Two elderly cruise ship passengers with coronavirus who were on Princess Cruises' Diamond Princess have died, according to Japan’s health ministry, the cruise line confirmed.

“Our hearts go out to the families, friends and all who are impacted by these losses," the company said in a statement provided by spokeswoman Alivia Owyoung Ender. "All of us at Princess Cruises, as well as the crew of the Diamond Princess, offer our sincere condolences.”

A health ministry official confirmed that the passengers had been previously hospitalized in serious condition and had existing chronic diseases. The official spoke anonymously, citing office protocol.

Johns Hopkins Center for Systems Science and Engineering, which has built a map of coronavirus data including cases, fatalities and recoveries, also cites two deaths from the Diamond Princess, which brings the total death toll from the virus in Japan to three. Per the data, 621 cases of the virus had been identified among the 3,711 quarantined passengers and crew, making the ship the site of the most infections outside of China; one Diamond Princess passenger has recovered.

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According to Japanese broadcast outlet, NHK, the two Japanese cruise passengers who died from the virus were an 87-year-old man and an 84-year-old woman.

The two passengers were taken to the hospital on Feb. 11 and 12, respectively, and each tested positive the day after they were admitted, Health Ministry official Masami Sakoi said. They are believed to have been infected before the ship was officially placed under quarantine on Feb. 5.

It was not immediately known why they were not tested earlier when they developed initial symptoms and consulted with the ship’s clinic, said Sakoi.

The Japanese Health Ministry also revealed Thursday that two more government officials became infected while lending clerical support to the quarantine effort on the Diamond Princess.

Four others associated with the quarantine – an official, a paramedic who carried an infected passenger, a Health Ministry worker and an emergency relief medical expert – have also been sickened.

The two deaths were the first on record of any of the people who tested positive on board. Those on board who tested positive over the course of the quarantine were taken off the ship and brought to hospitals for further evaluation and treatment.

Their deaths bring the Japanese count to three.

A Diamond Princess passenger who has been tweeting about the experience at @quarantinedondiamondpricess, shared a "wish for the frontline staff, on the ship and in hospitals, to have the resources they need."

Twitter user @theanhoe, a previous Diamond Princess passenger, expressed sympathy for the passengers and crew of the ill-fated cruise.

"My heart goes out to the crew and passengers of the #DiamondPrincess, have cruised twice on her and the crew have been nothing but lovely. Stay strong!"

Cases are still being diagnosed post-quarantine

Passengers began to return to land Wednesday after a two-week quarantine due to coronavirus on the Diamond Princess ship, which remains docked in Yokohama, Japan.

Approximately 600 guests disembarked on Wednesday and another several hundred guests were expected to be cleared to disembark on Thursday, according to a statement from Princess Cruises shared by Negin Kamali, director of public relations.

"We tested negative and will be leaving in a few hours," wrote @shannonvo. "Onward to the next phase of quarantine. At least we will be on land. Thank you for your thoughts and prayers!!"

Even as passengers make their way off the ship, some are still falling ill.

David Abel, the British passenger who likened the quarantined ship to a "floating prison" in a Facebook post earlier this month, revealed that he and his wife, who booked the cruise to celebrate their 50th wedding anniversary, both tested positive for COVID-19 and are hospitalized in Fujisawa, Japan.

"We arrived in lovely hospital a couple of hours ago. Taken by ambulance blues & twos the entire journey," he wrote. "Outside the hospital, I came over a bit weird and nearly passed out. Every pore on my body opened and i was wheelchaired to our room."

After a full health inspection, Abel said, "Now we know what’s going on. We both contracted a cold (unaware of) and it has not yet turned into pneumonia. (we do have coronavirus). Tomorrow the big tests commence. chest x-rays, ECG, chest scan, urine + more."

He added that once they complete treatment, they must test negative for two days, at which time, they will undergo a third round of exhaustive testing.

Despite his diagnosis, Abel sounded upbeat, writing, "We are both in the best place! They do know what they are doing."

Matt Smith, a passenger who has kept in touch with USA TODAY throughout the quarantine, was on solid ground around 1:20 p.m. local time Thursday. He and his wife, Katherine Codekas, had not yet heard of any passenger fatalities as a result of coronavirus.

The couple received their negative test results the night before on a form slipped into their state room, according to a tweet from Smith.

Although the ship's quarantine period was scheduled to end Wednesday, more than 100 American passengers on board will have to wait another two weeks to return home.

While 328 Americans had already evacuated the ship and are in quarantine in the U.S. – including 13who tested positive for the virus.Those individuals are under quarantine at the University of Nebraska Medical Center, officials told USA TODAY.

"Most of our guests aren’t showing symptoms of the disease, however several others are exhibiting minor symptoms," said Taylor Wilson, spokesperson for Nebraska Medicine.

Some Americans on board, including Smith, chose to finish their quarantine on the ship.

South Korea, Australia and Hong Kong evacuated their residents for quarantines, as well, and Canada and Italy also sent flights for their citizens.

According to a letter from the Centers for Disease Control and Prevention to American passengers who chose to remain on the ship, they must remain symptom-free and not have any positive tests for an additional 14 days before they can re-enter the U.S.

Smith and Codekas plan to spend that time exploring Tokyo and perhaps will take day trips to the surrounding area.

Japan's government has been questioned over its decision to keep people on the ship, which some experts have called a perfect virus incubator.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told the USA TODAY Editorial Board and reporters Monday that the original idea to keep people safely quarantined on the ship wasn't unreasonable. But even with the quarantine process on the ship, virus transmission still occurred.

"The quarantine process failed," Fauci said. "I'd like to sugarcoat it and try to be diplomatic about it, but it failed. People were getting infected on that ship. Something went awry in the process of the quarantining on that ship. I don't know what it was, but a lot of people got infected on that ship."

Health Minister Katsunobu Kato initially said those disembarking the ship with negative virus tests had fulfilled the Japanese quarantine requirement and were free to walk out and go home on public transportation. Later Wednesday, he urged the former passengers to refrain from non-essential outings and try to stay home for about two weeks.

"COVID-19 is not 100% known, and a lot of people got infected on the Diamond Princess. Taking those factors into consideration, we believe taking extra caution will contribute to preventing the risk of future infections," he said.

Japan's Chief Cabinet Secretary Yoshihide Suga said a more controlled health watch for the crew would start immediately because they can isolate themselves by spreading out and using vacated passenger rooms.

Crew on MS Westerdam cleared, allowed to disembark

The Cambodian Ministry of Health has confirmed that the 747 crew members on Holland America's MS Westerdam have all tested negative for COVID-19, the cruise line announced Thursday.

Holland America said that the 25 employees who had been scheduled to leave the ship last weekend will now disembark and make their way home. The remaining crew members will remain on the ship to continue their work contracts.

The news comes a day after the 781 passengers still in Cambodia were cleared to return to their home countries.

The MS Westerdam, which has been docked in Sihanoukville, Cambodia, for the past week, will remain in port a few days longer until the company decides on its next itinerary. Its next cruise, which was scheduled to begin on Feb. 29, was canceled weeks ago.

A maritime captain, Rabinder Singh, urged the cruise line to proceed cautiously in a tweet.

"While planning your new itinerary for the #Westerdam, please use due diligence and keep in mind what is going on the quarantined cruise ship DIAMOND PRINCESS," he wrote.

Contributing: David Oliver, Hannah Yasharoff, Jayme Deerwester, USA TODAY; The Associated Press