What the Diamond Princess taught the world about covid-19

Abstract

In the early days of the covid-19 pandemic, there was one place besides China that became infamous as a hotbed of SARS-CoV-2 transmission: a cruise ship. That ship has taught epidemiologists crucial lessons, writes Chris Baraniuk

Lessons Learned from Japan’s Response to the First Wave of COVID-19: A Content Analysis

“…This study clarified that the importance of expanding the diagnostic capacity by using university and large private laboratories and the necessity of capturing asymptomatic infections were the main topics in the early phase of the debate [23][24][25]. This corresponded to the most important issues at that point, which regarded Japan's testing capacity [19], the identification of asymptomatic infections [76][77][78][79][80][81][82], estimates of the magnitude of COVID-19 [83,84], and challenges in infection control [85].…”

COVID-19 isolation and containment strategies for ships: Lessons from the USS Theodore Roosevelt outbreak

“…Disease control in the early stages of a pandemic depends significantly on the ability to contain shipborne outbreaks, as these provide significant opportunities for pathogens to spread in an uncontrolled manner and propagate internationally when passengers are released before the outbreak has run its course. The challenge of managing shipborne disease outbreaks has been evident throughout history: the concept of quarantine itself dates back to restrictions placed on sailors in the era of the Black Death; in 1918, troopships were instrumental in spreading the influenza pandemic (Baraniuk, 2020); and in recent years, the cruise ship industry (“COVID-19 pandemic on cruise ships,” 2020; El Damanhoury and Cullinane, 2019; Hines, 2020) and the Navy (Aquino and Brice, 2014; Khaokham et al, 2013) have both struggled with a variety of infectious disease outbreaks on ships.…”

“…We note that lowering the R0 will also facilitate disease control on ships. A number of authors have pointed out the risk posed by unfiltered forced-air ventilation systems (Baraniuk, 2020; Malone, 2020), and installing higher-quality filters on heating, ventilation and air-conditioning systems is an easy step to take in reducing the rate of transmission of an airborne pathogen. Our work contains a number of simplifying assumptions that are worth exploring in further work.…”

Lessons and suggestions to travelers and cruise ships in the fight against COVID-19

“…‘The Diamond Princess is emerging as an unfortunate but informative experiment that taught scientists much about COVID-19’. 5 We hope our mentioned lessons and suggestions would help improve the situation on the cruise ships and travelers to fight against COVID-19 and other emerging infectious diseases in the future.…”

“…The scientist described ‘completely chaotic’ conditions aboard the Diamond Princess. 5 Second, the inappropriate quarantine on the Diamond Princess could accelerate a contagion of the virus because of its semi-enclosed space, limited sanitation as well as restricted water and food supply. Third, care for the passengers and crew on the Diamond Princess was poor, especially those elderly with existing with comorbidities who were at serious risk not just from COVID-19 infection, but from physical and psychological stress.…”