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Tests for all, masks in 74 'Healthy Sail Panel' recommendations to CDC

CRUISE Mike Leavitt and Scott Gottlieb.jpg
Universal testing, masks and daily temperature checks are among the 'Healthy Sail Panel' recommendations submitted jointly by Royal Caribbean Group and Norwegian Cruise Line Holdings to the Centers for Disease Control and Prevention as part of the agency's request for public comment.

The Healthy Sail Panel's 65-plus-page report includes 74 detailed best practices to protect the public health and the safety of passengers, crew and the communities where cruise ships call.

Five key areas

There are five key areas. First, aggressive measures to prevent SARS-CoV-2 from entering a ship through robust education, screening and testing of crew and guests prior to embarkation. Second, reducing transmission via air management strategies and enhanced sanitation practices. Third, implementing detailed plans to address infection on board, including contingencies for on-board treatment, isolation and rapid evacuation and repatriation. Fourth, closely controlling shore excursions and fifth, enhanced protection for crew.

Protocols, not community infection levels, should inform resumption decision

The panel said it was unable to suggest specific parameters, for example, the local incidence of SARS-CoV-2, that would indicate it is 'safe enough' to begin sailing again. Instead, it suggested that 'ultimately, the thoroughness of a cruise operator’s testing plan and implementation of on-board mitigation measures should be the driving factor in creating a safe environment for cruising.'

The panel of globally recognized experts has been working together for months and is chaired by Mike Leavitt, former secretary of health and human Services, and Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration.

'Taken as a comprehensive approach, we believe the panel's robust public health recommendations will help inform strategies for a safe resumption of sailing,' Gottlieb said.

Ambitious, cross-disciplinary approach

'This panel undertook an ambitious, cross-disciplinary, public health examination to develop standards and guidelines that create the highest level of safety in the complex environment of a cruise ship,' Leavitt added. 'We studied the industry's experiences combating the pandemic and we then incorporated the many lessons learned and advances made by medicine and science over the past six months. The panel's recommendations are grounded in the best scientific and medical information available and are intended to meaningfully mitigate public health risks to those who sail.'

Royal Caribbean Group Chairman and CEO Richard Fain and NCLH President and CEO Frank Del Rio said that in addition to CDC, the findings will be submitted to other authorities around the globe for review and approval as an important milestone in the process of resuming sailing around the world. Any cruise operator or industry can use them.

Many similar protocols, independently drafted, are already in practice by cruise operators that have restarted sailing in Europe and elsewhere.

Among the 'Healthy Sail Panel' specifics:

- Passengers should be tested for COVID-19 between five days and 24 hours before boarding

- At embarkation passengers should undergo an additional health screening

- Crew members should be tested between five days and 24 hours before leaving their home then quarantine on board for seven days and be retested before beginning duties

- Passengers and crew should undergo daily temperature checks

- Passengers and crew should wear a mask in accordance with CDC guidelines. Crew with prolonged passenger contact should wear additional PPE

- Ship capacity should be reduced to allow physical distancing. Density of crew areas should be managed, and single-occupancy crew cabins used whenever possible

- In terminals, touchless check-in and speedier boarding should be facilitated

- Enhanced sanitation, particularly of high touchpoints, on board and in destinations. Disinfectants should be on the Environmental Protection Agency's List N: Disinfectants for Use Against SARS-CoV-2 or national equivalent for terminals located outside the US, which must also comply with local government regulations

- A variety of indoor air management strategies should be used to reduce exposure to infectious droplets/aerosols. HVAC systems should be upgraded to, ideally, MERV 13 filters

- Shipboard capacity to treat critically ill patients, designated quarantine facilities, redundant/backup medical personnel

- Thorough mobilization response plan to address various debarkation scenarios of infected individuals and their close contacts

- Contact tracing methodologies to ensure potential infections are identified as quickly as possible

- Initially, shorter cruises and itineraries as simple as possible, using private, cruise line-operated destinations or ports where there can be tight control of the onshore experience

- Passengers going ashore should be on only cruise line-sponsored or verified excursions initially

The full report is here