CNN Chief Medical Correspondent Dr Sanjay Gupta had exclusive insight into the procedures and safety devices in place to make cruising possible in the age of Covid. The question is whether they will be enough to keep passengers and crew free from coronavirus?
To make cruising possible in the age of Covid, industry leaders convened the Healthy Sail Panel – which included experts from the public health, infectious disease, biosecurity, marine and hospitality – to make recommendations to make the experience healthier. and safer for guests and crew. These far-reaching recommendations, developed before vaccines were available, are consistent with the policy of Covid-19 members of the industry’s largest trade group, Cruise Lines International Association, and with requirements and guidelines for ships from cruise set out by the CDC, which has been – until now – deciding the circumstances under which ships may depart from the United States.
Celebrity chief medical officer Dr Calvin Johnson told CNN that neither he nor the crew were apprehensive. “I think everyone really believes in the protocols that we developed, in the processes that we put in place, because they were part of it,” he said.
“It’s been over a year of consistent, methodical, science-based operational reviews to examine the business, how it works and how we can do it safely. Putting protocols in place to protect our crew and then consider what it will be like when our guests come back to protect them – and so it’s a process that got us to this place, ”he said.
Industry closes hatches
So what’s the plan to make boating safer? At least this summer there will be fewer people on board; The Edge is sailing at 40% of its capacity. Because the coronavirus is spread through airborne particles, fewer people, fewer people, and good ventilation can make a big difference.
“For this start-up period, we’re sailing with reduced capacity to give all of us a chance to get used to the protocols and really allow for natural social distancing,” said Susan Lomax, Global Public Relations Manager at Celebrity Cruises. . She said the cruise line is not planning to exceed 50% of capacity on any of its trips this summer. Due to the reduced capacity, the occupancy of the cabins will be spaced out and people will be placed in cabins with windows facing outwards. Crew members will have their own cabins.
Lomax said filtration experts from the University of Nebraska were asked to rate the ventilation / HVAC system and said it was “better than what hospitals have.”
Linsey Marr, environmental engineer and professor at Virginia Tech, agrees that Edge’s ventilation system is more than adequate. “The combination of high air change rates and high quality filters… will drastically reduce the amount of viruses that can build up in the air. Thus, people are unlikely to be exposed to high levels of the virus in cabins and public indoor spaces, ”she told CNN. “If that’s the case, then the greatest risk comes from being nearby, in the exhaled respiratory plume of an infected individual. “
Yuguo Li, from the Department of Mechanical Engineering at the University of Hong Kong, sided with Marr.
“Taking all the evidence so far, I firmly believe that SARS-CoV-2 is mainly transmitted by the inhalation route at close range in insufficiently ventilated spaces. We have studied about 20 outbreaks of SARS-CoV-2 and performed ventilation measurements on 10 of them, all supporting this hypothesis, ”Li wrote in an email. His Diamond Princess study was published online in April in the journal Building and Environment and his editorial appeared in the journal Indoor Air in mid-May.
“For the Diamond Princess outbreak, we have shown that their cabin ventilation could be sufficient, and suspect that infections have occurred in public areas. There are two main factors in these public spaces: First, in gymnasiums and dance floors, people have high performance [energy] activities with more droplet release and a higher inhalation rate, so the risk of infection is high… Second, if occupancy is not controlled in these public spaces, ventilation per person may be even lower . In some spaces like restaurants, people cannot wear masks, ”he explained.
On board, other procedural changes include staggered arrival and departure times to avoid large crowds, and a muster drill – the mandatory safety drill performed at the start of every trip – performed virtually instead. than in person, again to avoid large crowds. And foodies need not fear: All-you-can-eat buffets will remain a staple of the dining experience, but instead of self-service, crew members will lend a hand.
In the unfortunate event of an outbreak, Edge has the capacity to handle 33 patients and there are four intensive care beds. The entire medical area is on a separate ventilation system.
Contact tracing plans using the vessel’s video surveillance have been developed, there are isolation and quarantine protocols, and procedures for disinfection after positive cases.
It is important to note that Royal Caribbean has agreements with a number of countries to serve as disembarkation ports, should it be necessary to get people off the ship.
“There is no more ‘Oh my God we sail for days and no one will take us’,” Lomax said. “There is no reason to wait until the end of the cruise; we have the option of going to these landing ports if and as needed. “
Vaccines are a game changer
But everyone from those in the cruise industry to health experts say the real game changers are vaccines, which offer up to 95% protection against symptomatic Covid-19. Even though there are peak infections, vaccines reduce the amount of virus in the body, making people less contagious to others.
“It was really the vaccines that got us back on the cruise with a sufficiently low level of transmission risk,” said Marr.
On Edge, 100% of the crew and at least 95% of the passengers are vaccinated, which significantly reduces the risk of infection and outbreak of an epidemic.
Regardless of how effective the vaccines are, it’s unclear if, when and where they may be mandatory on future cruises. The CDC is currently advising unvaccinated people against going on cruises – but that’s only a guideline. Additionally, Florida is one of a number of states that have banned companies from requiring customers to provide proof of vaccination, although upcoming cruises departing from Washington state ports and the United States. Alaska should have vaccination requirements.
And to top it off, a judge in the Federal District of Tampa recently ruled that the CDC’s restrictions on the cruise industry were likely unconstitutional and that the agency exceeded its legal authority. Thus, from July 18, the agency will no longer be able to enforce its navigation rules, including requirements that 95% of passengers must be vaccinated or that the ship successfully complete a mock trip. The judge gave the CDC until July 2 to offer more modest guidance.
Navigating these murky and fluctuating rules, Lomax said Edge capped the number of booths at 5% for people who choose not to disclose their immunization status. They are counted as unvaccinated. Those presumed to be unvaccinated will be required to wear masks in public areas and will also need to undergo additional Covid-19 testing – both to board and midway through the cruise – at their own expense. Everyone must be tested before disembarking in the United States.
“With 95% of passengers vaccinated, this is much more than what we have in any country. And we know that the higher vaccination rates have really brought the cases down. So I think it’s probably reasonable for healthy vaccinated people to go on a cruise, ”said Marr. “The risk of an outbreak on a cruise ship, as well as the steps they take to force unvaccinated people to wear masks, the overall risk of an outbreak is expected to be quite low. And I’d be surprised if we saw something like the Diamond Princess again. “
But, despite all precautions, the experience is still not guaranteed to be 100% coronavirus-free, if the Celebrity Millennium is an example. This ship, carrying the first North American paying passengers, set sail in early June from Saint-Martin and made several stopovers. The crew was fully vaccinated, as were more than 95% of the passengers. Nevertheless, two passengers tested positive for coronavirus at the end of the trip.
“In terms of vaccination, the protection is not 100%. Sufficient vaccination protects us from the development of a chain of infection, that is, sustained infection in a large population, but… ”Li noted.
Johnson, chief marketing officer for Celebrity, said the incident was unfortunate, but it shows the system is working. “It definitely caught my attention,” he said.
“But we also know that if we look [at] the world around us, in all places, infections occur every day. And so we fully anticipate that… however thorough our efforts are and as much as we prevent the virus up front from entering the ship, that could happen, ”he said. “That’s why we have protocols, we have a process; we have trained our people to know what to do when we identify that. We are working very quickly to identify and isolate this, and prevent and stop the spread. ”
But perhaps the most reassuring statement for future cruise passengers comes from Marr, who said she would not prevent her healthy, vaccinated and cruise-loving mother, 70, from taking one.