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The Grand Princess, which is carrying multiple people who have tested positive for COVID-19, passes the Farallon Islands while holding off the coast of San Francisco, Sunday, March 8, 2020.The Associated Press

The Public Health Agency of Canada is now warning Canadians against travelling on cruise ships after the federal government announced Sunday it will repatriate more than 230 Canadians on board the Grand Princess.

Chief Public Health Officer Dr. Theresa Tam said Monday that she previously asked Canadians to “think twice” about going on cruise ships but she said that the agency is now officially recommending that Canadians avoid all travel on the ships due to the COVID-19 disease.

Speaking in Ottawa on Monday, Dr. Tam said that cruise ships have passengers from all over the world who may be arriving from areas with known or unknown spread of the novel coronavirus.

Dr. Tam also said it can spread quickly on board due to the close contact between passengers, adding that the elderly, those with weakened immune systems or individuals with underlying medical conditions are at a higher risk.

Foreign Affairs Minister François-Philippe Champagne said Monday the cost of the plane to repatriate the Canadians from the cruise line will be assumed by the cruise line itself.

He also said it was “very exceptional circumstances” that prompted the federal government to step in to help, including a request from the U.S. government and the need to act to prevent the spread of disease in North America.

The federal government says the plane will be bringing passengers from San Francisco to Canadian Forces Base Trenton, where they will be assessed and undergo a 14-day quarantine.

Passengers will be screened for symptoms before boarding the plane, Global Affairs Canada said, noting if they exhibit symptoms they will not be permitted to board.

Dr. Tam said Monday that travel advisories that have been issued are based on existing data, adding the agency will be monitoring every part of the United States like it would any part of the world.

“Our advice would be focused on a specific area on the United States as opposed to the whole of the United States,” she said. “That would be the most appropriate approach.”

The Public Health Agency has said it is closely monitoring the situation of COVID-19 in the states of Washington, California and Oregon that have confirmed limited community spread of COVID-19 in some areas.

The Canadian government is recommending that travellers follow “usual precautions to protect themselves from respiratory illnesses.”

Meanwhile, the number of novel coronavirus cases in Canada climbed to at least 74 as patients in Alberta doubled to four and B.C. officials declared Canada’s first likely death from COVID-19, a man who was a patient at a long-term care facility in North Vancouver.

Several of Canada’s cases, including three from Alberta, stem from a trip on the Grand Princess cruise ship to Mexico in mid-February. A man in his 40s from Edmonton, who has been infected, was not on the voyage. However, he travelled in the U.S. Midwest with a companion from British Columbia who was on the ship, Dr. Hinshaw told reporters on Sunday as she announced two new cases. The man’s companion is in B.C. and has the COVID-19 disease.

Besides Alberta’s four cases, Ontario has reported 34, B.C. 32 and Quebec four. In Toronto, the principal of Whitney Junior Public School forwarded a letter to parents on Sunday from the city’s medical officer of health warning of a possible exposure to the coronavirus. The letter stressed, however, that the risk to the school is low.

Around the world, there have been almost 108,000 reported coronavirus cases in more than 80 countries, with 3,662 deaths, most of them in China, where the outbreak began. More than 60,000 people are said to have recovered.

The epidemic has disrupted travel and numerous other industries, leading to massive sell-offs in financial markets, including in Canada. Last week, the Bank of Canada slashed its key interest rate by half a percentage point and signalled the potential for future cuts to deal with the “material negative shock” that COVID-19 poses to the economy.

- With files from Andrea Woo in Vancover and Jeffrey Jones in Calgary