Safely returning to sailing: "Healthy Sail Panel" recommendations

I got wondering about distancing on the ships if you have a veranda cabin. Obviously, if you’re inside your cabin with all the doors closed that’s not an issue. But, would there be limits on being able to access your veranda? Would they make sure that no one was occupying a cabin either side of you to create distance. Does the fact that the ship moves and the wind could carry a cough or a sneeze downwind create an issue?

I hope not. In my opinion, the cabin verandas are divided/spaced sufficiently for outdoor spacing to make transmission very unlikely. I heard one epidemiologist explain outdoor settings by a smoking analogy. If someone is in a closed room smoking, over time the smoke fills the air of the room. Outside, you might smell the smoke, but it dissipates rather rapidly. The virus does the same, and wind would only increase that. Because of that, there almost certainly wouldn't be sufficient virus in the air between verandas to make someone sick. Maybe if someone directly sneezed from above and you happened to get actual droplets on you. But the odds of that seem rather low too.

Opening veranda doors would actually help reduce transmission. Schools in parts of Europe leave classroom windows open for that purpose.
 
Opening veranda doors would actually help reduce transmission. Schools in parts of Europe leave classroom windows open for that purpose.

Isnt there something with the air controls on ships that when the veranda doors are less open the climate control goes wacky in other staterooms on the same circuit? That would have HORRIBLE implications for air turnover in affected cabins.
 


I feel I am pretty conservative about Covid. I dont love 70% but I think as much as 50% to start might be OK. Does anyone know the average "party size" on DCL sailings? Because if you think of each party as a bubble then you only have to distance between bubbles and I'd thing that 50% occupancy would probably be enough to achieve this even if the bubbles werent always together. Id anticipate that the staff would be reduced by the same or similar amount as the guests.

I have a far bigger problem with the testing recommendations than the occupancy rate. Right now testing, distancing and masks are our biggest defenses. Masks are impractical for a lot of the cruising activities. Perfect distancing will not happen on cruises unless you got down to a ridiculous occupancy rate of like 10-15% (which I am not advocating).

I don't know that the data is out there, but I believe Disney's parks are operating at those 10-15% levels right now. Frankly, until Disney starts loosening restrictions in their parks, I find it hard to believe that Disney would just say "(bleep) it" and ignore those precautions on the boats because it's just too tough.
 
CILA has also made their announcement today:

https://cruising.org/en/news-and-re...e-mandatory-core-elements-of-health-protocols
PRESS RELEASE | SEPTEMBER 21, 2020
CLIA and its Cruise Line Members Announce Mandatory Core Elements of Health Protocols
QUOTE

Core elements include a travel-industry first with 100% testing for passengers and crew
Washington, DC (September 21, 2020)—Cruise Lines International Association (CLIA), which represents 95% of global ocean-going cruise capacity, announced today the adoption of mandatory core elements of a strong set of health protocols to be implemented as part of a phased-in, highly controlled resumption of operations. A critical next step, now that initial sailing has begun effectively with strict protocols in Europe, is the resumption of operations in the Caribbean, Mexico and Central America (the Americas), which encompass the largest cruise market in the world.

Informed by leading scientists, medical experts, and health authorities, the core elements are the product of extensive work by CLIA oceangoing cruise lines and their renowned teams of science and medical experts, including the recommendations from the Healthy Sail panel established by Royal Caribbean Group and Norwegian Cruise Line Holdings Ltd. released today, as well as MSC’s Blue Ribbon group and Carnival Corporation’s collection of outside independent experts. Other considerations included the effective protocols developed for the successful sailings in Europe by MSC Cruises, Costa, TUI Cruises, Ponant, Seadream, and others.

The CLIA Global Board unanimously voted to adopt all of the listed core elements for an initial restart of limited operations in the Americas and, most important, operations related to U.S. ports. These core elements will be continuously evaluated and adjusted against the current state of the COVID-19 pandemic, as well as the availability of new prevention, therapeutics, and mitigation measures.


Coinciding with the release of the core elements agreed to by CLIA ocean-going cruise line members, the Association issued the following statement:

Guided by world-class experts in medicine and science, CLIA and its ocean-going cruise line members have outlined a pathway to support a phased-in, highly-controlled return to passenger service in the Caribbean, Mexico and Central America with protocols that promote the health and safety of passengers, crew and the communities visited. The core elements mirror the successful resumption of cruising in other parts of the world and include 100% testing of passengers and crew prior to boarding — a travel industry first. Initial cruises would sail on modified itineraries under stringent protocols that encompass the entirety of the cruise experience, from booking to debarkation. With support and approval of regulators and destinations, cruises could feasibly begin during the remainder of 2020.

The core elements, which are applicable to CLIA member ocean-going cruise ships subject to the Center for Disease Control and Prevention (CDC) No Sail Order, will also be submitted by the Cruise Lines International Association (CLIA) on behalf of its members in response to the CDC’s Request for Information (RFI) related to the safe resumption of cruise operations. CLIA’s response to the RFI also details other measures that address the entire cruise experience from booking to disembarkation.


Highlights of the core elements include:

- Testing. 100% testing of passengers and crew for COVID-19 prior to embarkation.

- Mask-Wearing. Mandatory wearing of masks by all passengers and crew onboard and during excursions whenever physical distancing cannot be maintained

- Distancing. Physical distancing in terminals, onboard ships, on private islands and during shore excursions

- Ventilation. Air management and ventilation strategies to increase fresh air onboard and, where feasible, using enhanced filters and other technologies to mitigate risk

- Medical Capability: Risk based response plans tailored for each ship to manage medical needs, dedicated cabin capacity allocated for isolation and other operational measures, and advance arrangements with private providers for shoreside quarantine, medical facilities, and transportation.

- Shore Excursions: Only permit shore excursions according to the cruise operators’ prescribed protocols, with strict adherence required of all passengers and denial of re-boarding for any passengers that do not comply.

Implementation of these elements on board every oceangoing ship subject to the CDC’s No Sail Order is mandatory and requires written verification of adoption by each company’s CEO. These elements do not preclude additional measures that may be adopted by individual lines. Measures will be continuously evaluated and adjusted against the current state of the COVID-19 pandemic, as well as the availability of new prevention and mitigation measures.

END QUOTE

They then continue with a number of quotes, additional information and infographics.

DCL is a member of CILA.

SW
 
I don't know that the data is out there, but I believe Disney's parks are operating at those 10-15% levels right now. Frankly, until Disney starts loosening restrictions in their parks, I find it hard to believe that Disney would just say "(bleep) it" and ignore those precautions on the boats because it's just too tough.
According to George Kalogridis the Parks Pres they are between 20 and 30 % at the moment. That was what they presented to reopen, and have been considering increasing capacity but haven't said when or if. Fl Gov is ok with them upping the capacity.
 


Some additional CILA info:

Their COVID-19 Info page is at: https://cruising.org/en/cruise-industry-covid-19-facts-and-resources

It has a FAQ.

This is one of the questions:


What are the other measures that will be included in the global policy?
The additional measures, which will encompass a door-to-door approach covering the guest’s entire cruise experience, from booking through disembarkation, are being finalized now and will be announced in the coming weeks. They will apply globally with some variance for very small ships (less than 250 person capacity) or expedition vessels. Although I’m not able to provide you with a comprehensive list, examples include:
  • Booking procedures and risk disclosures
  • Staggered guest arrivals and departures
  • Health screening including temperature checks for anyone boarding
  • Onboard testing capability
  • Augmentation of medical facilities and staff
  • Capacity management/social distancing
  • Dining restrictions
  • Use of contactless technology
  • Contact tracing
 
I just had a nasal test with negative results in 20 hours.
I wonder if Disney could work out a list of testing sites that will agree to test Disney clients? Orlando, Miami, Port Canaveral, MCO,... just a list of 3-4 per city that will take scheduled appointments. Some travelers don’t have many/any test sites or require symptoms for a test. Then also a short notice facility for those that cannot produce results they forgot at home and needed redone.
Also maybe have those 5 minute testing kits at the ports. I’ll guess Port Canaveral might be considering a temporary testing site for the ships.
Although I’m sure PC and Disney are concerned about being sued for false positives and false negatives. People take their vacation very seriously so the risk is higher.
 
If someone tests negative within 5 days and catches Covid enroute to DCL, how long does it take the viral load to build up in the body to be positive, contagious and spreading? If you're on a 3 night Bahama cruise and catch Covid enroute to embarkation, I doubt that you would be contagious prior to the cruise ending.

I can tell you what happened with my parents. My dad went to a work meeting on a Friday. Someone had just returned from vacation in Michigan and had brought the virus back with him. My dad was sick on Sunday - 2 days from being exposed. My mom was sick on Tuesday - 2 days after my dad exposed her to the virus. 8 people got the virus from that meeting - so this timeframe is solid. Not sure how it has been for others.

My parents could have tested negative on day 5, but both been positive before getting on a Disney cruise ship with how their infection worked. We need testing at the pier.
 
According to George Kalogridis the Parks Pres they are between 20 and 30 % at the moment. That was what they presented to reopen, and have been considering increasing capacity but haven't said when or if. Fl Gov is ok with them upping the capacity.

I would be mega shocked if DeSantis would not be OK with Disney upping capacity at the parks.
 
The physical distancing thing is what is getting me. This is what will determine the capacity that the ship can cruise at. You figure no more sitting with strangers in the dining rooms. You are probably going to have to get rid of 2/3 of the lounge chairs on deck. The pools will have to be closed or maybe you can get 10 people at a time in the pool. Maybe Disney could modify the park reservation system for the onboard pools and deck chairs and bars to. The servers at the bars could where one of the suits like the Emmy presenters wore. What are you going to do about the passengers that refuse to wear a mask once onboard? WDW kicks them out and bans them for life in some cases. Airlines land the plane and kick them off and ban them from flying. I guess they could kick them off the ship at the next port no refund find your own way home.

The testing thing is dead in the water (get it). Around here testing takes about a week to get back and they will not test you unless you get an order from a doctor now. So now you have to make a doctors appointment or go and wait at an urgent care facility and pay for the doctors visit $150 and then pay for the Covid test $$$. I cannot imagine that an insurance company is going to come out of pocket for a test so you can go on a cruise without any symptoms.

But all this is not relevant any way. My wife just pointed out something to me which is hipaa laws. These cruise operators are going to have to set up secure hippa approved computer systems to get these test results and have tons of paperwork filled out to be able to access these computerized test results. No way you can walk into cruise terminal with a print out of a test result and have it be valid. Anybody can forge a test result. Just about all test results are computerized these days. When I got back my test results they were online and the printout that I made could have been printed from any word processor. The cruise line cannot call the lab, the lab will not give them the time of day due to hipaa. Do you think that you are just gonna walk up to your check in host and hand them a test result. What are they going to do with it anyway? If one other person sees that result hipaa violation. These are nothing to be trifled with there are serious penalties for the mishandling of medical records.

If the cruise operators contract with a lab to do the tests you still have all the hipaa law problems once the lab gives the test results to the cruise operator.
 
The physical distancing thing is what is getting me. This is what will determine the capacity that the ship can cruise at. You figure no more sitting with strangers in the dining rooms. You are probably going to have to get rid of 2/3 of the lounge chairs on deck. The pools will have to be closed or maybe you can get 10 people at a time in the pool. Maybe Disney could modify the park reservation system for the onboard pools and deck chairs and bars to. The servers at the bars could where one of the suits like the Emmy presenters wore. What are you going to do about the passengers that refuse to wear a mask once onboard? WDW kicks them out and bans them for life in some cases. Airlines land the plane and kick them off and ban them from flying. I guess they could kick them off the ship at the next port no refund find your own way home.

From the report - bold added by me:

Recommendation 16: To prevent the spread of SARS-CoV-2, cruise operators should require guests and crew to wear cloth face coverings/face masks in accordance with CDC recommendations.24

Specifically, guests should wear face coverings in any indoor, congregate setting regardless of physical distancing measures, but should not be required to wear face coverings in their own cabins. A notable exception is indoor dining. Seating in restaurants and bars/lounges should allow for physical distancing, so guests can eat and drink without needing face coverings while seated.

Face coverings are not required in outdoor settings as long as physical distancing is feasible. However, if physical distancing is not feasible in certain outdoor settings, masks/face coverings among guests should be required in those locations.

For crew members, masks should be worn any time they are engaging with other crew members or guests (i.e., in all public settings, both indoors and outdoors).
 
Rapid testing is coming on board that delivers results in 15 minutes, so you could get swabbed upon arrival at the port and then get results before boarding. This is how the Big Ten conference was able to restart their football season.

https://www.djournal.com/sports/nat...cle_1218670b-bd79-53bd-b5fd-7726d413d59c.html
But yes, you will have to have physical distancing on the ships, and I don't see how Disney can get around that. We'll see much larger crowds at Disney's parks before Disney can operate at 50% of capacity.
 
From the report - bold added by me:

Recommendation 16: To prevent the spread of SARS-CoV-2, cruise operators should require guests and crew to wear cloth face coverings/face masks in accordance with CDC recommendations.24

Specifically, guests should wear face coverings in any indoor, congregate setting regardless of physical distancing measures, but should not be required to wear face coverings in their own cabins. A notable exception is indoor dining. Seating in restaurants and bars/lounges should allow for physical distancing, so guests can eat and drink without needing face coverings while seated.

Face coverings are not required in outdoor settings as long as physical distancing is feasible. However, if physical distancing is not feasible in certain outdoor settings, masks/face coverings among guests should be required in those locations.

For crew members, masks should be worn any time they are engaging with other crew members or guests (i.e., in all public settings, both indoors and outdoors).
This does not sound fun.
 
Face coverings are not required in outdoor settings as long as physical distancing is feasible. However, if physical distancing is not feasible in certain outdoor settings, masks/face coverings among guests should be required in those locations.
Thanks for the info.

In my opinion no way this flies for DCL. WDW requires face coverings any time you are outside of your room or while actively eating or drinking while remaining stationary away from others or physically distanced in a pool. The rules will be the same for a DCL ship and any sort of workaround will be squashed quickly just like at WDW. Other cruise line will have different rules, of course.
 
If one other person sees that result hipaa violation.
This is not quite the case. They do have to have protocols, but it doesn't mean only one crew member can see it, or that other passengers who see it are a violation.
 
Most of the questions in this thread can easily be answered by observing how MSC and other European cruise lines are running cruises in Europe right now. There isn't much new the 'Healthy Sail Panel' has added here.

And if anything on the list is a deal breaker for you, that's great. We need to bring the occupancy numbers down, and it's preferable that people self-select themselves out of it. Round 1 is not for everyone. Sit this one out - your time will come.
 
But all this is not relevant any way. My wife just pointed out something to me which is hipaa laws. These cruise operators are going to have to set up secure hippa approved computer systems to get these test results and have tons of paperwork filled out to be able to access these computerized test results. No way you can walk into cruise terminal with a print out of a test result and have it be valid. Anybody can forge a test result. Just about all test results are computerized these days. When I got back my test results they were online and the printout that I made could have been printed from any word processor. The cruise line cannot call the lab, the lab will not give them the time of day due to hipaa. Do you think that you are just gonna walk up to your check in host and hand them a test result. What are they going to do with it anyway? If one other person sees that result hipaa violation. These are nothing to be trifled with there are serious penalties for the mishandling of medical records.

If the cruise operators contract with a lab to do the tests you still have all the hipaa law problems once the lab gives the test results to the cruise operator.

HIPPA does not apply to the cruise line in general [it may in relation to their direct provision of medical services to a passenger and electronic records related to same]. The cruise line is not a health plan, healthcare provider, or healthcare clearinghouse.

If a passenger provides the cruise line with some kind of proof of a negative covid test, HIPPA is not at play. There may be other privacy laws which are at play that obligates the cruise line to protect the passenger's personal information once they receive it, but HIPPA is not.

The passenger is voluntarily* giving the information to the cruise line. It is the patient's information, and they have the right to give their own to whom they choose.

(*yes I realize it is more "voluntarily" since it is a condition of sailing, but ultimately you do have the choice to not provide it and thus not sail)


Per HHS [ https://www.hhs.gov/hipaa/for-profe...omply-with-hipaa-privacy-standards/index.html ]


Who must comply with HIPAA privacy standards?

Answer:
As required by Congress in HIPAA, the Privacy Rule covers:

  • Health plans
  • Health care clearinghouses
  • Health care providers who conduct certain financial and administrative transactions electronically. These electronic transactions are those for which standards have been adopted by the Secretary under HIPAA, such as electronic billing and fund transfers.
These entities (collectively called “covered entities”) are bound by the privacy standards even if they contract with others (called “business associates”) to perform some of their essential functions. The law does not give the Department of Health and Human Services (HHS) the authority to regulate other types of private businesses or public agencies through this regulation. For example, HHS does not have the authority to regulate employers, life insurance companies, or public agencies that deliver social security or welfare benefits. See our business associate section and the frequently asked questions about business associates for a more detailed discussion of the covered entities’ responsibilities when they engage others to perform essential functions or services for them.

See also https://www.hhs.gov/hipaa/for-professionals/privacy/index.html :

The HIPAA Privacy Rule
The HIPAA Privacy Rule establishes national standards to protect individuals' medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.


ETA: And there is this example discussing why most schools are not subject to HIPPA; while obviously not a cruise ship, similar logic would apply...

https://www.hhs.gov/hipaa/for-profe...ipaa-apply-to-an-elementary-school/index.html

Does the HIPAA Privacy Rule apply to an elementary or secondary school?

Generally, no. In most cases, the HIPAA Privacy Rule does not apply to an elementary or secondary school because the school either: (1) is not a HIPAA covered entity or (2) is a HIPAA covered entity but maintains health information only on students in records that are by definition “education records” under FERPA and, therefore, is not subject to the HIPAA Privacy Rule.

The school is not a HIPAA covered entity. The HIPAA Privacy Rule only applies to health plans, health care clearinghouses, and those health care providers that transmit health information electronically in connection with certain administrative and financial transactions (“covered transactions”). See 45 CFR § 160.102. Covered transactions are those for which the U.S. Department of Health and Human Services has adopted a standard, such as health care claims submitted to a health plan. See the definition of “transaction” at 45 CFR § 160.103 and 45 CFR Part 162, Subparts K–R. Thus, even though a school employs school nurses, physicians, psychologists, or other health care providers, the school is not generally a HIPAA covered entity because the providers do not engage in any of the covered transactions, such as billing a health plan electronically for their services. It is expected that most elementary and secondary schools fall into this category.


(on DCL, if you receive medical care from the medical team, you normally are given a nice paper bill; they do not bill to your insurance; your stateroom account is charged, you pay it, and then you submit a claim to your insurance to be reimbursed; so no electronically billing of health plans for services...)
 
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