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In breakthrough opening, CDC seeks public comment on cruise operations in COVID-19 era

In a significant move, the US Centers for Disease Control and Prevention formally requested information on how cruise lines could safely operate in the COVID-19 era.

The information may be used to inform future public health guidance and preventative measures relating to cruise ship travel.

This is a breakthrough because, for the first time, it signals an opening for the cruise industry, whose dialogue with CDC, until now, has focused on the safety of crew aboard ships during the no-sail period. It also clearly spells out the multitude of specifics lines will need to address and provides a process for any interested persons or organizations to comment.

Public process, anyone can comment

CDC's request for information, published in the Federal Register, signals an open, public process, since submissions will be part of the public record. All relevant comments will be posted without change to www.regulations.gov.

Comments open to Sept. 21

Written comments will be accepted until Sept. 21. CDC earlier this week extended the US no-sail order though September. Given that comments will be open until just over a week before that, it seems unlikely that cruise ships would be sailing soon after since the agency will need to process and analyze what may be a flood of submissions.

Shorter cruises? Stateroom occupancy limits? Single cabins for crew?

CDC's request for information is in the form of 28 questions with numerous subheads. The agency goes into great detail, covering all aspects of operations and policies. For example: Should cruise lengths be limited? Stateroom occupancy? Should people denied boarding get refunds? 

To what extent and for how long should passenger capacity be reduced?  Should crew cabins be single-occupancy with private bathrooms? 

CLIA 'encouraged' by the chance to engage

Cruise Lines International Association said it's encouraged by this opening and looks forward to engaging with the CDC 'through this and a variety of mediums to achieve our shared objectives and commitments to public health.'

CLIA added that it's actively engaged with oceangoing member lines in their efforts to address public health and will use the research and findings from these engagements to inform an industry-wide COVID-19 policy that addresses the needs of the CDC and other public health authorities around the world.

CDC's request starts with broad-stroke questions, then gets more granular.

Concerning planning and infrastructure, for starters, the agency posed: Given the challenges of eliminating COVID-19 on board cruise ships while operating with reduced crew during the period of the April 15 no-sail order extension, what methods, strategies and practices should operators implement to prevent transmission when operating with passengers?

How should operators bolster their internal public health programs with public health experts and invest in a robust public health infrastructure to ensure compliance with measures to detect, prevent and control the spread of COVID-19?

How should operators ensure internal public health programs are involved in all levels of decision-making processes relating to passenger and crew operations, crew welfare and mental health, occupational health, food safety, potable and recreational water safety, outbreak prevention and management response and illness surveillance?

COVID-19 testing

What is the feasibility of conducting COVID-19 diagnostic testing using FDA-approved or authorized laboratory tests on board a cruise ship? What should be the medical capacity to manage an outbreak or a severe case of COVID-19 on board the ship?

What pre-arrangements should be made to ensure that all US seaport communities will accept a returning ship after an outbreak?

What plans should operators have for shoreside quarantine facilities in the event of an outbreak, without exposing the public and without relying on federal, state or local resources?

Due to obstacles with commercial travel thus far, what pre-arrangements should operators make with airlines to accept crew and passengers from ships not affected by COVID-19?

How should operators address specific country travel restrictions that emerge as COVID-19 increases in certain areas, such as border closures preventing passengers and crew from repatriating? Port closures? Embarking passengers originating from countries with heightened COVID-19?

Further questions invite information on innovations cruise ship operators could develop to reduce the transmission of the virus on board.

The agency wants to know how passengers and crew can go ashore without endangering host communities, whether shore excursions should be limited and how those would safely operate.

Refunds for denied boarding?

CDC also seeks specifics on what would happen if COVID-19 cases are identified on board or following disembarkation.

And, the agency asks, 'Because of the economic costs associated with cruising, some cruise ship passengers may be reluctant to cancel travel plans if they become ill or are exposed to COVID-19 or may try to hide symptoms of illness. Should cruise ship operators fully refund or provide incentives to passengers that: a. Are denied boarding due to COVID-like illness symptoms, confirmed infection or known exposure? b. are denied boarding due to coming from high-incidence geographic areas? c. request last-minute cancellations due to COVID-19 concerns?

Due to the costs associated with seeking medical care on board, and the likelihood that sick passengers will be isolated and their travel companions quarantined for the remainder of their voyage, how should cruise ship operators encourage people to notify the medical center when they experience COVID-19 symptoms?

Cost-benefit analysis

Some questions related to the financial implications for measures. Pointedly, CDC asks what benefits can be expected in terms of averted deaths and illnesses and how does this compare to the expected financial costs of measures that would be implemented?

Legal responsibility for failure to protect public health?

Should cruise ship operators be required to designate a responsible company official who will accept legal responsibility for failure to implement measures to protect public health?

The Federal Register notice is here

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