How Japan Made COVID-19 Worse

The Diamond Princess is now a human buffet

The Japanese quarantine of an entire cruise ship has turned one case of COVID-19 into 454 and growing. In the time that I wrote this cases jumped by over 100, now reaching over 12% of the ship. Japan has, in effect, laid out a human buffet for the novel coronavirus. It’s shocking, but this one ship now has more cases than the rest of the non-Chinese world combined.

This is a case study in how not to conduct a quarantine. It’s a case study in how political expediency can make a medical emergency worse.

The point of quarantine is to separate the sick from the healthy. Medically, what Japan should have done was take the sick cases off the ship and quarantine them somewhere on land. However, this was not a medical quarantine. It was a political one.

The goal was not public health, it was Japanese sensibilities. The goal was to keep the virus from touching Japanese shores at all costs, even if it meant putting 3,700 souls at risk.

“All the evidence we’ve got to go on is based on quarantining people who are infected,” said Mark Eccleston-Turner, a global health law researcher at Keele University in England. When quarantines are done arbitrarily, with no scientific basis, he added, they’re “not in line with human rights obligations.”

Besides being a huge human rights violation, it was also incredibly counterproductive. Japan has now created the largest international spread of COVID-19, in record time.

By quarantining the sick and the healthy together the Japanese government has created a floating petri dish, a human buffet for coronavirus. Perhaps worst of all, the working-class crew is the most exposed, while the rich passengers get the media attention.

I watch this Johns Hopkins outbreak visualization every day, and the big red spot over Japan came out of nowhere. From one sick passenger disembarking in Hong Kong, to 10 cases, to 61, and now to 454. The next highest country has 6x fewer cases than this one ship. This is partly a testament to the infectiousness of the disease, but also to the wrongheadedness of the quarantine.

As you can see in this graph of the viral spread, the Diamond Princess has now overtaken the rest of the non-Chinese world in the next few days, and it’s getting worse. It’s hard to see where this goes besides everyone on the ship getting infected.

This is because cases on the Diamond Princess are not in any real sense ‘quarantined’. Coronavirus is, if anything, being artificially bred by giving it a captive human population to feed on. The point of quarantine is to contain and reduce cases. As you can see from the graph, the Japanese actions have had the opposite effect.

Japan’s actions are also tremendously if inadvertently classist. This cruise ship is staffed by 1,000 people, primarily from developing nations. The rich passengers number 2,700. The guests can ‘self-quarantine’ in their rooms, but the working-class crew share bedrooms, bathrooms and dining quarters. They cannot quarantine. They are at high risk, and are expected to continue to feed and serve the rich people.

The result, of course, is to break the self-quarantine as well. What’s the point of being locked in your room if the people serving your food are all mixed up, and more likely to be sick? No doctor would design or allow this as a quarantine site, because it is medical madness. But again, this isn’t a medical quarantine. It’s political.

The decision to keep the passengers & crew on the ship is no longer ethical and is wholly inappropriate. 10 crew are infected and crew cannot self-quarantine, and room together. Clearly this has transmitted among them placing all at unacceptable risk. (Michael Mina, epidemiologist)

There’s a reason that the WHO doesn’t recommend blanket quarantines and travel bans and the like. It’s because they don’t work. Condemning 3,700 people to a floating Wuhan isn’t just unethical, it’s counter-productive. Instead of containing 61 cases in a hospital, Japan is now containing 454 on a virally leaky boat. And that’s not even getting to the people who may need oxygen, ventilators or medical attention.

You’ll note that other countries have contained the spread below 100 cases not by separating the sick and not, for example, quarantining entire buildings together. Japan, on the other hand, is rapidly accelerating ahead of the rest of the world out of a purely symbolic desire to keep COVID-19 ‘off its shores’. It’s a meaningless political stance that has real consequences for the poor souls on board the ship, and for public health at large.

At a time when we should be uniting against a common threat, Japan has made this novel coronavirus worse. It’s terrifying for the people on board, and this giant batch of virus Japan is brewing should scare us all.

UPDATE: as of February 19th, Japan has started releasing people from the ship. So after creating hundreds of new cases, they are finally letting people go. This is dangerous, but the danger only gets worse the longer this incompetent quarantine goes on. At this rate, the whole ship would become infected if they didn’t let the healthy off. As it is, the Japanese government’s actions have been incredibly inhumane, and dangerous to all.

UPDATE UPDATE: and now cruise ship passengers have brought the virus to the US, with help from Trump administration malcompetence: