YOKOHAMA, Japan — Hundreds of passengers walked off a coronavirus-stricken cruise ship Wednesday after getting the all-clear from the Japanese authorities, but the scene that greeted them as their feet touched solid ground for the first time in weeks suggested that some found the assurances less than reassuring.
The taxi drivers who would ordinarily flock to meet arriving cruises were in short supply. There were yellow city buses to ferry passengers to airports and train stations, but their drivers were blocked off by plastic sheeting and tape. Even workers just walking around the terminal wore hazmat suits.
That was perhaps unsurprising: The very day the 443 passengers were released to the port city and the world beyond, the number of confirmed infections on the Diamond Princess rose again, to 621, as 79 new cases were announced.
And just a day before the mass disembarking, a Japanese infectious disease specialist who visited the cruise ship offered a damning assessment of what he had seen: “Completely chaotic.”
“I would not be surprised if they spread infections,” the doctor, Kentaro Iwata of Kobe University Hospital, said of the passengers let off the ship.
In notifying the passengers that they were free to return to their families, the Japanese government declared that they had satisfied the terms of a two-week quarantine imposed when the Diamond Princess arrived in port earlier this month.
But outside health experts have expressed deep concerns about how well Japan has handled the outbreak. On Tuesday, the United States ordered American citizens who have been on the ship not to return home for at least two weeks, “to protect the health of the American public.”
In recent days, some of the passengers from the Diamond Princess who were repatriated and placed into quarantine have begun testing positive for the virus.
But on Wednesday, the ship nevertheless began disgorging passengers wholesale.
Shortly before 11 a.m., they began making their way off the ship through an improvised tunnel shrouded in blue tarp, through an array of orange pylons and out into a parking lot under a clear sky.
Taxis may have been in short supply, but the news media was not.
One of the earliest to disembark, a woman wearing a conical rice hat and a heavy-duty face mask with a strap hanging loose, was mobbed by journalists as she walked out of a guarded gate, pulling a red suitcase. She eventually wandered off on foot.
One passenger, Masako Ishida, 61, remained on board on Wednesday as she waited to receive her test results, and said she was frustrated by the suggestion that anyone who tested negative should have to remain in quarantine any longer.
“I heard that some people think us passengers should be put another two weeks in quarantine,” she said. “We were quarantined, and if we test negative, we will be given a certification that proves we’re negative. We’re one of the safest people right now.”
Another passenger seemed less certain.
“I’m a bit concerned if I’m OK to get off the ship, but it was getting very difficult physically, a 77-year-old man who got off with his wife told the Kyodo News agency. “For now, we just want to celebrate.”
Dr. Iwata, the infectious disease expert, sounded far more concerned.
He said he had visited the ship on Tuesday with the goal of advising public health officials on how to prevent the further spread of infection. He expressed astonishment at what he had seen, and took to YouTube to share his findings.
Health ministry officials, crew members and psychiatrists mingled and ate together, Dr. Iwata said, with some in full protective gear and others not — a violation of ordinary procedures.
He said in an interview that the Japanese authorities had taken only “half measures” and “did not protect” the 3,700 passengers and crew members on the ship.
Part of the problem is that Japan’s response has been conducted by public servants who do not necessarily have expertise in infectious disease. The country does not have a government agency that specializes in disease control.
“They want to handle the case based on a successful plot that the bureaucrats created, and they just want to follow it,” Dr. Iwata said. “Without setting an objective or goal, they just want to show they are trying hard enough, even if they end up with many infections.”
Dr. Iwata, who said he feared he may have contracted the virus himself on the ship, is now in a self-imposed quarantine away from his family.
Japanese officials defended their decisions.
In remarks to reporters on Wednesday, Yoshihide Suga, the chief cabinet secretary to Prime Minister Shinzo Abe, said the country’s authorities had “made the maximum consideration to secure the health of passengers and crew.”
Gaku Hashimoto, the vice health minister, said on Twitter that upon discovering Dr. Iwata on board the ship on Tuesday, he asked him to leave. Mr. Hashimoto said the health ministry was “currently receiving help from many experts both within and outside of the ship, and is conducting an extraordinary quarantine.”
He acknowledged, though, that after three health ministry officials who had tended to passengers on the ship tested positive for the virus, “I cannot say that things are being controlled completely.”
Early Thursday morning in Japan, Dr. Iwata removed his video, with little explanation. “I removed my YouTube clip myself since there is no need for further discussing this,” he said on Twitter. “Thank you and I apologize to those who got involved in.”
Other infectious disease experts said they were distressed by Dr. Iwata’s description of the conditions on board.
“Hearing his account was pretty harrowing, actually,” said Dr. Benjamin Cowie of the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia.
Between the evacuations earlier and the disembarkation on Wednesday, it appears there are now fewer than 1,100 passengers on board the Diamond Princess, and perhaps 1,000 crew members.
More releases were scheduled over the next two days.
The Japanese health authorities said that any passenger or crew member who tested positive would be taken to a hospital, and that anyone who showed symptoms would have to remain on board until medically cleared.
Officials said that the 443 people who left the ship on Wednesday had no symptoms and had tested negative for the virus. It was not clear when they had taken the test, however. Some indicated that they had been tested over the weekend, which would mean they had possibly been exposed to infection for another three days.
Dr. Cowie said that people who were newly infected could test negative for the coronavirus only to become ill a few days later.
“If the government is correct and those individuals are not only clear of infection but are not incubating infection, then the decision by the authorities to release them will have proven to be the correct one,” he said. “If indeed transmission was ongoing on the ship, then ultimately I suspect that decision will be proven to be incorrect.”
A mother of a customer service agent on the Diamond Princess has been exchanging text messages with her daughter, who asked to remain anonymous for fear of losing her job. In the texts, the crew member, who had watched Dr. Iwata on YouTube, said he had accurately captured the conditions on board.
The crew member said she was frightened after carrying luggage for passengers who had tested positive for the virus. The crew will be required to stay on board to help disinfect the ship after all passengers disembark. It is not clear whether they will undergo a separate quarantine after that.
Kyle Cleveland, a sociology professor at Temple University’s Tokyo campus who has studied Japan’s response to another crisis, the Fukushima nuclear meltdowns, said he saw troubling similarities.
“The lack of a coordinated response in which genuine experts are responsible for decision making is problematic,” he said, ”because what happens instead is that you have political functionaries who are placed in roles of authority beyond their competency.”
Mr. Cleveland said that the ship had put Japan into a difficult and fast-moving situation.
“Japan is sometimes a victim of its own competence,” he said. “Everything works, and it’s a highly structured, functional society in every respect. And then when things go off the rails, they think that normal everyday processes are going to be sufficient.”
“But exceptional circumstances,” he said, “require exceptional responses.”
Hisako Ueno and Makiko Inoue contributed reporting from Tokyo.
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