Wednesday, April 10, 2024

COVID changed the cruise ship experience Here's how. Los Angeles Times

covid cruise ship

As noted above, health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19. Viking on Sunday was forced to announce a major revision of its soon-to-begin, 120-day world cruise after India notified the line it was closing to cruise ships. Viking's 930-passenger Viking Star will begin its world cruise this week by heading south from Los Angeles to Central America and South America instead of sailing westward toward Asia, where it was scheduled to spend a significant amount of time in India. Health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19.

Cruises

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Several ships recently had to skip port calls in Mexico, for instance, after passengers and crew on board the vessels tested positive for COVID-19. The ports have since reopened after Mexico's Health Department overruled the decisions of local port officials. Governments and ports responded by preventing many cruise ships from docking and advising people to avoid travelling on cruise ships. Many cruise lines suspended their operations to mitigate the spread of the pandemic.

Average age of cruise passengers

Infection prevention and control (IPC) are critical to reducing the spread of ARI. Each cruise ship should maintain a written Infection Prevention and Control Plan (IPCP) that details standard procedures and policies to specifically address infection control and cleaning/disinfection procedures to reduce the spread of ARI. Cruise ship operators should consider screening embarking passengers for viral ARI symptoms, a history of a positive COVID-19 viral test within the 10 days before embarkation, and a history of exposure to a person with COVID-19 within the 10 days before embarkation. Many lines are adjusting their masking, testing and vaccine rules, while criticism is mounting about the lack of transparency in reporting positive cases to passengers and crew members. One day after the C.D.C. announcement, as dozens of crew members and other passengers were confined to small cabins, infected and quarantined, thousands of revelers packed into ship bars, casinos and deck venues, partying like it was 2019. Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries.

Outbreak Control

The results of testing of passengers and crew on board the Diamond Princess demonstrated a high proportion (46.5%) of asymptomatic infections at the time of testing. Available statistical models of the Diamond Princess outbreak suggest that 17.9% of infected persons never developed symptoms (9). A high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew. Although these data cannot be used to determine whether transmission occurred from contaminated surfaces, further study of fomite transmission of SARS-CoV-2 aboard cruise ships is warranted. During February 11–21, 2020, the Grand Princess cruise ship sailed roundtrip from San Francisco, California, making four stops in Mexico (voyage A). Most of the 1,111 crew and 68 passengers from voyage A remained on board for a second voyage that departed San Francisco on February 21 (voyage B), with a planned return on March 7 (Table).

Celebrity Solstice

Lines also are dealing with a small but growing number of destinations -- India and Hong Kong, for example -- that are at least temporarily closing to cruising completely, even for ships where no one has tested positive for COVID-19. Meanwhile, the 86 cruise ships currently under CDC investigation continue to sail. Recently, Bonaire and Aruba denied the Carnival Freedom entry to its ports after the ship reported a number of positive cases. And Royal Caribbean’s Odyssey of the Sea changed course from planned stops in Curacao and Aruba after 55 cases of Covid-19 were identified. People who are up to date with COVID-19 vaccines are less likely to have severe outcomes if they develop COVID-19 after boarding.

Cases Rise, Criticism Mounts, but Ships Keep Cruising

Meanwhile, just getting to ships is becoming increasingly stressful, as getting the pre-cruise COVID-19 test that's often required before cruising is getting more difficult. Plus, a "perfect storm" of soaring COVID-19 cases and rough winter weather has wreaked havoc with airline operations for weeks. Cruise operators should ensure passengers and crew have access to well-stocked hygiene stations with soap and water and/or hand sanitizer, tissues, paper towels, and trash receptacles. Respiratory specimens for ARI testing should be collected immediately upon illness onset, with the understanding that repeat testing may be indicated based on the viral etiology or state of the COVID-19 pandemic. In general, molecular tests are recommended over antigen tests because of their greater sensitivity; multiplex assays are available that can detect SARS-CoV-2, influenza A and B, and RSV.

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The company will also offer a pro-rated cruise fare refund if a cruise is cut short for reasons related to COVID-19, for cruises departing on or before September 30, 2022. The CDC advised that those who choose to travel on a cruise should get vaccinated against COVID-19 before their trip and, if eligible, receive a booster dose. This is one of the biggest risks of taking a cruise right now, and one reason you may consider canceling a sailing scheduled in the short term (see the section on more-flexible cancellation policies below). Other lines canceling one or more sailings in recent days include Holland America, Silversea, Atlas Ocean Voyages, Regent Seven Seas Cruises, MSC Cruises, Costa Cruises and Oceania Cruises.

Crew strandings and repatriations

The current protocol on most ships is to isolate COVID-19-positive passengers and crew but otherwise continue on with voyages as planned. The number of passengers being quarantined on ships (after testing positive for COVID-19) also is on the rise. And passengers who aren't COVID-19 positive are getting caught up in short-term quarantines for being "close contacts" of shipmates who are. Despite tight industrywide protocols — including pre-departure Covid testing as well as vaccine mandates — it is not uncommon for ship passengers or crew to test positive for the illness.

covid cruise ship

The Diamond Princess and Grand Princess had more than 800 total COVID-19 cases, including 10 deaths. Since February, multiple international cruises have been implicated in reports of COVID-19 cases, including at least 60 cases in the United States from Nile River cruises in Egypt (Figure 2). Secondary community-acquired cases linked to returned passengers on cruises have also been reported (CDC, unpublished data, 2020).

Green status means there have been no reported cases of coronavirus or COVID-19-like illnesses on board. As of Monday morning, there were 16 ships with green status, and some of those ships are on crew-only voyages. While health authorities no longer are quarantining whole ships when a few passengers or crew test positive for COVID-19, the presence of the illness on board a vessel still could result in notable disruptions to your itinerary.

Insider spoke with Matt Hochberg who has been on hundreds of cruises and runs a website called RoyalCaribbeanBlog.com that shares travel tips and advice for those interested in booking a cruise. § Quarantine was used for persons who were exposed; isolation was used for persons who had positive test results for SARS-CoV-2. Overall, 111 (25.9%) of 428 U.S. citizens and legal residents did not join repatriation flights either because they had been hospitalized in Japan or for other reasons. To mitigate SARS-CoV-2 importation into the United States, CDC used temporary “Do Not Board” restrictions (7) to prevent commercial airline travel to the United States,†† and the U.S. Departments of State and Homeland Security restricted travel to the United States for non-U.S.

Many lines are adjusting their masking, testing and vaccine rules, while criticism is mounting about the lack of transparency in reporting positive cases to passengers and crew members during sailings. You will usually be required to show proof of vaccination at the terminal before boarding. Some cruise lines will also require passengers — whether vaccinated or not — to show proof of a COVID-19 test taken within two days of boarding a vessel.

covid cruise ship

The table below provides disease-specific recommendations for persons on board with COVID-19, influenza, or RSV and those exposed (i.e., contacts). Cruise ship operators should consider denying boarding for passengers who test positive for infectious viral etiologies during pre-embarkation screening, as well as those who tested positive for COVID-19 within 10 days before embarkation. If boarding is permitted, see guidance for isolation and other measures provided below. This document also provides guidance for preventing spread of ARI during and after a voyage, including personal protective measures for passengers and crew members and control of outbreaks. The federal agency recommends that people avoid cruise travel if they are at increased risk of severe illness, regardless of vaccination status. But in recent months, as new and highly contagious variants have emerged and case numbers steadily increase worldwide, these measures are being put to the test.

Cruise ship operators may consider this strategy in situations where exposures may have occurred in crowded settings, if unsure of the date of exposure, or if there is difficulty identifying index cases, as often occurs in the cruise ship environment. Cruise ship operators should consider performing viral testing (e.g., COVID-19, influenza, RSV) for passengers with ARI before they embark. Fever (a temperature of 100°F [37.8°C] or higher) will not always be present in people with influenza, COVID-19, or RSV. Cruise ship medical personnel should consider someone as having a fever if the sick person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100°F (37.8°C) or higher. None of the ships so far appear to have so many cases that they would overwhelm medical resources on board and require a return to port. And the CDC did not say it would adopt any changes, adding it still had plans to allow for the expiration of a set of rules that cruises must follow to sail during the pandemic.

Factors that facilitate spread on cruise ships might include mingling of travelers from multiple geographic regions and the closed nature of a cruise ship environment. This is particularly concerning for older passengers, who are at increased risk for serious complications of COVID-19 (4). The Grand Princess was an example of perpetuation of transmission from crew members across multiple consecutive voyages and the potential introduction of the virus to passengers and crew on other ships. Vessel captains may request assistance from CDC to evaluate or control ARI outbreaks as needed.

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