Cruises Have a Cunning Plan to Stop Superspreaders

By Alex Christian, Wired

Off the Jurassic Coast sits a flotilla of vessels: hulking feats of extravagance, excess and engineering. In normal times, they’d be traversing warm Caribbean currents or Mediterranean waves, stopping off at tourist hotspots, old fishing villages and idyllic islands fringed by rocky cliffs and sandy beaches.

Instead, these ships remain moored in the English Channel. For much of the past year, the furthest they have travelled has been from Bournemouth to Weymouth – wherever on the Dorset coastline is offering the most cost-efficient anchorage. Even with nowhere to go, skeleton crews are on board, testing emergency generators and carrying out maintenance work to delay these 350-metre-long boats from rusting.

But as travel restrictions ease, these cruise ships are finally preparing to up-anchor. And despite a brutal 18 months of travel restrictions and Covid outbreaks on board, operators remain bullish. When a Royal Caribbean Cruises ship became the first major liner to restart US operations in June, its chairman Richard Fain claimed vessels’ contained environment – a hotbed for Covid transmission at the start of the pandemic – now actually brought positives. “Unlike anywhere else we’re able to control our environment, which eliminates the risks of a big outbreak,” he told the New York Times.

Epidemiologists disagree. “It’s contained on the ship, but transmission on board will be very difficult to control,” says Paul Hunter, professor in medicine at the University of East Anglia. “If you have two people meeting on board to talk about their dinner then go on their way, that’s an opportunity of spreading the infection. You can’t control that.”

Cruise lines have felt the effects of Covid more than most industries. Back in February 2020 the Diamond Princess hosted a superspreader event with passengers forced to quarantine in their cabins, yet the outbreak still ripped through the ship. It was not the only such incident. And, as transmission rates fell last summer and borders opened, cruises remained banned in the UK and companies were forced to improvise with trips to nowhere.

When domestic cruises returned to British shores in May they were largely Covid-free, with reduced travel, stop-offs and passenger numbers. But the pandemic struck ships again in July, when luxury cruise line Cunard had to cancel its first local trips because crew members aboard the Queen Elizabeth tested positive. The ship remains moored in Southampton where its 800-strong crew await the cruise line’s first passengers since March 2020. Part of Carnival Corporation, the world’s largest cruise operator, Cunard’s other vessels, the Queen Victoria and its flagship Queen Mary II, are anchored off England’s South Coast. Cunard and Carnival didn’t respond to requests for comment.

Muddying the waters has been the lack of government-sanctioned restrictions on both sides of the Atlantic. Since Fain’s confident comments in June, Florida’s state governor has sued the Centers for Disease Control and Prevention (CDC) over the US public health agency’s guidelines requiring nearly all passengers and crew to be vaccinated against Covid. “Florida wants to be open for business,” says Mark Hanson, a cruise line litigation attorney based in West Palm Beach. “But the State feels that proving vaccines will hamper the industry and cost jobs for the citizens of Florida.”

Court rulings have flip-flopped. Currently, Florida has had the CDC’s Condition Sailing Order overturned, meaning mandated protocols have been reduced to a list of suggestions. The upshot is that passengers boarding in the state where the biggest operators call home – Royal Caribbean, Carnival and Norwegian Cruise Line are all headquartered in Miami – can do so without being jabbed.

While ostensibly for the benefit of the industry, this legal wrangling is hampering it instead. Norwegian has filed a claim against Florida over its ban on requiring proof of immunisation. “Operators want to assure their passengers that they’ll have a safe experience by requiring proof of vaccines,” Hanson explains. “So, the operators are doing a juggling act with the conflicting messages being sent by the Governor and the CDC.”

A spokesperson for Norwegian declined to comment, but pointed to its health and safety protocols which include being able to travel mask-free outside of Europe, as well as no social distancing – so long as passengers are fully vaccinated. Pre-boarding testing, staggered embarkation and controlled guest capacity are some of the other measures being implemented. A Royal Caribbean spokesperson says that guests must complete Covid testing and online health check-ins before sailing, with signage, ground markings and crew safety ambassadors posted throughout. Medical staff are also available via video consultation.

Although cruise lines have said that they’ll voluntarily follow CDC’s guidelines, in legal terms there’s nothing to prevent them from reneging. It’s a similar tale on these shores. Government advice on Covid safety measures for cruise lines is just that – advice with no legal requirement. “If there isn’t a standard practice endorsed by governments or large infectious disease organisations like the CDC, it gives cause for concern that cruise lines will adopt different control measures and maybe not all of them will be the best,” says Bahrat Pankhania, senior clinical lecturer at the University of Exeter.

Cruise lines are, therefore, having to set the rules themselves. By and large, operators require guests to be fully vaccinated. In England, they’re working from guidance produced by the UK Chamber of Shipping. According to the framework, a ship’s contingency plan should come into effect if one individual shows Covid symptoms. Alongside self-isolation cabins fitted with enhanced ventilation, retroactive contact tracing kicks in. The officer in charge would then contact authorities at the next port of call – responsibility for arranging flights back to the UK, if required, falls on the operator.

But it’s not as simple as locking people away in their rooms, nor booking them on the next flight home with airlines not wanting to board symptomatic passengers. “You’d need to set aside secure zones for people quarantining,” Pankhania says. “Going by the experience of the Diamond Princess, more cases arose when people were locked in their cabins because the virus is aerosol-spread – it then circulated through ventilation systems.”

We’re already seeing minor Covid outbreaks on cruises – and how operators are combating them. Last month, six guests tested positive on a seven-night Royal Caribbean round-trip departing from the Bahamas. Each person was quarantined before they disembarked early, travelling home via private transportation. The logistical burden will be greater once passengers from around the world return in their droves.

And it seems that many will. For it’s not governments or health agencies which cruise lines need to convince as much as the holidaymakers themselves. And many are already booking up their next getaway. Paul Derham is a former deputy captain for P&O Cruises. He’s run ‘ghost ship’ tours in which passengers aboard his ferry sightsee the cruise ships anchored off the Bournemouth coast. In lieu of voyages, many of them have made pilgrimages. “We had one passenger pick out the cabin where they’d stayed on a Royal Caribbean from 50 metres away. One of them was able to still pick up the free Wi-Fi.”

Cruises bring about a fervent devotion among its passengers, arguably unlike any other mode of transport. “It’s escapism,” Derham says. “Very rarely will someone do only one cruise. One passenger of mine had done more than 30 of them.” His last cruise was to the ABC Caribbean islands: Aruba, Bonaire and Curaçao. “There were dance classes, deck buffets, gyms. It was the best hotel I’ve stayed at – it just happened to float,” he says. Derham claims that neither masks nor Covid testing would detract from the experience.

Many cruise passengers tend to be older and, therefore, more vulnerable to Covid. The difference now, however, and what cruise lines are banking on, is the success of the vaccine programme in countries that make up the bulk of their customer base. “We didn’t even have the availability of testing before – simple measures like testing before boarding and arrival wasn’t possible,” says Richard Ballantyne, chief executive at the British Ports Association. “I don’t see a repeat of horror stories like the Diamond Princess with the vaccination programme so well progressed. There might be isolated cases, but we’re more prepared as a society for them.”

Cruise operators are also well practised in controlling viral outbreaks like norovirus, although the vomiting bug has a strange advantage over Covid. “It’s very visual – it makes itself known quickly so it’s easier to manage,” says Hunter. “With Covid you can be asymptomatic. Ultimately, you’re bringing people together from all over the world in a relatively small space. The predominant demographic is older. That places cruise liners at higher risk.”

Mix high capacities with close quarters, and a significant Covid outbreak, at some point, seems likely. The question is how bad it will be. Pankhania believes we could see a repeat of the Diamond Princess – and a scenario where swathes of passengers and crew have to be quarantined on board. “I’m very nervous about it. We’re talking about a large floating vessel with thousands of people and many modes of transmission,” he says. “I can foresee a situation where passengers become very ill on a cruise liner and there’s a big outbreak.”