On March 5, back when Arizona had only one active coronavirus case, James set off on a four-day Carnival Imagination cruise from Baja California with a group of friends from around the country. It was still over a week before the rush of canceled events, business closures, and suspended school year would set in.
When he got back, James had a hacking cough and felt unwell. A little over a week later, on March 17, James learned another passenger on the cruise had tested positive for COVID-19. (Phoenix New Times is withholding James' real name at his request to protect his privacy and personal health information).
James and his fellow Arizonans met up with other groups of friends for the cruise, including people from Utah, Washington, California, and Idaho. It was one of the Utah friends who tested positive; the person sent a group text to everyone to let them know. One day later, Carnival emailed its passengers informing them a guest had tested positive, an email shared with New Times shows.
"Dear Carnival Imagination Guest," the email began, addressing the 2,000-plus passengers from the March 5 cruise. "We have been informed by the U.S. Centers for Disease Control and Prevention (CDC) that a guest who traveled on board Carnival Imagination during the sailing of March 5-8, 2020 has been confirmed with a positive case of COVID-19."
The email went on to state that no guests reported symptoms of influenza-like illnesses when on the cruise, and no guests or crew members went to the Medical Center for influenza-like illnesses on that ship even after its next two cruises.
Around the world, cruise ships have been a hotspot for the 2019 novel coronavirus. On March 1, Carnival temporarily suspended operations of its Princess Cruise line following outbreaks on the ships Diamond Princess and Grand Princess. Ultimately, 700 passengers on the Diamond Princess cruise became infected with the virus; at least eight have died.
On April 9, the Centers for Disease Control and Prevention extended a "no sail order" from the month before, stating that cruise ships cannot board passengers until the U.S. Department of Health and Human Services declaration that COVID-19 is a public health emergency expires, or the CDC director rescinds the no-sail decision.
James knew he had come into close contact with the positive case from Utah — the two had sat next to each other at dinner for several hours. So, back in Arizona, he tried to get tested.
"I called a couple of different hospitals," James told New Times. "Most of them gave me the same number for the state health department. I called that and said I needed to be tested because I was sick and had come into contact with someone who tested positive."
James had symptoms of lower respiratory illness and had come into close contact with a confirmed COVID-19 patient. But the state health line told James he didn't need to get tested.
"They said my symptoms were not severe," James recalled. "But what if I'm a carrier? I could have been spreading it around without knowing."
James' roommate also contacted the Arizona Department of Health Services hotline. An operator told James' roommate that "there was no benefit in curbing the spread of the disease to test those, like my roommate, who were not elderly and otherwise healthy," the roommate told New Times.
The roommate called DHS again and said James met the testing criteria. After some back and forth, the operator said James qualified and she would pass his information along to the DHS. If the health agency thought he should be tested, they would call.
But the state never did.
Instead, James found out that he could get tested at a nearby Mayo Clinic. Two days later, on March 19, James was able to find out through private labs that he had tested negative for the virus.
James was relieved to learn he didn't have COVID-19 and had not potentially spread it to others after departing the cruise and resuming his normal life. But the state's refusal to test someone who met their own testing requirements leaves him wondering how many real infections in Arizona could have been prevented, he said.
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