Two people have tested positive for coronavirus and four have died on the Zaandam luxury cruise liner

Passengers on a cruise ship stranded off the coast of Panama have issued a desperate plea to be allowed to dock after four people died during a covid-19 outbreak on board.

Two people have tested positive for the disease and dozens are ill with flu-like symptoms on the Zaandam luxury cruise liner, which has not been able to dock after several Latin American countries closed their ports in response to the global pandemic.

Hundreds of North American, Australian and British citizens are in isolation in their rooms and a boat-to-boat operation is underway to move some healthy travellers to a sister ship, the Rotterdam, over the weekend.

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But there are fears that sick, elderly passengers and crew members will be left stranded at sea during a global pandemic, with some on board isolating in small, humid cabins with no natural light or fresh air.

Holland America Line, which owns the cruise ship, confirmed on Friday that four elderly passengers had died onboard. It is not clear whether they died after catching Covid-19.

“Unfortunately, four of our fellow guests have passed away – one last night, two yesterday and one a few days ago,” the ship’s captain Captain Jan Smit said in an announcement, which was obtained by The Guardian. “We are still seeing both guests and crew with symptoms reporting to the medical center. The situation continues to grow more challenging each day.”

Panamanian authorities have refused to let the Zaandam cruise liner pass through the canal in Central America to attempt dock in Fort Lauderdale, Florida. Chile and Argentina have also refused to let the cruise ship enter port, which departed Punta Arenas in Chile on 14 March.

Rick de Pinho, a passenger on the ship with his wife Wendy, told the Guardian: “Life on the boat took a serious turn when our captain asked us to return and stay in our cabins on March 22 around 2pm ship time.

“Meals were delivered three times a day and initially included hot meals but that seems to no longer be the case.”

“While we scraped together the pieces of information, no one was really prepared to learn that four had passed away. It’s one of those moments when you realise the severity of the situation. While we are holding up well I truly was bothered to see my wife’s eyes tearing up.”

Passenger Laura Gabaroni Huergo of Florida has been issuing pleas for government assistance for days from the cabin she’s sharing with her husband, but she said the bad news announced on the ship Friday left her speechless and fearful.

We’ve “not heard any details about where we go from here,” she said in a message to the Guardian. “We are waiting and hoping that all the parties involved will do the right thing, for both the ill and the healthy.”

Facebook Twitter Pinterest View of Holland America’s cruise ship Zaandam as it entered the Panama City bay. It’s being assisted by the Rotterdam cruise ship with supplies, personnel and COVID-19 testing devices, eight miles off the coast of Panama City. Photograph: Luis Acosta/AFP via Getty Images

Many on board the Zaandam have only been able to pass messages via Whatsapp or through family members due to poor internet connection. Before passengers are allowed to move to the Rotterdam, which brought supplies and Covid-19 test kits to the stranded boat, travellers are screened for illness but many are not passing the tests.

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“People are being screened on the basis of a medical questionnaire and if anyone has had a cough, cold, fever, runny nose, breathing problems, headaches or sore throat within the last 10 days, then they fail the medical. Lots of people are bound to have had non related coughs, colds, etc., during this time, so many are failing the medical,” one woman on board explained.

The wife of one of the 85 crew members in isolation with flu-like symptoms on the Zaandam expressed concerns about the conditions for staff.

“Those who are confined were quarantined in a five square metre cabin, given only three small pieces of bread and a small amount of cereals,” she said, adding there is a lack of water, fresh air and two people are confined to each cabin room.

The Guardian was also contacted by an NHS doctor whose mother and aunt are on the Zaandam, who was scared her loved ones were being left “stranded at sea” while she cared for people back in the UK.

“They are being left onboard scared and anxious. They have not stepped foot on land for over 2 weeks. My mum had an existing cough and for this reason she was refused on the rescue boat and kept on the ‘sick ship’ Zaandam. They are so close to land and just want to get home. Can someone not help them like I am helping others?” she told the Guardian.

The Zaandam, is just one of at least 10 ships stuck at sea as of Thursday-- carrying nearly 10,000 passengers – around the globe, after having been turned away from their destination ports in the face of the Covid-19 pandemic, a Guardian analysis of ship tracking data has found.

In a statement on Friday, Holland America Line said that once healthy passengers had been moved to the Rotterdam, the company planned to sail both cruise ships to Fort Lauderdale, Florida, keeping all passengers in isolation on both ships.

But when contacted by the Guardian, Broward County authorities in Florida said it had not yet received a formal request for docking from Holland America, nor has a plan been worked out with the federal and state health officials.

“It’s very scary,” said Broward County Commissioner Michael Udine Friday. “We are waiting for a plan to be presented to us.”

“I don’t believe that the Panama Canal people will let their employees get on a ship with coronavirus in order to get it through the canal,” he said. “It’s a sticky situation.”

He said, before the county commission could approve a docking in Fort Lauderdale “we would need to be sure that it is safe for the residents of South Florida”.

“Remember, we’re already a hotspot,” said Udine, noting that hospitals in Broward County are already filling up with Covid-19 patients and running short of medical supplies. “It would be difficult for us if 1500 people (potentially needing treatment) just got off the ship.”

In a statement, the Panama Canal said that all journeys through the system required their staff to board ships and restrictions on ships with Covid-19 outbreaks were in place to protect workers.

Panama is battling the largest outbreak in the region, with 786 cases and 14 deaths as of Friday.

The British Foreign Office said they are doing “all they can” to help citizens on board and are in close contact with the cruise operator and authorities in the region.