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. 2020 Aug;14(4):506-513.
doi: 10.1017/dmp.2020.50. Epub 2020 Mar 24.

Chronology of COVID-19 Cases on the Diamond Princess Cruise Ship and Ethical Considerations: A Report From Japan

Eisuke Nakazawa  1 , Hiroyasu Ino  2 , Akira Akabayashi  1   3
Affiliations

Chronology of COVID-19 Cases on the Diamond Princess Cruise Ship and Ethical Considerations: A Report From Japan

Eisuke Nakazawa et al. Disaster Med Public Health Prep. 2020 Aug.

Abstract

The Diamond Princess cruise ship has been anchored at the Yokohama port in Japan since February 3, 2020. A total of 691 cases of the coronavirus disease 2019 (COVID-19) infection had been confirmed as of February 23. The government initially assumed that the infection was not spreading aboard and therefore indicated that any persons who either tested negative for the virus or were asymptomatic should immediately disembark. However, on February 5, the government set a 14-day health observation period because of the severity of the infection. Passengers confirmed to be free from infection began disembarking on Day 15 (February 19) of the quarantine. The effectiveness and validity of infection control, justification for the timing of inspections, and even the nature of COVID-19 itself now are all in question. The ethical considerations related to cruise ship infection control include the reasonable justification for isolation, the psychological fragility and quality of life of the isolated passengers and crew members, the procedural justice inherent in a forced quarantine, and the optimization of control measures.The international coordination framework and the global ramifications of such outbreaks should be reevaluated by the international community. Denying a ship's entry based on local politics is incompatible with global justice. Events such as these require an international response and global regulations that seek to reduce disparities.

Keywords: COVID-19; Diamond Princess cruise ship; Japan; public health ethics.

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Figures

FIGURE 1
FIGURE 1
Itinerary of the Diamond Princess Cruise Ship From January 20 to February 4, and the Geopolitical Map.
FIGURE 2
FIGURE 2
Infected Passengers and Crew Members on the Diamond Princess. (All Data Were Retrieved From Press Releases By the Ministry of Health, Labour and Welfare of Japan.)
See this image and copyright information in PMC

References

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