Inside the cruise ship that became a coronavirus breeding ground

Christian Santos* remembers staying awake at night, anxiously listening to the sound of his colleague coughing. They were sleeping below deck, in one of the small rooms shared by workers on board the stricken Diamond Princess cruise ship.

He had spent the previous two weeks serving guests who were confined to their rooms, and watching the miserable failure of disease-control measures on the vessel. Now he knew the coronavirus, which had already transmitted to hundreds of people onboard, had almost certainly entered his own cabin.

He tried to move rooms, but was told this wasn’t possible. “Every time he coughed I was afraid,” recalls Santos, who, like many workers interviewed, asked to speak under a pseudonym. The next morning his colleague was taken to hospital for treatment.

Santos has since tested negative, but as he and other crew remain in quarantine, a separate cruise ship is now being held off the coast of San Francisco after it was linked to a coronavirus death in California. A further 21 people onboard are reporting possible symptoms. It is not known if guests will be allowed to disembark.

It is clear, said Santos, that passengers and crew from the Diamond Princess should have been evacuated far earlier from the ship, which became a breeding ground for the virus after it was stopped from sailing by the Japanese government. Crew, he added, should not have continued serving, cooking and cleaning while a quarantine was supposed to be underway.

“We were abused,” said Santos. “Can you imagine? The situation was alarming but they kept us working.” He fears he could still develop the virus, and worries about losing work because of the crisis.

Concerns were first raised about the ship when a former passenger who disembarked in Hong Kong tested positive for the virus on 1 February. Three days later, Japanese authorities stopped the ship from sailing. On 5 February, tighter controls were introduced and the 2,600 guests on board were told not to leave their rooms.

But these measures, which some have speculated were imposed days too late, only applied to passengers. Crew continued to eat in a large mess hall, share bathroom facilities and go to guests’ rooms. Some departments received protective equipment later than others. Santos says he did not receive a mask until a week after the ship had been stopped.

Passengers of the Diamond Princess cruise ship on their balconies at the Daikoku Pier cruise terminal in Yokohama, Japan, during the ship’s quarantine



Passengers of the Diamond Princess cruise ship are seen on their balconies at the Daikoku Pier cruise terminal in Yokohama, Japan, during the ship’s quarantine. Photograph: Jiji Press/EPA

At the time, Kentaro Iwata of Kobe University Hospital, an infectious disease specialist who visited the ship during the quarantine, described the procedures onboard as “completely inadequate”. In a scathing video posted online, he said he had worked during Ebola and Sars outbreaks and had never worried about getting infected but, after visiting the Diamond Princess, he was afraid of catching coronavirus.

Crew members described scenes of confusion and chaos, in which there was little separation between the healthy and the sick. “As a crew you don’t even know who is positive – you’re dealing with them and you’re going around the ship, eating in the mess together,” said another staff member, James Reyes, who worked in housekeeping.

“We are the one giving [isolated crew members] everything they need and sorting out their dirty dishes. Then one day you will notice those isolated cabins going empty because they [have tested] positive. Imagine the cross contamination.”

Six passengers have died as a result of the virus.

Princess Cruises said in a statement that Japan’s ministry of health was the lead authority “defining and executing the testing and quarantine protocols for all guests and crew”, and that the ship was legally obliged to follow the country’s public health and medical instructions.

Japan’s ministry of foreign affairs said in a statement that Japan “presented a criteria of behaviour” to limit infection along with equipment, but that “the responsibility for ensuring that the ship can be operated in a manner that provides a safe environment for passengers and crew rests with the ship operator”.

Q&A

How can I protect myself from the coronavirus outbreak?

The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.

The UN agency advises people to:

  • Frequently wash their hands with an alcohol-based hand rub or warm water and soap
  • Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
  • Avoid close contact with anyone who has a fever or cough
  • Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
  • Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
  • Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.

Despite a surge in sales of face masks in the aftermath of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided it is used correctly.

Justin McCurry

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Reyes isn’t sure who is to blame. He is now in quarantine with Santos, back in the Philippines, home to almost half of the Diamond Princess’s crew. The country is a major source of ship workers globally and depends heavily on remittances. Though most Filipinos are employed through land-based jobs, 330,859 people were at sea as of the end of 2018. Cruise ship work, thanks to its higher pay and the job’s glamorous reputation, is highly sought after.

This can leave employees reluctant to speak out when they are being unfairly treated, said Professor Helen Sampson of the seafarers international research centre at Cardiff University. “Most workers are employed on temporary contracts and are fearful of losing their jobs, making them extremely vulnerable to abuse of many kinds.”

The majority of crew members interviewed said they did not want to give their full name because they feared repercussions from Princess Cruises, or from their recruitment agency, the Magsaysay Maritime Corporation (MMC). Some crew and their relatives said they had been discouraged from sharing information about the outbreak by posting online or talking to the media. Princess Cruises said it had not stopped staff from using social media. MMC did not respond to a request for comment.

Joanna Concepcion, chairperson of Migrante International, a Manila-based group that supported affected crew members, said employees wanted to stop working but felt they had no choice. “It was almost as if they were forced to pick between their health and safety, and their economic livelihood,” she said.

A crew member at work onboard the Diamond Princess cruise ship



A crew member at work onboard the Diamond Princess cruise ship. Photograph: Tomohiro Ohsumi/Getty Images

Messages given to crew onboard varied. In one department, crew were told in a group meeting that if they did not wish to work they must come forward and write down their names, so that their details could then be provided to human resources – an announcement perceived by some staff present to be a threat. Elsewhere, staff said they were not informed of any option not to work, and instead found their hours increasing as they were tasked with delivering food and other treats to passengers who had been confined to their rooms. Crew were also given treats and vitamins.

“If we [had stood down] nobody would deliver food, and [passengers] would not be able to eat,” said one worker, who asked to be referred to by their initials, RCDG. Many guests were old and had underlying health conditions, making them more vulnerable to the virus, RCDG added.

Photographs shared online show a flood of thank-you letters written by the ship’s guests. Some passengers were frustrated by the quarantine, but most were extremely grateful to the crew, workers said.

“We sacrificed our health for the benefit of others. Now that the crisis is over, we feel this feeling of pride in ourself, and in what we did,” RCDG said, adding that the captain and department heads were supportive.

Others argue this isn’t a sacrifice crew members should have been asked to make. Relatives fear that Filipinos, who pride themselves on being hardworking, felt obliged to go above and beyond what should have been expected. “It’s no longer their job. It’s not part of their contract,” said the girlfriend of one man who worked onboard and later tested positive and remains in Japan.

There is often a culture of soldiering on among crews, added Sampson. The ships provide a unique environment in which diseases can spread, and there has long been concern about the need to minimise the risk of outbreaks. “On all cruise vessels most crew, other than the very senior ranks, share cabins which are small and which are very unhelpful in regard to infection control,” said Sampson.

Across the cruise sector, staff can be more vulnerable to illnesses – shift patterns can prevent employees from visiting the onboard doctors, and some feel obliged to carry on, especially if they are worried about being sent home. This, in turn, also puts guests at greater risk.

The lack of agreement over who had ultimate responsibility for staff members on Diamond Princess – the various companies or the Japan or Philippines government – shows how “completely under-considered” such matters are, added Sampson.

“Perhaps if anything positive eventually emerges from this global health crisis, it might be that cruise operators review crew working and living conditions, and upgrade these to provide for better physical and mental health, and welfare,” she said.

A port worker runs in front of the Diamond Princess cruise ship



A port worker runs in front of the Diamond Princess cruise ship. Photograph: Tomohiro Ohsumi/Getty Images

More immediately, cruise operators have cancelled and rescheduled trips, and introduced tighter health screening and staff training in an attempt to reassure passengers. The virus has wreaked havoc across the global tourism sector, with the overall economic cost yet to be seen.

Workers fear they will incur a loss of income. In 2018, seafarer remittances totalled $6.1bn (£4.7bn). Princess Cruises said staff members have been offered two months’ leave, and will be contracted to another ship.

Elsie Lavado, whose husband is among those in quarantine in the Philippines, says she just wants her family back together. During the height of the outbreak, she locked herself in her son’s bedroom, praying for the return of her husband and all other people onboard. “The life of my husband is more important than money,” she said.

* Names of workers have been changed.

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