In issuing new guidance, the US Centers for Disease Control and Prevention said cruise operators must screen passengers at embarkation for signs or symptoms of COVID-19 and for close contact to anyone with coronavirus in the prior 14 days.
Anyone with signs or symptoms who isn't fully vaccinated and without documentation of recovery must be denied boarding.
Close contacts with coronavirus in last 14 days
Those not fully vaccinated and without recovery documentation who had a close contact with coronavirus in the prior 14 days should be denied boarding. Fully vaccinated passengers who are asymptomatic and those with recovery documentation who are asymptomatic who had a close contact with coronavirus may be embarked at the cruise operator's discretion.
Documentation of recovery includes paper or electronic documentation of a previous positive viral test dated no more than 90 days ago and a signed letter from a public health official that the person has been cleared to end isolation.
Testing on embarkation and disembarkation days
Though fully vaccinated passengers are exempt from COVID-19 testing, the CDC recommends international travelers arriving in the US be tested three to five days after arrival, including those who are fully vaccinated. Cruise operators may follow this recommendation at their discretion.
Passengers who aren't fully vaccinated or with documentation of recovery in the past 90 days must be tested on the day of embarkation and the day of disembarkation. Testing is also required for these travelers who are on back-to-back sailings, prior to next voyage.
Antigen testing allowed though not preferred
For testing, the CDC will accept NAAT or antigen. (Things are different for crew; read on.)
The agency said it prefers NAAT for use on cruise ships because it is less likely to miss cases when compared to antigen testing. NAAT and antigen tests must meet the CDC's requirements.
Anyone who tests positive, and any of their close contacts who are not fully vaccinated, must be denied boarding. Cruise operators may use confirmatory NAAT testing for a positive antigen screening test.
Cruise operators must follow their Phase 2A port agreements to ensure all travelers identified through embarkation and disembarkation day testing as positive are appropriately managed.
All test results must be reported to CDC through the Enhanced Data Collection form.
No NAAT retesting for positives
To ensure the integrity of testing, persons with positive NAAT results must not be retested, and the original positive results must be reported. Subsequent negative results do not negate an initial positive result.
Unvaccinated crew will need NAAT testing at embarkation
The CDC also said cruise operators may elect not to test fully vaccinated crew when they embark. However, as with passengers, the agency does recommend testing for international travelers arriving in the US three to five days after their arrival, including those who are fully vaccinated.
No quarantine is required for fully vaccinated crew.
NAAT testing is mandated at embarkation for unvaccinated crew, followed by a seven-day quarantine with testing on the seventh day. The quarantine must continue until negative results are confirmed.
NAAT or antigen for routine testing of unvaccinated crew
Routine testing and disembarkation day testing of unvaccinated crew may be NAAT or antigen.
For fully vaccinated crew, routine and disembarkation day testing are left to the cruise operator's discretion.