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Federal and state officials were grappling with how to deal with the Grand Princess cruise ship off the coast of San Francisco after 21 people aboard tested positive for the coronavirus.

A state source described conversations about moving passengers and crew members as fluid and said discussions on how to proceed by state and federal officials would resume Saturday. A representative for Princess Cruises said the ship would not dock Friday night, but was moving to a position 20 nautical miles offshore “for logistical purposes.”

Testing was continuing on the ship, but its fate is emerging as a major public health challenge for California, where the number of coronavirus cases has pushed past 60. At least seven of those cases are believed to be connected to the same cruise ship, including a Placer County man who died after returning from an earlier voyage to Mexico. He is the state’s only confirmed COVID-19 fatality.

A Madera County resident has also tested positive for the coronavirus after a recent trip on the Princess Cruise. Citing health officials, the Fresno Bee reported that the resident and their partner are isolated in their home. One person who visited the couple is also isolated and being monitored.

The Princess Cruise ship was returning from a subsequent cruise to Hawaii when it was held off the California coast. With testing still underway, officials still don’t know how many of the more than 3,000 people on board have the virus. They also have not determined exactly where those who are infected would go.

According to a source on the ship who asked not to be identified, the boat had moved to just south of San Francisco and closer to shore to allow easier U.S. Coast Guard access. But on Saturday morning, the ship moved farther offshore, about 40 miles from the coast.

At least one person has been removed from the ship by the Coast Guard for medical reasons, sources on the ship said. Passengers aboard said helicopter visited the vessel last night, and a Coast Guard Cutter was present this morning. It was not immediately clear how the person was removed or if more than one person was evacuated.

“I woke up this morning to see the Coast Guard right off of the starboard side of the boat and a tender was being lowered,” said Debbi Loftus, a passenger on the boat from Wisconsin, on Saturday morning.

Loftus said the captain confirmed the Coast Guard was picking up a passenger with a critical medical condition, but it’s unclear if the passenger has tested positive for the coronavirus. Media outlets reported that one person aboard the cruise has cancer and needed to be removed to receive chemotherapy treatment.

Taylor Bacon, a spokesperson for the Coast Guard, could not confirm whether anyone was airlifted off the ship Saturday morning.

Vice President Mike Pence said the federal government is working with the state of California to bring the cruise ship into a noncommercial port over the weekend and quarantine those aboard as necessary. Those testing positive so far included 19 crew and 2 passengers. A total of 46 people had been tested, a sign the virus was spreading aboard the boat.

President Trump said he would ultimately let Pence, who leads the task force in charge of the response, decide whether to allow passengers to leave the ship. But he said several times that he would be inclined to leave them on board because bringing them ashore would increase the number of official cases on American soil.

“I like the numbers being where they are. I don’t need to have the numbers being doubled because of one ship,” Trump said.

“A lot of people think we should do it the other way,” he said. “We have to take care of Americans.”

Brian Ferguson, a spokesman for the Governor’s Office of Emergency Services, said in a statement that federal and state government “have been working in close collaboration overnight and throughout the day to quickly stand up a solution that meets the health needs for those on board and protects public health.”

He added that Trump and Gov. Gavin Newsom spoke Friday morning, with the governor also speaking with Pence throughout the day.

Friday’s announcement was the result of a helicopter crew delivering kits to the Grand Princess to test about 100 passengers for COVID-19. The next day, Princess Cruises spokeswoman Negin Kamali confirmed that the CDC had “recommended that guests should remain in their staterooms for the remainder of the cruise.”

Karen, a Canadian passenger who asked to be identified only by her first name, said she fears what could come next.

“I’m not afraid of this virus,” she said. “I’m terrified of a quarantine onboard.”

“That changes things,” said another person on the ship. “I’m not going home anytime soon.”

The one California man who has died disembarked from the Grand Princess last month in San Francisco after a cruise to Mexico. The ship was scheduled to return to San Francisco again Wednesday after a subsequent trip to Hawaii, but it has been held offshore while authorities evaluate crew members and passengers with symptoms of the virus.

Another man who had been on the Mexico trip was found unresponsive at his home in Sunnyvale on Thursday and later died. On Friday, Santa Clara County officials said that the man tested negative for COVID-19.

Passengers on the vessel — both current and those who may have been exposed earlier — told the Los Angeles Times that the response to the outbreak by the company and health officials had been filled with missteps.

In particular, passengers said that Princess Cruises was lax on health screening protocols prior to boarding and withheld information about the risks they faced, even as the ship’s situation became international news.

The quandary over the cruise ship comes as Stanford University said that it would shift classes online for the final two weeks of the winter quarter after a faculty member in the School of Medicine tested positive for the coronavirus.

School officials said the clinic where the faculty member worked was closed over the weekend for cleaning .

USC said it would conduct lectures and seminars online rather than in classrooms for three days next week as a test should the campus be forced to suspend in-person contact.

Three UCLA students who were self-isolating on campus have tested negative for the coronavirus. School officials said the university has”invested in tools that will aid in remote teaching and learning, when needed” but so far has not made changes to classes.

Times staff writers Richard Winton and Soumya Karlamangla contributed to this report.