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U.S. State Dept. will evacuate American citizens...

BREAKING
Fear and Boredom Aboard the Quarantined Coronavirus Cruise Ship
U.S. State Department to evacuate Americans and their families aboard the Diamond Princess
About 380 people will be offered seats on two evacuation flights from Japan back to the U.S. - CDC official
Some may quarantine at Travis Air Force Base in California, while others may be transferred to Lackland Air Force Base in Texas
TOKYO—The pools, hot tubs and bars of the Diamond Princess emptied out on Feb. 5, when authorities quarantined the luxury cruise ship at a Yokohama dock. Instead of overflowing buffets, staff in surgical masks deliver boxed meals and snacks, about 11,000 a day.
Life has taken a turn for the nearly 3,500 passengers and crew aboard the $500 million vessel who entered a second week under quarantine for the coronavirus disease.
“I can’t wrap my head around the fact that I could die from this cruise,” said Gay Courter, a 75-year-old American novelist confined to a cabin with her husband. “I go look outside and there’s people in white hazmat suits.”
The only trips ashore are for those infected with the coronavirus, 218 so far, or people with other serious ailments. Of the disembarked passengers sick with the virus, eight are in serious condition, authorities said. Outside of China, the biggest outbreak is on the Diamond Princess.
The nearly 2,400 passengers who remain are largely trapped in their cabins. Health workers in masks and body suits knock on doors to ask selected passengers, including the elderly, to open wide for a throat swab. Used bedsheets and towels go into bags for incineration.
Anxiety and boredom appear the most common symptoms aboard what amounts to a floating petri dish. Aun Na Tan, of Melbourne, Australia, her husband, a 19-year-old son, and a daughter, 16, are stuck in a windowless cabin with two bunk beds. While the teens practice handstands, Ms. Tan said, “my husband is trying to learn.”
Shipboard entertainers have been assigned to record trivia quiz shows and origami-making for passengers to join along on cabin TVs. The magician recorded a performance, and a room steward demonstrated how to make a bed.
Coralie Williamson, 57, and her husband, Paul Williamson, 62, from Queensland, Australia, take turns reading from a book they brought, “The Resilience Project: Finding Happiness Through Gratitude, Empathy and Mindfulness.”
The couple had booked passage with a last-minute deal: A 250-square-foot cabin with a balcony was marked down to about $1,240 for the 15-day cruise that started in Yokohama, traveled south toward Vietnam and returned.
Their shared book, by Hugh van Cuylenburg, a former volunteer teacher in India, recounts the optimistic attitude among his underprivileged students. “It is helping us stay positive and express gratitude,” Mrs. Williamson said.
Ellis Vincent, a 76-year-old retired airline executive from Sydney, Australia, said he has spent more time than customary conversing with his wife while cooped up inside. She has an excellent memory, he said: “She is able to bring up every transgression I’ve ever had. I believe she is not finished.”
The operator of Diamond Princess, Princess Cruises, told passengers they would be refunded for the trip. Jan Swartz, the president of Princess Cruises, said last week the company was working closely with health authorities.
The shipboard contagion offers an opportunity to study the virus, said Michael Ryan, executive director of the World Health Organization’s Health Emergencies Program. He also acknowledged Thursday that “it’s a difficult thing for anybody to live in a closed environment like that.”
Japanese authorities on Friday arranged for 11 passengers to leave the ship and stay in government housing until the scheduled end of the ship’s two-week quarantine on Feb. 19. The passengers allowed to disembark were 80 and older and had met other conditions, including testing negative for the virus.
The total of laboratory-confirmed cases of the coronavirus, named Covid-19, reached 64,437 in China and 24 other countries. There have been 1,384 deaths, all but three in China. The U.S. confirmed its 15th case on Thursday.
Anxiety on the Diamond Princess over who will be next also infects the ship’s crew. Some were diagnosed with the virus and taken to hospitals. Those working received thermometers and were instructed to remain in their room if they had a fever. They were also given hand sanitizer, masks and gloves.
One waitress who had been delivering box meals sought help after she got a cough. “I realized it’s better to test for the virus,” the woman said. She tested positive and was taken to a hospital this week.
A waiter from Mumbai who worked with the woman was worried. “I feel like slowly the whole ship will be testing positive,” he said.
SET SAIL
When the Diamond Princess set off from Yokohama on Jan. 20, there weren’t widespread worries about the virus. In Wuhan, the Chinese provincial capital at the center of the outbreak, people went about their workaday lives.
Passengers aboard the 116,000-ton ship, operated by Princess Cruises, expected nothing less than a pleasant East Asia trip, including stops in Hong Kong and the isles of Vietnam’s Ha Long Bay.
A day before embarking, an 80-year-old man from Hong Kong developed a cough. He had crossed into mainland China’s Guangdong province 10 days earlier. Hong Kong health officials said he boarded the ship with two daughters and visited the ship’s sauna and restaurants.
The news gave passengers their first inkling of how serious a turn the virus had taken. The Hong Kong man, whose name hasn’t been released by authorities, left the ship early and, five days later, he went to the hospital.
During a shore excursion, a stranger at a Hong Kong subway station stopped Mrs. Williamson and suggested she wear a medical mask. “It got me worried,” she said. Mrs. Williamson and her husband looked but couldn’t find any in nearby stores.
Cruise passengers walked onto a disinfectant mat, then went through a thermal-imaging camera to detect higher-than-normal temperatures. People suspected of having a fever were pulled aside and asked if they had recently been to China. The new inspection procedure caused hours of delay.
The mood among passengers soon turned from impatience to worry. “People started hearing that an older person had disembarked and had tested positive,” said Rebecca Frasure, 35, from Forest Grove, Ore. “People started to think, ‘Wow, this is a big deal.’ ”
Mr. Vincent, the retired airline executive, had hoped to visit the site of the World War II Battle of Okinawa. He and his wife, he said, “ended up going to the quarantine hall and turning right around and getting back on the ship.”
Late that day, Hong Kong’s health authority announced that the 80-year-old Hong Kong man who left the cruise early had the coronavirus disease.
Japanese officials said a formal notification didn’t arrive until the next day, Feb. 2. If it had come earlier, the Diamond Princess might have been refused entry to Japan, said Kenichi Hoshino, a health ministry official. Another cruise ship, the Westerdam, headed for Japan later that week was denied access and stayed at sea until receiving permission to dock Thursday in Cambodia.
From Okinawa, the Diamond Princess, with 2,666 passengers and 1,045 crew, headed for Yokohama and another immigration inspection. Ship passengers said they didn’t get any special precautions on the last leg of the trip.
OPEN BAR
Diamond Princess revelers crowded the captain’s farewell cocktail hour after sunset on Feb. 2. They drank free beer and wine in the ship’s atrium, which rose three decks. Guests filled seats in the Princess Theater for a production of the musical “Bravo.” Lines of diners stretched past buffet tables.
Kazunori Oishi, who formerly headed infectious-disease surveillance at Japan’s National Institute of Infectious Diseases, said it was a ripe environment for the virus to spread. Delays in recognizing the danger “created a lot of occasions for close contact,” said Dr. Oishi, especially the eating, drinking and conviviality that is common in the close confines of a cruise ship.
On the evening of Feb. 3, the Diamond Princess arrived in Tokyo Bay. Japanese health officials met the ship. They took the temperature of passengers and later collected throat swabs from those suspected of having the virus.
The next day, Feb. 4, passengers mingled without restrictions or warnings, said Mr. Vincent, the retired airline executive. “We could eat where we want, we could go where we want.”
Early the next morning, everything changed. Around 6:30 a.m. a captain’s announcement startled passengers. He ordered them to stay in their cabins. Shortly after, he said that 10 people had tested positive for the virus. Then he announced that everyone on board was under quarantine for two weeks. The only exception was one nobody wanted: a positive test for the virus.
Quarantine officers first entered the ship without full body suits, and one contracted the virus.
Over the following days, dozens of people a day tested positive. A parade of ambulances ferried them to hospitals. As fear spread, some passengers called for everyone on board to be tested. Japan rejected the request, citing logistical hurdles.
With many elderly people under stress, other medical problems emerged. Mr. Vincent’s wife, Kimberly Vincent, 73, learned that a friend on the ship suffered a stroke and was taken to a hospital.
Tadashi Chida, a retired university professor in his 70s, organized an impromptu group, the Emergency Support Network for Those Living Under Quarantine on the Diamond Princess. The group submitted two sheets of handwritten demands to a health ministry official aboard the Diamond Princess.
Among other things, they asked for faster refills for people who were running out of their medical prescriptions. They also asked for clean sheets. Both demands were met a few days later. More than 100 doctors, pharmacists and nurses are now on the Diamond Princess every day.
Passengers have since been allowed stroll the deck for an hour in limited groups. They have been told to stay at least 6 feet from others.
Mrs. Williamson said she and her husband weren’t interested. “We’d rather stay in our cabins and exercise and not expose ourselves,” she said.
Meals are still being prepared on the ship. When the food arrives, the Williamsons have to put on a protective mask before opening the door. “Every time service comes around, we say, ‘Wait, wait, wait,’ and go to put on our mask,” Mrs. Williamson said.
Kent Frasure’s wife, Rebecca Frasure, was among 41 people on board diagnosed with the virus on Feb. 7. She remains in an isolation ward of a Tokyo hospital. Mr. Frasure, 42, has tested negative. He is anxious for the couple to be reunited and worries the quarantine may stretch longer than two weeks.
“If this goes past Feb. 19, there will be panic, Mr. Frasure said. “Then it will be, ‘Are we ever going to get off the boat?’ ”
Not all shipboard amenities have disappeared. The Valentine’s Day box dinner included teriyaki shrimp and heart-shaped chocolate mousse.
“The pastry chef is my hero,” said Mrs. Courter, the American novelist on board. “I think he thinks he can sedate us with chocolate, which, you know, is not a crazy idea.”
Miho Inada, Rachel Yeo and Betsy McKay contributed to this article. 
Graphics by Roque Ruiz and Elbert Wang.