There are question marks surrounding the cruise industry’s response to the coronavirus pandemic, and travel bans and restrictions are also certain to hit the industry hard. Princesses Cruises’ ships the Grand Princess and Diamond Princess were stranded and quarantined with coronavirus victims onboard in a move that epidemiologist at Harvard University Michael Mina described as ‘no longer ethical’ and ‘wholly inappropriate’. A cruise ship can easily act as a breeding ground for a virus, particularly when a bunch of healthy people (spoiler: not for long!) are trapped onboard amongst infected individuals. We’ve seen it before with norovirus and we’ve seen it now with coronavirus. And, no doubt we’ll see it time and time again in the future with any number of viruses that we are yet to encounter. Sounds like we need a protocol for this.
Taking a different approach, the cruise ship MS Westerdam allowed passengers to disembark in Cambodia. Subsequently, a former passenger tested positive for covid-19, meaning that it was necessary to track down all other passengers. Initially, the World Health Organization (WHO) had praised the decision to let the vessel dock, but this later ended up being questioned. So, what is the right protocol in times like these? Has the new coronavirus forced the cruise industry to consider new measures following a longstanding issue with infectious disease control?
No industry could have been prepared or could have known for sure which steps to take
Dealing with an unprecedented situation
ITIJ asked assistance companies and insurers whether they think the cruise industry’s response to having – or potentially having – coronavirus cases onboard was adequate.
AP Companies’ Project Manager, Development and Cooperation, Elena Glukhman told ITIJ: “To begin with, we should bear in mind that the situation we are facing is totally unique and unpredictable.
No industry could have been prepared or could have known for sure which steps to take. No contingency plan, until now, includes measures for such an outbreak. In our mind, the cruise industry was strictly following WHO’s recommendations, together with local governments’ demands. In many cases, the cruise lines went the extra mile to make sure that everyone on board and in the destinations was safe.”
Julie Remmington, a UK-based insurance industry consultant, believes perhaps more could have been done. She told ITIJ: “I would have thought, bearing in mind the experience the cruise sector has of mass illness outbreaks onboard ships, they would have been better prepared. Having said that, maybe the actions they took stopped the virus spreading more than it did; these are things we will never know the answer to.” She also said that she is surprised that cruise ships kept running. “Bearing in mind the Ruby Princess only last Thursday (19 March) docked in Sydney and allowed people to disembark for onward travel.”
ITIJ also spoke to Andy Harmer, UK and Ireland Director of Cruise Lines International Association (CLIA). He said that policies and protocols were followed to a T. “Since the end of January when WHO first announced the global health emergency, through the time when the WHO declared Covid-19 as a pandemic, CLIA and member lines have consistently and increasingly enhanced our health policies and protocols,” he said. “With the declaration of Covid-19 as a pandemic, we have continued to take unprecedented steps in the face of our common need to address this global health crisis.” He provided an insight into the steps taken: “CLIA has a longstanding member health policy that requires screening of all embarking passengers and crew to help prevent the spread of communicable diseases. CLIA oceangoing members implement outbreak prevention and response measures and their ships must be fitted with medical facilities and shipboard medical professionals available around the clock, 24/7, to provide initial medical care in the event of illness and to help prevent disease transmission. Furthermore, passenger and crew health is protected by a robust system of oversight and enforcement, and public health authorities worldwide inspect cruise ships and enforce health requirements.”
Meanwhile, US-based Royal Caribbean International is enhancing its ‘rigorous global boarding and screening measures’ to protect its guests and crew, in line with guidance from CDC, WHO, public health authorities around the world, and CLIA. As such, the cruise line states: “Until further notice, all ships in the Royal Caribbean International fleet will adopt the following health screening protocols: Mandatory temperature screenings using digital, non-touch scanners are being conducted with guests, crewmembers, and visitors on embarkation day prior to boarding any vessel. If temperatures register about 100.4° F (38 °C), the person and his/her travel companions will be referred to a secondary health screening.” In addition, the cruise line will deny boarding to: Any person age 70 or older, unless the guest provides written verification from a qualified treating physician that certifies the person has no severe, chronic medical condition and is fit to travel; any person with a severe, chronic medical condition, including those specified by the CDC; any person who has travelled from, to or through mainland China, Hong Kong, Macau, Europe, Iran, or South Korea 15 days prior to embarkation; any person who has come in contact with anyone with 15-day prior travel to mainland China, Hong Kong, Macau, Europe, Iran, or South Korea; any person who within 15 days prior to embarkation has had contact with, or helped care for, anyone suspected or diagnosed as having Covid-19; as well as anyone who is currently subject to health monitoring for possible exposure to Covid-19.
Harmer said: “As we face the prospect of new restrictions impacting across our daily lives, the cruising community has been stepping up to the challenge. Everyone has been working around the clock to adapt to the new landscape we find ourselves in and are making every effort to keep customers informed with updated information, even as developments are seeming to occur so rapidly. Our customers should feel assured that our industry remains focused on their safety, health and wellbeing.”
Greg Lawson, Head of Travel Insurance at Collinson Group, agrees that it’s not fair to point the finger of blame at the cruise industry: “Personally, I’m not of the belief that cruise companies are to blame any more than airlines, restaurants or pubs are to blame for social transmission of a virus,” he told ITIJ. “Unfortunately, the nature of cruises means that there are vast numbers of people travelling together in a confined space for a longer period of time, often of a certain age and demographic, and we have always known that the risk of illness and its rapid spread is higher on cruises than anywhere else − I don’t think coronavirus has changed this but has brought a new severity and maybe opened people’s minds up to the inherent risks.”
This challenging and sad situation will contribute to creating new enhanced processes, shipboard protocols and screenings for the industry
In the UK and US, the latest government travel advice states that people over 70 and people with pre-existing health conditions should avoid cruises. Saga, the UK-based travel and insurance company for the over-50s, has cancelled all cruises until May. “The health and safety of customers and colleagues is our number one priority. We have, therefore, made the decision to temporarily suspend operations of our cruises until 1 May 2020. Our customer service teams will be in contact with cruise customers who were due to travel in the next six weeks to offer them either a full refund or a credit for a future departure,” it said.
Princess and Viking have also halted all cruises – Princess Cruises for two months and Viking until 1 May, while Virgin Voyages, the new cruise line that is part of Virgin Group, announced that it will delay its inaugural voyage until 7 August. Jan Swartz, President of Princess Cruises, said: “By taking this bold action of voluntarily pausing the operations of our ships, it is our intention to reassure our loyal guests, team members and global stakeholders of our commitment to the health, safety and wellbeing of all who sail with us, as well as those who do business with us, and the countries and communities we visit around the world.”
But is the action of voluntarily pausing operations bold or is it an imperative measure? It seems cruise companies have no choice but to suspend operations. Given governments’ guidance and the knowledge of previous cruise ship quarantines, surely nobody is clamouring to cruise and surely it would be irresponsible for cruise companies to continue to promote cruises as a safe and enjoyable experience.
Losses and lessons
As such, cruise lines are undoubtedly bracing for losses. “This will be a disastrous time for the industry,” said Dr Christopher Muller, a senior professor at Boston University’s School of Hospitality Administration. “When you have 3,500 people booked on one of these mega cruises and the boat doesn’t go, it’s an enormous expense.” Indeed, it’s been reported that according to a memo sent to staff members, Norwegian Cruise Line will reduce salaried employees’ pay by 20 per cent on a temporary basis starting 30 March. What’s more, the company will also move to a four-day work week.
There is no doubt that cruise companies are better prepared than they have been historically – persistent disease outbreaks throughout history have made sure of this. But coronavirus is unparalleled, in scope and scale, for everyone. And with the cruise industry growing apace, it’s necessary that cruise lines become even better prepared. “The Covid-19 virus has presented the world with a new challenge that is unprecedented in scale. The cruise industry’s already strict protocols have been strengthened throughout as the world has learned more about the challenge faced, under the guidance of international health authorities,” Harmer told ITIJ. “Looking ahead, we will continue to review measures in collaboration with international health authorities. It will also be important that we continue to play our part informing the public of the level of health and hygiene measures that do exist onboard ship for their protection.”
If there is even the smallest silver lining to coronavirus versus cruise ships situation, perhaps it’s that it offered up some useful findings to science. Researchers were able to use the Diamond Princess outbreak to estimate the true fatality ratio of the novel coronavirus in China – around 0.5 per cent. Note, though, that this ratio depends on available healthcare and public health measures. In addition, as some patients initially counted as asymptomatic may later develop symptoms, or even die, it’s possible that the true fatality rate is higher.
In addition, a new government study has found that food-service employees aboard the Diamond Princess hastened the spread of coronavirus on the cruise ship, ultimately contributing to more than 700 cases. When passengers were asked to go into a two-week quarantine in their cabins, crewmembers continued regular duties and delivered meals to guests. “This investigation underscores the need for swift epidemiologic investigation as soon as a Covid-19 case is detected in an area or group where a large number of persons gather in a closed or crowded setting,” researchers said in the report. Yet more lessons learned.
Flattening the curve vs a steep learning curve
Could it be that this period in time, in which we are battling the Covid-19 pandemic, acts as a steep, and somewhat inevitable, learning curve for all stakeholders? As Glukhman sees it, the situation could lead to quicker action being taken in future. “This situation is a big and tough lesson for all the stakeholders: healthcare systems, regulatory bodies, travel industry, cruise lines, and insurers of all kinds. We will all inevitably have to learn from our mistakes. Next time the drastic measures might come quicker, and the industry might even overreact considering all the economic and media challenges they are going through these days.” Remmington agrees: “I think it will have to, not only to regain customer confidence to get people travelling again but from a compliance issue as I think countries will enforce much more stringent rules before allowing ships to dock in the future,” she said.
Maybe the actions they took stopped the virus spreading more than it did, these are things we will never know the answer to
Ultimately, mistakes have been made and lessons learnt that, hopefully, will stand industries in good stead to adequately respond to future unprecedented occurrences. As Glukhman states: “From now on, the industry will be much more prepared, as this challenging and sad situation will contribute to creating new enhanced processes, shipboard protocols and screenings for the industry, in case something similar ever happens again.”