14 Sick on Second Cruise Ship Used to Evacuate Seemingly Healthy Passengers from Earlier Outbreak

Four people have died and 233 are ill with coronavirus-like symptoms aboard two Holland America cruise ships making their way to Ft. Lauderdale.

The MS Zaandam, which had been stranded off the coast of Panama with 189 sick passengers and crew on board as of Monday, met up with another ship, the MS Rotterdam, in order to transfer asymptomatic passengers to the new boat. Those making the switch underwent a health screening before boarding.

Since the transfer, however, 14 people aboard the Rotterdam have begun showing coronavirus symptoms as well, according to a statement issued by Holland America on Wednesday.

On Monday, Holland America confirmed that two people on the Zaandam out of an undisclosed number tested had been confirmed to have the novel coronavirus (COVID-19).

It’s unclear if the four “older guests” who died had been tested for the virus.

“Our thoughts and prayers are with their families and we are doing everything we can to support them during this difficult time,” the company said in an earlier statement.

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The Zaandam set sail from Buenos Aires on March 7, days before Holland America, which is part of the Carnival Corporation, suspended all sailings for 30 days on March 13. Its voyage was intended to end in San Antonio, Chile on March 21.

After March 13, all ships currently at sea were ordered home by the company and the Zaandam began looking for “an expedient and safe port” from which it could fly the 1,243 passengers on board home, a spokesperson tells people.

However, “as the ship proceeded north, port options became more limited due to the continued port closures and travel restrictions surrounding COVID-19,” the spokesperson added. “San Antonio was closed for disembarkation as well as all Chilean ports.”

No passengers had left the boat since March 14, when it made a planned stop in Punta Arenas in far southern Chile.

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The second ship, the MS Rotterdam, met the Zaandam off shore on Thursday evening to deliver medical supplies, including coronavirus tests, and begin to transfer some asymptomatic passengers to the new, empty ship.

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Luis Acosta/Getty The MS Rotterdam meets the MS Zaandam off the coast of Panama.

Holland America stated at the time that this would be done “with strict protocols for this process developed in conjunction with the U.S. Centers for Disease Control and Prevention,” Priority was given to passengers over the age of 70 and those who were staying in interior staterooms.

Members of Panama’s Aeronaval National Service were also seen heading off shore to assist the two ships.

Luis Acosta/Getty Members of Panama’s Aeronaval National Service head for the Zaandam to deliver supplies.

Any passenger who is ill or has been in contact with someone who is ill, as well as all crew stayed aboard the Zaandam. There are also four doctors and four nurses on the ship.

The vessels needed to make an unplanned passage through the Panama Canal, which caused further delay. But both have now passed and are en route to Florida.

Holland America operates 14 ships on voyages on all seven continents. President Orlando Ashford said of the decision to cancel cruises on March 14, “We thank all of our guests, travel advisor partners, employees and business partners for their support during this challenging time. We look forward to welcoming our guests back on board soon.”

Since the beginning of the global spread of COVID-19, several cruise ships have seen severe — and deadly — outbreaks of the virus.

The Diamond Princess cruise ship, was quarantined off Yokohama, Japan, for weeks in February with sick passengers on board. A total of 621 people eventually tested positive. According to Reuters, seven former passengers have now died. Some of the infected passengers from that ship have since become among the first to take part in a coronavirus drug trial.

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A second ship, the Grand Princess, was quarantined off San Francisco after 21 people on board tested positive for the illness in March. That ship has since docked in the port of Oakland and those on board have been placed in quarantine on land.

A few days before most major cruise lines made the call to suspend voyages, the U.S. State Department issued a warning that U.S. citizens “should not travel by cruise ship” during the coronavirus outbreak, noting that the “cruise ship environment” can foster an “increased risk of infection.” The CDC issued a similar statement.

“Cruise ships are incubators,” according to infectious disease expert Dr. William Haseltine. “Everybody’s close together, packed in all the time. One person gets sick, a lot of them get sick. It’s a very unfavorable environment for disease transmission.”

As information about the coronavirus pandemic rapidly changes, PEOPLE is committed to providing the most recent data in our coverage. Some of the information in this story may have changed after publication. For the latest on COVID-19, readers are encouraged to use online resources from CDC, WHO, and local public health departments and visit our coronavirus hub.