Boost and cruise: CDC pushes for COVID boosters in new optional program for cruise lines
- The CDC released COVID guidelines for cruise lines with Feb. 18 deadline to opt in.
- Are COVID tests required on cruises with new CDC guidance? Yes, the new program still requires testing.
- Cruise Lines International Association called the CDC's latest cruise guidelines "out of step" and "unnecessary."
The Centers for Disease Control and Prevention announced new guidance for the cruise industry Wednesday and will give cruise lines until Feb. 18 to decide whether they want to opt in or not.
The new COVID-19 program comes nearly a month after the agency's Conditional Sailing Order – which outlined numerous health and safety protocols – expired on Jan. 15. Most guidelines outlined in the CSO remain in the updated program.
"The CDC is committed to continuing to work with a cruise industry," Capt. Aimee Treffiletti, who leads the CDC's maritime unit, told USA TODAY in January. "We do hope that cruise lines choose to follow this program, because it does represent the best public health measures to help prevent illness onboard, and COVID transmission, as well as severe outcomes."
"The chance of getting COVID-19 on cruise ships is high because the virus spreads easily between people in close quarters on board ships," the agency says on its website. "If you travel on a cruise ship, make sure you are vaccinated and up to date with your COVID-19 vaccines."
CDC pushes for COVID booster shots among passengers
The CDC's new COVID-19 program adds a new "vaccination status" tier that offers a tailored approach for ships that operate with passengers and crew that are almost entirely fully vaccinated and boosted.
Cruise ships are split into three tiers under the new program: "Highly vaccinated" ships have at least 95% of passengers and crew fully vaccinated. "Not highly vaccinated" ships have less than 95% of passengers and crew fully vaccinated. Ships that fall under the third and newest tier, "vaccination standard of excellence," have at least 95% of passengers and crew "up to date" with their COVID-19 vaccines, which would mean full vaccination plus any eligible booster shots.
COVID-19 quarantine and isolation rules will vary depending on vaccination status:
► On vaccination standard of excellence ships, close contacts to people identified with COVID-19 must quarantine until at least five full days after their last exposure. On ships that do not meet the vaccination standard of excellence, close contacts must quarantine at least 10 days.
► Isolation on vaccination standard of excellence ships can be discontinued after 5 days. On ships that do not meet the vaccination standard of excellence, isolation must last at least 10 days.
Cruise lines with ships of any vaccination classification can opt into the COVID-19 program, but they must share the vaccination status of each ship with the CDC. The agency will post the information on its website along with the ship's color status, which indicates the number of COVID-19 cases reported on board.
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What are the new COVID-19 protocols?
Changes in the new COVID-19 program compared to the CSO program include:
► Cruise ship operators will be able to report if no cases were identified or testing was conducted through an online Enhanced Data Collection form.
► Cruise lines will no longer need the pre-approval from the CDC for diagnostic and screening tests. Testing requirements will remain.
► The CDC will also scrap its requirement to have negative air pressure in quarantine cabins. The CDC does require quarantine cabins to remain in a separate HVAC zone, and isolation cabins will still need to have negative air pressure.
► U.S. ports will still be required to have port agreements with local health authorities, but signed contracts between medical and housing facilities will no longer be required.
► The CDC is also changing its color-coded system for grading cruise ships from red-yellow-orange-green to red-orange-yellow-green, and the criteria for assigning a red, yellow and orange status has changed.
The CDC plans to reevaluate its guidance "based on public health conditions and available scientific evidence" by March 18 and update "as needed."
Trade association 'dismayed' by new guidance
Cruise Lines International Association, a cruise industry trade association, released a statement Wednesday calling the CDC's latest cruise guidelines "out of step" and "unnecessary," pointing to the cruise industry's stringent testing requirements, on-site quarantine facilities and "extensive" response plans.
"The result has been a dramatic drop in the number of COVID-positive cases, with hospitalizations being extraordinarily rare," the CLIA statement read. "The latest CDC guidance appears out of step with the actual public health conditions on cruise ships and unnecessary in light of societal trends away from more restrictive measures."
The trade group also noted that it is "dismayed" by the level 4 travel health notice label, noting that vaccination rates on cruises are much higher than on land.
"It seems unnecessarily discriminatory against cruise to maintain that the chances of getting COVID-19 on a cruise 'is very high' even if you are up to date with your COVID-19 vaccines," the statement said.
Cruises will still be regulated by the CDC regardless of commitment
The CDC has said its new program is voluntary. Cruise lines can choose whether or not to participate. But "voluntary" doesn't mean that cruise ships will not be regulated by the CDC – regardless of whether they opt into the program.
Cruise ship operators "can choose the 'healthy sail' option, or they can choose to kind of do their own thing, but it's very important to keep in mind that ships will still be under CDC's regulatory authority," Treffiletti told USA TODAY in January.
If a cruise line chooses to opt out of the program, its ships would then fall under the CDC's mask order for public transportation and the agency's regulatory authority for inspections. And cruise ships, regardless of participation in the voluntary program, will still be required to report every COVID-19 case on board, just through a "different mechanism" than the way they now report cases.
And if the CDC is concerned about COVID-19 on a ship that isn't under the new program?
"I think (we) will be probably quicker to exercise our regulatory authority," Treffiletti said. "Because, you know, we won't know what's happening on the ship as far as the mitigation measures."
The CDC reserves the right to issue a "no sail" order for a particular ship if the agency has concerns about what is happening on board.
It's in the best interest of public health for lines to volunteer to follow the "healthy sail" program, Treffiletti said. She noted that the program will provide transparency about levels of COVID-19 on board and how the pandemic is being managed, while ships that don't opt in won't have to make public how they are managing the coronavirus on board.
"Passengers should feel good that the industry is really going above and beyond to create a very safe and healthy environment for them," Laziza Lambert, spokesperson for Cruise Lines International Association, told USA TODAY Wednesday.
Contributing: Eve Chen, USA TODAY.