Coronavirus outbreak: 'We're past the point of containment' - Los Angeles Times
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‘We’re past the point of containment’: Coronavirus fight enters new phase

Grand Princess by the Golden Gate Bridge
Grand Princess passengers showing signs of the coronavirus are expected to remain in California, while others will be sent to a military base in the San Antonio area.
(Scott Strazzante / San Francisco Chronicle)
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As a cruise ship with nearly 3,000 stranded travelers prepares to dock Monday in the Port of Oakland, top health officials warned that the country has entered a new stage in dealing with the deadly coronavirus — one in which containment is no longer possible.

“We’re past the point of containment,†Dr. Scott Gottlieb, commissioner of the Food and Drug Administration during the first two years of President Trump’s administration, said on CBS’ “Face the Nation.â€

“We have to implement broad mitigation strategies. The next two weeks are really going to change the complexion in this country. We’ll get through this, but it’s going to be a hard period. We’re looking at two months, probably, of difficulty,†Gottlieb said.

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U.S. Surgeon General Jerome Adams said that shifting to a mitigation phase means that communities will see more cases and need to start thinking about whether it makes sense to cancel large gatherings, close schools and make it more feasible for employees to work from home.

That’s what happened Sunday, with more reported school closings, warnings against group gatherings and cancellation of big events, such as the BNP Paribas Open, an Indian Wells tennis tournament scheduled to start this week.

“And that’s going to be different in Seattle than what it’s going to be in Jackson, Miss.,†Adams said on CNN’s “State of the Union.†“But communities need to have that conversation and prepare for more cases so we can prevent more deaths.â€

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Hours later on Sunday, health officials in central Washington reported the state’s 19th death attributed to COVID-19, the first outside the Seattle area.

The resident of Quincy, Wash., whose gender was not disclosed, was “in their 80s,†officials had said previously, and died at Central Washington Hospital in Wenatchee. The person had not traveled outside of the country recently, and was the only resident of Grant County to have tested positive for the disease.

In California, Santa Clara County has been hardest hit, with five new cases Sunday, bringing its total to 37. The only other counties nationwide with higher numbers are King County, Wash., and Westchester County, N.Y.

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Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that people who are older or have underlying health conditions should also consider avoiding large crowds and travel.

“If you are an elderly person with an underlying condition, if you get infected, the risk of getting into trouble is considerable,†Fauci said on NBC’s “Meet the Press.â€

“So it’s our responsibility to protect the vulnerable. When I say protect, I mean right now. Not wait until things get worse. Say no large crowds, no long trips. And above all, don’t get on a cruise ship.â€

The comments from current and former officials marked a big shift, acknowledging that the country is past the point of being able to contain the outbreak and needs to pivot to aggressive efforts to mitigate the virus’ spread.

Trump administration officials have previously sought to downplay the risk to Americans posed by the coronavirus outbreak.

In California, officials said the Grand Princess cruise ship would dock Monday at the Port of Oakland and outlined plans for the nearly 3,000 people aboard the ship, about 1,000 of whom are from California. They stressed that no one on board would be released immediately to the general public.

All of those passengers will be quarantined for 14 days at military installations, the Department of Health and Human Services said.

The Port of Oakland was chosen because it is one of a limited number of docks that can accommodate a ship the size of the Grand Princess, and because it was the easiest “to seal off, securely move passengers toward their isolation destinations and protect the safety of the public,†the California Governor’s Office of Emergency Services said in a statement.

On Sunday, Gov. Gavin Newsom said the ship would dock Monday at the commercial Port of Oakland to disembark all passengers and those who need medical attention.

The governor expected the operation to take up to three days but emphasized that the situation was “fluid†and could take longer, in part because the port does not regularly deal with cruise ships and there would only be small windows of opportunity for it to enter the port, based on tides and currents.

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Newsom said that after the medical cases disembark, California residents would be taken off the ship first, with the majority being sent to Travis Air Force base in nearby Solano County to begin a 14-day quarantine.

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It is the same base where passengers from the Diamond Princess were recently held after that ship had an outbreak of the virus, and where there has been suspected community spread of COVID-19. The rest of the California residents will be sent to Marine Corps Air Station Miramar in San Diego.

The remainder of the American passengers will be sent to Joint Base San Antonio Lackland in Texas or Dobbins Air Reserve Base in Georgia, while foreign passengers will be sent to their home countries via charter flights from Oakland International Airport. Newsom emphasized those cruise passengers traveling by air would have no contact with regular travelers.

Crew members will be quarantined on board, with the ship leaving the Oakland port. The majority of the crew are foreign nationals, and Newsom said that many are younger, a demographic with less risk from COVID-19.

He said that 12 positive cases of COVID-19 had been identified in passengers on the previous cruise, which went from San Francisco to Mexico, and included a Placer County man who later died of the virus. The cruise line and California health officials have disagreed on whether the man contracted the illness on board or was infected prior to the journey.

Route of the Grand Princess
(Thomas Suh Lauder / Los Angeles Times)

Health officials are also monitoring 1,540 passengers on the previous Grand Princess cruise to Mexico, Newsom said.

The governor’s detailed account of next steps brought comfort to some on the ship who are growing frustrated with a lack of information.

Canadian passenger Karen Spoon said prior to the news briefing that she is “growing frustrated that my own government hasn’t said much ... I’m starting to feel the effects of cabin fever.†After hearing that the California governor said charter flights would repatriate her, Spoon said, “If that’s correct, then yippee!â€

Debbie Loftus, a passenger from Wisconsin, said she was pleased Newsom spoke directly to passengers and thought the news conference, which she watched, represented a “change in attitude.†“It is nice that he is now welcoming us into California. A few days ago, he did not want us anywhere near his state,†Loftus said.

Loftus said that many uncertainties remained that are causing her anxiety.

“This is all going to be a very new experience, going to a military base in Oakland, getting on what I assume is not going to be a commercial airline or ... going someplace I’ve never been,†she said. “Not sure what the accommodations are going to be like and how long we’re going to be held there. Yes, it’s a little bit anxiety-producing, but [we] will handle it minute by minute.â€

Matt LaGesse’s mother and aunt are on the ship, and he has been trying for days to get information, with little luck. LaGesse said he was angered by the president’s comments about potentially keeping passengers aboard, and what he felt was a lack of planning and leadership around the crisis.

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Despite details given by Newsom, he remained frustrated and uncertain about what would come next. LaGesse said he has not been contacted about the disembarkation plan by authorities or the cruise line.

“As a family member and son of a mom that I really, really love ... I’m scared and nervous and disappointed,†he said Sunday. “You expect your leadership ... to give you clear messaging so that you can understand the planâ€

At least 21 people on board the ship have confirmed cases of COVID-19, which is caused by the coronavirus that originated late last year in China.

Princess Cruises initially stated that the docking would begin Sunday, then pushed it back to Monday after “further review by the state and federal authorities.â€

Newsom said the number of Californians testing positive for COVID-19 jumped from 88 Saturday to 114 Sunday, but he emphasized that the number was expected to rise as testing became more widely available.

Newsom said California has testing kits for 8,000 individuals and that a private lab — Quest Diagnostics in San Juan Capistrano — will also have the capacity to run an additional 2,000 tests each day beginning Monday, if needed.

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There are also 15 public labs processing tests, including a facility in Richmond, where testing for the Grand Princess passengers was conducted.

Newsom said California has so far tested about 788 people for the virus, but he expected that figure to increase dramatically in the coming days with the new capacity.

“It goes without saying that if you are elderly, you have preexisting conditions ... I would highly recommend, almost demand, that you not go on a cruise,†Newsom said.

The Department of State also announced Sunday that all U.S. citizens should avoid traveling by cruise ship for the time being, noting that the Centers for Disease Control and Prevention has cited an increased risk of COVID-19 infection on such ships, and that many countries have denied port of entry rights and prevented passengers from disembarking.

The State Department on Sunday issued the warning, which could further hurt the cruise ship industry and the port cities that depend on it.

The passengers aboard the Grand Princess departed for Hawaii on Feb. 21. The ship was supposed to proceed to Ensenada, but the onboard coronavirus outbreak prompted the vessel to sail to San Francisco instead. It reached the California coast Thursday, but was not able to dock.

Before the Hawaii excursion, the Grand Princess took an ill-fated cruise to Mexico. One of the passengers — a 75-year-old man from Placer County — fell ill during the trip and became the first Californian to die of COVID-19. Altogether, a dozen coronavirus cases in California have been linked to passengers on that cruise.

Passengers on the ship are eager to disembark but remain frustrated by the many unknowns that remain.

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Debra Gooch Healer, a passenger from Napa, said all she knew is that she would be taken to a federal facility in California. She did not know where that will be or how long she will have to stay there.

“Any ACLU attorney out there who can tell us our rights??†she tweeted.

She and others also complained that they were forced to remain in their rooms, and that food supplies had run low.

The American Civil Liberties Union of Northern California replied via Twitter that the government should “make every effort†to ensure passengers’ rights are protected, including due process rights to appeal any mandatory confinement.

At least 537 coronavirus cases have been confirmed across the U.S., including 114 in California. Worldwide, more than 109,000 people have been infected and more than 3,800 have died.

Most recently, Riverside County announced its first “locally acquired†case of the virus, a person who is being treated at Eisenhower Health in Rancho Mirage, Riverside University Health System-Public Health said in a statement. Public health officials are still investigating how the person caught the virus, and are working to contact other people who may have been exposed.

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The person was taken immediately into an isolation room and had no contact with other patients, said Michael Connors, infection preventionist at Eisenhower Health.

The person, who is an older adult, had not recently traveled or been in contact with a confirmed COVID-19 case, a family member said.

The person became ill about a week and a half ago and was taken to the hospital on March 1, according to the family member. The person was put on a ventilator and placed in an induced coma on Thursday, the family member said. The ventilator was removed on Sunday, and the patient is now conscious and appears to be recovering, the family member said.

The announcement of the positive result came two days after Murrieta school officials said 71 students had been placed in self-quarantine and a high school would be closed and cleaned because an employee was tested for the coronavirus.

The person who tested positive in Riverside County has no known connection to county schools, public health officer Dr. Cameron Kaiser said Saturday. He declined to disclose additional information about their condition or where they’re thought to have contracted the virus but said that officials believe “the community exposure to be low.â€

Kaiser declared a local public health emergency on Saturday.

He said the declaration could affect local events. Coachella and Stagecoach are both scheduled to take place in Indio in April. Kaiser said there’s no clear threshold for recommending the cancellation of such large gatherings, and that each will be assessed on a “case-by-case basis.â€

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Another Riverside County resident who was evacuated from the Diamond Princess cruise ship off Japan and then quarantined at Travis Air Force Base previously tested positive for the virus. That person is continuing to recover in a Northern California hospital and has not returned to Riverside County since leaving the cruise ship, the statement said.

Also on Sunday, Contra Costa County announced five new cases of COVID-19, four of which had no known history of travel outside the U.S. or contact with a confirmed case. Those four residents were hospitalized, Contra Costa Health Services said in a news release.

The fifth person had close contact with another person who previously tested positive for COVID-19 and is isolating at home, officials said.

Times staff writers David Lauter, in Washington, Richard Read, in Seattle, and Karen Kaplan contributed to this report.

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