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Worried about your upcoming cruise? This infectious disease expert has some advice: don’t be

TORONTO —
Infectious disease specialist Dr. Neil Rau said he would avoid going on a cruise right now, but not because he’s afraid of the new coronavirus that has prompted a two-week quarantine in Japan.

What’s worse, he said, is the response.

“It’s an AK-47 approach to infection control,” Rau said. “I’m not saying there should be no reaction to the problem, but these reactions are increasingly impractical.”

An estimated 3,700 people are trapped aboard the Diamond Princess ship, where at least 174 passengers have tested positive for the newly renamed COVID-19. Ten Canadians are among those infected, while another 255 Canadians remain on the ship, which will be quarantined for another week.

Rau said the cruise ship quarantine is a drastic approach that creates unnecessary fear and inconvenience. But it also may be spreading the virus to healthy people.

“Cruise ships can be a bit of a crucible if you have a disease that spreads through direct person-to-person contact or if they spread through shared bathroom use or shared food handling,” he said. “This is why norovirus does so well on a cruise ship.”

The problem with the COVID-19 is that scientists still don’t have the complete picture of how it spreads. It appears to be passed through respiratory droplets, but it’s still unclear if it could spread through fecal-oral means.

One particularly concerning case, reported earlier this week from Hong Kong, involved an apartment building where two individuals separated by several floors tested positive for the virus. The building has since been evacuated.

Rau said the case bears resemblance to the 2003 outbreak at Amoy Gardens, where the plumbing system helped spread the disease by allowing contaminated sewage to be aerosolized from home to home.

“One wonders if that could also be explaining what’s been going on in the cruise ship,” Rau said. However, he described the possibility as “remote.”

But there are other ways the virus could be spreading on the ship. Rau said a single source of exposure could be spreading the virus. Person-to-person contact could also be a factor, but Rau said that remains unlikely because passengers are being kept in their cabins and only allowed outside for brief, supervised walks.

Passengers who test positive for the virus are removed from the ship and treated at a local hospital.

Rau expressed doubts about the initial decision to keep all the passengers in one confined space.

“If I had been running the show, I would’ve tested the entire ship and freed the prisoners who are negative and then observe them. I would keep them all together,” he said.

In Canada, hundreds of people evacuated from Wuhan are under quarantine at CFB Trenton, a military base in Ontario. So far, no cases of COVID-19 have been reported at the base.

For anyone feeling unnerved about taking a cruise ship vacation this winter, Rau points out that the virus does not appear to be particularly deadly. Globally, COVID-19 has killed more than 1,100 people and infected more than 45,000 in at least 25 countries. By comparison, the flu causes about 3,500 deaths and 12,200 hospitalizations in Canada each year, according to government estimates.

“They should be worry about the reaction to the disease rather than the disease itself,” Rau said.

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