'Never-ending nightmare': Evacuated Americans carried virus from cruise ship to airplane

TOKYO — The ground rules were clear. A day before 328 Americans were to be whisked away from a contaminated cruise ship in Japan, the U.S. Embassy in Tokyo told passengers that no one infected with the coronavirus would be allowed to board charter flights to the United States.

But as the evacuees began filing onto reconfigured cargo planes early Monday for departures to military bases in California or Texas, some noticed a tented area in one of them that was separate from the rest of the cabin.

Then reality hit: After 12 days stuck on the cruise ship as more and more people tested positive for the virus, they would now be sharing a plane with those carrying the same pathogen they were desperate to escape.

“I didn’t know until we were in the air,” said Carol Montgomery, 67, a retired administrative assistant from San Clemente, California. “I saw an area of plastic sheeting and tape.”

While the planes were aloft, the State Department and the Department of Health and Human Services said in a joint statement that the results for 14 passengers who had been tested two or three days earlier came back positive just as they were boarding buses to the airport. After consultations with health experts, the U.S. government decided to let the infected evacuees, who were not yet exhibiting symptoms, board the flights.

The reversal was the latest chaotic turn in a two-week quarantine of the ship that has become an epidemiological nightmare.

Even as the Americans were flying home and countries like Australia, Canada and South Korea were preparing to evacuate their own citizens, the Japanese Health Ministry announced Monday that 99 more cases had been confirmed on the cruise ship, bringing the total to 454.


Among them was the third Japanese public health official to contract the virus while tending to passengers and crew members aboard the ship, the Diamond Princess.

The unstinting rise in infections raised questions about how Japanese authorities would handle the offloading of passengers in two days when the quarantine period is supposed to end. Health officials have already raised the possibility that the quarantine could be extended for some passengers.

“The quarantine on the ship ended up being an unprecedented failure,” said Eiji Kusumi, a doctor specializing in infectious diseases at Navitas Clinic in Tokyo. “We should learn from this lesson that a quarantine on a ship is impossible, and we should not repeat this in the future.”

U.S. authorities had strongly encouraged American passengers to accept the offer of a flight out. Getting them off the ship took several hours as they were screened, their passports were checked, and they were loaded onto buses that took them from the port of Yokohama to Haneda Airport in Tokyo.

The State Department said the infected passengers “were moved in the most expeditious and safe manner to a specialized containment area on the evacuation aircraft to isolate them in accordance with standard protocols.”

The U.S. passengers were taken to either Travis Air Force Base in California or Joint Base San Antonio in Texas, and they will remain under quarantine for an additional 14 days.

When one of the planes landed in California, a line of officials from the military, the Centers for Disease Control and Prevention, and the Department of Homeland Security welcomed the passengers with banners that read “Welcome home.”

After being ushered through an isolation tent, they were assigned to apartments on the base.

“They have flown in specialists from across the country,” said Sarah Arana, 52, a medical social worker from Paso Robles, California. “It’s a phenomenal amount of resources. I’m kind of blown away.”

Epidemiologists said U.S. officials had made a difficult decision to allow infected passengers onboard the charter flights.

“The degree of difficulty in getting someone sick home is much greater than repatriating people who are otherwise well and possibly incubating,” said Dr. Allen Cheng, an infectious disease specialist at Monash University in Melbourne, Australia.

Cheng added, “You don’t want to expose anyone on the plane who hadn’t otherwise been exposed before on the boat.”

Australia is planning to take approximately 200 passengers off the Diamond Princess on Wednesday. Cheng said that Australia had decided that “anyone who is sick or becomes sick in the next 48 hours will stay in Japan and stay in the hospital.”

With Australia and other countries preparing to help transport their citizens off the boat, the captain told the more than 2,000 people still on board that Japanese health authorities could swab everyone for the coronavirus by the end of Monday and begin letting guests leave the ship Wednesday.

“This disembarkation will be an ongoing process” until Feb. 22, the captain said in an onboard announcement.

The captain said the cruise line was “coordinating closely with your embassies to understand the arrangements for you once you are cleared from the quarantine on the Diamond Princess and how we can best support you.”

In a briefing Monday, Shigeru Omi, president of the Japan Community Healthcare Organization, said that Japan had made the right decision to put the ship in quarantine based on the information available when the ship arrived in Yokohama on Feb. 3.

“At that time, the international community was trying to contain the virus,” Omi said.

According to the Japanese Health Ministry, at least 55 Americans on the ship were infected with the coronavirus. Many of them remain in hospitals around Japan.

John Haering, 63, a retired operations manager for Union Pacific Railroad who lives in Tooele, Utah, was taken to a hospital in Chiba prefecture last week with a fever and tested positive for the virus. He said he felt stranded as he lay in an isolation room.

His wife, Melanie, left on one of the charter flights.

“I’m happy for her that she got out of here and that she’s going to get some attention in the U.S.,” said John Haering, who retired in November and was about a third of the way through a six-month trip around the world. “But at the same time I’m sad. You feel that loss of somebody leaving.”

Haering, who said that he no longer had any symptoms or a fever but that a CT scan showed signs of pneumonia, said he was not sure how much longer he would have to stay.

“They did swab me today again, and I’ll get my test back tomorrow,” he said. “I asked the doctor if the swab shows that I’m negative, and he just shook his head and said, ‘I don’t know.’ There’s a lot of stuff that they don’t know.”

Haering said he had not heard from anyone at Princess Cruises, the company that operates the Diamond Princess, since he arrived at the hospital. Until Sunday, he had not heard from anyone at the U.S. Embassy in Tokyo, either.

He received a call and a follow-up email urging him to get in touch with the cruise ship company for further information about how he will get home.

“It’s very scary,” he said. “It feels like a little bit of abandonment.”

The spread of the virus on the ship was illustrated by one extended family.

Tung Pi Lee, 79, a retired physician, was left in a Tokyo hospital with a coronavirus infection while his wife, Angela, flew to California on one of the charter flights. Several of her siblings and their spouses were among the 14 infected passengers who flew home. Two were taken to Nebraska, and another was in California for treatment.

“I am glad for my aunts and uncles to be in the U.S. and to be receiving treatment here,” said JoAnn LaRoche Lee, one of Lee’s daughters. “Had they been left in Japan, I wonder what would have happened to them.”

Trying to coordinate her father’s care in Tokyo with her siblings in the United States, she said, “feels like a never-ending nightmare.”

2020 The New York Times Company

New York state bans flavored e-cigarettes over vaping concerns

NEW YORK - New York became the second US state to ban flavored e-cigarettes Tuesday, following several vaping-linked deaths that have raised fears about a product long promoted as less harmful than smoking.

A health council passed emergency legislation proposed by Governor Andrew Cuomo outlawing flavored vaping products amid an outbreak of severe pulmonary disease that has killed seven people and sickened hundreds.

The ban comes into force with immediate effect. Michigan became the first state to declare a ban earlier this month, but that law has yet to be implemented.

"It is undeniable that vaping companies are deliberately using flavors like bubblegum, Captain Crunch and cotton candy to get young people hooked on e-cigarettes -- it's a public health crisis and it ends today," said Cuomo.

President Donald Trump's administration announced last week that it would soon ban flavored e-cigarette products to stem a rising tide of youth users.

The move could later be extended to an outright prohibition of vaping if adolescents migrate to tobacco flavors, seen as more legitimate products that help smokers quit their habit, said the Food and Drug Administration (FDA), which regulates e-cigarettes.

"New York is not waiting for the federal government to act, and by banning flavored e-cigarettes we are safeguarding the public health and helping prevent countless young people from forming costly, unhealthy and potentially deadly life-long habits," Cuomo added.

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Shops in New York now have two weeks to remove vaping products from their shelves. The ban does not prohibit menthol or tobacco-flavored e-cigarettes.

E-cigarettes have been available in the US since 2006 and are sometimes used as an aid to quit smoking traditional tobacco products like cigarettes.

Their use among adolescents has skyrocketed in recent years: some 3.6 million middle and high school students used vaping products in 2018, an increase of 1.5 million on the year before.

The Centers for Disease Control and Prevention (CDC) recently that there were now more than 450 possible cases of pulmonary illness associated with vaping in the US.

The CDC has cautioned against vaping as officials investigate the precise cause of the deaths. No single substance has been found to be present in all the laboratory samples being examined.

New York's health department found very high levels of vitamin E oil in cannabis cartridges used by dozens of people in the state who had fallen ill after using e-cigarettes.

Vitamin E is a commonly used nutritional supplement but is dangerous when inhaled.

San Francisco, the home of market leader Juul Labs, became the first American city to ban e-cigarettes in June last year.

The FDA has warned Juul to stop advertising itself as a less harmful alternative to smoking, noting in particular the company's attempts to attract young people.

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source: news.abs-cbn.com

How grocery lists may help lower body weight

Heading to the grocery store armed with a list may make it easier to follow a healthy diet, a study of shoppers in Pittsburgh suggests.

Researchers surveyed more than 1,300 mostly overweight and obese residents in two poor, primarily African American communities and found that shoppers who regularly made grocery lists also made higher quality food choices and had lower body weights.

"We don't know whether people who are healthier pay more attention to what they eat and pay more attention to their weight and are also people who do more planning, or if people who do more planning are more able to avoid impulse purchases and the less healthy options presented to them at the supermarket," lead study author Tamara Dubowitz said.

"We can say there is a link but we can't say what causes it," Dubowitz, a researcher at RAND Corporation in Pittsburgh, told Reuters Health.

More than one-third of U.S. adults are obese, putting them at increased risk of heart disease, stroke, type 2 diabetes and certain cancers, according to the Centers for Disease Control and Prevention. Among all adults nationwide, nearly half of African-Americans and more than 40 percent of Hispanics are obese, as are about a third of Caucasians.

While many factors can contribute to obesity, poverty and lack of quality grocery stores close to home are two important contributors, Dubowitz said.

Dubowitz and colleagues surveyed a population with 80 percent of participants reporting household income of less than $20,000 a year. Just 33 percent were employed. They lived in what's known as a food desert, an area with limited access to healthy foods.

Just under one third of the participants said they “always” shopped with a grocery list, while another 17 percent did so often and 26 percent did so occasionally.

People who used grocery lists all the time were more likely to be female and older, less likely to be employed, and more likely to be trying to eat fewer calories.

After controlling for these factors, the researchers found that dietary quality remained significantly higher among participants who always shopped with a list.

The study team also weighed participants and measured their heights to calculate body mass index (BMI), a ratio of weight to height. A BMI between 18.5 and 24.9 is considered healthy weight, 25 to 29.9 is considered overweight and 30 or above is obese.

Using a shopping list was also associated with having a BMI about one point lower compared to people who didn’t use lists. That amounts to a weight difference of about five pounds for somebody whose height is 5' 5" (1.65 meters).

The researchers acknowledge in the Journal of Nutrition Education and Behavior that the study isn't designed to show shopping lists cause people to be healthier, only that there is a link between the two.

They are also following residents over a longer period of time to see if the opening of a new grocery store in the community changes people's dietary habits or makes a dent in obesity rates, Dubowitz said.

"Shoppers don't have control over the availability of healthy produce or their pricing; those problems will require structural interventions to fix them such as attracting grocery stores to move into food deserts," Dr. Ichiro Kawachi, chair of social and behavioral sciences at Harvard School of Public Health in Boston, said by email.

Given the lack of groceries and other structural problems encountered by the study participants, the findings "suggest that there are things that people can do for themselves" to pursue healthy eating habits, said Kawachi, who wasn't involved in the study.

It's possible that some things people did to eat healthier food and maintain a lower weight had nothing to do with shopping lists, said Dr. Jason Block, associate director of the obesity prevention program in the department of population medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute.

He noted that the modest one-point difference in BMI linked to grocery lists makes it more likely that some other behavior not measured in the study may have explained the change.

"It's quite likely that using a list is a behavior linked to other healthful behaviors," Block, who wasn't involved in the study, said by email.

Still, it points to the power of advance planning to help improve impulse control, Kawachi said.

"The typical supermarket these days is carefully engineered so that they are constantly tempting customers to make impulse purchases and unwise food choices (e.g. placing candies at the checkout)," Kawachi said. "Having a plan and sticking to it is a good start to pre-committing yourself to a healthy purchase pattern."

source: www.abs-cbnnews.com

Measles threat looms over Super Bowl weekend

REDWOOD CITY, California - A measles outbreak that started in Disney parks in Southern California in December has now spread to Arizona where it could threaten this weekend’s Super Bowl festivities.

Health officials there say about a thousand people in the Phoenix area, including 200 children, could have been exposed to measles at a medical center that was visited by one of the states’ eight confirmed measles patients.

It’s a major health concern that comes just days before millions of Seattle Seahawks and New England Patriots fans descend upon Phoenix for the Super Bowl.

Elsewhere, at least 79 cases of measles are now confirmed in California.

Cases linked to the outbreak have also been found in Mexico, Utah, Washington, Colorado, Oregon, Michigan, and Nebraska.

New cases were reported this week in Illinois and Minnesota.

“We’re concerned because it can be a very, very serious disease. It can, not in most instances, not in the vast majority, but it can be fatal, because you can get severe complications from the actual viral illness itself — developing a pneumonia, neurological complications, heart complications, etc.," explained Dr. Rachel Rubin of Cook County Department of Health.

According to doctors, measles outbreaks have worsened in recent years, partly because of a growing movement by parents who choose not to vaccinate their children, citing personal beliefs.

Last year, there were 644 confirmed measles cases in the country. It’s the highest number of cases since the highly contagious disease was eliminated in the US 14 years ago.

The Centers for Disease Control and Prevention linked many of those measles cases to unvaccinated people who were infected while traveling in the Philippines during an outbreak there.

Doctors in Phoenix ask those who have not been vaccinated against measles to stay home for 21 days or wear masks if they have to go out in public.

Read more from Balitang America.

source: www.abs-cbnnews.com