Diamond Princess update from a specialist of infectious diseases at Kobe University Hospital



Hello my name is professor Kentaro Iwata I am a specialist of infectious diseases at Kobe University Hospital, Kobe Japan.

Today I entered into the cruise ship Diamond Princess which is bombarded by a-lot of COVID 19 infection right now and I was removed from the ship on the same day and I’m going to talk to you why this happened.

I was very concerned of the number of the people who got infected with COVID 19 disease infections. Then I was wondering why this is happening, I wanted to enter into the cruise ship and wanted to be useful in helping to containing infection there I spoke with several people and finally the one officer at working for Ministry of Health and Labor called me yesterday saying that well you can come and enter into a cruise ship and do the infection control work and I said fine, then I prepared my stuff and I did all the paperwork’s and arrangement and they got in onto the Shinkansen? from Kobe to Yokohama all the way to go to Yokohama

I got another call from the same officer say that somebody didn’t like me so do you can’t get into the cruise ship. He was not able to say who and he was not able to say why but certainly some power over him affected his decision and I was blocked from entering into the ship then after several discussions he found another way that if you could come as a DMAT team member you can come in at into the cruise ship. DMAT is the disaster management medical team in Japan and usually deals with disaster not infectious diseases but because of the lack of the people who could help people inside a cruise ship to get out of the ship or the managing of people and the swan song DMAT was requested to enter in the cruise ship because my specialty is not a disaster management

So I was not very happy about that, but because we have no other way I said fine I’ll do that. Additionally I got another call that some people didn’t like me getting into the cruise ship present even as a DMAT member. Another discussion happened then the I waited about our one hour in shin-yokohama sessions and finally the officer find a way that if you work for DMAT not as an infection prevention specialist, but as the ordinary routine Diamond officer working under wounded team at doctor doing a routine job then you could come into the cruise ship.

I was not very happy with that decision but because there’s no other way so I said finding out get into the ship I entered the ship then I found the chief officer of the DMAT and spoke with him I said well I was assigned to the DMAT members or the out whatever you want to say they hes well you don’t have to work team DMAT work because that’s not your specialty and you are an infection prevention specialist so why don’t you do the infection control then I said fine

I spoke with the superior of him who is in charge of the DMAT operations and he also said that you are infection control person so you should do infection control I said fine but he said well you shouldn’t be here as a DMAT member you should come as the along to infection control specialist he was not very happy about while I was inside a DMAT but because that was not my decision there was no other way so he I said well I have to do it

I looked into the several places inside the ship and the turned out that the cruise ship was completely inadequate in terms of the infection control there was no distinction between the Green Zone which is the free of infection and the Red Zone which is potentially contaminated by virus.

So the people could come and go wearing a PPE of PPE crews were just walking around and the officers of ministry the health and the labor was walking around, DMAT people are walking around, psychiatrists are walking around, and people were eating in one place, people were wearing PPE and off PPE and eating lunch with their gloves on and just dealing with the smart phone with full PPE so it was completely chaotic and some crews had a fever they went to the medical center while wearing and N95 masks but he didn’t have any protection between his room and a medical room and the medical officer was not protecting herself and that she was very happy saying that well she was already infected I’m sure about that, so the she was completely giving up protecting herself anyways

I dealt with a lots of infections more than twenty years and I was in Africa dealing with the Ebola outbreak, I was in another country is dealing with the cholera outbreak I was in China in 2003 to deal with the SARS, and I saw many febrile patient there. I never had fear of getting infection myself, for Ebola, SARS, cholera because I know how to protect myself and how to protect others and how the infection control should be.

So I could do the adequate infection control protect myself and protect others. but inside Princess Diamond I was so scared, I was so scared of getting COVID-19 because there was no way to tell where the virus is. No green zone no red zone everywhere could have Virus and everybody was not careful about it. There was no single professional infection control person inside the ship and that there was nobody in charge of infection prevention as a professional.

The bureaucrats were in charge of everything and I spoke with the head officer of the Ministry of Health on labor and he was very unhappy with my suggestion of protecting DMAT people and other staffs so that no other secondary transmission to occur then after several hours of talking to people and finding problems I found a lot of issues there for example informed consent of getting a PCR from the people in the ship was on a paper and that paper was going back and forth back and forth with the room of the infection from the paper by touching there.

So I suggested that maybe it’s better to abandon the paper type informed consent but resolutely getting the informed consent probably would be more protective so on so on so yeah I, I think I was reasonable, and I never yell at anybody, and I never criticize anybody personally, but I was trying to be constructive but we try to seek the constructive but immediate improvement to protect everybody inside the ship

Then about five o’clock the person from the quarantine office came in and approached said well you have to be out because you will not be allowed to inside of ship because I was inside ship as the temporary officer of the quarantine that he apparently my my rank was removed by somebody and then nobody said who that the I was out. And the officer who offered me the job of infection control said he was sorry then I asked him so what do you want to do then do you want to infect everybody in the ship? it will be your thousands of people who could potentially get COVID-19.

I don’ t criticize DMAT people they were not infection control specialists, Society of infection prevention entered the, a lot of specialists came in but they spend only a few days and to left. And they said they were fearful of getting infections themselves. I share the same fear because I’m in the same room now and I separated from my family I’m very scared of getting infection myself and I’m very scared of infecting my family too.

I’ll be out of my medical services at Culver University Hospital for maybe next two weeks to avoid further infections to occur that is very likely to occur if you keep zero infection control inside the ship that brings us like this.

You might know that there is no CDC in Japan but I thought there must be some specialists called on and was in charge of infection control in ship it’s not expecting nobody was professional infection control specialist and the only the bureaucrats were doing the jobs completely layman’s work in the violating all the infection control principles and the risking people inside further infections so I’m not very surprised to see many new positive PCR’s to be broadcasted every day hundreds of people got infected and the lot of people from outside Japan decided to take the people away from the ship and bring them to their home countries by airplane and offered them another 14 days of quarantine. I hope this will be the opportunity to raise a question what is happening inside ship.

I wish all the international bodies to request Japan to change. I wish everybody to call for protection of people inside the Diamond Princess. Otherwise there will be far more infections for passengers for crews for Diamond members for psychiatrist for officer of the Ministry of Health and labor DMAT member consists of nurses and doctors and that they will go back to the hospital they work routinely and it’s a much infected their patients further to spread and the disease.

I can’t bear with it, I can’t bear with it, I think we have to change we have to do something about these crews and we have to help people inside the ship their safety and their life.

Again I am professor Kentaro Iwata of infection this infectious disease specialist thank you for listening.