After cases of the novel coronavirus were confirmed aboard the Grand Princess cruise ship, a question lingered for weeks as the evacuated American passengers adjusted to life under quarantine on U.S. military bases.
These numbers indicate that the coronavirus spread more widely among those who had traveled on the ship than was previously known, and they raise questions about whether potentially infected people could be returning to their communities when they are scheduled to begin leaving the bases this week.
“I’d be surprised if some people weren’t contaminated while here in quarantine and are taking that home,” Stuart Freedman, 61, who lives in California and tested negative for the virus last week, said in an interview from Travis Air Force Base.
Some travelers said they were discouraged from taking the test because they lacked symptoms, or feared it might extend their limbo beyond a 14-day quarantine, because officials had warned that was possible.
“I’m not going to take the test, because, number one I’m not symptomatic,” Robert Archer, 65, of San Francisco, said in an interview from his quarantine at Travis. “Number two, if we took the tests, it would delay our release date, and there’s no way in the world, besides breaking out in a fever, I’m going to risk being able to get released” as scheduled.
“They tell you up front they don’t want you to take the test unless you’re showing symptoms,” Archer said, adding that testing began on the base only after he had already been there several days.
The Department of Health and Human Services, which is overseeing the quarantined passengers on the bases, defended both the timing and handling of testing.
“HHS staff provided passengers with information about testing so that passengers could make informed decisions,” a spokeswoman said in a statement responding to questions from The Washington Post.
“We began testing as soon as logistically possible,” the statement said. “We did not want passengers to be surprised that staff could not test hundreds of passengers simultaneously, at how long test results might take to receive, and if, at the 14-day mark, some passengers would have to remain at a quarantine location because his or her test was still pending.”
While travelers had been told their quarantines could be extended if test results were pending, that changed over the weekend. HHS said Sunday that it received “new guidance” from the Centers for Disease Control and Prevention and that people with pending test results who don’t have symptoms would also be released when their quarantines are up — just like the people who did not get tested and lack symptoms.
An HHS spokeswoman said in another statement that the department’s officials were not worried about whether people who were not tested might take the virus home from bases in California, Texas and Georgia.
“All passengers completed their 14-day quarantine and showed no signs of illness. They will be checked prior to boarding buses,” the statement said.
The Grand Princess passengers have had a unique vantage point as the coronavirus outbreak has rippled across the globe. They were affected by the pandemic but isolated from many of its most severe effects so far, spending days confined to their rooms on the ship before getting an early taste of the seclusion that large swaths of the country are now experiencing.
“We feel like we’re removed from society, but then there’s not really much of a society to get back to,” said Michelle Heckert, a recent college graduate and Bay Area resident who traveled on the Grand Princess with her grandparents before they were quarantined at Travis.
During Heckert’s time under quarantine, orders restricting movement were announced in the Bay Area and then across California.
“It just kind of seemed like I was going to be hopping around from place to place learning how to quarantine again and again,” Heckert said. “Now I’m kind of an expert, I guess.”
Hundreds of the people who were on the Grand Princess and were taken to bases have been sent home to isolate there, while others still under 14-day quarantines on the bases are scheduled to begin leaving, starting on Monday.
They will return to communities transformed by the virus.
The Grand Princess left San Francisco on Feb. 21 for a 15-day cruise to Hawaii, with a planned stop in Mexico. Then, on March 5, passengers were confined to their rooms as officials investigated a coronavirus cluster linked to a previous voyage. At the time, cases had not been confirmed in most states, and the U.S. death toll had just reached double figures.
A day later, passengers found out that 21 people on the ship had tested positive, 19 of them crew members.
A plan took shape: The ship, still floating off the California coast, would dock in Oakland. Americans would be taken to military bases for two weeks of quarantine, and people from other countries would be sent home.
The process unfolded slowly over several days, staggering when people would arrive on bases and when their quarantines would end. But the crisis was escalating significantly, as the virus was declared a pandemic and much of life in the United States and many other countries started grinding to a halt.
Several states decided to bring their residents home from the bases before the two weeks were up, including Wisconsin, Oregon, Washington state and Nevada. Officials warned some travelers they would be quarantined all over again at home.
James Lamaire said he and his wife, Helga, were brought back to their home in Carson City, Nev., last week and told they would have to begin a new 14-day quarantine.
“Our clock started again,” Lamaire said amiably. “For the third time.”
Most of the passengers taken to bases remain there. In interviews, they reported falling into routines: twice-daily temperature checks, walks inside fenced-in areas, FaceTiming family and friends.
Some travelers praised the officials at the bases for how they treated the quarantined passengers.
Mary and Bernie Shapiro, who were taken to Dobbins Air Reserve Base in Georgia, said they were happy to settle into their room after being stuck on the Grand Princess for so long. “I got a little resentful because I felt like I was in a stable,” Mary Shapiro said.
Their facility is fenced off on all sides, and even a Postal Service drop-off mailbox is wrapped in protective plastic, photographs they provided showed.
Still, anxieties emerged on the bases, with some passengers reporting that in their first days there, people crowded into communal areas for meals — actions that ran counter to the social distancing measures being recommended nationwide. Passengers worried about further spread of the virus.
Quarantines are “for people who aren’t sick but have been exposed,” Saskia Popescu, an infection prevention epidemiologist for HonorHealth in Phoenix, said in an interview. “Ideally, if you’re going to quarantine all of these people so they don’t spread the disease externally into the community, you also want to make sure they’re not spreading it to each other.”
The situation changed after the first few days, some travelers said. Guards told people who went for walks together to keep some distance from each other, one traveler said. Meals were eaten in rooms instead of shared spaces.
In another response to questions, HHS said: “The number one priority for HHS is the health of the passengers. During the first two days of this undertaking, HHS focused on screening passengers for symptoms, addressing any underlying health conditions, providing access to prescription medication, and getting passengers settled into their rooms.”
Passengers who went to bases were screened for the coronavirus multiple times, including when they arrived, and monitored during quarantine. People who tested positive or showed symptoms — or had contact with someone who did — would see their quarantine orders extended, HHS said.
But travelers still had to decide whether to be tested — which many had not expected to be optional. On March 6, when Vice President Pence announced that 21 people on the ship had tested positive, he said everyone on board would be tested.
“All passengers and crew will be tested for the coronavirus,” Pence said. “Those that need to be quarantined will be quarantined.”
But after arriving at the bases, passengers found out taking the test was up to them. Asked what changed since the earlier announcement, HHS said that while passengers were all offered testing, “the federal government cannot coerce anyone to be tested.”
A notice given to people quarantined at Travis and shared with The Post stated: “You are NOT required to be tested. It will be your choice.”
It makes sense that not everyone from the ship would get tested given the limited supplies, said Lucy Wilson, an infectious disease specialist and former Maryland Department of Health official.
“There are health-care workers who can’t get tested right now, who are actively sick, who have respiratory symptoms and are taking care of people,” she said. “In a perfect world it would be great if you could test everybody frequently.”
That left people on the bases unsure whether they had been exposed and weighing what to do.
“It’s a tricky question,” said Donna LaGesse, 64, of Greenville, N.C., who was at Dobbins and has not been tested. “There’s a part of me, it would be really nice to know, do I have it? Or don’t I have it?”
Heckert, the traveler from the Bay Area, said she and her grandparents decided to be tested for the virus to be “as safe as possible.”
Steve Houghton and his wife, Diane, worried about extending their time on Travis if they took the test. “We decided we would not test as we are feeling fine and want to go home,” said Houghton, 77, of Pleasant Hill, Calif.
Testing finished across all four bases by Wednesday and Thursday of last week. More than 900 people agreed to be tested, while 801 declined testing, HHS said.
As of Saturday morning, more than 400 test results were in, with 40 of them positive, according to HHS. Hundreds of test results remained pending.
People who tested positive but did not have symptoms were being moved to other facilities staffed by HHS personnel, the spokeswoman said, while people with “more severe symptoms” would be taken to a hospital.
Experts and some on the base questioned continuing these quarantines when the virus has spread so widely across the country.
“It’s becoming increasingly untenable with so much community spread to be doing this type of quarantine,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Archer, the quarantined passenger from San Francisco, said, “We can’t understand why we’re being viewed as lepers, or pariahs.”
Archer said he was looking forward to his scheduled release date on Wednesday despite the shelter-in-place orders in California, because “at least we’ll be experiencing it in our own homes.”
“We’ll be able to eat our own food in our own homes, surrounded by our own family members and friends, as opposed to being in this environment,” he said. “I’d trade that in a heartbeat.”
Siddiqui reported from San Francisco. Julie Tate, Hannah Knowles and Rosalind S. Helderman in Washington contributed to this report.