In the wake of the state’s first coronavirus death Wednesday, an ill-fated Grand Princess cruise ship with sick people aboard is sailing toward San Francisco from Hawaii, carrying passengers who may have acquired the potentially deadly respiratory disease.

With 11 passengers and 10 crew members showing possible signs of the virus, the vessel will be delayed along the coast while health officials with the U.S. Centers for Disease Control fly tests to the ship and screen its passengers, Gov. Gavin Newsom said at a Wednesday press briefing. The ship was scheduled to arrive back in port Thursday.

“The ship will not come ashore until we appropriately assess the passengers,” Newsom said. The release plans for the sick and healthy passengers have not been revealed.

Newsom noted that more than half of the 2,500 passengers on board are Californians. He said getting everything in order before the ship returns is important “because we have a number of passengers and crew members who have developed symptoms.”

Two passengers who were on the ship’s previous trip that began in San Francisco on Feb. 11 and ended on Feb. 21 are confirmed to have been infected — and, on Wednesday, one became the first person in California to die from the disease. He was an elderly man with underlying health conditions who lived in the Placer County town of Rocklin. The other person, a friend of the dead man and a resident of Sonoma County, is hospitalized “in difficult condition,” according to Newsom. The cruise company urged anyone who develops symptoms to contact their doctor or hospital.

The vast majority of coronavirus cases are minor, involving mere cold-like symptoms to mild pneumonia. But the illness can be catastrophic for five percent of patients, particularly the elderly.

California declared a state of emergency on Thursday, boosting available resources, and is taking steps to trace contacts of the infected passengers. The Placer County resident was on a tour with others from San Francisco to Mexico and shared a shuttle to Sonoma County Airport in Santa Rosa after disembarking from the ship.

Concerned about contagion — and seeking to avoid a repeat of last month’s disastrous Diamond Princess cruise, where six people died and 705 were infected after inadequate protocols — the Grand Princess cancelled its planned final stop in Ensenada, Mexico.

The ill passengers and crew are isolated in their cabins. An estimated 50 to 60 of the ship’s current passengers and an unknown number of crew members were on the earlier leg of the cruise.

Life on the cruise is as elegant as always — but much has changed, said passenger Suzanne Suwanda, of Los Gatos.

The shared salt and pepper shakers have vanished, she said. Also gone are table menus, drink cards and touchscreen iPads in the corridors. Gloved hands present tea service. A pair of stylish stone sinks at the cafeteria’s entrance are tended by dutiful staff who request hand washing. Outside of restroom entrances, paper towels are dispensed for use with handles. Some gatherings have been cancelled.

“But we’re having a grand time,” said Suwanda, who is striving to stay healthy while enjoying scenic vistas of the vast blue sea.

“There’s nothing you can do. The ship keeps moving along,” she added. “But you realize that you’re all confined together, sharing railings, elevators and elevator buttons.

“The captain has been the voice you want to hear, telling us that our health and safety are his top priority,” she said.

The CDC website — which includes data through Tuesday afternoon — reported 80 U.S. cases, although some reports put that number above 120. Newsom said Wednesday that there are 54 cases in 12 counties in California.

Also on Wednesday, Santa Clara and Los Angeles counties announced a number of new cases of the virus.

In Santa Clara County, one man was hospitalized, with the transmission of the virus under investigation, and two men who had close contact with existing patients are isolating themselves at home. That brings the total number of cases in the county to 14, county health officials said in a news release.

Officials in Los Angeles also announced six new cases, all related to travel or contact with someone who had exposure to a confirmed case of the virus.The Associated Press reported that a medical screener at Los Angeles International Airport has tested positive.

Contra Costa County also reported its first case Tuesday.

The Placer County death brings the confirmed death toll in the U.S. to 11, with the other 10 coronavirus deaths reported in Washington state.

Officials with Placer County department of public health said they believe the victim “had minimal community exposure between returning from the cruise and arriving at the hospital by ambulance on Feb. 27,” the department said.

Ten Kaiser healthcare workers and five emergency workers were exposed to the victim before the person was put in isolation and are now quarantined, with no symptoms so far, the officials said. The City of Rocklin said in a news release Wednesday that three employees of its fire department were among the emergency workers exposed, but they were not showing symptoms.

In Sonoma County, health officials are trying to identify people in the community who had contact with the other sick passenger from the cruise before hospitalization, the county health department said.

The Grand Princess is the fifth cruise ship with coronavirus cases since the outbreak began in Wuhan, China, in December. Cruise ship travel presents a unique combination of health concerns, according to the CDC and other experts.

“Outbreaks on ships can be sustained for multiple voyages by transmission among crew members who remain onboard or by persistent environmental contamination,” the CDC states. Because ships are out at sea, there is limited access to specialized emergency medical care.

Miami-based attorney Jack Hickey of Hickey Law Firm, who represents people injured on cruise ships, agrees.

“Any enclosed building — whether a hotel, office or cruise ship — can contain viruses, bacteria and other things,” he said. “But you do have people from different backgrounds and places from all over the Earth who come together to go on a cruise. You are on the ship 24/7 for seven, ten, sometimes 14 days.”

Princess Cruises on Tuesday posted a notice to its website warning passengers that staff will be scanning passports to ensure anyone who has traveled from or through mainland China, Macau, Hong Kong, South Korea, Iran or lockdown areas within Lombardy and Veneto, Italy, within 14 days of the start of their cruise won’t be allowed to board.