Last month, a 77-year-old woman made a fateful decision: she boarded a Carnival cruise to Galveston, Texas, scheduled in sunny Belize.
The cruise was to be vaccinated, and about 96% of the 4,336 passengers and crew were said to have been vaccinated, but none were required to submit a negative COVID test before boarding. After four days on the water, the ship reported a COVID outbreak of 27 people spreading to passengers and crew. One of the passengers, 77, died 10 days later – the first such death reported since cruises resumed in the United States in June.
The tragic incident begs the question: is it safe to travel on a cruise at this time?
As you might expect, Carnival says yes. In recent weeks, the company has imposed negative pre-boarding COVID tests for all passengers and issued a statement to the Washington Post saying the woman who died “almost certainly did not contract COVID on our ship.” Notably, when she boarded the ship on July 31, no testing procedures were in place.
Medical experts are not convinced. Any type of travel is currently a very high-risk activity, says Dr. Luis Ostrosky, division chief of infectious diseases at UT Health, which is part of the University of Texas at Houston. Things are “completely out of hand,” he says. “And we don’t have the level of immunization we need to ensure that people will survive if they [Covid]”
And even with security measures in place, cruises carry residual risks that cannot be ignored, such as the inevitable nearby neighborhoods and the potential for a revolutionary transition.
Here’s why these risks are particularly dangerous, especially compared to other forms of travel – and what can be done to make cruises safer:
Cruises are “a recipe for transmission”
Ostrosky says that even on a good day outside of the pandemic, cruises are tough environments from an infection control standpoint.
On a cruise, you often spend time in shared common areas. You eat and drink indoors at buffet restaurants with large communal tables, watch shows in theaters, and touch all kinds of surfaces, from railings to casino games. If an outbreak occurs at sea, you are confined to the boat, which can make it more difficult to prevent and treat an outbreak.
“It’s just a recipe for transmission,” says Ostrosky. This is why it is common to see outbreaks of other infectious respiratory or gastrointestinal viruses, such as noroviruses, on cruises.
Cruises are particularly risky compared to other types of travel, such as driving or flying, as they present more opportunities for long-term exposure. “Frankly, the risk on a two hour flight where everyone is masked and the air circulation is good [lower] Instead of staying on a cruise ship for five days straight, ”says Dr. Preeti Malani, health officer at the University of Michigan.
Vaccine requirements help, but are not foolproof
Several cruise lines, including Disney Cruise Line and Norwegian Cruise Line, are cracking down on vaccine requirements. It’s a good start, experts say, but not enough.
While being fully vaccinated significantly reduces your risk of hospitalization or death from COVID, Ostrosky notes, the increased transmission of the Delta version means that vaccination “no longer guarantees that you will contract the infection.” I will not receive it, nor be able to transmit it. This means that any vaccination mandate must be combined with other safety measures, such as wearing a mask and maintaining social distance.
“We can try to navigate safely, but we will have success stories,” says Ostrosky.
Another factor to keep in mind: the level of community spread to where you live – or, in this case, where a cruise departs – greatly affects your level of risk. “When the spread is widespread in the community, as it is in Florida right now, everything becomes risky,” says Malani. “The idea of going on a cruise is just as risky.”
Some cruise lines are fighting another battle, this also against state governments that have passed laws or decrees to end vaccination mandates. Texas Governor Greg Abbott passed an executive order on Wednesday banning any state or local mandate requiring COVID vaccination. In Florida, home to several popular cruise departure ports, Governor Ron DeSantis signed an executive order in May banning vaccine passports statewide.
Norwegian Cruise Line sued Florida’s top health official in July, seeking a preliminary injunction asking the company to enforce its vaccine mandate for all passengers and crew. The company won the case earlier this month, with U.S. District Judge Kathleen Williams writing that the Norwegian had “demonstrated that there would be a risk to public health if there was a need to suspend the obligation to vaccination”.
Relying on a negative covid test is also a flawed strategy
If you don’t quarantine yourself for two weeks before your pre-board COVID test, the test is “fundamentally irrelevant,” Ostrosky says.
To make cruising truly safe, they say, companies would require a mandatory two-week quarantine for each passenger and crew member, a negative Covid test 24 to 48 hours before boarding and another immediately after boarding. A negative covid test should be done. It’s a tedious process, and particularly difficult to organize and achieve in the middle of a traveler’s vacation.
If you must navigate, here’s how to stay safe.
It may take some time before it is really safe to board a cruise. The country’s leading infectious disease expert, Dr Anthony Fauci, recently said he believed the country would be under Covid control and normalcy would be restored by spring 2022. But even then, travel and cruises will be high risk activities.
“We look forward to a future where more people are vaccinated and the numbers will be smaller, maybe more than we are in the delta version,” Ostrosky said. “It will be a much safer time to travel. “
If your heart is ready to go on a cruise before then, you should get the vaccine if you’re eligible, says Malani. Next, look for cruises that require proof of vaccination and only allow low capacity – less the better. While on a cruise, take low-risk activities and excursions, she says, like always dining out. And of course, board the ship knowing that no matter what, you are taking a risk.
The Centers for Disease Control and Prevention (CDC) assigns cruise ships a color-coded safety status – green, yellow, orange and red – based on reports of cases of covid or covid-type disease. The agency also indicates when outbreak investigations take place on ships. You can check the CDC’s website to find out the ship’s COVID status before planning or embarking on a cruise.
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