A day in the life of a passenger in lockdown aboard a Holland America cruise ship where 42 people have reported feeling 'influenza-like symptoms

• Passengers on board the MS Zaandam, a Holland America Line cruise ship, are being confined to their staterooms after 42 crew members and guests began exhibiting "influenza-like symptoms."
• Business Insider reviewed an internal ship itinerary distributed to the Zaandam's 1,243 guests.
• The brochure includes health advisories, information about meal deliveries and laundry services, and even mental health counseling resources.
• The Zaandam is currently sailing north to an undetermined destination after being shut out of South American ports over coronavirus concerns.
• Are you a cruise ship passenger or employee with a story to share? Email acain@businessinsider.com.
• Visit Business Insider's homepage for more stories.

Passengers aboard the MS Zaandam, a Holland America Line cruise ship, are adjusting to new ship-wide rules meant to prevent the spread of illness after 42 passengers and crew members reported "influenza-like symptoms."

"Out of an abundance of caution, we have now asked all guests to remain in their staterooms until we have more information," a Holland America representative told Business Insider in a statement. "Since it is flu season, and COVID-19 testing is not available on board, it is difficult to determine the cause of these elevated cases at this time."

One guest onboard provided Business Insider with a photograph of the Zaandam's "Where & Where" brochure for March 23. The document provides insight into the precautions being taken aboard the cruise, one that was previously shut out of Chilean ports due to coronavirus concerns even before news of the as-of-yet-undiagnosed illness broke.

The cruise on the Zaandam was scheduled to last 14 days, with 1,243 guests and 586 crew members embarking from Buenos Aires, Argentina, on March 7 and set to end in San Antonio, Chile, this past Saturday. Those plans were diverted because of the coronavirus pandemic, and the cruise ship rerouted its course to sail north to an undetermined destination.

Currently, the ship is attempting to secure "a reservation to transit the Panama Canal" with the intention of sailing up to Fort Lauderdale, Florida for a March 30 arrival. In the meantime, a statement from the cruise line noted that passengers are being asked to "monitor their health."

"If they become symptomatic, they are asked to call the medical center for an evaluation and care from the ship's medical professionals (at no charge)," the spokesperson said. "Effective today, meal service will be provided by room service until further notice. All public areas are closed."

The quarantine will also apply to all crew members "who are not required for the safe operation of the ship," the person said, adding that all cruise staffers would be asked to practice social distancing and self-isolation.

According to the When & Where brochures, guests will "receive a bag with clean towels" dropped outside their state room each morning. Guests were asked to fill that same bag with used towels and leave it outside their rooms between 2 p.m. and 3 p.m., along with waste bins.

"You will receive a knock on the door when your waste bin has been emptied," the brochure read. Guests with clothing to be laundered were asked to "fill out a form" and "place the filled laundry bag in the corridor."

The Zaandam crew will take similar contactless precautions when delivering meals to passengers.

"Staff will knock on your door and your meals will be outside," the pamphlet said. "Staff will not enter your state room."

The document also gave passengers a time table for meal deliveries: 6:30 a.m. to 9:30 a.m. for breakfast with coffee, juice, and a daily beverage service order form; 11 a.m. to 2 p.m. for lunch plus an afternoon snack; and 5:30 p.m. to 8:30 p.m. for dinner, a late snack, and menus for the next day.

"We apologize, but the menus will be fixed to enable us to provide room service to all guests," the pamphlet said. The notice also says that the Zaandam crew members already have information on each guest's allergy and dietary restrictions, and that those will be "taken into consideration." The document said that no special orders will be accommodated at this time.

"Once you've finished your meal, please immediately place your tray outside your stateroom," the brochure said.

Guests were also told to fill out and drop their beverage service order forms into their mailboxes by 10 a.m.

The rest of the brochure included a mix of its usual "lighthearted fun" content - including Dutch and Spanish phrases of the day, riddles, historical facts, and trivia about Star Wars, the Beatles, and Pablo Picasso - and more "valuable information" pertaining to sanitary practices on the ship. Passengers were advised to wash their hands for 20 seconds, with soap and water, cover their noses and mouths when sneezing, and avoiding touching their faces.

Television channels available for guests stuck inside their rooms include National Geographic, HGTV, movies, ESPN, BBC, Fox, MSNBC, and the Food Network. An "activities channel" also features electric slide lessons, dancercise, movie trivia, and line dance sessions.

Passengers were asked to abstain from calling the ship's medical center except in cases of an emergency. And guests were also asked to "limit calls" to the ship's guest services line "to those absolutely necessary." The brochure also added a line for confidential mental health counselors.

"We realize that some of you may be having a difficult time dealing with yesterday's news," the ship's pamphlet said. "Counselors are available to support you by phone if you'd like to speak with someone."

Read Holland America's full statement:

This morning aboard Zaandam, 13 guests and 29 crew reported to the ship's medical center with influenza-like symptoms. Out of an abundance of caution, we have now asked all guests to remain in their staterooms until we have more information. There are 1,243 guests and 586 crew on board.

Zaandam is following the response protocols that have been developed in coordination with the U.S. Centers for Disease Control and Prevention (CDC). Since it is flu season, and COVID-19 testing is not available on board, it is difficult to determine the cause of these elevated cases at this time.

The safety and well-being of our guests and crew is one of our highest priorities. The ship has activated these precautionary measures out of an abundance of caution:

• As is our standard practice, all ill persons have been isolated and their close contacts placed in quarantine.
• Guests have been asked to remain in their staterooms and monitor their health. If they become symptomatic, they are asked to call the medical center for an evaluation and care from the ship's medical professionals (at no charge).
• Effective today, meal service will be provided by room service until further notice. All public areas are closed.
• The entire ship is operating at maximum sanitation levels, including rigorous cleaning and disinfecting of public and crew areas.
• Crew who are not required for the safe operation of the ship are being quarantined. Those that are needed to maintain the ship's operation are being asked to self-isolate when not performing essential functions, practice social distancing, self-monitor and report any illness to the Medical Center.
• Both internet and guest stateroom telephone services remain complimentary so that guests may stay in touch with their families.

Zaandam was sailing a South America voyage that departed Buenos Aires, Argentina, on March 7 and was originally scheduled to end in San Antonio, Chile, on March 21. However, due to global health concerns, Holland America Line made the decision to suspend its global cruise operations for 30 days and end its current cruises in progress as quickly as possible and return guests home. Despite previous confirmations that guests could disembark in Punta Arenas, Chile, for flights, we were not permitted to do so. No one has been off the ship since March 14 in Punta Arenas.

Zaandam then sailed to Valparaiso, Chile, where it remained at anchor March 20-21 while taking on provisions and fuel, including regular medications for those that needed them. Zaandam departed Valparaiso on March 21 and is currently sailing north. Our intention is to proceed to Fort Lauderdale, Florida, for arrival on March 30, however we are still working on securing a reservation to transit the Panama Canal. Alternative options are also being developed.

For those with family members on board, they can call the following numbers for information: 1-877-425-2231 and 1-206-626-7398.

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