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Diseases can spread quickly on a cruise ship. Rossella Terranegra/EyeEm/Getty Images
  • The Centers for Disease Control and Prevention (CDC) is advising travelers to avoid cruising for quite a while. The agency rates cruise travel a Level 4: Very High Level of COVID-19.
  • COVID-19 continues to surge in the United States, where more than 267,000 people have died.
  • If you have a cruise trip coming up, it’s best to postpone it.

The Centers for Disease Control and Prevention (CDC) has recommended travelers to avoid cruise ships for the foreseeable future due to a very high risk of COVID-19 transmission.

This advisory comes on the heels of the CDC lifting an order on Nov. 1 that had previously prevented cruise ships of at least 250 passengers in waters subject to U.S. jurisdiction.

Despite lifting the order, the CDC is now advising travelers to avoid cruising for quite a while. The agency rates cruise travel a Level 4: Very High Level of COVID-19.

The CDC recommends “that all people avoid travel on cruise ships, including river cruises, worldwide, because the risk of COVID-19 on cruise ships is very high. It is especially important that people with an increased risk of severe illness avoid travel on cruise ships, including river cruises.”

Most cruise ships with U.S. departures have canceled or postponed their sailings for the 2020-21 season because cruise passengers are at a higher risk for person-to-person transmission of infectious diseases, including COVID-19.

“While I am pleased that the CDC has finally recommended that people avoid cruises for the foreseeable future, it’s unfortunate that they did not take this stance much earlier in the pandemic,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York.

During the initial stages of the pandemic, cruise ships were a major concern for disease transmission.

On Feb. 20, the World Health Organization (WHO) announced that more than 50 percent of the known COVID-19 cases in the world, apart from China, could be traced to one cruise ship, the Diamond Princess.

The ship was quarantined in Japan with more than 3,700 people onboard. Hundreds had become sick with COVID-19.

“Asymptomatic spread of the virus among passengers contributed to the significant morbidity and mortality,” Glatter said.

“Cruise ships are often referred to as ‘floating petri dishes,’ recognizing their high potential for rapid spread of infectious diseases — particularly the norovirus, but COVID-19 of late,” he said.

In March, more than 800 COVID-19 cases were linked to three different cruise ship voyages, according to the CDC.

“Even pre-COVID, we learned that cruise ships are ideal incubators for infectious diseases like E. coli, norovirus, chickenpox, and the flu,” said Dr. Shirin Peters, founder of Bethany Medical Clinic in New York.

“The risk of infection is amplified on a cruise ship because of close quarters of the passengers, and passengers really being at the mercy of the hygiene protocols of the company running the cruise lines,” she said.

Additionally, people can transmit the coronavirus even when they don’t have symptoms. Approximately 40 percent of coronavirus infections occur asymptomatically or before symptoms appear, so containing the spread of the virus onboard is challenging.

The modes of COVID-19 transmission make it difficult to not only detect but challenging to enforce isolation and quarantine protocols in an environment where physical distancing is difficult.

“It’s vital to understand that the difficulty of detecting spread of infection among crew members on a ship may consequently allow the virus to continue spreading among passengers and crew alike during sequential voyages,” Glatter said.

“We also have realized that COVID-19 can spread from ship to ship as a result of crew from a ship with an outbreak transferring to other ships for additional trips. This can facilitate rapid spread from country to country,” he said.

A cruise is a prime example of nonessential travel. Cruises are voluntary and designed entirely for leisure travel.

If you’re scheduled for a cruise itinerary, cancel or reschedule it. If you still decide to cruise during the COVID-19 pandemic, the CDC has the following recommendations:

  • Don’t board if you’re sick, know you have COVID-19, or were exposed to a person with a coronavirus infection in the past 2 weeks.
  • Discuss the travel with your healthcare provider. Older adults and anyone with underlying health conditions have an increased risk for severe illness.
  • Practice physical distancing at all times with anyone who’s not traveling with you.
  • Wear a mask in shared spaces, including public transportation.
  • Wash your hands often, or use hand sanitizer with at least 60 percent alcohol.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.

Passengers who decide to travel are advised to quarantine for 14 days after their return from a cruise journey.

The CDC also suggests getting tested for the coronavirus 3 to 5 days after your trip, and staying home for 7 days after travel. Even if your test is negative, stay home for the full 7 days.

If you don’t get tested, it’s safest to stay home for 14 days after travel.