Updated Wednesday, 7:15 pm
After more than two weeks of being stuck on the luxury cruiseliner Westerdam, which was rejected by several ports before successfully berthing in Cambodia, Tom and Dianne Durawa disembarked, boarded a flight, and returned home to Martha’s Vineyard.
In the days since the Durawas’ departure from the vessel, a Westerdam passenger has tested positive for coronavirus, casting doubts on the screening methods used onboard, and the infectious disease protocols applied to passengers who left the ship and traveled home.
In recent days, Holland America reported on a blog dedicated to Westerdam news that all passengers subsequently disembarking from the ship had been tested and none were found to have the virus. In Edgartown, the Durawas decided on their own to stay isolated at home for the two weeks following their return, according to an email they sent to family and friends.
As of Tuesday morning, the World Health Organization has said 74,000 people within China have contracted the virus, with 1,870 deaths. Outside China, there have been 804 cases in 27 countries, resulting in five deaths.
Edgartown health agent Matt Poole has been designated the primary point of contact for potential public health–related matters related to the couple, Edgartown town administrator James Hagerty told The Times. Hagerty said Poole is “working in tandem” with the Massachusetts Department of Public Health (DPH). Hagerty said the couple have been deemed “low risk based on federal and state criteria.”
“Based on them being low risk,” he said, “they have no restrictions on their movement. However, they’ve chosen to self-isolate as an extra precaution.”
He said federal and state criteria presently indicate “close personal contact with a symptomatic individual is required for transmission.”
However, he said the nature of the disease and elements known about it constitute “an ever-changing situation.”
Poole and other town officials have had conference calls with Martha’s Vineyard Hospital and its parent company, Mass General Brigham, Hagerty said. Efforts will elevate if there’s a “situation development,” he said. To date, “no one from town hall has visited them at their home,” he said.
Hagerty answered an email question about whether the couple’s travel route and travel modes once they entered the commonwealth were known.
“We can’t speak on how they traveled to the Island,” he said.
The Westerdam left Hong Kong on Feb. 1, and was scheduled to end its cruise on Feb. 15 in Yokohama, Japan. During the cruise on the Westerdam, a vessel owned by the Holland America Line, reports from the cruise line website stated that 2,257 passengers and crew were screened for coronavirus on Feb. 10 by having their temperatures taken with an infrared thermometer, a method that has since been met with skepticism by some medical professionals. According to the New York Times, only 20 people on board the ship were actually tested for the presence of the virus before disembarking, “and that was because they had reported themselves to ship medical staff with various ailments.”
In a phone conversation with Dianne Durawa on Wednesday, she reiterated to The Martha’s Vineyard Times that passengers underwent health checks on three different occasions. On each occasion, each passenger had their temperature taken, and were asked to report if they had experienced any symptoms.
According to the New York Times, five countries refused to let the Westerdam dock, despite Holland America’s assurances that all passengers had been screened. On Feb. 14, the prime minister of Cambodia allowed the ship to dock in Sihanoukville, and greeted passengers as they disembarked.
After docking in Cambodia, the Durawas wrote that they were cleared by the Cambodian health department and allowed to come ashore. They then traveled to Phnom Penh in Cambodia, where they spent nearly an entire day waiting to return home. Holland America arranged all the Durawas’ travel back to the U.S.; the U.S. State Department was involved.
“We spent a long day at the airport in Phnom Penh, followed by 22 hours of flights from there through Dubai to Logan,” the letter read.
After hundreds of passengers had disembarked, one, an 83-year-old American traveling on to Malaysia, later tested positive for the coronavirus, according to the New York Times. The woman was not among the original 20 tested onboard. “Now health officials worry that what Cambodia opened its doors to was the outbreak, and that the world may pay a price as passengers from the cruise ship Westerdam return home,” the New York Times reported.
In an article published by Bloomberg News, Ben Cowling, a professor of epidemiology at Hong Kong University, said that quarantining passengers after they return home is a reasonable precaution to take. Cowling said that false negatives are possible when testing for the disease, and infected individuals can be asymptomatic for long periods before symptoms surface. “There may be other people from the ship who have acquired the infection, didn’t show symptoms, yet are now returning home,” Cowling said. “Now that there’s a confirmed case, putting people who return home in quarantine is a natural and reasonable thing to do.”
When asked about the state’s response to returning Westerdam passengers, Massachusetts Department of Public Health spokesperson Ann Scales said in an email to The Times that the “local board of health would be taking the lead.”
The couple have agreed to voluntarily self-isolate for 14 days, with concurrent status checks every 48 hours to see if symptoms occur, Hagerty wrote in an email.
“Public and private healthcare professionals have been notified at every level, and the town will follow the guidance, recommendations, and protocol of the Mass. DPH epidemiologist,” he wrote.
Sam Telford, the director of the New England Regional Biosafety Laboratory, in a conversation with The MV Times, agreed that the thermal scans, such as the ones administered to the Westerdam passengers, “aren’t terribly helpful,” as they will not necessarily point to someone who might be carrying the virus.
When asked about the Durawas’ protocol, Telford said, “They’re doing the right thing. They’re self-quarantining,” noting that coronavirus is spread the same way as the flu.
Edgartown health agent Matt Poole said in a phone call to The Times that Islanders should practice all the same personal hygiene precautions as they would to prevent the spread of influenza. “The real keys should be consistent handwashing, sneeze etiquette, basically some common-sense actions,” Poole said.
Currently, Poole said, there is no reason to be concerned about coronavirus on the Island, but officials are following the advisories of federal health agencies.
When asked if he knew how the Durawas had traveled to Martha’s Vineyard, Sean Driscoll, spokesman for the Steamship Authority, said, “Our enabling act would prevent us from disclosing [whether or not the Durawas traveled to the Island via the steamship]. We will be reaching out to [the Durawas] in light of the media reports. We have spoken with MVH to raise awareness of best practices.”
On Feb. 12, Martha’s Vineyard Hospital issued a travel alert for the disease, and said in a press release that infectious disease specialists, emergency management, occupational health, communications, and other leadership groups are working on fine-tuning emergency response.
Communications assistant at MVH Marissa Lefebvre said the hospital doesn’t have any further updates on the spread of the disease since the press release.
Assistant airport director Geoff Freeman said the airport has not been advised of any precautionary measures from the Centers for Disease Control and Prevention, but will act accordingly if any such advisory is issued.