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Repatriation flights for foreign nationals were organized by several governments in coordination with U.S. federal and California state government agencies. Following disinfection of the vessel according to guidance from CDC’s Vessel Sanitation Program, remaining foreign nationals will complete quarantine on board. The quarantine will be managed by the cruise company, with technical assistance provided by public health experts. Public health responses to COVID-19 outbreaks on cruise ships were aimed at limiting transmission among passengers and crew, preventing exportation of COVID-19 to other communities, and assuring the safety of travelers and responders. These responses required the coordination of stakeholders across multiple sectors, including U.S. Government departments and agencies, foreign ministries of health, foreign embassies, state and local public health departments, hospitals, laboratories, and cruise ship companies.
Pre-embarkation COVID-19 Testing
On March 5, a response team was transported by helicopter to the ship to collect specimens from 45 passengers and crew with respiratory symptoms for SARS-CoV-2 testing; 21 (46.7%), including two passengers and 19 crew, had positive test results. Passengers and symptomatic crew members were asked to self-quarantine in their cabins, and room service replaced public dining until disembarkation. Following docking in Oakland, California, on March 8, passengers and crew were transferred to land-based sites for a 14-day quarantine period or isolation.
Diagnostic Tests for Acute Viral Respiratory Illness (ARI)
All major cruise lines currently are requiring all or nearly all passengers to be fully vaccinated for COVID-19, with some also starting to require booster shots, to boot. This creates an onboard population that is far less likely to experience serious symptoms of COVID-19 than a cross-section of people on land, according to CDC data. A growing number of cruise lines are canceling sailings on short notice, citing the disruptions caused by COVID-19. The world's largest cruise operator Royal Caribbean on Friday canceled soon-to-depart sailings on four of its 25 ships, including the next three departures of the world's largest ship, Symphony of the Seas. Cruise ships also have had to cancel stops recently at the islands of Aruba, Bonaire and Curaçao, and at San Juan, Puerto Rico, due to local worries about COVID-19-positive passengers and crew on board and/or tighter COVID-19-related entry requirements.
Common Health Concerns During Cruise Travel and what You Can Do to Prevent Illness
The agency’s color-coding system is based on both surveillance data collected over the previous 7-day period as well as the findings of any CDC investigations. Passengers and crew members should be reminded to wash their hands often with soap and water, especially after coughing or sneezing. If soap and water are not available, they can use an alcohol-based hand sanitizer that contains at least 60% alcohol. For more information, read updated resources for clinicians and guidance on the medical evaluation and management of people with COVID-19, influenza, or RSV are available on CDC’s websites. "CDC acknowledges that it is not possible for cruising to be a zero-risk activity," CDC spokesperson Jasmine Reed said in an emailed statement.
Recommendations when a voyage’s crew or passenger ARI attack rate reaches 3%‡
CDC recognizes that cruise ships travel worldwide, necessitating awareness of, and responsiveness to, local jurisdictional requirements. Cruise ship management and medical staff need to be flexible in identifying and caring for people with ARI. The healthcare provider’s assessment of a patient’s clinical presentation and underlying risk factors is always an essential part of decisions about the need for further medical evaluation, testing, and treatment.
Hochberg decided to disembark where the ship was docked, in Vancouver, Canada, and drive his rental car back to the US. The threshold is higher for passengers on restricted voyages; the number of passengers with COVID-19 or COVID-19-like illnesses over the preceding seven days must equal or surpass 0.10% of the total number of passengers on board to merit investigation. So if a ship has 5,000 passengers, it would need at least five cases over seven days to be classified as yellow. The Centers for Disease Control and Prevention is monitoring or investigating 94 ships for COVID-19 as of Monday, as it warns Americans to "avoid cruise travel" regardless of vaccination status. In addition, most cruise lines now are requiring passengers to wear masks at all times while in interior spaces of vessels, and they have stepped up cleaning regimens, improved air filtration systems on ships and made other onboard changes. Cruise lines are reporting that the vast majority of passengers testing positive for COVID-19 in recent weeks are asymptomatic or have mild symptoms.
Government travel advisories
Centers for Disease Control and Prevention reported that 5,013 COVID-19 cases had been reported on cruise vessels operating in U.S. waters during the last two weeks of the month, up from just 162 cases during the first two weeks of the month. Respirators or well-fitting masks should be readily available and symptomatic passengers and crew should be encouraged to use them if they have to be outside their cabins. People with ARI should be advised of the importance of covering coughs and sneezes and keeping hands clean because respiratory viruses may be shed after the isolation period ends. [4] Back-to-back sailing refers to passengers who stay on board for two or more voyages. All passengers and crew are also recommended to be up to date with all routine vaccines. "Our warnings have proved sadly prescient and continuously compelling. Time for CDC and cruise lines to protect consumers, again pause — docking their ships," the Connecticut senator posted on Twitter.
The current protocol on most ships is to quickly isolate COVID-19-positive passengers and their close contacts. Anecdotal reports are that the number of cases on ships is up even more in the first 10 days of the new year. Still, the situation isn't anywhere near as dramatic or disruptive as what we saw at the start of the COVID-19 pandemic two years ago, when whole ships were being quarantined due to outbreaks of the illness and, eventually, the entire industry shut down.
Ships with confirmed cases on board
Simulation study shows best air exchange for cruise ships - University of Minnesota Twin Cities
Simulation study shows best air exchange for cruise ships.
Posted: Wed, 01 Nov 2023 07:00:00 GMT [source]
Democratic Sen. Richard Blumenthal is calling for the CDC and cruise lines to again halt cruise travel, six months after the industry mounted its comeback. While cruising is a popular way to travel, there are some health concerns to be aware of. Find out more about health issues on cruises and steps you can take to stay safe and healthy during your trip. Most self-serve buffets have been modified so that employees serve passengers to avoid unnecessary crowding.
Persons requiring medical attention for other conditions or for symptoms consistent with COVID-19 were evaluated, tested for SARS-CoV-2 infection, and hospitalized if indicated. During land-based quarantine in the United States, all persons were offered SARS-CoV-2 testing. As of March 21, of 469 persons with available test results, 78 (16.6%) had positive test results for SARS-CoV-2.
If the ship will not be arriving imminently at a U.S. seaport, CDC maritime staff will provide guidance to cruise ship officials regarding management and isolation of infected people and recommendations for other passengers and crew members. Even with stringent vaccination, testing and masking, among other protocols, it is fairly common for coronavirus cases to emerge among passengers and crew on cruise vessels. The Mexican government said Tuesday it would allow cruise ships with reported coronavirus cases to dock. The country's Health Department said passengers or crew who show no symptoms will be allowed to come ashore normally, while those with symptoms or a positive virus test will be quarantined or given medical care.
At the time of the Diamond Princess outbreak, it became apparent that passengers disembarking from cruise ships could be a source of community transmission. Therefore, aggressive efforts to contain transmission on board and prevent further transmission upon disembarkation and repatriation were instituted. Outbreaks of influenza, COVID-19, respiratory syncytial virus (RSV), and other viral respiratory infections can occur at any time of the year among cruise ship passengers and crew members. Many cruise ship travelers are older adults or have underlying medical conditions that put them at increased risk of complications from these respiratory virus infections. Early detection, prevention, and control of such acute viral respiratory infections are important, not only to protect the health of passengers and crew members on cruise ships, but also to avoid spread of these viruses into communities. During the initial stages of the COVID-19 pandemic, the Diamond Princess was the setting of the largest outbreak outside mainland China.
As my colleague Ashley Kosciolek experienced first-hand on a cruise in 2021, close contacts only are being isolated for a short period while they are tested for COVID-19. If they test negative, they typically are allowed out of their rooms to rejoin the rest of their fellow cruisers on board. Norwegian Cruise Line on Wednesday canceled soon-to-depart voyages on eight of its 17 ships. The result is the detection of many asymptomatic cases that otherwise would have gone undetected. Passengers need to be prepared that the cruise they booked might not be the one they take, as operators may be forced to make itinerary changes on the fly. [6] These thresholds are subject to change based on the characteristics of the dominant COVID-19 variant or a novel respiratory virus in the United States or elsewhere.
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