Cruise ships hit by coronavirus outbreaks have quickly found themselves with no ports for thousands of passengers as countries on four continents have quarantined vessels or kept them at sea for days.

Keeping all the passengers on board instead of letting them disembark on land is a strategy that can backfire, however, according to experts, because the ventilation systems and close quarters of cruise ships make them ideal places for illness to jump from one person to the next.

“They’re not designed as quarantine facilities, to put it mildly,” said Don Milton, an epidemiologist with the University of Maryland.

A ship with more than 3,500 people aboard was sailing in circles off the coast of California on Saturday after 19 crew members and two passengers tested positive for the new virus. Originally bound for San Francisco, the Grand Princess might be sent instead to a non-commercial port, officials said.

While restaurants and other shipboard locations were closed, passengers were able to watch TV and use the internet, or if they were lucky enough to have one, go outside on their balcony overlooking the water.

Passenger Karen Schwartz Dever said she and her husband were enjoying their balcony and keeping themselves busy with playing cards, while meals and water were being delivered by room service. But she worried about some of the other passengers.

“I met someone who is in the middle of chemo for cancer,” she said. “There are people on oxygen. There are also children on board. I can’t imagine what it’s like if they are in an inside cabin.”

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