https://www.wsj.com/articles/cruise...ew-11588346502?mod=itp_wsj&mod=&mod=djemITP_h
Early in March, the world’s cruise-ship operators had ample evidence to believe their fleet of luxury liners were incubators for the new coronavirus.
Yet they continued to fill cruise ships with passengers, endangering those aboard and helping spread Covid-19 to the U.S. and around the globe, a Wall Street Journal investigation found.
All told, the Journal found that the cruise industry launched voyages on more than 100 ships on or after March 4—the day of the first confirmed Covid-19 death of a passenger from a cruise stopping in the U.S., a marker of the pandemic’s long reach.
The U.S. Centers for Disease Control and Prevention has so far determined that 17 of the vessels, which were on international voyages and had entered at least one U.S. port, carried people who tested positive for Covid-19 within two weeks of disembarking.
The virus passed among ship crews and travelers, finding easy passage to ports of call as well as the hometowns of those aboard, according to interviews with passengers and relatives, epidemiologists, ship employees and port and health officials in more than 20 countries.
Cruise companies allowed passengers to travel home without telling them about fellow travelers who fell ill with symptoms of Covid-19 or tested positive for the coronavirus disease, or those who were sent to hospitals.
Government officials in Australia, New Zealand, Canada, Dominican Republic, Trinidad and Tobago, as well as communities in Iowa, Ohio, California, Minnesota, Florida, Hawaii and Puerto Rico, traced either their first Covid-19 cases or an acceleration of local infections to cruise-ship travelers.
By March 13, the CDC had linked cruise passengers to 17% of reported Covid-19 cases in the U.S. at the time.
The U.S. Coast Guard said it was investigating whether two cruise ships owned by Carnival Corp. violated federal law by failing to alert health authorities about sick travelers disembarking in San Francisco and Puerto Rico, the Journal found. A criminal investigation and a separate government-ordered probe are under way in Australia about similar suspicions regarding a third Carnival-owned cruise ship. The company said it didn’t believe it broke any laws.
As early as January, with the virus overtaking Wuhan, China, a number of cruise lines, including Carnival, Royal Caribbean Cruises Ltd. and MSC Cruises SA, began canceling voyages in Asia after governments urged people to avoid infected areas.
News of the shipboard danger soon circulated world-wide. On Feb. 5, some 3,700 passengers and crew were quarantined aboard the Diamond Princess, a Carnival-owned ship docked in Yokohama, Japan. By late February, more than 700 of the passengers and crew tested positive for the virus and six people died, according to the World Health Organization. The ship also yielded one of the first confirmed Covid-19 cases in the U.S.
On Feb. 27, the Braemar, a ship owned by British-based Fred.Olsen Cruise Lines, was denied port access by the Dominican Republic for what the company called “an overreaction” to a small number of passengers with influenza-like symptoms.
Nine days later, the company said two passengers had been diagnosed with Covid-19 after returning home. Fred.Olsen didn’t respond to questions from the Journal.
Reports of the virus kept spreading. On March 4, MSC—the largest privately owned cruise line—said an Austrian passenger who disembarked in Genoa, Italy, had tested positive for Covid-19. And in California that day, authorities announced a recent passenger on Carnival’s Grand Princess died from the coronavirus disease.
Carnival, with more than 100 ships and nine cruise-line brands, including Costa Cruises, Holland America Line and Princess Cruises, largely continued full steam ahead. They were joined by the biggest names in the industry, including brands from Norwegian Cruise Line Holdings Ltd. and Royal Caribbean.
Once at sea, passengers said it was difficult to get information. “Other people are sick here,” Tom Sheehan, a passenger on a trans-Atlantic Costa Luminosa cruise, said in a March 13 text to his son Ryan Sheehan. “They won’t tell us anything.” He died from the virus in a Florida hospital 15 days later, Mr. Sheehan said.
The list of coronavirus-infected ships continues to grow as health authorities trace the source of outbreaks. Travelers from 20 ships that had stops in U.S. ports and set sail during the first 15 days of March have tested positive for Covid-19, according to the CDC. Those passengers started showing symptoms either during the cruise or within two weeks of disembarking.
The ships identified by the CDC include: Carnival’s Carnival Imagination and Crown Princess; Royal Caribbean’s Celebrity Eclipse and Oasis of the Seas; and Norwegian Cruise’s Norwegian Bliss and Norwegian Breakaway.
The Cruise Lines International Association said in a statement to the Journal that the cruise industry was one of many businesses that continued to operate in early March. “We know now that, tragically, this virus affects every setting where people come together to socialize and enjoy shared experiences, which includes cruise ships, as well as restaurants, hotels, movie theaters, and the like,” the statement said. “That knowledge will serve us well in the future.”
Carnival Corp. spokesman Roger Frizzell said, “It’s easy to look back once you know the future and second-guess decisions made in the past. Just like the rest of the world, we were responding in real time based on the very best information available at the time.”
Royal Caribbean said in a statement it had “no higher priority” than keeping guests and crew safe, and the company was working with authorities to get crew members home. Norwegian didn’t respond to requests for comment.
Arnold Donald, Carnival’s chief executive, said at an April 16 news conference that “cruise ships aren’t the cause of the virus nor are they the reason for the spread in society.”
Seven ships owned by Carnival accounted for 49 of the roughly 70 deaths of passengers and crew with Covid-19 on vessels that began voyages or boarded new passengers in the first two weeks of March, the Journal found.
The House Committee on Transportation and Infrastructure, signaling its intention to exercise its oversight role, sent letters Friday to Carnival, the CDC and the Coast Guard requesting copies of all memos, emails and other communications that pertained to Covid-19 or other infectious disease outbreaks aboard cruise ships.
Australia began a probe that could lead to criminal charges against Carnival or its staff regarding the March 8 voyage of the Ruby Princess around New Zealand. Authorities are trying to determine whether Carnival, or its Princess Cruises subsidiary, knew or should have known about potential Covid-19 cases before allowing some 2,700 passengers to disembark in Sydney.
In public hearings that began April 22, the ship’s senior physician, Ilse Von Watzdorf, was asked why she didn’t update the ship’s medical log books to show that some ill people aboard the ship had been swabbed for possible Covid-19. “I did not have enough hours, I think” to update records, she testified.
Dr. Von Watzdorf said she wasn’t sure why ship officers told shore officials it had no crew displaying possible Covid-19 symptoms before docking in Sydney. She also said the cruise company didn’t brief her on the Diamond Princess Covid-19 outbreak, which she followed on social media.
Princess Cruises said in a written statement that “it would be inappropriate for us to comment” on matters under official inquiry.
Shortly before returning to Sydney on March 19, ship officers told New South Wales health authorities that 104 passengers and crew had acute respiratory infections, including 36 who visited the ship’s clinic with influenza-like illnesses. Ship officers, though, didn’t notify other passengers aboard.
A day after Lyn Davidson disembarked, she learned in a text from local health authorities that other passengers from the Ruby Princess had tested positive for Covid-19. By then, Ms. Davidson had traveled by train to her home in Blayney, about a four-hour trip from Sydney. She was sweating and had a cough. After she got home, she got tested for the virus.
Ms. Davidson, a retired paramedic, said she wouldn’t have taken the train had she known she might have been exposed. Instead, she said, she would have stayed in Sydney to self-quarantine.
“They never let us know that there was the possibility of the virus on board,” she said. “We didn’t know that the danger was all around us at that time, and we were part of it.” Her test returned positive for the virus, she said.
Australian authorities traced 973 Covid-19 cases and 28 deaths, more than a quarter of the country’s total fatalities, to the Ruby Princess, including community transmissions. At least two more passengers died outside the country, including two Americans, making it the deadliest of all cruise ships in the pandemic.
Health authorities on Australia’s island state of Tasmania concluded Wednesday that returning Ruby Princess passengers likely triggered a hospital outbreak and 114 local Covid-19 cases. Twelve people died, including three passengers, and thousands were quarantined, authorities said, prompting the closing of two hospitals because of infections among staff and patients.
New Zealand is considering its own investigation into whether the cruise line gave misleading information to health authorities about illnesses on board, including at a stop in Napier, where authorities say the ship’s visit led to a cluster of cases. Health officials have attributed 22 local cases to the cruise. Princess Cruises declined to comment on the matters for this article.
Roughly 80,000 crew members remained stranded on 95 ships off the coasts of the U.S. and the Bahamas, the CDC said on April 9 when the federal agency extended a no-sail order for cruise ships into July. An additional 15 ships docked or anchored in the U.S. had confirmed or suspected cases.
“The intensive care requirements for infected crew in need of life-critical care greatly stresses an already overburdened health care system,” the CDC said.
Early warning
Carnival learned on March 2 that a passenger aboard a Feb. 11 voyage from San Francisco to Mexico on the Grand Princess had tested positive for Covid-19 after returning home to Placer County, Calif.
The man had disembarked on Feb. 21 in San Francisco, a day after visiting the ship’s medical center with what Carnival’s Chief Medical Officer Grant Tarling said at a March 7 news conference was a “six- to seven-day history of symptoms of an acute respiratory illness.”
The Coast Guard is now investigating whether Carnival violated a federal law that requires ships approaching U.S. ports to report outbreaks of illness to the Coast Guard and, in certain cases, to the CDC. The rules are specific, defining a fever as a temperature of 100.4 degrees Fahrenheit or higher, as well as anyone who reports feeling feverish.
Lt. Cmdr. Matthew Kroll said Coast Guard officials only “indirectly received information regarding ill passengers and crew” on the Grand Princess. Mr. Frizzell, the Carnival spokesman, said the company “fully disclosed all of our illnesses to officials, as required.”
On March 4, the man from Placer County died.
Twelve days after passengers disembarked, Carnival informed them they may have been exposed to the virus.
Vicki Eschelbach left the Grand Princess when it returned to San Francisco from Mexico on Feb. 21 and traveled home to Santa Rosa, Calif. She spent the next several days going to stores and attending church.
Ms. Eschelbach got the March 4 email from Princess Cruises saying she might have been exposed. “I was freaking out. Like, where am I spreading all these germs?” she said. She had no symptoms and didn’t get tested.
That same day, Grand Princess passengers in the middle of the vessel’s subsequent cruise to Hawaii received a letter saying the CDC was investigating “a small cluster of Covid-19” cases in Northern California that were connected to the ship’s previous voyage to Mexico.
Some travelers and crew had stayed aboard the Grand Princess after the Mexico cruise for the Hawaii voyage, joining hundreds of new passengers who climbed aboard on Feb. 21. Among those on the Hawaii cruise, five people have died and 131 have tested positive, the U.S. De
Health authorities in Austria notified MSC on March 3 that an Austrian man had tested positive for Covid-19. He disembarked the MSC Opera on Feb. 28 in Genoa, Italy.
A MSC spokesman said in an interview that the Austrian man showed no symptoms while on the cruise, and that he traveled home through northern Italy, where a Covid-19 outbreak was under way. The company said it had no way of knowing whether he contracted Covid-19 while on board or en route home.
Over the next week, pressure over the cruise-ship cases grew. On March 6, Canada’s chief public-health officer, Theresa Tam, issued a public warning about the easy spread of the virus aboard the vessels.
Also that day, Maryland announced that three people who had been on a Nile river cruise in early February had tested positive for the virus after returning home. Florida and Iowa also announced cases related to Nile cruises.
Adam Goldstein, chairman of the cruise lines trade group, met as part of an industry roundtable March 7 with Vice President Mike Pence, chair of the coronavirus task force. Mr. Goldstein said at the briefing that the industry had committed to “monitor, test, and care for those who are on board.”
He said that “given the significance of travel and tourism, it is critical that Americans keep traveling. And yet, we also recognize that this is an unprecedented situation: Covid-19.”
Carnival’s Dr. Tarling, the company’s chief medical officer, said during a March 7 call with news media that ships would be vigorously sanitized by cleansers, including one “known and proven to kill coronavirus in 30 seconds.”
Six days later, on March 13, the cruise lines association announced the voluntary cancellation of all future cruises for 38 member companies. The next day, the CDC issued a no-sail order for cruise ships traveling in U.S. waters.
The cancellations halted only voyages not yet launched. At the time, the CDC estimated that 250,000 people were aboard approximately 120 vessels.
Turned away
In late February, Dr. Tarling said in a videotaped message on the company’s website that its ships would take temperatures of all boarding guests, give out hand sanitizer and closely check passports.
Half a dozen passengers on Holland America’s Zaandam, a Carnival ship that left Buenos Aires on March 7, said in interviews that none of the extra precautions was evident. “No temperature, nothing,” said Chris Joiner, a retired Canadian government official who was on the ship.
Carnival’s Mr. Frizzell said that with the company’s more than 100 ships, implementation of the added measures “took a few weeks to get rolled out.”
About halfway through the Zaandam’s monthlong cruise along South America, Mr. Joiner and his wife, Anna Joiner, said they noticed that crew members had started scrubbing railings, doors and other surfaces.
A few days later, on March 22, the Zaandam’s captain announced over the ship’s public address system that all passengers needed to isolate themselves immediately in their cabins because of a flu outbreak.
Food was delivered to ship cabins. Passengers interviewed later said some crew members didn’t wear masks or gloves until after a local boat delivered a shipment of the protective gear.
Port officials fearful of receiving infected cruise-ship passengers began turning away the vessels, leaving ships at sea with sick travelers. That included the Zaandam, which was later granted permission to dock in Florida. By then, four vacationers were dead, and 27 passengers and crew required hospitalization.
The evening before the Zaandam was granted permission to disembark passengers on April 2 in Fort Lauderdale, Fla., the ship delivered sparkling wine to guest quarters.
Nadine Eaton, 78, suggested to her husband Bryan Eaton, 79, that they send it back. Mr. Eaton had been nauseated and weak for days. “He wanted to have some,” Mrs. Eaton said, “So we each had half a glass to celebrate.”
Mr. Eaton tested positive for Covid-19 while on board, Mrs. Eaton said. He was taken to a Florida hospital and put on a ventilator. Last week, he died.
Disclosure dispute
The Costa Luminosa, owned by Carnival’s Costa Cruises, set sail on March 5 from Fort Lauderdale to Puerto Rico and other stops in the Caribbean before heading back to Europe.
Shortly after the ship docked in San Juan three days later, an Italian couple were taken to Ashford Presbyterian Community Hospital. The woman had flu-like symptoms and difficulty breathing, said Dr. Rafael Gonzalez, the hospital’s medical director.
While doctors treated the woman, hundreds of passengers left the ship to wander Old San Juan, swelled with people in town for a salsa festival.
“Everyone was allowed ashore. No problem,” said Fabian de la Fuente, a passenger from Victoria, British Columbia. He said his entire family of five later tested positive for Covid-19.
The Costa Luminosa should have disclosed any contagious illnesses before the couple were admitted to the hospital, Dr. Gonzalez said. The staff was led to believe the Italian woman had pneumonia, he said.
When emergency-room staff asked if anybody else was sick on the ship, the ship’s medical staff denied it, Dr. Gonzalez said. He later learned several crewmen were in quarantine for symptoms of Covid-19 at the time, he said.
“That’s not right,” the doctor said later in an interview. “That’s just not right.”
Any company that fails to properly notify the CDC of a serious outbreak of shipboard illness ahead of pulling into port can draw penalties as high as $200,000 for each violation. If a death is involved, the potential penalty can reach $500,000 for each case.
Ricardo Castrodad, a Coast Guard spokesman in San Juan, said maritime authorities weren’t told of illnesses aboard the Costa Luminosa, or that passengers had been hospitalized, until after the ship left San Juan harbor on March 8 for Antigua. The Coast Guard is investigating, he said.
Carnival said in a written statement to the Journal that a ship physician suggested testing the woman for Covid-19 after she arrived at the hospital. Notifying the Coast Guard after the fact “was completely acceptable,” the company said, because it was a medical emergency.
Authorities also raised questions about disclosures by the Breakaway, a Norwegian Cruise Line ship, after it left Florida’s Port Canaveral on March 7. The company’s chief executive sent a letter to passengers that day saying, “I firmly believe that we have some of the most robust measures in place to protect our guests and team members.”
On March 9, passenger Shirley Reittinger, 65, had onboard X-rays and a consultation with a doctor at the Cleveland Clinic in Florida. Mrs. Reittinger was diagnosed with fever, pneumonia, acute respiratory distress and a blood disorder linked to diabetes known as ketoacidosis, according to a copy of the ship’s medical record viewed by the Journal.
A doctor recommended that the woman be isolated in intensive care, according to the record. Shortly after the ship docked the next day in Ocho Rios, Jamaica, Mrs. Reittinger was taken by ambulance to a hospital.
William Tatham, vice president of operations for Jamaica’s port authority, said the ship didn’t report Mrs. Reittinger’s illness before docking, as required by port officials. “She would not have been allowed to disembark,” Mr. Tatham said, if officials knew she had flu-like symptoms.
Dr. Charmaine Thomas, who oversaw Mrs. Reittinger’s care in Jamaica, said she received no information about acute respiratory issues, a red-flag symptom of Covid-19. The ship revealed only the ketoacidosis diagnosis, the doctor said.
Mrs. Reittinger’s daughter, Melissa Veino, a physician, had her mother airlifted March 13 to a Florida hospital, where she was placed on a ventilator. Mrs. Reittinger tested positive for Covid-19 on March 15, her daughter said.
“I am beyond heartbroken after reviewing my mother’s medical records,” Dr. Veino said. “It defies logic that her care was transferred from the onboard intensive care unit to a small wellness hospital in Jamaica.”
Norwegian Cruise sent an email on March 18 notifying Breakaway travelers, four days after the cruise ended, that a passenger had tested positive for Covid-19 after leaving the ship.
After nearly 30 days on a ventilator in a Florida hospital, Mrs. Reittinger died April 9 in isolation. Hospital rules didn’t allow Mrs. Reittinger’s husband and two daughters to say goodbye at her bedside.
Left at sea
Royal Caribbean, the industry’s second-biggest cruise operator, sent its 6,000-passenger Oasis of the Seas on a weeklong voyage from Miami on March 8. Two days before its March 15 return, Royal Caribbean and other cruise lines said they would halt operations.
With the ship emptied of passengers, more crew members came aboard, and the vessel returned to sea.
While Royal Caribbean searched for a port that would let crew disembark, employees used the gym and swimming pools, amenities normally reserved for passengers. Crew members said in interviews they were encouraged to keep a distance from one another but weren’t given face masks or gloves.
Ten days later, the Royal Caribbean alerted passengers that someone on the March 8 cruise had tested positive for Covid-19. Shortly after, most of the crew aboard the Oasis of the Seas were confined to their cabins.
By mid-April, dozens of the ship employees on board were sick, crew members said. The ship cruised between Florida and the Bahamas, with permission to stop in Florida ports only to send a seriously ill crew member to the hospital.
The ship’s captain announced on April 18 and April 20 that two crew members had died in Fort Lauderdale, far from home: waiters Dexter Joyosa, of the Philippines, and Iputu Sugiartha, of Indonesia.
The captain urged his crew, isolated in single-person cabins for three weeks, “to look after each other and support each other.”
—Lisa Schwartz and Suryatapa Bhattacharya contributed to this article. Graphics by Joel Eastwood and Max Rust.
Write to Jacquie McNish at [email protected], Rebecca Smith at [email protected], Erin Ailworth at [email protected] and Rachel Pannett at [email protected]
Early in March, the world’s cruise-ship operators had ample evidence to believe their fleet of luxury liners were incubators for the new coronavirus.
Yet they continued to fill cruise ships with passengers, endangering those aboard and helping spread Covid-19 to the U.S. and around the globe, a Wall Street Journal investigation found.
All told, the Journal found that the cruise industry launched voyages on more than 100 ships on or after March 4—the day of the first confirmed Covid-19 death of a passenger from a cruise stopping in the U.S., a marker of the pandemic’s long reach.
The U.S. Centers for Disease Control and Prevention has so far determined that 17 of the vessels, which were on international voyages and had entered at least one U.S. port, carried people who tested positive for Covid-19 within two weeks of disembarking.
The virus passed among ship crews and travelers, finding easy passage to ports of call as well as the hometowns of those aboard, according to interviews with passengers and relatives, epidemiologists, ship employees and port and health officials in more than 20 countries.
Cruise companies allowed passengers to travel home without telling them about fellow travelers who fell ill with symptoms of Covid-19 or tested positive for the coronavirus disease, or those who were sent to hospitals.
Government officials in Australia, New Zealand, Canada, Dominican Republic, Trinidad and Tobago, as well as communities in Iowa, Ohio, California, Minnesota, Florida, Hawaii and Puerto Rico, traced either their first Covid-19 cases or an acceleration of local infections to cruise-ship travelers.
By March 13, the CDC had linked cruise passengers to 17% of reported Covid-19 cases in the U.S. at the time.
The U.S. Coast Guard said it was investigating whether two cruise ships owned by Carnival Corp. violated federal law by failing to alert health authorities about sick travelers disembarking in San Francisco and Puerto Rico, the Journal found. A criminal investigation and a separate government-ordered probe are under way in Australia about similar suspicions regarding a third Carnival-owned cruise ship. The company said it didn’t believe it broke any laws.
As early as January, with the virus overtaking Wuhan, China, a number of cruise lines, including Carnival, Royal Caribbean Cruises Ltd. and MSC Cruises SA, began canceling voyages in Asia after governments urged people to avoid infected areas.
News of the shipboard danger soon circulated world-wide. On Feb. 5, some 3,700 passengers and crew were quarantined aboard the Diamond Princess, a Carnival-owned ship docked in Yokohama, Japan. By late February, more than 700 of the passengers and crew tested positive for the virus and six people died, according to the World Health Organization. The ship also yielded one of the first confirmed Covid-19 cases in the U.S.
On Feb. 27, the Braemar, a ship owned by British-based Fred.Olsen Cruise Lines, was denied port access by the Dominican Republic for what the company called “an overreaction” to a small number of passengers with influenza-like symptoms.
Nine days later, the company said two passengers had been diagnosed with Covid-19 after returning home. Fred.Olsen didn’t respond to questions from the Journal.
Reports of the virus kept spreading. On March 4, MSC—the largest privately owned cruise line—said an Austrian passenger who disembarked in Genoa, Italy, had tested positive for Covid-19. And in California that day, authorities announced a recent passenger on Carnival’s Grand Princess died from the coronavirus disease.
Carnival, with more than 100 ships and nine cruise-line brands, including Costa Cruises, Holland America Line and Princess Cruises, largely continued full steam ahead. They were joined by the biggest names in the industry, including brands from Norwegian Cruise Line Holdings Ltd. and Royal Caribbean.
Once at sea, passengers said it was difficult to get information. “Other people are sick here,” Tom Sheehan, a passenger on a trans-Atlantic Costa Luminosa cruise, said in a March 13 text to his son Ryan Sheehan. “They won’t tell us anything.” He died from the virus in a Florida hospital 15 days later, Mr. Sheehan said.
The list of coronavirus-infected ships continues to grow as health authorities trace the source of outbreaks. Travelers from 20 ships that had stops in U.S. ports and set sail during the first 15 days of March have tested positive for Covid-19, according to the CDC. Those passengers started showing symptoms either during the cruise or within two weeks of disembarking.
The ships identified by the CDC include: Carnival’s Carnival Imagination and Crown Princess; Royal Caribbean’s Celebrity Eclipse and Oasis of the Seas; and Norwegian Cruise’s Norwegian Bliss and Norwegian Breakaway.
The Cruise Lines International Association said in a statement to the Journal that the cruise industry was one of many businesses that continued to operate in early March. “We know now that, tragically, this virus affects every setting where people come together to socialize and enjoy shared experiences, which includes cruise ships, as well as restaurants, hotels, movie theaters, and the like,” the statement said. “That knowledge will serve us well in the future.”
Carnival Corp. spokesman Roger Frizzell said, “It’s easy to look back once you know the future and second-guess decisions made in the past. Just like the rest of the world, we were responding in real time based on the very best information available at the time.”
Royal Caribbean said in a statement it had “no higher priority” than keeping guests and crew safe, and the company was working with authorities to get crew members home. Norwegian didn’t respond to requests for comment.
Arnold Donald, Carnival’s chief executive, said at an April 16 news conference that “cruise ships aren’t the cause of the virus nor are they the reason for the spread in society.”
Seven ships owned by Carnival accounted for 49 of the roughly 70 deaths of passengers and crew with Covid-19 on vessels that began voyages or boarded new passengers in the first two weeks of March, the Journal found.
The House Committee on Transportation and Infrastructure, signaling its intention to exercise its oversight role, sent letters Friday to Carnival, the CDC and the Coast Guard requesting copies of all memos, emails and other communications that pertained to Covid-19 or other infectious disease outbreaks aboard cruise ships.
Australia began a probe that could lead to criminal charges against Carnival or its staff regarding the March 8 voyage of the Ruby Princess around New Zealand. Authorities are trying to determine whether Carnival, or its Princess Cruises subsidiary, knew or should have known about potential Covid-19 cases before allowing some 2,700 passengers to disembark in Sydney.
In public hearings that began April 22, the ship’s senior physician, Ilse Von Watzdorf, was asked why she didn’t update the ship’s medical log books to show that some ill people aboard the ship had been swabbed for possible Covid-19. “I did not have enough hours, I think” to update records, she testified.
Dr. Von Watzdorf said she wasn’t sure why ship officers told shore officials it had no crew displaying possible Covid-19 symptoms before docking in Sydney. She also said the cruise company didn’t brief her on the Diamond Princess Covid-19 outbreak, which she followed on social media.
Princess Cruises said in a written statement that “it would be inappropriate for us to comment” on matters under official inquiry.
Shortly before returning to Sydney on March 19, ship officers told New South Wales health authorities that 104 passengers and crew had acute respiratory infections, including 36 who visited the ship’s clinic with influenza-like illnesses. Ship officers, though, didn’t notify other passengers aboard.
A day after Lyn Davidson disembarked, she learned in a text from local health authorities that other passengers from the Ruby Princess had tested positive for Covid-19. By then, Ms. Davidson had traveled by train to her home in Blayney, about a four-hour trip from Sydney. She was sweating and had a cough. After she got home, she got tested for the virus.
Ms. Davidson, a retired paramedic, said she wouldn’t have taken the train had she known she might have been exposed. Instead, she said, she would have stayed in Sydney to self-quarantine.
“They never let us know that there was the possibility of the virus on board,” she said. “We didn’t know that the danger was all around us at that time, and we were part of it.” Her test returned positive for the virus, she said.
Australian authorities traced 973 Covid-19 cases and 28 deaths, more than a quarter of the country’s total fatalities, to the Ruby Princess, including community transmissions. At least two more passengers died outside the country, including two Americans, making it the deadliest of all cruise ships in the pandemic.
Health authorities on Australia’s island state of Tasmania concluded Wednesday that returning Ruby Princess passengers likely triggered a hospital outbreak and 114 local Covid-19 cases. Twelve people died, including three passengers, and thousands were quarantined, authorities said, prompting the closing of two hospitals because of infections among staff and patients.
New Zealand is considering its own investigation into whether the cruise line gave misleading information to health authorities about illnesses on board, including at a stop in Napier, where authorities say the ship’s visit led to a cluster of cases. Health officials have attributed 22 local cases to the cruise. Princess Cruises declined to comment on the matters for this article.
Roughly 80,000 crew members remained stranded on 95 ships off the coasts of the U.S. and the Bahamas, the CDC said on April 9 when the federal agency extended a no-sail order for cruise ships into July. An additional 15 ships docked or anchored in the U.S. had confirmed or suspected cases.
“The intensive care requirements for infected crew in need of life-critical care greatly stresses an already overburdened health care system,” the CDC said.
Early warning
Carnival learned on March 2 that a passenger aboard a Feb. 11 voyage from San Francisco to Mexico on the Grand Princess had tested positive for Covid-19 after returning home to Placer County, Calif.
The man had disembarked on Feb. 21 in San Francisco, a day after visiting the ship’s medical center with what Carnival’s Chief Medical Officer Grant Tarling said at a March 7 news conference was a “six- to seven-day history of symptoms of an acute respiratory illness.”
The Coast Guard is now investigating whether Carnival violated a federal law that requires ships approaching U.S. ports to report outbreaks of illness to the Coast Guard and, in certain cases, to the CDC. The rules are specific, defining a fever as a temperature of 100.4 degrees Fahrenheit or higher, as well as anyone who reports feeling feverish.
Lt. Cmdr. Matthew Kroll said Coast Guard officials only “indirectly received information regarding ill passengers and crew” on the Grand Princess. Mr. Frizzell, the Carnival spokesman, said the company “fully disclosed all of our illnesses to officials, as required.”
On March 4, the man from Placer County died.
Twelve days after passengers disembarked, Carnival informed them they may have been exposed to the virus.
Vicki Eschelbach left the Grand Princess when it returned to San Francisco from Mexico on Feb. 21 and traveled home to Santa Rosa, Calif. She spent the next several days going to stores and attending church.
Ms. Eschelbach got the March 4 email from Princess Cruises saying she might have been exposed. “I was freaking out. Like, where am I spreading all these germs?” she said. She had no symptoms and didn’t get tested.
That same day, Grand Princess passengers in the middle of the vessel’s subsequent cruise to Hawaii received a letter saying the CDC was investigating “a small cluster of Covid-19” cases in Northern California that were connected to the ship’s previous voyage to Mexico.
Some travelers and crew had stayed aboard the Grand Princess after the Mexico cruise for the Hawaii voyage, joining hundreds of new passengers who climbed aboard on Feb. 21. Among those on the Hawaii cruise, five people have died and 131 have tested positive, the U.S. De
Health authorities in Austria notified MSC on March 3 that an Austrian man had tested positive for Covid-19. He disembarked the MSC Opera on Feb. 28 in Genoa, Italy.
A MSC spokesman said in an interview that the Austrian man showed no symptoms while on the cruise, and that he traveled home through northern Italy, where a Covid-19 outbreak was under way. The company said it had no way of knowing whether he contracted Covid-19 while on board or en route home.
Over the next week, pressure over the cruise-ship cases grew. On March 6, Canada’s chief public-health officer, Theresa Tam, issued a public warning about the easy spread of the virus aboard the vessels.
Also that day, Maryland announced that three people who had been on a Nile river cruise in early February had tested positive for the virus after returning home. Florida and Iowa also announced cases related to Nile cruises.
Adam Goldstein, chairman of the cruise lines trade group, met as part of an industry roundtable March 7 with Vice President Mike Pence, chair of the coronavirus task force. Mr. Goldstein said at the briefing that the industry had committed to “monitor, test, and care for those who are on board.”
He said that “given the significance of travel and tourism, it is critical that Americans keep traveling. And yet, we also recognize that this is an unprecedented situation: Covid-19.”
Carnival’s Dr. Tarling, the company’s chief medical officer, said during a March 7 call with news media that ships would be vigorously sanitized by cleansers, including one “known and proven to kill coronavirus in 30 seconds.”
Six days later, on March 13, the cruise lines association announced the voluntary cancellation of all future cruises for 38 member companies. The next day, the CDC issued a no-sail order for cruise ships traveling in U.S. waters.
The cancellations halted only voyages not yet launched. At the time, the CDC estimated that 250,000 people were aboard approximately 120 vessels.
Turned away
In late February, Dr. Tarling said in a videotaped message on the company’s website that its ships would take temperatures of all boarding guests, give out hand sanitizer and closely check passports.
Half a dozen passengers on Holland America’s Zaandam, a Carnival ship that left Buenos Aires on March 7, said in interviews that none of the extra precautions was evident. “No temperature, nothing,” said Chris Joiner, a retired Canadian government official who was on the ship.
Carnival’s Mr. Frizzell said that with the company’s more than 100 ships, implementation of the added measures “took a few weeks to get rolled out.”
About halfway through the Zaandam’s monthlong cruise along South America, Mr. Joiner and his wife, Anna Joiner, said they noticed that crew members had started scrubbing railings, doors and other surfaces.
A few days later, on March 22, the Zaandam’s captain announced over the ship’s public address system that all passengers needed to isolate themselves immediately in their cabins because of a flu outbreak.
Food was delivered to ship cabins. Passengers interviewed later said some crew members didn’t wear masks or gloves until after a local boat delivered a shipment of the protective gear.
Port officials fearful of receiving infected cruise-ship passengers began turning away the vessels, leaving ships at sea with sick travelers. That included the Zaandam, which was later granted permission to dock in Florida. By then, four vacationers were dead, and 27 passengers and crew required hospitalization.
The evening before the Zaandam was granted permission to disembark passengers on April 2 in Fort Lauderdale, Fla., the ship delivered sparkling wine to guest quarters.
Nadine Eaton, 78, suggested to her husband Bryan Eaton, 79, that they send it back. Mr. Eaton had been nauseated and weak for days. “He wanted to have some,” Mrs. Eaton said, “So we each had half a glass to celebrate.”
Mr. Eaton tested positive for Covid-19 while on board, Mrs. Eaton said. He was taken to a Florida hospital and put on a ventilator. Last week, he died.
Disclosure dispute
The Costa Luminosa, owned by Carnival’s Costa Cruises, set sail on March 5 from Fort Lauderdale to Puerto Rico and other stops in the Caribbean before heading back to Europe.
Shortly after the ship docked in San Juan three days later, an Italian couple were taken to Ashford Presbyterian Community Hospital. The woman had flu-like symptoms and difficulty breathing, said Dr. Rafael Gonzalez, the hospital’s medical director.
While doctors treated the woman, hundreds of passengers left the ship to wander Old San Juan, swelled with people in town for a salsa festival.
“Everyone was allowed ashore. No problem,” said Fabian de la Fuente, a passenger from Victoria, British Columbia. He said his entire family of five later tested positive for Covid-19.
The Costa Luminosa should have disclosed any contagious illnesses before the couple were admitted to the hospital, Dr. Gonzalez said. The staff was led to believe the Italian woman had pneumonia, he said.
When emergency-room staff asked if anybody else was sick on the ship, the ship’s medical staff denied it, Dr. Gonzalez said. He later learned several crewmen were in quarantine for symptoms of Covid-19 at the time, he said.
“That’s not right,” the doctor said later in an interview. “That’s just not right.”
Any company that fails to properly notify the CDC of a serious outbreak of shipboard illness ahead of pulling into port can draw penalties as high as $200,000 for each violation. If a death is involved, the potential penalty can reach $500,000 for each case.
Ricardo Castrodad, a Coast Guard spokesman in San Juan, said maritime authorities weren’t told of illnesses aboard the Costa Luminosa, or that passengers had been hospitalized, until after the ship left San Juan harbor on March 8 for Antigua. The Coast Guard is investigating, he said.
Carnival said in a written statement to the Journal that a ship physician suggested testing the woman for Covid-19 after she arrived at the hospital. Notifying the Coast Guard after the fact “was completely acceptable,” the company said, because it was a medical emergency.
Authorities also raised questions about disclosures by the Breakaway, a Norwegian Cruise Line ship, after it left Florida’s Port Canaveral on March 7. The company’s chief executive sent a letter to passengers that day saying, “I firmly believe that we have some of the most robust measures in place to protect our guests and team members.”
On March 9, passenger Shirley Reittinger, 65, had onboard X-rays and a consultation with a doctor at the Cleveland Clinic in Florida. Mrs. Reittinger was diagnosed with fever, pneumonia, acute respiratory distress and a blood disorder linked to diabetes known as ketoacidosis, according to a copy of the ship’s medical record viewed by the Journal.
A doctor recommended that the woman be isolated in intensive care, according to the record. Shortly after the ship docked the next day in Ocho Rios, Jamaica, Mrs. Reittinger was taken by ambulance to a hospital.
William Tatham, vice president of operations for Jamaica’s port authority, said the ship didn’t report Mrs. Reittinger’s illness before docking, as required by port officials. “She would not have been allowed to disembark,” Mr. Tatham said, if officials knew she had flu-like symptoms.
Dr. Charmaine Thomas, who oversaw Mrs. Reittinger’s care in Jamaica, said she received no information about acute respiratory issues, a red-flag symptom of Covid-19. The ship revealed only the ketoacidosis diagnosis, the doctor said.
Mrs. Reittinger’s daughter, Melissa Veino, a physician, had her mother airlifted March 13 to a Florida hospital, where she was placed on a ventilator. Mrs. Reittinger tested positive for Covid-19 on March 15, her daughter said.
“I am beyond heartbroken after reviewing my mother’s medical records,” Dr. Veino said. “It defies logic that her care was transferred from the onboard intensive care unit to a small wellness hospital in Jamaica.”
Norwegian Cruise sent an email on March 18 notifying Breakaway travelers, four days after the cruise ended, that a passenger had tested positive for Covid-19 after leaving the ship.
After nearly 30 days on a ventilator in a Florida hospital, Mrs. Reittinger died April 9 in isolation. Hospital rules didn’t allow Mrs. Reittinger’s husband and two daughters to say goodbye at her bedside.
Left at sea
Royal Caribbean, the industry’s second-biggest cruise operator, sent its 6,000-passenger Oasis of the Seas on a weeklong voyage from Miami on March 8. Two days before its March 15 return, Royal Caribbean and other cruise lines said they would halt operations.
With the ship emptied of passengers, more crew members came aboard, and the vessel returned to sea.
While Royal Caribbean searched for a port that would let crew disembark, employees used the gym and swimming pools, amenities normally reserved for passengers. Crew members said in interviews they were encouraged to keep a distance from one another but weren’t given face masks or gloves.
Ten days later, the Royal Caribbean alerted passengers that someone on the March 8 cruise had tested positive for Covid-19. Shortly after, most of the crew aboard the Oasis of the Seas were confined to their cabins.
By mid-April, dozens of the ship employees on board were sick, crew members said. The ship cruised between Florida and the Bahamas, with permission to stop in Florida ports only to send a seriously ill crew member to the hospital.
The ship’s captain announced on April 18 and April 20 that two crew members had died in Fort Lauderdale, far from home: waiters Dexter Joyosa, of the Philippines, and Iputu Sugiartha, of Indonesia.
The captain urged his crew, isolated in single-person cabins for three weeks, “to look after each other and support each other.”
—Lisa Schwartz and Suryatapa Bhattacharya contributed to this article. Graphics by Joel Eastwood and Max Rust.
Write to Jacquie McNish at [email protected], Rebecca Smith at [email protected], Erin Ailworth at [email protected] and Rachel Pannett at [email protected]
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