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Table of Contents
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 1-4

From Diamond Princess to Cordelia Cruises (Empress): Déjà vu in the New Year, lessons unlearned!

Department of Radiodiagnosis and Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Date of Submission01-Oct-2022
Date of Decision01-Dec-2022
Date of Acceptance19-Jan-2022
Date of Web Publication24-Feb-2022

Correspondence Address:
Abhishek Mahajan
Fellowship in Cancer Imaging, MRes (KCL, London), FRCR (UK) Consultant Radiologist, The Clatterbridge Cancer Centre NHS Foundation Trust, Pembroke Place, Liverpool, L7 8YA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_20_22

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How to cite this article:
Chakrabarty N, Mahajan A. From Diamond Princess to Cordelia Cruises (Empress): Déjà vu in the New Year, lessons unlearned!. Cancer Res Stat Treat 2022;5:1-4

How to cite this URL:
Chakrabarty N, Mahajan A. From Diamond Princess to Cordelia Cruises (Empress): Déjà vu in the New Year, lessons unlearned!. Cancer Res Stat Treat [serial online] 2022 [cited 2022 May 28];5:1-4. Available from: https://www.crstonline.com/text.asp?2022/5/1/1/341232

The never-ending saga of the coronavirus disease 2019 (COVID-19) pandemic that we are confronting dates back to December 2019, when it all began in Wuhan city in China.[1],[2],[3],[4],[5] Soon after the inception of COVID-19, the New Year 2020 was ushered in with the news of a cruise ship, “Diamond Princess”, quarantined off the Yokohama Port in Japan for 2 weeks, as passengers and crew members tested positive for COVID-19.[6],[7] Diamond Princess, owned by the British-American cruise company, Carnival Corporation, embarked on this ill-fated journey on January 20, 2020, from the Yokohama Port.[6] The cruise then sailed on to Hong Kong on January 25, 2020, where an 80-year-old passenger (native of Hong Kong) deboarded the ship. The cruise continued its journey, while this passenger developed fever and later tested positive for COVID-19 on January 30, 2020. On February 01, 2020, when the cruise was on its way back to Yokohama from Naha, the captain of the cruise learned about the COVID-19-positive status of the Hong Kong-native passenger from the Hong Kong government officials, due to a robust contact tracing system that was already in place. He preferred to have a hiatus of 48 hours before divulging this important piece of information to all the crew members and passengers. Despite this revelation, public recreational activities continued as usual on board. There was no restriction of movement until 11 p.m. on February 03, 2020, when everyone was asked to remain inside their cabins while the cruise was anchored off the coast of Japan.[6]

On February 03, 2020, the quarantine officials began real-time reverse transcription-polymerase chain reaction (RT-PCR) testing of the oropharyngeal swabs collected from suspected and close contacts of the Hong Kong-native passenger; following this, the ship was quarantined.[8] On February 07, 2020, a fever clinic was set up next to the ship's medical center, where doctors from Japan's disaster medical assistance team and the Ministry of Defense performed testing after evaluating the passengers in their cabins.[8] Testing was prioritized for older individuals (aged more than 80 years). N95/surgical masks and hand sanitizers were provided by the Ministry of Health, Labor, and Welfare, Japan, to all the passengers along with the basic knowledge of infection control.[8] In the days that followed, 712 people of the total 3711 (19.2%) were found to be infected with COVID-19.[7] About 14 people died, and most of them were older adults, with an overall death rate of 2%.[9],[10] All those who tested positive were moved to designated hospitals. A study conducted for evaluating the chest computed tomography findings of 104 patients on board revealed ground-glass opacities in asymptomatic patients (83%) and consolidation in symptomatic patients (41%) to be the predominant findings.[11],[12] The United States of America sent chartered flights to evacuate American passengers from the cruise even before their test results became available, resulting in the embarkment of 14 infected asymptomatic passengers on the flight.[6] These 14 passengers were taken to the 20-bedded quarantine facility at Nebraska Medical Center (USA) after landing at Eppley Airfield in Omaha (Nebraska, USA) on February 17, 2020. Meanwhile, five more passengers were isolated as they developed fever and the remaining were quarantined.[13]

  Lessons Learned from the Diamond Princess Cruise (2020) Top

Those were the early days of the COVID-19 pandemic, when not much was known about the virus and its infectivity; in fact, COVID-19 was not even declared a pandemic then. An 80-year-old passenger from Hong Kong had symptoms of cough a day before he boarded the cruise; this information was not provided to the crew members, and hence, no precautions could be taken. A negative RT-PCR test was not mandatory before boarding the cruise at the time. Moreover, there was a delay of 48 hours before the news of the COVID-19-positive passenger was revealed to the crew members and passengers, which allowed the unabated spread of the virus. Recreational and public activities continued on board without any restrictions, which led to the spread of the virus on a gigantic scale. All this paved the way for cross-country travel restrictions, mandatory immunization, and awareness about COVID-19 spread and prevention. The Diamond Princess quarantine became so infamous that a movie in 2021, “The Last Cruise,” was based on the COVID-19 outbreak on this cruise.[14]

  Continued Learning and the Second Wave Top

On March 11, 2020, the World Health Organization declared COVID-19 a pandemic.[15] Soon thereafter, a nationwide lockdown was imposed in India on March 24, 2020, and all modes of travel, except for essential services, were suspended.[16] The evacuation mission, “Vande Bharat” started on May 07, 2020, to bring back Indians stranded in different countries due to the pandemic.[17] Domestic flights resumed operation on May 25, 2020.[18] The operation of international flights resumed on December 15, 2020, with the exception of 14 countries with whom air bubble arrangements continued.[19] People were afraid of contracting COVID-19, and hence, religiously wore face masks and practiced social distancing and frequent handwashing. By the fall of 2020, a new variant emerged in the United Kingdom (UK), and India imposed a temporary ban on flights from the UK.[20],[21] From January 16, 2021, vaccination against COVID-19 began in India, and by the middle of March 2021, we were struck by the second wave of COVID-19.[22],[23] Several states in India imposed either a complete or partial lockdown in April 2021, which continued until June 15, 2021.[24] All Indian states were instructed to formulate their own interstate travel guidelines, and most of them made a negative RT-PCR result or proof of completion of two doses of vaccination mandatory for interstate travel.[25] International flights remained suspended during the lockdown and beyond with only travel bubble flights being operational.[26] Most public places throughout the country were allowed to operate at 50% capacity after the lockdown.

  The Cordelia Cruise Affair Top

Two years later, our home coast gave us a feeling of déjà vu, as the New Year 2022 brought in the news of another COVID-19 outbreak in Cordelia Cruises (Empress) traveling from Mumbai to Goa to celebrate the New Year.[27] The cruise was supposed to return to Mumbai after halting at Goa, Kochi, and Lakshadweep.[27] Only those passengers and crew members who had a negative RT-PCR test result done in the 48 hours preceding boarding and a vaccination certificate were allowed to embark on this voyage that began on December 31, 2021, from the Mumbai port.[27] One of the crew members fell ill very close to departure and was isolated on the cruise itself.[27] Before the passengers could disembark in Goa, the isolated crew member tested positive for COVID-19 on the rapid antigen testing. This led to the testing of all other passengers and crew members.[27] The cruise was eventually sent back to Mumbai. As of January 05, 2022, 209 of 2000 passengers (10.5%) tested positive for COVID-19.[28] The Brihanmumbai Municipal Corporation did a commendable job of conducting RT-PCR testing for all passengers on board; those who tested positive were moved to a hospital, and those who were negative were advised home quarantine for 7 days.[29]

  Lessons Unlearned During the Third Wave Top

COVID-19-positive and-negative passengers were again sailing on the same cruise ship. People became laid back and their “chalta hai” (nonchalant) attitude made them board a luxury cruise at a time when 5631 new COVID-19 cases (Omicron) had been reported in Mumbai on December 31, 2021.[30] Thanks to these “Cordelia kinds,” the economy of our country had stayed afloat at the expense of our overburdened frontline health-care workers, who came to their rescue when Omicron threw cold water on their plans.[31] Lockdown and restrictions on non-essential services during the initial phases of the pandemic had a huge impact on the economy.[32] Despite the recent surge in the Omicron variant, businesses such as restaurants, movie theaters, and travel have by and large been functional and a lockdown is not on the cards as of now.[33] Entertainment is what keeps the “Cordelia kinds” going, when livelihood is at stake for the poor.[31] [Figure 1] shows the schematic representation of the key events in the COVID-19 pandemic to date.[15],[16],[22],[23],[24],[34]

To conclude, in these unprecedented times of the COVID-19 pandemic, the onus of infection control lies not only on the governing bodies but also on the public at large. We must behave responsibly and alleviate the sufferings of the already overburdened frontline health-care workers.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Pande P, Sharma P, Devandra G, Kulkarni T, Rane S, Mahajan A. COVID-19: A review of the ongoing pandemic. Cancer Res Stat Treat 2020;3:221-32.  Back to cited text no. 1
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Bothra M, Shera TA, Bajpai J, Mahajan A. COVID-19: A review of the pandemic with emphasis on the role of imaging. Indian J Med Paediatr Oncol 2020;41:640-51.  Back to cited text no. 2
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Kulkarni T, Sharma P, Pande P, Agrawal R, Rane S, Mahajan A. COVID-19: A review of protective measures. Cancer Res Stat Treat 2020;3:244-53.  Back to cited text no. 3
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Sharma PJ, Mahajan A, Rane S, Bhattacharjee A. Assessment of COVID-19 severity using computed tomography imaging: A systematic review and meta-analysis. Cancer Res Stat Treat 2021;4:78-87.  Back to cited text no. 4
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Wu F, Zhao S, Yu B, Chen YM, Wang W, Song, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020;579:265-9.  Back to cited text no. 5
Available from: https://en.wikipedia.org/wiki/COVID-19_pandemic_on_Diamond_Princess. [Last accessed on 2022 Jan 09].  Back to cited text no. 7
Yamagishi T, Kamiya H, Kakimoto K, Suzuki M, Wakita T. Descriptive study of COVID-19 outbreak among passengers and crew on Diamond Princess cruise ship, Yokohama Port, Japan, 20 January to 9 February 2020. Euro Surveill 2020;25:2000272.  Back to cited text no. 8
Available from: https://www.hdruk.org/news/131952. [Last accessed on 2022 Jan 09].  Back to cited text no. 9
“Cruise Ship Accounts for more than Half of Virus Cases Outside China – As It Happened”. The Guardian; February 20, 2020. Archived from the original on 4 March 2020. Retrieved 5 April 2020. Available online at: https://www.theguardian.com/world/live/2020/feb/20/coronavirus-live-updates-diamond-princess-cruise-ship-japan-deaths-latest-news-china-infections [Last accessed on 2022 Jan 09].  Back to cited text no. 10
Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Chest CT findings in cases from the cruise ship diamond princess with coronavirus disease (COVID-19). Radiol Cardiothorac Imaging 2020;2:e200110.  Back to cited text no. 11
Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Erratum: Chest CT findings in cases from the cruise ship “diamond princess” with coronavirus disease 2019 (COVID-19). Radiol Cardiothorac Imaging 2020;2:e204002.  Back to cited text no. 12
Available from: https://www.nytimes.com/2020/02/17/world/asia/japan-cruise-ship-coronavirus.html. [Last accessed on 2022 Jan 09].  Back to cited text no. 13
Available from: https://en.wikipedia.org/wiki/The_Last_Cruise. [Last accessed on 2022 Jan 09].  Back to cited text no. 14
“World's largest vaccination programme begins in India on January 16”. The Hindu; January 15, 2021. Available from: https://www.thehindu.com/news/national/coronavirus-worlds-largest-vaccination-programme-begins-in-india-on-january-16/article33582069.ece. [Last accessed on 2022 Jan 09].  Back to cited text no. 22
Kar SK, Ransing R, Arafat SMY, Menon V. Second wave of COVID-19 pandemic in India: Barriers to effective governmental response. EClinicalMedicine 2021;36:100915.  Back to cited text no. 23
Available from: https://en.wikipedia.org/wiki/COVID-19_lockdown_in_India. [Last accessed on 2022 Jan 12].  Back to cited text no. 24
Available from: https://timesofindia.indiatimes.com/blogs/voices/the-omicron-vs-the-cordelia-syndrome. [Last accessed on 2022 Jan 09].  Back to cited text no. 31
Mahajan A. COVID-19 and its socioeconomic impact. Cancer Res Stat Treat 2021;4:12-8.  Back to cited text no. 32
  [Full text]  


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