On June 30, 2020, the European Union (EU) released their first EU Healthy Gateways Report: their guide for cruise companies operating in the EU resuming operation. The report was written by a “working group” that represented the Ministries of Health in nine European nations. While many major cruise lines participated in the writing process, the report probably went further than many of them wished.
The report emphasizes mandatory testing for guests and crew; quarantine facilities both on the ship and in ports; compulsory notification to port authorities of guests and crew if COVID-19 infections are suspected; and costly engineering changes that assure that both guests and crew have proper ventilation throughout the ship and can maintain social distancing.
But even these changes may not go far enough. Three of the first ships to sail this summer have already reported COVID-19 outbreaks among crew and guests. These infections didn’t occur on ships calling in crowded ports: They occurred north of the Arctic Circle in Norway, in Tahiti, and in the Med before the ship entered service.
The EU Gateway Report is 49 pages, and it’s backed by hundreds of pages of references. In the next two weeks, we’re going to take you through most of the report and suggest how it will affect cruises in the next few years. We’ll cover Chapters 1-5 this week which gives the background of the project and describes what needs to be done before a ship sails; and cover Chapters 6-10 next week that outlines the essential engineering changes and what needs to happen when a ship is underway or docked.
The recommendation made by this committee are not (yet) law. They are “guidelines.” However, now that they’re available and supported by the EU, it’s probable that the legal community and the insurance industry will make it very expensive to ignore them. As noted earlier, the virus breakouts on the few ships that sailed this summer, which followed many of the practices the report recommends, makes it likely that the recommendations will become even more stringent by the end of the year.
This will inevitably raise the cost of cruising. Many of the changes are very expensive — especially on older ships that depend on full loads and many inside cabins. However, the higher daily fares will quickly become the New Normal, especially if they mean less crowded ships, better service and food, and dramatic improvements in safety.
Essential preparations (Chapter 3)
Chapters 1 and 2 describe the purpose and development of the report. Recommendations begin in Chapter 3, which starts out with a bang. It states that the responsibility for monitoring the health of the passengers and crew are those of the cruise ship operators. Ditto for determining whether the health conditions in each port makes it safe for passengers and crew to disembark. Based on long-standing nautical practices, this makes the captain of the ship and the cruise line’s executives responsible for fighting the virus: No more sloughing off these life-and-death decisions to PR staff, lawyers, and lobbyists.
The cruise ship operators are also responsible for arranging in advance for medical treatment, ambulance services, and repatriation in every port. These must be included in a comprehensive plan that is filed before the ship gets underway. They also must arrange in advance for quarantine facilities in at least one port on the journey, and for quarantine prices and logistics to be arranged in advance for all crew members and guests.
This will most likely result in mandatory insurance that is built into the price or compensation for everyone onboard. As an example, from the airline industry, Emirates has just bundled a COVID-19 insurance policy in all of its tickets that covers medical and quarantine expenses plus “free” burial! Many cruise ships will introduce similar insurance policies, if only because they’re the most cost-effective way of sharing COVID-19 risks with insurance companies that have deep pockets.
Chapter 3 also calls for “adequate testing capacity” for SARS-CoV-2 infections (the official name for COVID-19) to be carried on the ship, and/or made available onshore before the ship sails. Most of the ships that have begun sailing this summer have testing labs onboard, along with medical personnel who can administer and analyze the tests. This recommendation has already paid off by permitting some of the ships with COVID-19 outbreaks to take action before the disease spreads further.
The final recommendations in this chapter require the immediate reporting of any possible case to the next port of call and having quarantine facilities onboard the ship, near the medical suite, that can accommodate both guests and crew. If the ship will be any place where it can’t reach the needed medical and quarantine facilities in less than 24 hours, 5% of the cabin space for guests and crew must be set aside for this purpose. If the ship can reach a well-equipped port within 24 hours at any point the voyage, this requirement is reduced to 1%. Since many ships will want to sail anywhere, the 5% set-aside will probably become the standard.
Single cabins must be allocated for guests and doubles for crew. Further, these must have adequate ventilation – which usually means window or balcony cabins. As we will learn next week, some of the new medical suites even have negative air pressure similar to hospital operating rooms; and some have telemetry equipment that permits patients to be connected electronically to hospitals anywhere in the world. Also, the entire crew must be trained in their roles in possible outbreaks. This will result in potential COVID-19 outbreaks being treated the same as fires or other emergencies at sea.
These recommendations were tested this week when, on one of the first ships to set sail, the Hurtigruten Roald Amundsen, 36 crew members and several guests tested “positive” while the ship was sailing close to the North Pole. The ship docked in Tromso, Norway, and notified the nearly 500 guests who were still on the ship, or had left it the week before. All of the guests were asked to self-quarantine ashore. Most of the crew were quarantined or treated onboard.
Luckily, Tromso is home to The Arctic University of Norway, one of the northern-most medical schools in the world. This makes it ideal for treatment and infection tracking. My wife and I visited Tromso last summer on the Azamara Journey, and its combination of physical isolation (ships and aircraft are the only way out); communications and computer facilities; and medical students (most of whom speak at least four languages) – are a contact tracker’s dream. If this incident is any evidence of what will come when more ships start sailing, most of the EU recommendations in this section are spot-on, even if they are very expensive to implement.
This chapter is aimed at ensuring that potentially infected passengers don’t board the ship or make reservations. Everyone along the line, from travel advisors, to airline staff, to check-in staff in cruise terminals, will ask guests a series of questions. Those over 65 and members of other high-risk groups with pulmonary or cardiac problems, or diabetes, may have to produce a note from their doctor saying they are permitted to cruise. Also, the report recommends that high-risk guests dine together and have staterooms close to each other.
Good luck on the luxury small ships, which will probably be among the first to sail. On Seabourn, Silversea, Crystal, etc., probably 90 percent of the guests will fall in the high-risk category. Another chapter recommends testing guests and crew within a few days before boarding. Some airlines such as Emirates are already requiring these tests — and the infections on cruises that have just occurred make this a sure bet.
Cruise ships need to have detailed written plans and adequate medical equipment to deal with infections and outbreaks before they occur. Adequate supplies of PPE including gloves, long-sleeved impermeable gowns, goggles or face shields, medical face masks and filtering face-piece (FFP) respirators should be carried on board. An adequate supply of RT-PCR diagnostic panel test kits and equipment for collecting specimens to be tested at facilities on board, or ashore, should be available.
Additional medical crew need to be available on board if required. These decisions should be based on passenger load and demographics in order to support surveillance, testing and case management. Information should be provided to passengers and crew members both before and during the voyage as to what to do to avoid infections or after they occur.
The first half of the report deals with what must be done by the time a cruise is announced to travel advisors and guests. In the second part of this article, that will appear next week, we’ll discuss what should be done to the ships — safety-wise — and what should be done during the cruise to attempt to make it COVID-19 free. Whether you’re a travel advisor, a company executive, or simply a cruising fan, don’t permit the EU recommendations to discourage you. All but a few are eminently possible and may save lives.
Also, don’t forget that hotels, resorts and tour groups will have to make similar adjustments for guests to vacation safely. Here, the cruise lines will have a tremendous advantage because they have much more control over how guests and staff conduct themselves. The costs of all kinds of vacations will inevitably rise, but cruising will remain a top choice for enthusiasts and novices alike.
Dr. Steve Frankel and his wife have sailed on most of the Seabourn, Silversea, Crystal, Azamara, Oceania, Regent, and Windstar ships on more than 40 cruises. Steve’s company, Cruises & Cameras, LLC, partners with LUXE Travel, a FROSCH Company, and the Signature Travel Network. Since the start of the Covid-19 Pandemic, he’s earned two certificates in epidemiology from Johns Hopkins University’s Bloomberg School of Public Health. He’s using what he has learned in six courses, along with his earlier training in measurement and statistics, to help his clients deal with the realities of the pandemic. His most recent book is How to Plan Your Next and BEST Cruise (Amazon, 2019, 186 pages). His email address is Steve@CruisesAndCameras.com.