Transmission of the novel coronavirus onboard the Diamond Princess
COVID-19: Transmission of the novel coronavirus onboard the Diamond Princess. Spencer EA, Heneghan C.
https://www.cebm.net/study/covid-19-transmission-of-the-novel-coronavirus-onboard-the-diamond-princess-cruises-ship/
Published on June 22, 2020
Included in
Transmission Dynamics of COVID-19
| Reference |
Mizumoto K, Chowell G. Transmission potential of the novel coronavirus (COVID-19) onboard the diamond Princess Cruises Ship, 2020. Infect Dis Model. 2020;5:264‐270. Published 2020 Feb 29. 2020 |
| Study type |
|
| Country |
Japan |
| Setting |
The Diamond Princess cruise ship |
| Funding Details |
Japan Society for the Promotion of Science (JSPS) and the joint NSF-NIH-USDA Ecology and Evolution of Infectious Diseases program. |
| Transmission mode |
Close contact, person to person |
| Exposures |
Cruise Ship |
Bottom Line
Passengers and crew in the cruise ship experienced high transmission rates, hypothesised to be due to the close quarters and confined living spaces.
Evidence Summary
454 confirmed cases on board. Among the 3,711 passengers and crew on board, there were 621 (17%) symptomatic and asymptomatic people with positive COVID-19 tests.
| 20th Jan |
- Departed from the Port of Yokohama
- Index case embarked
|
| 25th Jan |
- Arrived at the Port of Hong Kong
- Index case disembarked in Hong Kong
- Departed from the Port of Hong Kong
|
| 27th Jan |
- Arrived at the Port of Chan May (Vietnam)
- Departed from the Port of Chan May (Vietnam)
|
| 28th Jan |
- Arrived at the Port of Cai Lan (Vietnam)
- Departed from the Port of Cai Lan (Vietnam)
|
| 31st Jan |
- Arrived at the Port of Keelung (Taiwan)
- Departed from the Port of Keelung (Taiwan)
|
| 1st Feb |
- Arrived at the Port of Naha (Japan)
- Departed from the Port of Naha (Japan)
- The index case was confirmed
|
| 4th Feb |
- Arrived at the Port of Yokohama (Japan)
- Passengers and crews were asked to stay on the ship for quarantine
- Health status of all passengers and crew members were checked by questionnaire by quarantine officers
|
| 5th Feb |
- A lab-confirmed case of COVID-19 was detected.
- Quarantine for 14 days begins at 7 am.
- Passengers requested to stay in their cabins.
|
| 18th Feb |
|
What did they do?
This study looked at transmission during the outbreak of COVID-19 on the Diamond Princess cruise ship, January to February 2020.
PCR laboratory tests were used to test for COVID-19 among the passengers and crew of the ship, prioritising symptomatic or high-risk groups.
The study used mathematical modelling and time-series incidence data describing the trajectory of the outbreak among passengers and crew members, to characterize how the transmission potential varied over the course of the outbreak.
Study reliability
The dataset was incomplete due to missing the date of onset for around a third of cases.
This is an unusually confined setting for a large number of people and may not represent a typical transmission setting. A total of 103 laboratory-confirmed symptomatic cases with unknown onset dates were not in the analysis.
| Clearly defined setting |
Demographic characteristics described |
Follow-up length was sufficient |
Transmission outcomes assessed |
Main biases are taken into consideration |
|
Yes |
No |
Unclear |
Yes
|
No |
What else should I consider?
Reporting delays could have influenced the infection estimates; for example, after disembarkation at least 14 American passengers tested positive.
Asymptomatic COVID-19 cases on the Diamond Princess cruise ship
COVID-19: Transmission aboard the Diamond Princess cruise ship
About the authors
Carl Heneghan
Carl is Professor of EBM & Director of CEBM at the University of Oxford. He is also a GP and tweets @carlheneghan. He has an active interest in discovering the truth behind health research findings
Elizabeth Spencer
Dr Elizabeth Spencer; MMedSci, PhD. Epidemiologist, Nuffield Department for Primary Care Health Sciences, University of Oxford.
Tom Jefferson
Tom Jefferson, epidemiologist.
