Thousands of passengers, including 12 Israelis, began disembarking a cruise ship off Japan Wednesday, following a two week quarantine to curb the spread of the novel coronavirus, as the death toll in China topped 2,000.
The Japanese authorities said overnight Tuesday that passengers who had shared a cabin with an infected person will not disembark the ship just yet.
The Diamond Princess, owned by Carnival Corp, has been quarantined since arriving in Yokohama, southwest of Tokyo, on February 3. The quarantine was imposed after a man who disembarked at the ship's previous stop in Hong Kong was diagnosed with the COVID-19 virus.
Twelve out of the 15 Israeli nationals aboard the ship will return to Israel on a charter plane, and are expected to arrive Thursday. Upon their arrival they will undergo another two week quarantine. They will also undergo further testing at Sheba Medical Center at Tel Hashomer hospital in Ramat Gan.
Israel's foreign and health ministries said in a joint statement on Wednesday that "two of the Israeli passengers have disembarked the ship, and the others are expected to disembark today or tomorrow."
The Israeli Embassy in Tokyo in cooperation with the Israeli Health Ministry officials have released guidelines regarding the conduct of the Israeli passengers on their leaving the ship and returning to Israel.
The Israeli passengers are expected to leave the ship on Thursday at 6 P.M. (Japan time) at the latest, and will fly back to Israel, where they will undergo medical tests and be placed in quarantine for 14 days in Sheba.
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Speaking in an interview with the Walla news website, Deputy Health Minister Yaakov Litzman said that the Health Ministry's working assumption has been that the coronavirus would reach Israel. "We are investing all of our efforts to prevent [coronavirus] from reaching Israel, and so far we've been successful in that."
Referring to Israel's general election on March 2, Litzman said that the Health Ministry is seeking to give people placed in quarantine the option to vote, and is looking for a solution in the form of special polling places.
"I was the first one to suspend flights from China. I was widely criticized, and I stood firm, and stuck to my decision. [Later] we suspended flights from other countries, such as Thailand and Hong Kong," Litzman said.
"If the number of coronavirus cases falls in other countries in the next couple of days, we may cancel the order to place suspected patients in quarantine," he added.
When asked if he plans to order the suspension of flights from additional countries, the deputy head minister replied in the negative, saying that "We have the situation under control."
Sheba Medical Center has allocated a structure for quarantining the passengers, completely separate from any other ward. This structure has its own sewage, water and ventilation systems, not connected with those serving the rest of the hospital.
Food will be prepared in a separate kitchen to prevent sharing of plates and cutlery. They will also be treated by a special medical team not associated with the rest of the hospital. Staff will wear protective gear and use "remote" medical procedures.
The structure however is designated only for isolation, and does not have respiratory isolation rooms. If one of the cruise passengers develops symptoms and is found to carry the novel coronavirus, he or she will be moved to yet another quarantine area at Sheba, which does have respiratory isolation rooms.
Lena Samuelov, one of the Israeli passengers on board the ship told Israel Radio that she is "not expected to disembark the ship, not today, or tomorrow, probably the day after tomorrow.
"The State of Israel can't bring back 12 people? They have to do what they promised. We're still being held in quarantine, but who has the right to keep us here? We're not in prison," she charged.
On Sunday, Israel's Health Ministry said that the other three Israelis on the ship had tested positive for coronavirus.
Two of the Israelis, a couple, have been transferred to a Japanese hospital in mild condition. A third Israeli was diagnosed shortly after disembarking the cruise ship and was later also hospitalized.
The Health Ministry sent Prof. Ran Nir-Paz of Hadassah Medical Center, an expert on infectious diseases, to Tokyo to observe the treatment of the three Israelis. Nir-Paz, together with the Israeli consul in Japan, Revital Ben Naim, visited the two military hospitals where the Israeli patients are hospitalized.
Nir-Paz and Ben Naim met with the medical teams taking care of the Israelis, all three of whom are in isolation. “We see good treatment by the Japanese and we will of course continue to monitor the situation firsthand,” Nir-Paz said.
The ship, with some 3,700 passengers and crew on board, has seen 542 cases of coronavirus, the most infections outside China.
Dr. Nathalie MacDermott, an outbreak expert at King’s College London, said the exact mechanism of the virus’ spread was unknown. Although scientists believe the disease is spread mostly by droplets – when people cough or sneeze – it’s possible there are other ways of transmission.
“There’s no reason this [quarantine] should not have worked if it had been done properly,” she said.
Cruise ships have sometimes been struck by outbreaks of diseases like norovirus, which can spread quickly in the close quarters of a boat and among elderly passengers with weaker immune systems.
Some passengers on the Diamond Princess described the ship as a “floating prison” but were allowed to walk on the decks every day while wearing a mask and were told to keep their distance from others.
Japanese officials defended the decision to quarantine the ship and test people on board.
"Unfortunately, cases of infection have emerged, but we have to the extent possible taken appropriate steps to prevent serious cases, including sending infected people to hospital," NHK quoted Health Minister Katsunobu Kato as saying.
Clyde Smith, 80, who was evacuated from the ship to a Tokyo hospital after testing positive for the virus told Reuters on Sunday he had not been told if would be allowed on a U.S. evacuation plane.
The United States, Canada and Hong Kong have already sent aircraft to Japan last week to bring back their citizens on board the ship.
The U.S. Embassy in Tokyo said passengers and crew on board the ship were at high risk of exposure to the virus and it recommended that its citizens get off and take one of the flights home.
"This is a rapidly evolving situation and we are taking additional steps to assist U.S. citizens," it said.
The latest figures bring the total number of cases in China to over 74,000 and the total death toll to 2,004, three quarters of which have occurred in the Hubei provincial capital of Wuhan. Six people have died outside mainland China, including a new fatality announced on Wednesday in Hong Kong.
Reuters contributed to this report.