friday, february 21 , 2020. the washington post eZ su A
whether the Westerdam passen-
gers spread the virus around the
world. Some are skeptical they
will see that, suggesting the sin-
gle positive test result may have
been erroneous.
“You would assume if one per-
son got infected on any cruise,
you would have a mini-outbreak,”
said one U.S. official involved in
the response. “maybe she wasn’t
positive.”
Based on what is known so far,
Cambodia’s approach is prefera-
ble to quarantining people
aboard a ship where the virus is
spreading, said Saskia V. Popescu,
senior infection prevention epi-
demiologist for HonorHealth, a
hospital system in Phoenix.
But that requires educating
passengers about reporting
symptoms and self-isolating if
necessary, and having public
health authorities in home coun-
tries closely monitor those who
have returned. It i ncludes quickly
tracing the contacts of anyone
who develops the infection.
“I think we can say if you’re
going to quarantine people, do-
ing it on a cruise ship is not the
best place,” Popescu said.
In an interview with The
Washington Post, Phay Siphan,
the Cambodian government
spokesman, expressed no regrets
on the handling of the Wester-
dam and its passengers.
“The ship was abandoned by
the Earth,” he said. “We under-
stood their predicament, and we
knew we had to help them.”A struggle to get home
Christina Kerby initially strug-
gled to find a flight home from
Cambodia.
“It literally is minute by min-
ute over here,” she said Wednes-
day. “one minute, they think they
have an agreement with a coun-
try to let us through and the next,
people are being held at the
airport.” She arrived in San fran-
cisco on Thursday.
fehrenbacher, the graduate
student, described his room at
Travis Air force Base as surpris-
ingly spacious. He was told that
for 48 hours, he could not leave
the room. To receive a meal from
uniformed personnel, he must
first put on a mask. He has never
tested positive for the virus.
“I’m just trying to stay hydrat-
ed and optimistic about what the
next 12 days are going to look
like,” he said.
In Japan, meanwhile, the Dia-
mond Princess is finally being
vacated. on Wednesday, Japan
released 443 people from the
ship, saying they had completed
their 14-day quarantines. Scores
of its passengers, about 40 of
them Americans, remain hospi-
talized with the infection.
on Thursday, t he State Depart-
ment urged U.S. citizens to recon-
sider cruise ship travel to or
within East Asia and the Asia-Pa-
cific region.
[email protected]
[email protected]
[email protected]
[email protected]mahtani reported from hong Kong.
simon denyer in tokyo, meta Kong in
Phnom Penh and William Wan and
alex horton in Washington
contributed to this report.on feb. 12, U.S. officials
briefed members of Congress i n a
closed-door hearing. rep. Phil
roe (r-Te nn.), a doctor, had also
heard from a friend and fellow
doctor, Arnold Hopland, of Eliza-
bethton, Te nn., who was on the
ship with his wife, Jeanie. Hop-
land told roe about the deterio-
rating conditions.
“That tipped the balance,” s aid
the senior administration offi-
cial.
By friday afternoon in Wash-
ington, there was agreement
among all the agencies in the U.S.
coronavirus task force to evacu-
ate the Americans.
The State Department,
through the U.S. Embassy in To -
kyo, posted an urgent notice to
U.S. citizens: Americans who
wanted to leave needed to let the
embassy know by 10 a.m. Satur-
day local time in To kyo.
In all, 328 Americans disem-
barked from the ship in the early
hours of monday, Tokyo time.
They boarded buses — and then
were forced to wait, in the port,
for more than two hours, accord-
ing to two passengers. They
couldn’t see out of the buses —
the windows were covered.
Some began crying because
they needed to use the bathroom,
said Vana mendizabal, 69, of
Crystal river, fla. The retired
nurse had taken the cruise with
her husband, mario, 75, a physi-
cian.
“We just couldn’t understand
why we were sitting there, load-
ed, and not going anywhere,” s he
said. “A nd we couldn’t get any
answers.”
Eventually the buses arrived at
the airport, and once again, ev-
eryone waited while top officials
in Washington argued about the
test results, according to a senior
administration official.
“Nobody anticipated getting
these results,” said another U.S.
official involved in the evacua-
tion.
During one call, the CDC’s
principal deputy director, Anne
Schuchat, argued against taking
the infected Americans on the
plane, according to two partici-
pants. She noted the U.S. govern-
ment had already told passengers
they would not be evacuated with
anyone who was infected or who
showed symptoms. She was also
concerned about infection con-
trol.
Anthony fauci, head of the
National Institute of Allergy and
Infectious Diseases, who was also
on the calls, recalled saying her
points were valid and should be
considered.
But robert Kadlec, assistant
secretary for preparedness and
response for the Department of
Health and Human Services and
a member of the coronavirus task
force, pushed back: officials had
already prepared the plane to
handle passengers who might
develop symptoms on the long
flight, he argued. The two Boeing
747s had 18 seats cordoned off
with 10-foot-high plastic on all
four sides. Infectious disease doc-
tors would also be onboard.
“We felt like we had very expe-
rienced hands in evaluating and
caring for these patients,” Kadlec
said at a news briefing monday.
The State Department made
the call. The 14 people were
already in the evacuation pipe-
line and protocol dictated they be
brought home, said William Wal-
ters, director of operational med-
icine for the State Department.
As the State Department draft-
ed its news release, the CDC’s top
officials insisted that any men-
tion of the agency be removed.
VIRUS from A
The Coronavirus Outbreak
Then came startling news. on
Saturday night, an 83-year-old
American woman, as yet uniden-
tified, tested positive for corona-
virus in malaysia. Her husband,
who also has symptoms of the
respiratory illness, tested nega-
tive.
Suddenly, as if flash-frozen, the
exodus from the Westerdam halt-
ed. Hundreds of passengers and
crew were ordered to remain
onboard. others retreated to the
Sokha hotel, where they were
asked to stay in their rooms — a
request some ignored, said Chris-
tina Kerby, 41, of Alameda, Calif.,
who had taken the cruise with her
mother.
Kerby had spent Saturday re-
laxing at the hotel. She went for a
swim, then out to dinner, publish-
ing photos of her meal on Twitter
for followers who had been track-
ing her ordeal over the previous
two weeks.
“It was my afternoon to relax
before a long trip home,” s he said.
Kerby has received blowback
on Twitter for going out in Phnom
Penh. Back home in Alameda, her
children’s preschool asked
whether she might endanger oth-
er kids when she returns. The
stigma of the virus is a new
feeling, she said.
on Sunday, she awoke to find a
note slipped under her door ask-
ing that she stay in her room.
“That, for me, was the moment
I lost it,” said Kerby, who had
been relentlessly optimistic dur-
ing her cruise ship confinement.
“A s Americans, we’re very used to
having agency over our own bod-
ies and being able to come and go
as we pleased.”
N ow, health experts say, there
is little to do but wait and seeout the red carpet. Without any
protective gear — not even a
mask or gloves — he greeted
passengers as they disembarked,
shaking their hands as he passed
out bouquets of flowers.
U.S. Ambassador W. Patrick
murphy also went to the dock
with his family to welcome pas-
sengers. murphy wore no face
mask or gloves, and maintained
little distance between himself
and jubilant, relieved passengers.
They filed off and dispersed to
hotels, hundreds to the luxury
Sokha in Phnom Penh, a little
more than 100 miles away. There,
some went out to dinner, assured
by Cambodia and cruise ship
officials that among the 20 people
who were tested for the virus,
none was positive. others took a
bus tour.
more than 700 headed for the
airport and flights to homes
around the world.“We still don’t have a good
understanding of the risk posed
by people who are infected but
without symptoms,” said Jeffrey
Duchin, an infectious disease
specialist at the University of
Washington.Another ship gets a warm
reception
Thousands of miles away, a
different scene was playing out in
Cambodia.
The Westerdam, a luxurious
Holland America Line ship with
2,257 passengers and crew, spent
days searching for a port amid
fears that it might have infected
passengers aboard — even
though there was no evidence of
it. The ship was turned away f rom
five ports, including Guam.
The Westerdam finally was
embraced feb. 13 by Cambodia, a
nation with close ties to China
and whose authoritarian prime
minister, Hun Sen, has used the
coronavirus crisis to advance his
country’s political interests.
Having lost a preferential
trade arrangement with the Eu-
ropean Union over human rights
abuses, Hun Sen used the Wester-
dam as a vehicle to alter head-
lines and potentially improve re-
lations with the West.
When the ship sailed into Siha-
noukville last Thursday, he rolled“CDC did weigh in on this and
explicitly recommended against
it,” Schuchat wrote on behalf of
the officials, according to an HHS
official who saw the email and
shared the language. “We should
not be mentioned as having been
consulted as it begs the question
of what was our advice.”
She wrote that the infected
passengers could pose “an in-
creased risk to the other passen-
gers.”
Schuchat declined to com-
ment.
About an hour before the
planes landed in California and
Te xas, the State Department re-
vealed that the 14 evacuees had
tested positive and did not men-
tion the CDC.
mendizabal, the retired nurse,
said she learned about the infec-
tions only when she landed at
Travis Air force Base in Califor-
nia and talked to one of her five
children, who had seen a news
report.
“We were upset that people
were knowingly put on the plane
who were positive,” she said
Wednesday in an interview from
the military base. She said she
and her husband had already
completed 12 days of quarantine
on the ship and both were
healthy.
“ I think those people should
not have been allowed on the
plane,” mendizabal said. “They
should have been transferred to
medical facilities in Japan. We
feel we were re-exposed. We were
very upset about that.”
After the planes landed, the
infected passengers were retest-
ed. on Thursday, the CDC con-
firmed that 11 were indeed posi-
tive and two tested negative. one
passenger is still awaiting results.
Scientists are still trying to
understand the virus. Some of
its features, such as how long it
can live on surfaces, are un-
known. But experts say it is
mainly spread by respiratory
droplets produced by coughs
and sneezes from an infected
person. That person must be in
close contact, usually defined as
six feet.heng sinith/associated Press
Passengers of the Westerdam, a Holland America Line ship, disembark Saturday in Sihanoukville, Cambodia. After many people left the
ship, officials discovered an 83-year-old American woman who was on the vessel tested positive for coronavirus in Malaysia.Paula Bronstein/agence France-Presse/getty images
A woman is screened on the Westerdam. The State Department told
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