Updated at 4 p.m. ET
Roughly 600 passengers left the Diamond Princess cruise ship in Yokohama, Japan, on Wednesday, as a controversial shipwide coronavirus quarantine finally began to wind down.
All of those passengers had been tested for the COVID-19 disease by the Japanese health ministry, according to cruise operator Princess Cruises. As they left, they were met in the terminal by the cruise line's president, Jan Swartz.
Several hundred other passengers who aren't taking repatriation flights to their home countries are expected to leave the ship on Thursday.
The quarantine has been heavily criticized for failing to prevent the spread of the COVID-19 among passengers and crew. Even as hundreds of people disembarked, Japanese officials announced 79 more confirmed cases aboard the ship. And in at least one case, a family was informed of a positive test result just hours before they were scheduled to disembark.
A total of 621 people from the cruise ship have now been confirmed to have the newly identified coronavirus — or about 20% of the 3,011 people who had been tested as of Wednesday.
Japanese expert criticizes cruise ship protocols
Some of the sharpest criticism of Japan's handling of the stricken cruise ship came from Kentaro Iwata, an infectious disease specialist at Kobe University who posted a video about his visit to the Diamond Princess on Tuesday.
After getting a look around the ship's interior, Iwata said, it "turned out that the cruise ship was completely inadequate in terms of the infection control."
"There was no distinction between the green zone, which is free of infection, and the red zone, which is potentially contaminated by virus," he added.
Iwata's comments quickly drew attention in Japan. In response to questions about red and green zones on the ship, Health Minister Katsunobu Kato insisted that sections of the ship have been "properly managed," The Japan Times reports. It adds that another government official said the crew had taken "thorough measures" to stop infections from spreading.
In the YouTube video, Iwata called the ship's environment "completely chaotic," saying that "people could come and go" regardless of whether they were wearing personal protective equipment such as gloves, face masks and other gear. He added that one medical officer had seemingly given up protecting herself and others, believing she was likely already infected.
"I dealt with lots of infections — more than 20 years," Iwata said. "I was in Africa dealing with the Ebola outbreak. I was in other countries dealing with the cholera outbreak. I was in China in 2003 to deal with SARS."
In those outbreaks, Iwata said, "I never had fear of getting infections myself ... because I know how to protect myself and how to protect others."
"But inside Princess Diamond, I was so scared," he added. "I was so scared of getting COVID-19 because there was no way to tell where the virus is."
Criticizing a lack of carefulness on the ship, Iwata said there was also no clear leadership role by medical experts.
"There was no single professional infection control person inside the ship, and there was nobody in charge of infection prevention as a professional. The bureaucrats were in charge of everything," he said.
When he raised those concerns with a senior officer of Japan's health ministry, Iwata added, the official was "very unhappy" with his suggestions for improving protections on the ship.
In his video, Iwata also noted that Japan, unlike the U.S. and other countries, does not have an agency with the specific task of combating disease and infections, such as the U.S. Centers for Disease Control and Prevention and similar agencies in other countries.
The Wall Street Journal reported that the health minister told a news conference late Wednesday that Iwata had violated the terms under which he boarded the Diamond Princess and had been ordered to leave.
Passengers face new quarantines and restrictions
Roughly 3,700 passengers and crew were aboard the Diamond Princess when it pulled into the Yokohama terminal south of Tokyo.
People who have tested positive for the virus have been taken off the ship and sent to local hospitals — and their traveling partners and close contacts put under a fresh 14-day quarantine order.
Those passengers who have been declared free of the virus and are leaving the ship for the first time in two weeks face a confusing array of circumstances. Many will be forced to undergo a 14-day quarantine upon their return home — reflecting a lack of trust in the effectiveness of the ship's quarantine. Others can remain in Japan under their own recognizance but are still barred from returning home for two weeks.
The family of passenger Aun Na Tan of Australia was hit with an eleventh-hour setback when her daughter, Kaitlyn, tested positive for COVID-19. They got the news after stacking their luggage near the front door, awaiting their turn to leave the ship.
"It wasn't a pretty sight for me and Kaitlyn," Tan wrote, describing the impact of the bad news. "The boys were calmer. We have bounced back now."
The good news, she added, is that her daughter hasn't developed symptoms of the respiratory illness. And Tan said she and her husband and son planned to stay with her daughter.
"We decided not to be separated," Tan said on Instagram. "They are trying to find a hospital which will take all 4 of us."
The embassies of Canada, Australia and Hong Kong are arranging for their citizens to travel home via charter flights this week, Princess Cruises said Wednesday. All of those governments and the U.S. are requiring a second quarantine, the cruise line says.
The U.S. government brought more than 300 American passengers back stateside on chartered repatriation flights early this week. Those passengers are now quarantined at military bases in California and Texas — and 14 of them who tested positive for COVID-19 are in hospitals.
Americans who stayed aboard are on temporary no-fly list
Some 61 U.S. citizens were not flown home and remained on board the Diamond Princess. The Department of Homeland Security has temporarily put those Americans on a federal no-fly list to bar them from traveling to the U.S., the CDC says.
"This action has been taken because you are reasonably suspected of having had an exposure to novel coronavirus (COVID-19) while onboard the Diamond Princess cruise ship," the CDC said in a letter to the passengers.
Anyone who tries to subvert the travel ban by flying first to Mexico or Canada "will be stopped by U.S. Customs and Border Protection officials," the CDC adds.