The passengers and crew of many cruise ships were found to be infected with the novel SARS-CoV-2 virus during the 2019–20 coronavirus pandemic. Many of these ships had substantial spread of the disease, although many did not. On the British-registered Diamond Princess, which had been quarantined at Yokohama from 4 February 2020 for nearly a month, there was substantial spread of the virus amongst the passengers and crew, drawing headlines worldwide throughout February. The ship had had about 3,700 passengers and crew on board; around 700 people were infected in the incident, and twelve died. On 20 February, the World Health Organisation stated that the ship accounted for more than half of the reported infections around the world, outside of China.[1]
The crisis management team of the German federal government said on 4 March 2020, following several actual and suspected outbreaks on cruise ships, "The Federal Foreign Office has included in its travel advice that there is an increased risk of quarantine on cruise ships."[2] On 11 March 2020, Viking Cruises suspended operations for its 79-vessel fleet until the end of April, cancelling all ocean and river cruises, after it was revealed that a passenger on a cruise in Cambodia had been exposed to the virus while in transit via plane, placing at least 28 other passengers in quarantine.[3][4] Similarly, on 12 March, Princess Cruises, owner of virus-stricken ships Diamond Princess and Grand Princess, suspended operations for all future cruises on its 18-ship fleet for 60 days.[5][6] The Federal Transport Minister of Canada announced on 13 March that ships carrying more than 500 people cannot dock in Canada through 1 July 2020.[7] The United States Coast Guard issued a safety bulletin for Florida, Georgia, South Carolina, and Puerto Rico on 29 March stating that foreign-flagged vessels carrying more than 50 people should prepare to treat any sick passengers and crew on board and try to medically evacuate the very sick to their home countries.[8] A US Coast Guard report on 4 April 2020 stated that "there are 114 cruise ships, carrying 93,000 crew members, either in or near U.S. ports and waters. ... Another 41 cruise ships, with 41,000 crew members, are underway and close to the U.S".[9]
Average age of cruise passengers
A report from Cruise Lines International Association from 2019 states the average age of cruise passengers is 46.9 years, with a median age between 60 and 69 years.[10] Research from 2001 studying the epidemiology of passenger mortalities on cruise ships, indicated a median age of 65 years of cruise participants. It also stated, that between April 1995 to April 2001 "there was an average of one death every six months per ship", with an average of 800 passengers on each ship.[11]
Incidents
Cruise ship incidents with confirmed positive cases on board
SARS-CoV-2 was confirmed on 4 February 2020 to have spread within Diamond Princess during cruise M003,[84] which had departed on 20 January 2020 from Yokohama (in Tokyo Bay near Tokyo) for a round trip.[85] On 20 February the World Health Organisation stated that the ship accounted for more than half of the reported infections around the world, excluding China.[86]
On 20 January 2020, an 80-year-old passenger from Hong Kong, China, embarked in Yokohama, and disembarked in Hong Kong on 25 January. On 1 February, six days after leaving the ship, he visited a Hong Kong hospital, where he tested positive for SARS-CoV-2.[87][88] The ship was due to depart Yokohama for its next cruise on 4 February, but announced a delay the same day to allow Japanese authorities to screen and test passengers and crew still on board. On 4 February, the authorities announced positive test results for SARS-CoV-2 for ten people on board, the cancellation of the cruise, and that the ship was entering quarantine.[87][89]
A total of 3,700 passengers and crew were quarantined by the Japanese Ministry of Health, Labour and Welfare for what was expected to be a 14-day period, off the Port of Yokohama.[90] On 7 February, the total number of people on board with confirmed SARS-CoV-2 infections grew to 61.[91] Another 3 cases were detected on 8 February, bringing the total to 64.[92] On 9 February 6 cases were detected,[93] while another 65 were detected on 10 February, bringing the total to 135.[94]
On 11 February, 39 more people tested positive for the virus, including one quarantine officer, bringing the total to 174.[95] Passengers with confirmed cases were reported to be taken ashore for treatment.[96] On 13 February, 44 more people tested positive for the virus, bringing the total to 218.[97] On 15 February 67 more people were reported to be infected, bringing the total to 285.[98] On 16 February 70 more people were reported to be infected, bringing the total to 355. The next day on 17 February, the Ministry of Health, Labour and Welfare confirmed 99 more cases, raising the total to 454, 33 of whom were crew members;[78][99] on 18 February, another 88 cases were confirmed, bringing the total to 542.[100] By late March it was stated that 712 of 3,711 people on the Diamond Princess, or 19.2% had been infected by COVID-19.[101][102] There is the possibility that quarantine in a cruise ship is dangerous, because the cruise ship does not use HEPA filters which can effectively screen 99 percent of the particles with a diameter of 3 microns or more, as is used in modern airplanes.[103]
Kentaro Iwata, an infectious diseases expert at Kobe University who visited the ship, strongly criticised the management of the situation in two widely circulated YouTube videos published on 18 February.[104][105][106][107] He called Diamond Princess a "COVID-19 mill".[108] He said that the areas possibly contaminated by the virus were not in any way separated from virus-free areas, there were numerous lapses in infection control measures, and that there was no professional in charge of infection prevention—the bureaucrats were in charge of everything.[109] Japanese officials denied the accusations.[110][109] While the U.S. Centers for Disease Control and Prevention commended the efforts to institute quarantine measures, their assessment was that it may have not been sufficient to prevent transmission among people on the ship.[111][112]Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said that the quarantine process had failed.[106] A day later, Yoshihiro Takayama, an acquaintance of Iwata and a doctor working on Diamond Princess, pointed out what he described as errors in Iwata's description of the situation in a Facebook post that went viral.[113] The next day on 20 February, Iwata removed his videos and apologised to those involved, but still insisted the situation on the ship had been chaotic.[113][110]
A preliminary report based on the first 184 cases by Japan's National Institute of Infectious Diseases (NIID) estimated that most of the transmission on the ship had occurred before the quarantine.[113] The cruise line, Princess Cruises had first assumed there was only minimal risk and had initiated only the lowest-level protocols for outbreaks before the quarantine.[114] By 27 February, at least 150 of the crew members had tested positive for the virus.[115][116] Dr. Norio Ohmagari, top government adviser and director of Japan's Disease Control and Prevention Center admitted that the quarantine process might not have been perfect.[115] A crew member reported that many of the crew had been expected to still work and interact with passengers even under the quarantine.[117][118] Princess Cruises stated that Japan's ministry of health was the lead authority defining and executing quarantine protocols, yet Japan's ministry of foreign affairs stated that a criteria of behavior was presented but the ultimate responsibility for safe environment rested with the ship operator.[117] Food service workers were found to have likely been the main early route of spread.[119] 46.5% of the infected passengers and crew members had no symptoms at the time of testing.[120][101][102] The ship outbreak had a basic reproduction number of 14.8;[121] much higher than the usual 2–4.[122]
By 1 March, all passengers and crew members had disembarked from the ship.[123] In early March 2020, Indonesia evacuated 69 Indonesian crew of Diamond Princess, after testing of COVID-19 results in Japan were negative. However, an Indonesian naval hospital ship bringing them to Sebaru Island for a mandatory quarantine period had two crew ill. All were tested again for of COVID-19; 67 passed the second test, 2 did not and were retested with a more accurate, different test, with one negative and one positive result. The 68 persons with negative tests disembarked at Sebaru Island for observation and the one positive person was evacuated by helicopter to Persahabatan Hospital.[124][125] Finally, all 69 persons are stated as definitely negative of COVID-19, after two another negative tests.[126]
Demographics
Of the 3,711 people aboard Diamond Princess 1,045 were crew and 2,666 were passengers.[127] The average age of the crew was 36 well the average age of the passengers was 69.[127] The passengers were 55% female and the crew was 81% male.[127] Of the 712 infections, 145 occurred in crew and 567 occurred in passengers.[128]
Deaths
Two passengers died on 20 February[129] and a third on 23 February, all three of whom were Japanese citizens in their 80s.[130] A fourth passenger, an elderly Japanese man, was reported on 25 February to have died.[131] The fifth fatality, a Japanese woman in her 70s,[17] and the sixth fatality, a British national in his 70s, both died on 28 February.[132][18] A 78-year-old Australian national, who was evacuated from the ship, died on 1 March in Australia, making him the seventh.[19] A Hong Kong national from the ship died on 6 March, making him the eighth.[133] A Canadian man in his 70s died on 19 March, making him the ninth coronavirus-related death from the ship.[134][21] Two Japanese male passengers in their 70s died on 22 March making them the 10th and 11th death.[22] A Hong Kong woman in her 60s died on 28 March, making her the twelfth.[23]
World Dream
World Dream
The cruise ship World Dream (registered in the Bahamas, operated by Dream Cruises) was on a journey from Nansha Port, Guangzhou, Guangdong, China to Nha Trang and Da Nang in Vietnam during 19–24 January 2020 with 6,903 persons on board including 108 from Hubei, in which 28 were from Wuhan.[135]
On 24 January 2020, the ship returned to Nansha Port. Port customs performed a temperature check for all disembarking passengers and crew, with 31 people sampled and tested for the virus, including those who had fever during the cruise and those who were in close contact with confirmed cases before they boarded for the cruise. All the test results were negative though some of them were later confirmed to be infected.[136]
Between 24 January 2020 and 2 February 2020, the ship made three additional cruises out of Guangzhou or Hong Kong, including two "cruises to nowhere" and one to the Philippines, although passengers from the journey were not disembarked at Manila due to local resident protests over fear on the virus.[137]
Confirmed cases
On 2 February 2020, the ship departed from Hong Kong for Taiwan with around 3,800 persons on board. On the same night, the cruise company was notified that there were confirmed cases from the ship's former passengers. On the next day, the Guangdong government officially announced that three former passengers from the Vietnam journey had been confirmed infected by the novel coronavirus after they were disembarked. Former passengers from the cruise in China were told to contact local health authority and observer quarantine.[138]
As of 11 February 2020, 12 cases associated with the cruise were confirmed, including 1 ground worker who had temporarily worked on the ship, and 4 relatives of passengers.[26]
Quarantine and preventive actions
After the Guangdong government official announcement of confirmed cases among former passengers, on 4 February 2020, Taiwan blocked the ship's port of call in Kaohsiung due to concern on the virus. On 5 February 2020, World Dream returned to Hong Kong and all 3,800 passengers and crew on board the ship at the time were put under quarantine at Kai Tak Cruise Terminal.[139] The quarantine was lifted on 9 February 2020 after all 1,800 crew members tested negative for the virus. The majority of the passengers were not tested as they had had no contact with the infected Chinese passengers who had been on the ship during 19–24 January.[140]
Evacuation of crew members
After all passengers were disembarked, World Dream cruised to Malaysia. The crew were not allowed to leave the ship in several countries, after one passenger who had disembarked tested positive for COVID-19. The ship finally anchored near Bintan Island, Indonesia.[141] The evacuation of 188 Indonesia crew members from the cruise ship was performed by an Indonesian naval hospital ship and all tested negative for COVID-19.[142] On 28 February 2020 they were quarantined for 14 days on the uninhabited Sebaru Kecil Islet, Thousands Islands, Jakarta.[143]
MS Westerdam
MS Westerdam pictured on 24 November 2015
In February 2020, the Holland America Line ship MS Westerdam, departing after a stop in Hong Kong on 1 February, was not allowed to call in the Philippines, Japan, and Guam over concerns regarding coronavirus infections.[144][145] After initially receiving approval on 10 February to let the passengers disembark in Thailand, as the ship was heading to Laem Chabang port near Bangkok, permission to dock was refused the next day. However, the ship was still maintaining its course to Bangkok and at around 10:30 am CET on 11 February, Westerdam sailed around the southern tip of Vietnam.[146][147][148] According to Flip Knibbe, a Dutch passenger on the ship, all the passengers had their temperatures checked a second time. Speaking to NOS on 11 February, Knibbe said "Dit schip is virusvrij": 'This ship is virus-free'. Unlike Diamond Princess, those on board were not in quarantine. Everyone could move freely, shops and restaurants were open and the entertainment programme continued.[148]
After Westerdam was refused at several points of call, on 13 February, the ship was allowed to dock in Sihanoukville, Cambodia.[149] At this point, only the 20 passengers who reported feeling ill were tested, and all of them tested negative.[150][151]
On 15 February, Malaysia reported that an 83-year-old US citizen who disembarked from Westerdam and flew into Malaysia on 14 February had tested positive for SARS-CoV-2.[152][153][154] In a second test, requested by both the Holland America Line and Cambodian authorities the woman tested positive again.[155][150][151][153][156] Despite these findings, Cambodian Prime Minister Hun Sen visited the ship, discouraged use of masks, and encouraged the passengers to tour the city, sparking concerns that another spoke was being added to the contagion network.[157] Further cruise passengers were denied entry to Malaysia from Cambodia as a result.[citation needed]
On 22 February, after treatment with antiviral medications that were speculated to have an effect against COVID-19, the woman's medical condition improved and she was tested negative for SARS-CoV-2. The United States Centers for Disease Control and Prevention (CDC) initially stated that the woman had never been infected by SARS-CoV-2, but withdrew the claim, clarifying that the CDC "[has] no visibility on whether the initial test of the woman was anything other than positive".[158] Due to possible background politics, it is uncertain whether these results were a false negative,[159] or whether the passenger cleared the virus from her system after 72 hours of intensive treatment.[160]
Public health officials from Placer County, California reported that an elderly resident with underlying health conditions who had died on 4 March 2020 had tested positive for SARS-CoV-2 after returning from a cruise from San Francisco to Mexico and back on Grand Princess between 11 and 21 February.[161][162][163] This marked the first death in California attributable to the virus.[164][165] The source of the new case's infection appeared to be the same as that of a resident of Sonoma County who tested positive on 2 March and who was also aboard Grand Princess on the same dates.[166][167]
Consequently, Princess Cruises, the owner and operator of Grand Princess, working with the Centers for Disease Control and Prevention (CDC), the government of California, and public health officials in San Francisco, terminated a port call in Ensenada, Mexico planned for 5 March and ordered the ship to return to San Francisco over concerns about the potential for an outbreak on board.[168]
After Grand Princess docked in San Francisco on 21 February, 62 passengers who had been on the previous cruise to Mexico reboarded the ship as it set sail for Hawaii, making stops at Kauai, Oahu, Maui, and Hilo (on the Big Island) between 26 and 29 February.[169][170] These passengers, who may have made been exposed to the same environment as were the Placer or Sonoma County cases during the previous cruise, were quarantined in their own on-board staterooms on 4 March by order of the CDC.[168] In addition, eleven passengers and ten crew members were exhibiting potential symptoms, and Grand Princess was ordered by the government of California to remain offshore while the California National Guard's 129th Rescue Wing airlifted test kits by helicopter to the ship.[171][172][173]
On 5 March, Princess Cruises confirmed that there were 3,533 people on board the ship—2,422 passengers and 1,111 crew members—representing 54 nationalities in total.[174]
On 6 March, U.S. Vice PresidentMike Pence announced that of the 46 tests run on selected passengers and crew members on Grand Princess, 19 crew members and two passengers had tested positive, 24 had tested negative, and one test was inconclusive.[175] Pence announced at a White House Coronavirus Task Force briefing that the ship would be brought to a non-commercial port, and that everyone on the ship would be tested and quarantined as necessary.[175] On 6 March, President Trump said that, despite what experts told him about limiting the spread of COVID-19, he wanted those on board Grand Princess to stay on the ship so that they would not be counted as American cases, which would otherwise "double because of one ship that wasn't our fault."[176]
On 7 March, Princess Cruises confirmed that Grand Princess was still at sea roughly 50 miles (80 km) from San Francisco, and that it was scheduled to dock in Oakland on 9 March, with its passengers to be transferred to facilities on land while the crew would be quarantined and treated on board.[174][177][178][179] The United States Coast Guard had airlifted supplies, including personal protective equipment, to the ship, and had medivacked a critically ill passenger and his travel companion for treatment unrelated to COVID-19.[174]
On 9 March, the ship docked at the Port of Oakland and passengers started disembarking.[180] More than 3,000 people on board were to be quarantined, with passengers at land facilities and the crew on board.[181][181] As of 22:00, 407 people had disembarked.[174]
Princess Cruises confirmed on 10 March that 1,406 people had disembarked from Grand Princess,[174] increasing to 2,042 on 12 March.[174]
Disembarked cases
2 March
California: The Sonoma County Department of Health confirmed that a former passenger of Grand Princess, on the cruise from San Francisco to Mexico, was a (presumptive) case.[182]
3 March
California: Placer County officials confirmed that a former passenger of Grand Princess, also on the cruise from San Francisco to Mexico, was a (presumptive) case.[183] Officials confirmed the next day that the passenger had died.[161][162][164]
5 March
Canada:
Alberta: Alberta reported its first presumptive case, a woman in her 50s who lives in the Calgary area, was on board Grand Princess and returned to Alberta on 21 February.[184]
United States:
California:
Placer County: Officials reported an additional three presumptive positive cases, with all three having travelled on the same cruise on the same dates.[185]
Sonoma County: Health officials announced another positive presumptive case who was a passenger on the same cruise between 11 and 21 February.[186]
Sunnyvale: Department of Public Safety officers reported that they performed CPR on an unconscious 72-year-old patient who was not breathing, but were ultimately unsuccessful in reviving him.[187] After the man died, a family member informed officials that the victim had been a passenger on Grand Princess with two other people currently suspected of being infected.[187]
Nevada: The Washoe County Health District announced that a presumptive positive patient, a male in his 50s, has been linked to Grand Princess.[188] He self-isolated at home.[188] An elementary school in Reno was closed because one of the man's family members is a student there.[188]
6 March
Canada:
Ontario: Health officials confirmed that two new cases, a married man and woman in their 60s, were aboard Grand Princess from 11–21 February and returned to Canada on 28 February.[189]
United States:
California:
Alameda County: Officials confirmed that a former passenger of Grand Princess, an older patient with underlying health problems, has tested positive.[190] The former passenger was on the ship during the trip to Mexico from 11–21 February 2020. The patient was hospitalised and family members were quarantined.
Contra Costa County: Health officials announced that two new cases have been identified, with both having traveled on the same cruise on the same dates.[191]
Marin County: The health department announced that two Marin County residents that were on the cruise and displayed symptoms have also been tested, but Governor Gavin Newsom has prioritised the testing of the passengers currently aboard Grand Princess, and all the tests are going through the same lab.[192]
Hawaii: Governor David Ige announced the state's first case, a male Oahu resident who was a passenger on Grand Princess.[193][194] Although the ship stopped in Hawaii in late February, the man disembarked Grand Princess in Mexico earlier in February (before it returned in San Francisco on 21 February) and flew back home to Honolulu from Mexico.[193][194][195]
Illinois: The Illinois and Chicago public-health departments announced that a former passenger of Grand Princess tested (presumptive) positive. The passenger, a woman in her 50s, had traveled on the same cruise to Mexico and disembarked at San Francisco on 21 February. She was hospitalized and isolated in stable condition. She is a special education assistant in the Chicago public school system, and the school where she worked was to be closed the following week, with all at-risk staff requested to self-quarantine for 14 days.[196]
Utah: The Department of Health confirmed that the first (presumptive) case in Utah is a former passenger of Grand Princess living in Davis County.[197]
7 March
Canada:
British Columbia: Health officials announced that two cases are former passengers of Grand Princess. Both in their 60s, the two patients rode the ship to Mexico and back to California.[198]
United States:
California:
Fresno County: Officials confirmed that a former passenger of Grand Princess had tested positive.[199] The former passenger was on the ship during the trip to Mexico from 11–21 February 2020. The family of the patient is reported to be self-monitoring.
21 and 23 March
Two passengers from Grand Princess died from complications of coronavirus: one on 21 March and the other on 23 March. Both were in their early sixties. Of the 1,103 passengers who elected to be tested, 103 tested positive, 699 tested negative. The remaining results are pending, the Department of Health and Human Services (HHS) said.[200]
1 April
One crew member died in a SF hospital after contracting COVID-19 on-board.[201]
A Taiwanese-American tourist, who had been a passenger on a Nile River cruise ship variously known as MS River Anuket[202] or Asara,[203] discovered that she was positive for SARS-CoV-2 after she returned to Taiwan. World Health Organization officials informed Egyptian authorities of the situation, and all crew members and 150 passengers aboard the cruise ship were tested for SARS-CoV-2.[202] On 7 March 2020, health authorities announced that 45 people on board had tested positive despite being asymptomatic,[30] and that the ship had been placed in quarantine at a dock in Luxor.[202]
On 13 March 2020, five passengers tested positive for the COVID-19 virus aboard MS Braemar. As a result, the ship was denied entry into its destination, the Bahamas. The infected patients were discovered after a former passenger of the cruise tested positive in the Canadian province of Alberta. The infected passenger disembarked off the cruise in Kingston, Jamaica, but it was unknown where they contracted the disease.[204]
Sint Maarten also denied a request from the cruise to allow passengers to fly out.[205]Cuba finally allowed the ship to dock and evacuated all travelers to the United Kingdom on 17 March.[206]
Ruby Princess
From 15 March 2020, Australia banned cruise ships arriving from foreign ports. However, exemptions were granted to allow four ships, already en route to Australia, to dock and disembark its passengers. On 19 March 2020, Ruby Princess, which was one of the four ships given the exemption, docked at the Overseas Passenger Terminal in Sydney, Australia, after a cruise to New Zealand. The cruise ship was forced to return to Sydney early after a passengers reported a respiratory problem, but when disembarking passengers were not told that anyone on board presented any symptoms during the voyage.[207] On 20 March, it was announced that three passengers and a crew member of Ruby Princess had tested positive for the virus.[208] The ship had docked in Sydney Harbour, and the passengers had disembarked before the results came back positive.[209] The ship had returned to Sydney with 1,100 crew members and 2,700 passengers, and 13 people who were sick were tested for the virus.[210]
On 24 March, one person who was a passenger on the 8–19 March cruise aboard Ruby Princess died after a coronavirus diagnosis.[211] As of 30 March, at least 440 passengers (211 in New South Wales, 71 in South Australia, 70 in Queensland, 43 in Western Australia, 22 in the Australian Capital Territory, 18 in Victoria, three in Tasmania and two in the Northern Territory) had tested positive for the virus.[212] As of 31 March 2020, five of them had died, one in the Australian Capital Territory, two in Tasmania, one in New South Wales and one in Queenland.[213] As of 2 April, the number of cases in New South Wales had risen to 337 passengers and 3 crew members, so total passenger cases in Australia had risen to at least 576 cases.[214] As of 4 April the total cases rose to 662 with 7 passengers have died.[53] It is a ninth of the national total of 5,548 confirmed COVID-19 cases, increase from a tenth, five days before.[215] This did not include passengers who left Australia without being tested. Another three passengers from the ship were reported dead in New South Wales[216] and a fourth in Queensland[217] on 5 April.[54] A man was reported to have died in Western Australian on 6 April,[55] bringing total deaths to 12.[54][55] 11 cases of secondary transmission from people infected on the ship had been reported, which had not led to any deaths.[218]
The ship was relocated to Port Kembla on 6 April and authorities will assess the medical situation. At the time, the ship had 1,040 crew members on board, with roughly 20 percent exhibiting COVID-19 symptoms. A news report made this comment: "how the crew will be repatriated, and where the ship will go next, remains unclear".[220]
Fuller particularly questioned whether Carnival Australia had been "transparent in contextualising the true patient and crew health conditions relevant to Covid-19". Coverage by The Guardian included this comment: "Since the ship's 2,700 passengers were allowed to freely disembark in Sydney on 19 March, federal and state authorities have been pinballing blame."[221]
Outbreak of Covid-19 in New Zealand
A crew member flew from Italy to join the Ruby Princess cruise ship in New Zealand on 12 March 2020. But a relationship between this crew member and the outbreak of Covid-19 in New Zealand cannot be confirmed.[222]
Other ships with confirmed cases on board
Pullmantur Horizon
A report on 4 April 2020 stated that this ship had roughly 150 persons who had tested positive for the COVID-19 virus.[223]
Coral Princess
News reports in early April 2020 indicated that Coral Princess, with 1,020 passengers and 878 crew, with some suffering flu-like symptoms, was hoping to be allowed to dock at Port Everglades in Fort Lauderdale to allow passengers to disembark. A news item on 2 April 2020 stated that "Passengers have been confined to their rooms...when the company noticed a higher than normal number of flu-like cases on board". Reports then specified that that "out of 13 passengers and crew tested for COVID-19 on board the Coral Princess, 12 were positive." Officials in Broward County, Florida said that a plan was not yet in place to handle the situation.[224][225]
Coral Princess was diverted and finally docked at the Port of Miami on the afternoon of 4 April with its over 1,000 passengers and 878 crew members. A CNN report that evening indicated that two passengers had died and some others were ill, including the 12 that had tested positive for COVID-19. Those who were not ill were to disembark when flights to their destinations were available; this was expected to take some days.[226] A subsequent news report later that evening stated that four passengers were scheduled to be taken to Florida hospitals and added that 67 persons would not be allowed to disembark.[227]
On 6 April, the death of a third passenger was announced.[228]
Costa Magica
On 12 March, two passengers aboard Costa Magica were reported to be tested positively for COVID-19 while quarantined in Martinique. The ship that departed from Guadeloupe with 3,300 people on board had been disallowed entry in several sea ports including in Grenada, Tobago, Barbados and Saint Lucia, due to over 300 Italian nationals on board.[229]
All the passengers were disembarked, and 930 crew members stayed aboard.[58] Eventually, the ship stopped three miles (4.8 km) offshore from Miami, and on 26 March, the U.S. Coast Guard reported evacuation of six sick crew members from Costa Magica.[230][231][58]
Costa Favolosa
Costa Favolosa departed from Guadeloupe. Six of the disembarked occupants of the ship were tested positive for COVID-19.[58] On 26 March, as the ship stopped three miles offshore from Miami, the U.S. Coast Guard reported evacuation of seven sick crew member, out of 1,009 who stayed aboard.[230][231][58]
Costa Luminosa
On 8 March, an Italian woman was quarantined in the U.S. Territory of Puerto Rico while being tested for the virus. She had arrived there via Costa Luminosa, a cruise ship that had departed from Fort Lauderdale, Florida, U.S..[232] On 13 March she, her husband and a third person's tests came back positive for the virus.[233]
On 19 March the ship disembarked more than 350 passengers from the United States and Canada only at Marseille, France, using buses and then a chartered plane to fly them to Atlanta, Georgia without testing of COVID-19. While in flight, the results from those who were tested in Marseille were positive, so those who positive results were sat in separated seats. At Hartsfield-Jackson Atlanta International Airport, the passengers met people with hazmat suits to check their body temperatures, perform visual assessment and ask if any have COVID-19 symptoms. Those without symptoms were to go to customs and then take their baggage. Several of the passengers became positive for COVID-19 later and some of them died.[234] There are 36 confirmed cases of COVID-19 of those who disembarked from the ship.[235]
On 21 March local news in Puerto Rico reported the death of the woman, aged 68.[236]
Costa Victoria
Costa Victoria left Dubai on 7 March 2020. A female Argentine national was tested positive and disembarked in Crete. 726 passengers were quarantined and managed to leave only after the ship docked in Civitavecchia, near Rome, Italy on 25 March.[62][237]
Silver Shadow
Silversea Cruises ship Silver Shadow was blocked from disembarking its 608 passengers and crew at the port of Recife in Brazil, as a 78-year-old Canadian aboard had been suspected of having the virus.[238] Two passengers were later medically disembarked, and one of them tested positive for the virus.[38]
Silver Explorer
Silver Explorer docked in Castro, Chile, with 111 passengers and 120 crew, after an 83-year-old man fell ill and tested positive for the virus.[38]
Zaandam
The Holland America cruise ship Zaandam was stranded off the coast of Chile after being denied entry to ports since 14 March. Of the 1,829 people (1,243 passengers, 586 crew) aboard, 13 passengers and 29 crew members fell ill with "flu-like symptoms".[64] The vessel is sailing for Port Everglades, Florida hoping to dock on 30 March with a total of 77 sick persons aboard as of 24 March.[239] Four passengers died while waiting for permission to transit the Panama Canal, while the number of sick aboard climbed to 148.[240] Two passengers tested positive for COVID-19.[241] However, on 27 March, the ship was denied transit through the Panama Canal due to the number of sick people on board.[242] On 28 March 2020, both Zaandam and the accompanying vessel Rotterdam were cleared by the Panama Department of Health to transit through the Panama Canal towards their destination in Florida.[243] Anchored thirteen kilometres (8 mi) off the coast, on 28 March asymptomic passengers and some medical staff were transferred from Zaandam to Rotterdam. 53 guests and 85 crew members aboard Zaandam reported flu-like symptoms.[244] By 31 March 2020, the number reported as being "ill" had increased to 193.[245]
Rotterdam followed Zaandam on its way to Florida. An unstated number of passengers from Zaandam were transferred to the second vessel on 28 March 2020.[246][247] At that time, the crew of Zaandam included four physicians and four nurses while Rotterdam had two physicians and four nurses.[248]
As of 30 March 2020, Holland America had not received permission to dock either vessel at Port Everglades in Fort Lauderdale as planned. According to an Associated Press report, the city's mayor, Dean Trantalis, "said he didn't want the ship to dock near his city, at least without extensive precautions".[249][250] The governor of Florida was also hesitant to accept Zaandam at Fort Lauderdale because the state already had so much to deal with during the pandemic; as of 31 March 2020, a decision had not yet been made. The president of Holland America made a public plea for acceptance of the ship and expressed concern that various ports in several countries had been reluctant to provide provisions and medical supplies.[251]
President Donald Trump said on 1 April 2020 that "we have to help the people" [on the ships] and that discussions were underway about Canada and the United Kingdom "arranging flights to retrieve their citizens from the ship". News reports on 2 April stated that the ships would be allowed to dock at Port Everglades that afternoon. The cruise line was making arrangements for passengers who fit to travel from other countries to leave via chartered aircraft, directly from the ship to bus and then to airplane.[252] From the 442 passengers on Zaandam and 808 passengers on Rotterdam there are 107 passengers and 143 crew from 1,186 crew that had influenza-like symptoms, those who had mild symptoms were quarantined in staterooms, and will be released later. All crew, no matter their condition, must stay on board.[253]
A report on 4 April stated that "14 critically ill people" were taken to area hospitals while the others were allowed to disembark when flights to their destinations were available.[254]
Artania
Artania docked at Fremantle in Western Australia on 27 March. Most of the 850 passengers flew home from Perth to Germany on 28–29 March. 41 passengers and crew tested positive to COVID-19 and are being treated in Perth hospitals.[255][65] On 1 April, the ship had 450 crew and about a dozen passengers on board. The Australian Government directed Artania to leave port, but the ship demanded to stay another 14 days, presumably so that they could be treated if COVID-19 symptoms developed.[256] According to the Australian Attorney-General, Christian Porter, "there are still 12 passengers on board some of whom are very unwell. And their level of either illness or frailty is such that they cannot get in a plane."[257]
Ovation of the Seas
In March 2020 thousands of passengers were ordered to self-isolate after disembarking from Ovation of the Seas in Sydney, Australia on 18 March due to COVID-19 fears.[258] 79 passengers subsequently tested positively for the virus. As of 1 April, the ship was located off the coast of New South Wales. The International Transport Workers' Federation had called on the Australian government to allow the crew members to be disembarked so that could be flown to their countries of residence.[45]
The ship departed Australia on 4 April 2020 with its crew.[259]
Voyager of the Seas
Passengers disembarked from Voyager of the Seas in Sydney, Australia on 18 March.[260] A Toowoomba, Queensland man was infected on the ship and was sent into intensive care unit of a Toowoomba hospital after disembarking but died.[261] On 2 April 34 passengers and 5 crew members had tested positively for the virus in New South Wales alone.[262]
The ship departed Australia on 4 April 2020 with its crew.[263]
Celebrity Solstice
Celebrity Solstice disembarked its passengers in Sydney, Australia on 20 March.[264] On 2 April 11 cases had tested positively for the virus in New South Wales alone.[262]
The ship left Australia during the weekend of 4 April 2020 with its crew as did four other vessels.[265]
Ships without confirmed cases on board
Suspected cases
AIDAmira: Six passengers on the ship were isolated, after flying on a plane with a sailor who later tested positive with the virus. More than 1,700 are now trapped on the cruise ship, docked at Cape Town, South Africa.[266]
Costa Diadema: On 24 March 2020, the ship docked at Limassol, Cyprus, and a crew member suspected of suffering from the coronavirus was taken to hospital. Several other crew members were also reported to be ill. Costa Diadema was sailing from Dubai to Savona, Italy, without passengers.[267]
Golden Princess: At least three passengers have been quarantined by the ship's doctor, according to local health officials. It was en route for Melbourne on 18 March 2020.[268] As of 1 April 2020, it was docked in Melbourne.[45]
MSC Magnifica and MV Seabourn Encore anchored off the coast of Western AustraliaMSC Magnifica: More than 250 suspected cases are on board. As of 23 March 2020, the ship was heading for Fremantle, Australia to disembark patients to hospitals and isolation.[271] Later that day, the cruise ship was denied entry into Australia.[272] The ship was subsequently denied entry to Dubai and as of 25 March continued to be in the Perth area.[273]
No currently suspected cases
AIDAaura: The German cruise ship AIDAaura, with about 1,200 people on board, was held on 3 March 2020 in the harbour of Haugesund, Norway, while two asymptomatic German passengers were tested who had been in contact with a person who subsequently developed COVID-19; their test results were negative.[2][274]
Carnival Panorama: On 7 March 2020, the Centers for Disease Control and Prevention (CDC) halted passengers disembarking from the cruise ship Carnival Panorama docked at Long Beach Cruise Terminal in California when a female passenger was reported to be sick.[275] The sick passenger was transported to a hospital to be tested, and all passengers were held on board the ship pending test results.[276][277] The test came back negative late that evening, and disembarkation was scheduled to resume the next morning.[275]Carnival Panorama was returning from a trip to Mexico with scheduled stops at Cabo San Lucas, Mazatlán and Puerto Vallarta, which were also scheduled stops for Grand Princess during the previous month.[275][278][195]
Costa neoRomantica: On 26 March 2020, the ship with no passengers on board, previously quarantined at Nagasaki, Japan, anchored at the roadstead of Vladivostok, Russia to refresh the ship with water, fuel, and food. However, it was denied entrance as the Russian sanitary officials stipulated the dock workers to be quarantined for 14 days. No COVID-19 cases on board were reported.[279][280]
Costa Fortuna: The Italian cruise ship Costa Fortuna attempted to dock at Phuket, Thailand, on 6 March 2020, but was denied by Thai officials because it was carrying passengers who had left Italy within the past two weeks.[281] On 7 March, the ship attempted to dock at Penang in northern Malaysia, but was denied pursuant to a complete ban on cruise ships.[281] The vessel docked in Singapore on 10 March and the passengers disembarked, with some being bused directly to the airport. There were no confirmed cases of COVID-19 aboard the ship.[282]
Costa Serena: Fifteen passengers aboard Costa Serena on 24 January were suspected to have SARS-CoV-2. The ship arrived at its destination, Tianjin, China, on 25 January. With 17 suspected cases, and 146 (of 3,706) passengers from Hubei province where the disease originated, an emergency was declared. The cruise ship was locked down for 19 hours before the passengers were allowed to disembark; no confirmed cases were found.[283]
Costa Smeralda: In January, Costa Smeralda and her 6,000 passengers were quarantined at the port of Civitavecchia in Rome, Italy, following two suspected cases.[284] A spokesperson from Costa Cruises stated that a 54-year-old woman aboard the ship was suffering from a fever and that she and her husband were both being tested. They were found to be uninfected, and passengers were allowed to go on shore the next day.[285]
Grandeur of the Seas: On 12 March 2020, Grandeur of the Seas was denied a request to berth at the Austin "Babe" Monsanto Marine Terminal in the United States Virgin Islands because a crew member had travelled to Japan within the previous two weeks, even though no confirmed cases of coronavirus were on board.[286][287] The ship, however, was eventually allowed to return to transport a seriously-injured passenger to a hospital for treatment.[286]
Europa: The ship docked in Purta Vallarta, Mexico. The government announced on 25 March that it would receive cruise ships “for humanitarian reasons,” but that passengers would be individually "fumigated" before being taken directly to airports to be returned to their home countries. The protocol would apply to Europa and other ships in Mexican waters.[288]
Maasdam: 842 guests and 542 crew members from Holland America Line's Maasdam were not allowed to disembark in Honolulu on 19 March 2020.[289]
Marco Polo: Kenyan authorities screened passengers on Marco Polo for coronavirus when the cruise ship docked at Mombasa on 13 February 2020.[290]
Monarch: On 14 March, Panama repatriated 1,504 Colombian tourists from the cruise ship Monarch. Since the port of Cartagena, Colombia is closed, the people have to fly from Colón, Panama. About 300 people were still waiting to buy tickets.[291]
MSC Meraviglia: On 26 February, Mexican authorities granted permission for MSC Meraviglia, registered in Malta, to dock in Cozumel, Quintana Roo, because she carried a passenger presumed to be infected with the coronavirus. The ship was previously denied access to ports in Jamaica and the Cayman Islands.[292] Two cases of common seasonal flu were found.[293]
Norwegian Jewel: The cruise ship was stranded in the middle of the Pacific Ocean, after being denied entry into Papeete, French Polynesia and Lautoka, Fiji, due to fears of possible infection.[268] On 19 March the 1,700 passengers were prevented from disembarking in Honolulu.[289] On 23 March, the passengers were allowed to disembark in Honolulu in order to catch chartered flights to return to the home locations. There were no confirmed cases of COVID-19 aboard Norwegian Jewel.[294]
Regal Princess: On 7 March, two crew members of Regal Princess were tested and the docking of the ship at Port Everglades in Fort Lauderdale, Florida, U.S., was delayed for about a day while waiting for test results. The tests were negative, and the crew did not have respiratory complications, so the ship was allowed to dock.
Royal Princess: As a crew member from Grand Princess had transferred to Royal Princess fifteen days earlier, the CDC issued a "no-sail order" for Royal Princess on 8 March 2020, prompting Princess Cruises to cancel the ship's seven-day cruise to Mexico before it departed Los Angeles.[195][295][296]
Sun Princess: Princess Cruises ship Sun Princess was not allowed to dock at a port in Madagascar on 13 February 2020, as it had visited Thailand less than 14 days before. The ship docked at the French island of Réunion on 1 March, but passengers were met by a crowd of about 30 who insisted that the passengers be tested and tried to prevent them from leaving the port area. Objects were thrown at passengers, and the police deployed tear gas. Princess Cruises said that there was no evidence of SARS-CoV-2 on the ship.[162]
Vasco da Gama: The cruise ship docked in Fremantle in late March 2020. Almost 100 New Zealand passengers were flown from Perth on 29 March and arrived in Auckland on 30 March. As of 31 March, about 200 West Australian passengers were to be ferried to Rottnest Island, which had been converted to a quarantine zone. Another 600 Australians were to be taken to Perth hotels for 14 days of quarantine.[65]
According to the U.S. Centers for Disease Control and Prevention, proper hazard controls for cruise ships and other commercial vessels include postponing travel when sick, and self-isolating and informing the onboard medical center immediately if one develops a fever or other symptoms while on board. Ideally, medical follow-up should occur in the isolated person's cabin.[297]
A new regulation issued by the CDC on 6 April 2020 stated that passengers on cruise ships would not be able to travel home on commercial flights. They were to travel only by "charter flights and private transportation".[298]
Cruise line stock fell sharply on 27 March 2020 when the US$2 trillion relief package passed by the U.S. Congress and signed by President Trump excluded companies that are not "organized" under United States law. Carnival Corporation & plc is registered in Panama, England and Wales; Royal Caribbean International is chartered in Liberia, and Norwegian Cruise Line Holdings is domiciled in Bermuda. Senator Sheldon Whitehouse, (D-RI), tweeted: "The giant cruise companies incorporate overseas to dodge US taxes, flag vessels overseas to avoid US taxes and laws, and pollute without offset. Why should we bail them out?" Senator Josh Hawley (R-MO) tweeted that cruise lines should register and pay taxes in the United States if they expect a financial bailout. U.S-based employees and American-owned passenger ships will still be eligible for financial assistance.[299]Carnival Cruise Line stock fell 75% between 1 January and 31 March 2020 and dividend payments to shareholders were suspended. On 13 March the company drew down its $3 billion revolving credit line and Moody's and S&P Global downgraded Carnival's debt rating. On 31 March Carnival announced plans to issue $1.25 billion in stock and $4.75 billion in notes due in 2023. The Cruise Lines International Association, a cruise line trade association, claims that the cruise industry supports 400,000 jobs in the United States.[300]
^"クルーズ船で新たに39人感染確認 検疫官も". www3.nhk.or.jp (in Japanese). NHK News Web. 12 February 2020. Archived from the original on 12 February 2020. Retrieved 12 February 2020.
^ abcMoriarty, Leah F. (27 March 2020). "Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020". MMWR. Morbidity and Mortality Weekly Report. 69 (12): 347–352. doi:10.15585/mmwr.mm6912e3.
^"Cruise ship docks in Mombasa, passengers cleared of coronavirus". KBC Channel. Kenya Broadcasting Corporation. Kenya News Agency. 13 February 2020. Archived from the original on 14 February 2020. Retrieved 30 March 2020. The Port of Mombasa Thursday morning welcomed a cruise ship christened 'Ms Marco Polo with 575 passengers and 346 crew members on board. [...] Kenya Ports Authority managing director Daniel Manduku [...] said that the port health department has taken measures to screen all passengers before disembarking from the ship in order to avert entry of diseases such as coronavirus which has greatly affected China.
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