Last month, a 77-year-old woman made a fatal decision: she embarked on a carnival cruise in Galveston, Texas, bound for sunny Belize.
The cruise required vaccination, and approximately 96% of the 4,336 passengers and crew were vaccinated, but no one had to present a negative Covid test before boarding. After four days in the water, the ship reported a 27-person Covid outbreak involving both passengers and crew. One of the passengers, the 77-year-old, died ten days later, the first death reported since cruises began in the United States in June.
The tragic incident raises the question: is traveling on a cruise safe right now?
Predictably, Carnival says yes. In recent weeks, the company has been forced to conduct negative pre-board Covid tests for all passengers and has issued a statement to the Washington Post saying that the woman who died “almost certainly did not hire COVID at the our ship ”. In particular, when he boarded the ship on July 31, there were no testing procedures.
Medical experts are not convinced. Currently, any type of travel is a very high-risk activity, says Dr. Luis Ostrosky, head of the infectious diseases division at UT Health, University of Texas, Houston. The cases are “completely out of control,” he says. “And we don’t have the level of vaccination we need to ensure people will survive if it happens [Covid]. “
And even with established safety measures, cruises present residual risks that cannot be ignored, such as the inevitable proximity and the potential for advanced infections.
The following explains 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”
Even on a good day out of the pandemic, cruises are challenging environments from an infection control standpoint, Ostrosky says.
On a cruise, you often spend time in shared common areas. Eat and drink indoors in buffet restaurants with large communal tables, attend shows in theaters and touch all kinds of surfaces, from railings to casino games. If an outbreak occurs at sea, you are restricted to the boat, which can make the outbreak more difficult to contain and treat.
“It’s just a recipe for transmission,” Ostrosky says. Therefore, it is common to see outbreaks of other contagious respiratory or gastrointestinal viruses, such as norovirus, aboard cruise ships.
Cruises are even particularly risky compared to other types of travel, such as driving or flying, because they present more opportunities for prolonged exposure. “Frankly, the risk in a two-hour flight where everyone is masked and the airflow is good is [lower] than being on a cruise for five days in a row, ”says Dr. Preeti Malani, head of health at the University of Michigan.
Vaccine requirements help, but they are not infallible
Several cruise companies, including Disney Cruise Line and Norwegian Cruise Line, are cracking down on vaccination requirements. Experts say is a good start, but not enough.
While full vaccination significantly reduces the risk of hospitalization or death from Covid, Ostrosky notes, the increased transmissibility of the delta variant means that vaccination “no longer guarantees that it does not acquire the infection or can transmit it.” This means that all vaccination warrants must be combined with other safety measures, such as wearing masks and maintaining social distance.
“We can try to make cruises as safely as possible, but we will have advanced cases,” Ostrosky says.
Another factor to consider: the level of spread of the community in the place where you live or, in this case, from where a cruise departs, significantly affects your level of risk. “When outreach is widespread in the community, such as in Florida, everything becomes risky,” Malani says. “The idea of taking a cruise is much riskier.”
Some of the cruise companies are also waging another battle – against state governments that have passed laws or executive orders aimed at stopping vaccine mandates. On Wednesday, Texas Gov. Greg Abbott passed an executive order banning any state or local mandate that required vaccination against Covid. In Florida, where there are several popular cruise departure ports, Gov. Ron DeSantis signed an executive order in May banning vaccine passports statewide.
Norwegian Cruise Line sued Florida’s top health official in July, requesting a preliminary order to let the company implement its vaccine mandate for all passengers and crew. The company won the case earlier this month, and U.S. District Judge Kathleen Williams wrote that Norway “demonstrated that public health would be endangered if it was required to suspend its requirement to vaccination “.
Relying on a negative Covid test is also a flawed strategy
If it is not quarantined for two weeks before Covid’s pre-test, the test is “basically irrelevant,” Ostrosky says.
To make cruise ships truly safe, he says, companies should require mandatory two-week quarantines for each passenger and crew member, negative Covid tests 24 to 48 hours before boarding, and another negative Covid test. immediately after boarding. It is a costly and difficult process to organize and carry out, especially in the midst of a passenger’s vacation.
If you have to take a cruise, here’s how to be safer
It could be a while before it’s really safe to get on a cruise. Dr Anthony Fauci, a leading national expert on infectious diseases, recently said he believes the country will take control of Covid and regain a sense of normalcy in the spring of 2022. But even then, travel and cruises are likely to be high risk activities.
“We expect a future where more people get vaccinated and the numbers are lower, maybe we’re above the delta variant,” Ostrosky says. “It will be a much safer time to travel.”
If before then your heart is willing to take a cruise, you should get vaccinated when eligible, Malani says. Then look for cruises that require vaccination testing and only allow for reduced capacity : the lower, the better. While you’re on the cruise, choose lower-risk activities and excursions, she says, as you always dine al fresco. And of course, get on the boat understanding that no matter what happens, you take a risk.
The Centers for Disease Control and Prevention (CDC) offers cruise ships a color-coded safety status (green, yellow, orange, and red) based on Covid or Covid-like disease case reports. The agency also indicates when there are investigations into outbreaks on ships. You can check the CDC website for the Covid status of a boat before planning or embarking on a cruise.
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