship and took buses to the airport, where they expected aircraft hired by the US State Department. On the way, US officials received the results of tests carried out two to three days earlier and found that 14 of the evacuees were infected with the novel corona virus.
After some consideration, U.S. officials decided to allow the 14 travelers who were asymptomatic when disembarking from the ship to return to the United States. The 14 flew back into a special security area on the evacuation plane and isolated them from the other evacuees.
All returning ship passengers would be held in a 14-day federal quarantine in one of two military bases upon their arrival today.
According to reports, 44 Americans tested positive for the virus and stayed in Japan. Others reported that they chose to stay on the ship and take their risk – a decision that may seem wise in retrospect.
Sacramento-based Matthew Smith, a Diamond Princess passenger, told CNN subsidiary KOVR that he and his wife "had chosen to face the consequences [on the ship] rather than the [evacuation] situation suspend ".
"It somehow made no sense – if the United States was concerned that they were infected, which is why they would quarantine them for another two weeks – to throw them all together."
The messy evacuation highlights the difficulty in controlling the spread of COVID-19, especially on cruise ships, as many people infected with the novel coronavirus have mild to no symptoms. At the same time, hundreds of passengers boarding another cruise ship, the MS Westerdam, in Cambodia were chased after an 83-year-old American who had previously been on board tested positive for the virus in Malaysia.
In a daily situation report today, experts from the World Health Organization found that the latest data from more than 44,000 cases in China indicate that more than 80 percent of those infected have mild diseases and are fully recovering. About 14 percent of those infected suffer from serious illnesses, including shortness of breath and pneumonia, and 5 percent have critical cases involving respiratory failure, organ failure and septic shock. The virus appears to be fatal in China in about 2 percent of cases, with the risk of death increasing with the age of the patient.
There are currently over 71,000 laboratory-confirmed and clinically diagnosed cases worldwide with 1,775 deaths. Of the cases, 794 are outside of China, spread across 25 countries. Three of the deaths occurred outside of China.
While the daily number of new cases in China has recently declined, WHO Director General Tedros Adhanom Ghebreyesus warned that the trend "needs to be interpreted very carefully".
"It is too early to say whether this reported decline will continue," he said. "Every scenario is still on the table."
It is likely that mild cases will not be adequately reported and that case tracking will become increasingly difficult and complex.
Officials in the United States have repeatedly stated that current quarantine measures and travel restrictions are not designed to protect the country from the virus – such an effort would be in vain. Instead, the measures should provide additional preparation time to prepare for the likely scenario that cases will continue to arrive in the country.