Four elderly passengers onboard Holland America Line’s Zaandam have died, the line has confirmed.

Zaandam is currently off the coast of Panama, where it met with sister ship Rotterdam on Thursday to transfer medical supplies and staff.

The line confirmed in a statement on Friday that 53 guests and 85 crew have reported flu-like symptoms. Of these, a number have been tested with two confirmed cases of Covid-19.

It has not been confirmed whether the four passengers who have died reported symptoms consistent with coronavirus.

The statement issued on Friday said: “Holland America Line can confirm that four older guests have passed away on Zaandam. Our thoughts and prayers are with their families and we are doing everything we can to support them during this difficult time.”

It added: “Yesterday a number of patients with respiratory symptoms were tested for Covid-19 and two individuals tested positive.

“Out of an abundance of caution, on March 22 when Zaandam first saw a number of guests reporting to the medical center with influenza-like illness symptoms, we took immediate protective measures, including asking all guests to self-isolate in their staterooms and implementing all other appropriate precautions that have been developed in coordination with the CDC.

“All guests and crew received face masks yesterday and were provided with instructions on when and how to wear them.

“Currently, 53 guests (4%) and 85 crew (14%) have reported to Zaandam’s medical center with influenza-like illness symptoms. There are 1,243 guests and 586 crew on board. On Zaandam there are four doctors and four nurses. On Rotterdam there are two doctors and four nurses.”

HAL said an onward plan for both ships was still being finalised, and it is continuing to work with Panamanian authorities on approval to transit the Panama Canal before sailing to Fort Lauderdale.

It also said there were plans to transfer groups of healthy Zaandam guests to Rotterdam, following strict protocols developed in conjunction with the U.S. Centers for Disease Control and Prevention (CDC).

The line added: “Only those who have not been ill will be moved, and health screenings will be conducted before transferring. Priority for the first guests to transfer will be given to those on Zaandam with inside staterooms and who are over 70.

“Once aboard Rotterdam, all guests will continue to remain in their staterooms until disembarkation. Any guests who are currently ill, or in isolation as a close contact, and all crew will remain on Zaandam.”