When retiree Linda Ip booked a 10-day voyage on board the Diamond Princess with her husband and a group of friends, she hoped the party’s toughest decision would be whether to dine on sushi or steak.

The 62-year-old Hong Kong resident knew of the mysterious coronavirus that had taken hold in the Chinese city of Wuhan — Hong Kong declared a state of emergency on January 25, the day before they departed — but her group was in good spirits as they boarded the luxury cruise ship and set sail for the Japanese port of Yokohama.

What the Ips never imagined was that the deadly epidemic would erupt on board the ship and they would spend almost two weeks confined to a windowless cabin, before they tested positive themselves and the holiday took an even darker turn.

“The virus was spreading widely. We didn’t know which corner of the ship, which person was infected,” said Ms Ip, who admitted it was hard to stay calm as the number of cases steadily rose. “Unfortunately everyone on board may have been in contact with the virus.”

Passengers wearing masks leave the coronavirus-hit cruise ship Diamond Princess at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 21, 2020. REUTERS/Athit Perawongmetha
A passenger has his temperature taken after disembarking from the Diamond Princess on Friday © Reuters

Ms Ip is one of the 3,711 passengers and crew caught up in the worst outbreak of the deadly disease outside China, with 621 confirmed cases, after a controversial quarantine blamed by some experts for making the outbreak worse.

Two passengers have died but more than a thousand have been allowed to leave the ship this week, even though US and Hong Kong authorities say they pose an ongoing risk of spreading the virus.

The troubled quarantine of the Diamond Princess — with thousands of people packed together in a perfect environment to spread the disease, not control it — has exposed an international loophole in the handling of cruise ships. Once on board, the passengers are beyond national borders. If they fall ill with a contagious pathogen, no country will let them in.

That was illustrated by the plight of a second cruise ship, the Westerdam, which was turned away by four countries and the US territory of Guam even though there were no known cases of the virus on board.

After a fortnight at sea, passengers on the Westerdam were eventually allowed to disembark in Sihanoukville, Cambodia, only for one of them to test positive for the virus — an illustration of why nobody wanted to accept the vessel in the first place.

Christina Kerby, who travelled on the Westerdam, said that despite the unusual circumstances, the passengers had bonded as their vessel plied the seas looking for a port, although the virus test itself was “terrible and frightening”. It involved a “painful swab up my nose that felt like it went straight through the back of my head. I panicked and screamed”, she said.

The Westerdam passengers had the amenities of a normal cruise. But after their quarantine began on February 4, those on board the Diamond Princess had only their roommate, a WiFi connection and the valiant efforts of the crew, who amid the crisis did their best to maintain onboard morale by delivering Valentine’s Day gifts, thermometers, sudoku and vitamins.

What happened in this period is the subject of controversy. When Kentaro Iwata, a Japanese infectious diseases expert, visited the Diamond Princess on Tuesday he denounced its infection controls as “completely inadequate”, with no clear separation between a green zone, free of the virus, and a red zone of potential infection. Four Japanese officials have caught the disease, hinting at the quarantine’s makeshift and inadequate nature.

Dr Iwata’s comments raised the possibility that the infection spread during quarantine. But he later claimed to be reassured, after Japan’s infectious diseases institute published data showing a declining number of new cases among passengers as the confinement continued.

A bus carrying passengers from the quarantined Diamond Princess cruise ship leaves a port in Yokohama, near Tokyo, Thursday, Feb. 20, 2020. Passengers tested negative for COVID-19 started disembarking since Wednesday. (AP Photo/Eugene Hoshiko)
A bus carrying passengers from the ship leaves Yokohama © AP

As the two weeks of quarantine came to an end on Wednesday, Japan began to release hundreds of passengers who had tested negative, dropping them off at Yokohama’s train station despite international fears that the ineffective quarantine meant they could be coronavirus carriers.

The US Centers for Disease Control and Prevention said allowing the passengers to leave the vessel was an error, while Lam Ching-choi, an adviser to Hong Kong chief executive Carrie Lam, also slammed the decision. “It is very difficult to convince our experts that those released from the quarantine centre are free from the virus,” he said. “It is an infected ship.”

As some of the passengers who disembarked from the Diamond Princess made plans to make their way home, the vessel’s crew began a fresh quarantine. Ms Ip, meanwhile, now a patient at the Nagara Medical Centre in Japan, is no longer sure if she even has the virus.

“There might have been some miscommunication — the hospital did lots of check-ups and just told me the test is negative. They’ll do it again today or tomorrow.”

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