ITIC Americas 2024 | Cruise trends and assistance challenges
Dr Joe Scott of the Carnival Corporation, and Sebastian Kaisin, General Manager of MAWDY Ecuador, asked if the cruise industry has recovered from Covid-19, and what strides forward have been made with regard to medical care and staffing levels onboard ships
Dr Joe Scott, Sr Director, Fleet Medical Operations, Carnival Corporation and PLC, started his talk byexplaining how devastating Covid-19 was to the cruise industry, and that when he started at Carnival it was February 2020 – only a month after the first case of Covid was identified in the US.
Dr Scott went on to talk about the recovery of the industry, and said that between June and July 2021 the first ships returned to service; from May to September 2022 cruise lines returned to full service; and from 2023 there was a gradual de-escalation of Covid protocols. He added that about 35.7 million passengers are expected to cruise in 2024, up from 31.5 million in 2023. This is six per cent more than in 2019, according to the Cruise Lines International Association (CLIA).
Dr Scott then spoke about the long-term risks of Covid-19, pointing out that people who had recovered from Covid-19 had an increased risk of arrhythmia, heart failure, atrial fibrillation, heart attacks, myocarditis, pericarditis, and stokes, alongside gastrointestinal bleeds, hip fractures, vomiting and diarrhoea, influenza, appendicitis, head injury, bowel obstruction, kidney failure, and pneumonia.
Dr Scott said thatGrant Tarling envisioned a set of Carnival Corporation Health Operations Centers (HOC). The development of these centres was accelerated during the pandemic and was unique in the industry. The centres were situated in Miami, Southampton, Hamburg and Sydney, and their activities include:
- Emergency operations
- Regional expertise
- Policy guidance
- Shoreside governmental relations
- Public health surveillance and response
- Ship visits and medical centre audits
- Remote voyage preparation and coordination
- Ship/shore meeting coordination
- Clinical quality reviews, and
- Support for shoreside partners.
To finish, Dr Scott advised that to help cruise companies, assistance companies could do several things more proactively:
- Encourage travel insurance policies that include medevacs
- Answer the phone
- Facilitate rapid replies, and
- Share medical facility knowledge.
He added: “Encourage your clients to carry their medical information, sufficient meds for the cruise and any delays, and to remind them to carry their medication in their hand luggage.” Finally, he stated: “When we call, we need you. There is a liability if the response is delayed.”
Sebastian Kaisin, General Manager at MAWDY Ecuador, started his talk by giving examples of repatriation, and said that: “Taking care of travellers who have had a problem onboard can be a very rewarding activity, but also enormously complex, requiring the collaboration of numerous professionals, sometimes in countries thousands of kilometres away”.
He went on to say that ships are closed or semi-closed settings, in which infection can easily spread and difficult to control. Pool activities, dancing, slippery decks, stairs, and ship maintenance hazards pose trauma risks to both passengers and crew, he added.
Kaisin said there are lots of complexities when it comes to cruise assistance, including:
- Customer profile – ie, issues related to elderly passengers, including past medical history or comorbidities (high risk of decompensation) and that some clients might have mobility limitations.
- Health problems and disease outbreaks could occur onboard a ship due to the particular facilities of cruises and the varied nature of the holidaymakers who choose this experience.
- Cancellations and delays, which are more frequent in cruise tourism due to its nature, as they are subject to more transportation connections and stops.
- Managing medical assistance on cruises is uniquely complex when operating in a maritime environment. This requires company expertise and effective management with special attention to detail.
- Smooth communication with maritime port authorities for effective coordination.
- Healthcare professionals involved must be specialised in maritime health, logistics, and operations coordination.
He went on to say that there is a consensus in the tourism sector that cruising is expected to grow close to a 25-per-cent increase in 2024, compared to the pre-pandemic period, and that insurers should prepare and review their solutions for cruise passengers to ensure coverage is adequate for cancellation/curtailment etc.
When activity resumed after Covid-19, Kaisin said they had the opportunity to create and promote innovative digital solutions, such as telemedicine and online mental health services.
In conclusion, Kaisin said, assistance on cruises is designed for a demographic that presents higher risks and takes place in a maritime environment under very complex circumstances. As a result, the following aspects are essential:
- Specialised medical capabilities with medical teams highly trained and experienced in emergency medicine in maritime environments
- Reliable medical providers: a solid network of hospitals, clinics, and doctors in port destinations
- Efficient coordination between the insurer, the medical staff on the cruise, land-based medical care providers, and maritime ports are critical to ensuring a rapid and adequate response in emergencies
- Clear and efficient processes.