These instructions relate to the initial phases of CDC’s Framework for Conditional Sailing Order issued last Friday.
That Order contained 42 references to 'technical instructions' that would be forthcoming.
Shoreside laboratory PCR testing
This is the first batch, pertaining to shoreside laboratory testing of crew. By Dec. 29 — 60 days after the effective date of the Framework Order — cruise ship operators must collect specimens for SARS-CoV-2 testing of crew currently on board their ships and arrange for shoreside PCR testing at a certified laboratory. Specimens have to be tested at the same laboratory and results reported to the CDC.
Those who test positive must not be retested, and the original positive results must be reported. Subsequent negative results do not negate an initial positive result.
CDC will consider all positive results as new cases, unless laboratory documentation of a previous PCR test result within the previous three months is provided. While some positive results may be from people who have recovered from COVID-19 and are no longer infectious, CDC said it cannot adjudicate this without submission of previous laboratory results.
Embarking crew must be tested on the day they join the ship, with their specimens sent to a shoreside laboratory for PCR testing in the same procedure as for the crew already on board. They must immediately quarantine for 14 days, and those who test positive must be isolated until they meet criteria according to the most current CDC guidance.
On-board testing for asymptomatic crew and future passengers
Also by Dec. 29, cruise ship operators in coordination with CDC must implement on-board testing capabilities to be able to test all symptomatic crew and future passengers and their close contacts. Ships must procure rapid PCR equipment for these tests. Antigen testing is not recommended.
All symptomatic crew must be immediately tested and their close contacts quickly identified and tested. CDC said a negative test during quarantine doesn't mean the contact will remain negative after testing so contacts must quarantine for 14 days.
Quarantine and isolation details
Symptomatic crew, close contacts and confirmed cases must isolate or quarantine in single-occupancy cabins with private bathrooms. CDC recommends spacing between cabins and balcony rooms for morale. Meals should be packaged in disposable dining ware with single-use cutlery and delivered with no face-to-face interaction.
Cabins housing isolated or quarantined crew should not be cleaned by other crew members. Cleaning supplies and extra linens can be provided to isolated or quarantined persons so they can clean their cabin by themselves. Instructions for food waste and other trash collection, along with laundry procedures, are specified.
CDC suggested the use of surveillance cameras or security personnel to ensure compliance with isolation or quarantine protocols wherever possible.
Specifics for disembarking crew to obtain medical care are outlined, along with criteria for discontinuing quarantine or isolation and cleaning and disinfection.
Green, yellow, red
And CDC has a color-coded system for preventative measures based on green, yellow or red ship status.
Green ship criteria include no confirmed COVID-19 cases or COVID-like illness for 28 days, no crew transfers from a ship with cases in the last 28 days and immediate 14-day quarantine of embarking crew. Yellow is one or more suspected cases pending PCR test results. And red is one or more confirmed cases in the past 28 days or receiving transfers of crew from a ship that had COVID-19 or COVID-like illness in the past 28 days or that embarked land-based crew who weren't immediately quarantined for 14 days.
A whole variety of actions and scenarios depend on the color code. For example, commercial transport of crew is allowed only for green ships. If crew are asymptomatic, CDC recommends single cabins for a green status ship and requires single cabins for yellow and red status. Crew are recommended to wear masks when outside their cabins on a green ship and required to do so on a yellow or red ship.
Social events, employee meetings, group training, crew bars, gyms and other group settings are only allowed on green ships. Self-service dining at crew and officer messes is not allowed, even for green ships.
More to come
The CDC will continue to update its technical instructions for the additional phases of resuming cruise operations and in future conditional sailing orders.