Four passengers have died on board a Holland America Line cruise ship currently sailing off the coast of Panama. Many other passengers on the ship have flu-like symptoms and two have tested positive for COVID-19.

A total of 247 Canadians are among the 1,243 passengers on the Zaandam, which is also carrying 586 crew members — one of whom is Canadian, according to Global Affairs Canada.

"Holland America Line can confirm that four older guests have passed away on Zaandam," the cruise line said in a statement. "Our thoughts and prayers are with their families, and we are doing everything we can to support them during this difficult time," said the cruise line.

None of the dead is a Canadian citizen.

Holland America — which first announced some of its passengers had fallen ill with "influenza-like symptoms" last Sunday — has since reported that 138 passengers and crew aboard the ship have sought medical care.

The cruise line didn't provide a cause of death for the four passengers but said that the ship tested a number of patients with respiratory symptoms for COVID-19 on Thursday, and two individuals tested positive.

'This is shocking'

CBC News spoke with several distraught Canadian passengers on board by a combination of phone, email and WhatsApp, as phone service from the ship was intermittent. Passengers are currently confined to their cabins and have been given face masks as a safety precaution.

"It really drives home how lethal this disease is," said passenger David Kirkham, of Victoria who believes the deaths are related to COVID-19.

"It's taken the lives of four people, and God knows how many more people it could take, because we have many people on board who are seniors, presumably others who have underlying health conditions."

Kirkham, 68, is travelling with his wife, Norma. She said the captain announced the news to passengers on Friday afternoon.

"We received very sad news," the 63-year-old said. "Four guests have died: one overnight, two yesterday and one the day before. This has hit us very hard … This is shocking."

Anna Joiner remains confined to her cabin with husband, Chris on board the Zaandam cruise ship. (submitted by Chris Joiner)

The news has frightened and surprised many Canadian passengers aboard the ship, which has been seeking a place to dock since cutting short its South American cruise on March 14 in a bid to allow passengers to fly home amid the growing COVID-19 pandemic.

"We are slowly losing hope that we will ever dock and get off this ship," said Chris Joiner, of Orleans, Ont. "We need the Canadian government to step up to the plate and help us."

Joiner, 59, said passengers continue to report to the ship's medical centre with symptoms.

"What's really hard on us now is the stress that we're under," he said. "We don't know what's going to happen next."

Joiner's wife, Anna, said she has developed a cold but was unable to get tested on board for COVID-19.

"We are in a Petri dish of sickness," said the 59-year-old.

A total of 247 Canadians are among the 1,243 passengers on the Zaandam, which also has 586 crew members. (Holland America Line)

Global Affairs Canada told CBC News that it's monitoring the situation.

"We continue to engage with the Panamanian government, and are working with Holland America on their plans to get passengers home," spokesperson Angela Savard said in an email.

No dock in sight

The Zaandam began its South American cruise on March 7 when the continent had very few COVID-19 cases. As the virus spread globally, the ship had initially planned to dock 11 days ago in Punta Arenas, Chile, to let passengers off early. However, the country refused to allow passengers to disembark.

The ship was hoping to secure passage through the Panama Canal in order to dock in Fort Lauderdale, Fla., by the end of the month.

However, in a statement this evening, the Panama Canal Authority said that the Zandaam can't enter the canal because passengers on board have tested positive for COVID-19, and canal officials must board ships transiting the canal.

Norma and David Kirkham, of Victoria, are shown during their cruise on the Zaandam before people started falling ill. (Submitted by Norma Kirkham)

"We don't know where we'll end up," said David Kirkham. "Who will want to take a ship that is sick, that has people dying on board?"

Holland America said it plans to transfer healthy passengers to its sister ship, the Rotterdam, which is currently with the Zaandam. Priority will be given to passengers over the age of 70 who have an inside cabin, the cruise line said.

Ill Passengers will remain in isolation on board the Zaandam.

No word yet if the Rotterdam will be allowed to pass through the canal.

Holland America is owned by Carnival Corporation, which also owns Princess Cruises. Since the COVID-19 pandemic began, three Princess cruise ships that are no longer at sea — the Diamond Princess, the Grand Princess and the Ruby Princess — have had coronavirus outbreaks.