CDC Reveals New COVID-19 Program for Cruise Ships

On Wednesday, the Centers for Disease Control and Prevention finally revealed details on the new COVID-19 Program for Cruise Ships. This information comes nearly a month after the Conditional Sailing Order (CSO) expired on January 15, 2022. Moving forward, the CDC recommends that cruise ships operating in U.S. waters choose to participate in CDC’s COVID-19 Program for Cruise Ships.

Before we get into the details, please keep the following in mind – the rule of the land for your next Disney Cruise will be what is defined in the information provided directly by Disney Cruise Line for your specific sailing, and shared on Disney Cruise Line’s Know Before You Go pages for US sailings.

According to the CDC, cruise lines have until February 18, 2022, to inform CDC if they are participating in CDC’s COVID-19 Program for Cruise Ships. Until then, CDC encourages cruise lines to continue to follow all CDC public health measures for cruise ships, including reporting, testing, and infection prevention and control.

Between now and February 18, all cruise ships in U.S. waters will continue to be assigned a Red, Orange, Yellow, or Green color status unless they inform CDC they are choosing not to participate in CDC’s COVID-19 Program for Cruise Ships.

Additionally, cruise ships’ vaccination status classification will reflect their vaccination status classification in effect prior to January 15, 2022, unless they inform CDC of a different status.

On February 22, 2022, if cruise lines have not informed CDC of their decision to participate in the program, their ships will automatically be designated as “Gray” indicating they are not participating in CDC’s COVID-19 Program for Cruise.

Cruise lines choosing to opt into the program will be required to follow all recommendations and guidance as a condition of their participation in the program. Those opting in will continue to receive a color status for cruise ships operating in U.S. waters on CDC’s Cruise Ship Color Status webpage.

Cruise ships opting into CDC’s COVID-19 Program for Cruise Ships must have a COVID-19 response plan detailing protocols and procedures, provide daily surveillance data to the CDC, and have port agreements in place with U.S. port and local health authorities where the ship intends to dock or port.

Cruise Ship Vaccination Status Classifications

As part of CDC’s COVID-19 Program for Cruise Ships, cruise ship vaccination status classifications are defined as:

  • Not Highly Vaccinated: ships with less than 95% passengers and 95% crew who are fully vaccinated.
  • Highly Vaccinated: ships with at least 95% passengers and 95% crew who are fully vaccinated, but with less than 95% of passengers and 95% of crew who are up to date with their COVID-19 vaccines.
  • Vaccination Standard of Excellence: ships with at least 95% passengers and 95% crew who are up to date with their COVID-19 vaccines.

As of January 16, 2022, the CDC defines “up to date” as “a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.”

Cruise Ship Passenger Impacts

Below is just a brief overview of the hot topic issues such as embarkation screening, mask requirements, and shore excursions. The complete summary of the new program can be reviewed here (archived pdf).

Onboard COVID-19 Testing for Symptomatic Travelers (Crew and Passengers) and Close Contacts

All travelers onboard the cruise ship with signs and symptoms of COVID-19, regardless of vaccination status, must be isolated and tested immediately upon notifying medical staff of symptom onset. Results must be reported to CDC in aggregate through the EDC form.

Close contacts must quarantine for at least 5 full days on ships that have a Vaccination Standard of Excellence, otherwise at least 10 days after their last exposure.

Screening of Embarking Passengers

Cruise ship operators choosing to opt into CDC’s COVID-19 Program for Cruise Ships Operating in U.S. Waters must screen passengers for signs or symptoms of COVID-19 and screen for a known close contact exposure to a person with COVID-19 within the past 10 days.

Passengers with signs or symptoms of COVID-19

  • Deny boarding if not fully vaccinated and without documentation of recovery.
  • May board at operator’s discretion if fully vaccinated, up to date with their COVID-19 vaccines, or with documentation of recovery and embarkation day test is negative by viral test (antigen-negative must be confirmed with NAAT). If an alternate infectious etiology (e.g., influenza, respiratory syncytial virus (RSV), Legionella, Streptococcal pharyngitis) is identified through laboratory testing, routine infection control precautions recommended for the diagnosis should be followed.

Passengers who have a known close contact exposure in the past 10 days

  • Deny boarding unless fully vaccinated, up to date with their COVID-19 vaccines, or has documentation of recovery
  • May board at operator’s discretion if:
    • fully vaccinated or up to date with their COVID-19 vaccines, and asymptomatic
    • with documentation of recovery from COVID-19 and asymptomatic

Testing of Embarking and Disembarking Passengers for Cruise Ship Operators Choosing to Opt into CDC’s COVID-19 Program for Cruise Ships

Passengers Who Are Not Fully VaccinatedPassengers Who Are Fully Vaccinated or Up to Date with COVID-19 Vaccines
Pre-embarkation Day TestingViral (NAAT or antigen test) no more than 3 days before boarding;
NAAT is preferred
Viral (NAAT or antigen test) no more than 2 days before boarding
OR
Viral test on embarkation day
Embarkation Day TestingViral (NAAT or antigen test);
NAAT is preferred
Viral (NAAT or antigen test) no more than 2 days before boarding
OR
Viral test on embarkation day
Disembarkation TestingViral (NAAT or antigen test)Not Applicable
Back-to-Back Sailing TestingViral (NAAT or antigen test)Recommended Viral (NAAT or antigen test)

Mask Use

At this time, all persons, including port personnel, crew, and passengers are advised that CDC’s Mask Order remains in effect and requires the wearing of well-fitting masks on conveyances entering, traveling within, or leaving the United States, and in U.S. transportation hubs.

  • While the Order permits temporarily removing a mask for brief periods of time while eating or drinking, removal of the mask for extended meal service or beverage consumption would constitute a violation of this Order.
  • Cruise ship operators, at their discretion, may advise all passengers and crew that they do not have to wear a well-fitting mask if outdoors. CDC still recommends that people wear a mask if they are not up to date with their COVID-19 vaccines and in crowded outdoor areas.
  • Masks do not have to be worn while inside one’s own cabin.
  • Travelers should not wear a mask when doing activities that may get the mask wet, like swimming at the beach or in recreational water facilities. A wet mask can make it difficult to breathe and may not work as well when wet. This means it is particularly important for bathers who are not fully vaccinated to maintain physical distancing of at least 6 feet (2 meters) when in the water with others who are not traveling companions or part of the same family.

For ships with at least 95% of crew and 95% of passengers up to date with their COVID-19 vaccines, cruise ship operators choosing to opt into CDC’s COVID-19 Program for Cruise Ships, at their discretion, may advise passengers and crew that they do not have to wear a mask in any areas. Confirmation that 95% of crew and 95% of passengers are up to date with their COVID-19 vaccines must be made available to CDC upon request.

Shore Excursions & Transportation Services

Cruise ship operators, at their discretion, may advise passengers and crew that – if they are fully vaccinated or up to date with their COVID-19 vaccines – they may engage in self-guided or independent exploration during port stops or shore leave. The cruise ship operator is additionally advised that foreign or local jurisdictions may have their own requirements.

Cruise Ship Color Status

Color status for cruise ships participating in the program is based on data reported by cruise ships and relevant public health authorities.

The CDC says the color-coding system gives travelers information they can use to make informed decisions before choosing to travel. Color status designations indicate the number of COVID-19 cases reported for each ship in the program, whether an investigation is needed, additional public health measures a ship is taking, and whether a ship has opted out of the program.

“Gray” designated cruise ships are foreign-flagged cruise ships operating in U.S. waters that have chosen not to participate in CDC’s COVID-19 Program for Cruise Ships. These ships may have their own COVID-19 health and safety protocols, which CDC has not reviewed or confirmed. CDC cannot confirm the COVID-19 public health measures implemented on “Gray” designated ships. Therefore, CDC does not have information about precautions and interventions, such as mask use, crew testing, or vaccination status of travelers for these ships.

The process for CDC to determine a ship’s color status is based on the following steps:

  1. COVID-19 program participation Applicable ship types choose whether to participate in CDC’s COVID-19 Program for Cruise Ships. Cruise ships opting into the program on a voluntary basis agree to follow all recommendations and guidance issued by CDC. Foreign-flagged cruise ships operating in U.S. waters will have a “Gray” color status if they choose not to participate in the program. U.S.-flagged cruise ships that choose not to participate in the program will not be listed.
  2. Surveillance data collectionCruise ships submit surveillance data on a daily basis when they participate in the program. CDC monitors data collected and determines each ship’s color status using surveillance data from the previous 7 days—regardless of voyage dates— and CDC’s investigation findings, as applicable.
  3. COVID-19 investigationCDC established an investigation threshold based on suspected or confirmed cases of COVID-19 on board cruise ships operating under the program. CDC uses the investigation threshold to determine when an investigation of a ship is needed and determine the appropriate color status of a ship. As part of the investigation, CDC will obtain additional information from the cruise ship, such as case exposure histories, details about close contacts, proportion of travelers on board who are vaccinated for COVID-19, and the ship’s medical capacities. Any ship that meets CDC’s investigation threshold will be designated “Orange”. CDC will work closely with the cruise line and state and local health departments to consider multiple factors before assigning a “Red” status to the ship.  

Color Status Definitions

CDC amended its color-coding system for CDC’s COVID-19 Program for Cruise Ships to align with its revised investigation threshold. The “Orange” and “Yellow” ship colors were reversed for the COVID-19 Program for Cruise Ships to go in a more logical color order.

GreenNo reported cases of COVID-19 or COVID-19-like illness (CLI).
Yellow^Reported cases of COVID-19 are below the threshold for CDC investigation.
Orange^Reported cases of COVID-19 have met the threshold for CDC investigation.
RedReported cases of COVID-19 are at or above the threshold for CDC investigation. Additional public health measures are in place.
GrayOpted out of CDC’s COVID-19 Program for Cruise Ships. CDC has not reviewed or confirmed the cruise ship’s health and safety protocols.

Color Status Thresholds

When a cruise ship notifies CDC of suspected or confirmed cases of COVID-19 on board, CDC determines whether an investigation is needed based on a predetermined investigation threshold outlined below. CDC will continue to monitor the pandemic, work closely with cruise lines and state, territorial, and local health partners, and consider multiple factors to determine if and when threshold criteria should be revised.

Color StatusThreshold for Passenger ShipsThreshold for Crew-Only Ships
GreenZero casesZero cases
YellowLess than 0.3% of total passengers and/or crewLess than 1% of total crew
Orange0.3% or more of total passengers and/or crew1% or more of total crew
Red†More than 0.3% of total passengers and/or crew plusSustained transmission,Multiple factors that overwhelm onboard medical and/or public health resources, orVariants of concern are identified among on board cases.More than 1% of total crew plusSustained transmission,Multiple factors that overwhelm onboard medical and/or public health resources, orVariants of concern are identified among on board cases.
GrayNot applicableNot applicable

Cruise Ship Status Dashboard

A revised cruise ship color status dashboard has been created to look up the status of cruise ships. It is not easy to read embedded, but it can be opened in a separate browser window. The dashboard can be filled to just show one cruise line.

CDC Cruise Ship Dashboard 20220209
CDC Cruise Ship Dashboard Based on 2/9/2022 Data

The window to view the line item ship data limited as it does not adjust to your computer screen. However, you can right click on the table area and choose view as table to see the encapsulated data set. As of now, the data is locked in, and not easily exportable.

According to the data published by the DCD on February 10th, the Disney Cruise Line ships have not informed CDC of their decision to participate in the COVID-19 Program for Cruise Ships. Remember, the cruise lines have until February 18th to notify the CDC of their decision to participate in the program.

CDC Cruise Ship Dashboard DCL Details 20220209
CDC Cruise Ship Dashboard Based on 2/9/2022 Data

Only time will tell how this will or will not impact the experience of your next cruise. Each cruise line will inevitably have their own set of protocols and procedures in place. Therefore, as I mentioned at the start, the rule of the land for your next Disney Cruise will be what is defined in the information provided directly by Disney Cruise Line for your specific sailing, and shared on Disney Cruise Line’s Know Before You Go pages for US sailings.

Cruise Lines International Association (CLIA) Statement

Cruise Lines International Association (CLIA) issued the following statement regarding guidelines and travel health notice updates from the Centers for Disease Control and Prevention (CDC):

The protocols adopted by every CLIA cruise-line member remain unequaled by other industries. Cruise lines are a model for adopting and employing highly effective, layered mitigation measures and have proven their effectiveness in a way that is unmatched by virtually any other commercial setting.

Unlike any other travel, tourism, hospitality, or entertainment sector, cruise ships test all persons boarding, have medical, isolation and quarantine facilities on site, implement extensive response plans using only private shoreside resources, and have created an environment where almost every single person is fully vaccinated. The result has been a dramatic drop in the number of COVID-positive cases, with hospitalizations being extraordinarily rare – in fact 80 times lower than on land in the U.S. As compared to all the other sectors which, ironically, are much larger, cater to magnitudes more patrons, and operate many more conveyances and facilities without testing and at only a fraction of the cruise industry’s vaccination rates, cruising has emerged as the safest venue for mitigating COVID-19. 

It is through this lens that we are reviewing the details of the guidelines released by the CDC on Feb. 9.

Regrettably, upon initial review, 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. We are confounded by the CDC’s imposition of even more complex and unwarranted measures which ignore empirical evidence that the industry’s protocols have provided a greater level of COVID mitigation than most any other setting. The CDC’s guidance for multitiered cruises is counterproductive to consumers, creating market confusion between the various tiers, and potentially unworkable in practice.

CLIA and its members are fervently devoted to preventing the spread of COVID-19 and protecting passengers, crew, and the public against any adverse health consequences. The record of this unwavering commitment is extensive and irrefutable. 

Against this backdrop, we continue to be dismayed by the CDC’s decision to maintain any Travel Health Notice for cruise. CDC has long recognized the paramount importance of vaccination in protecting against COVID-19 and the vaccination rate on cruise ships is close to 100%, whereas on land it is only about 63%. 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. This discounts the importance of what the CDC has otherwise promoted as the single most important touchstone for public health and safety.

The cruise industry remains one of the most highly regulated sectors even after the expiration of the Conditional Sailing Order. CLIA cruise line members will continue to comply with all applicable regulations. CLIA and its members are committed to continue working with the CDC in mutual, cooperative partnership as part of our shared commitment to putting health and safety first. Part and parcel of that goal is seeing signals from CDC that it recognizes the lengths the entire cruise industry has gone to and the success it has achieved in guarding against COVID-19. 

5 Replies to “CDC Reveals New COVID-19 Program for Cruise Ships”

  1. Larry

    At little confused by a portion of this. Why would non vaccinated travellers have MORE leeway on their pre-testing than vaccinated travellers? According to this non-vaccinated travellers can get tested 3 days out but vaccinated travellers must wait until 2 data out. Feel backwards to me.

    Reply
    1. Christina

      It seems non-vaccinated individuals must be tested twice – no more than 3 days before embarkation AND at embarkation whereas for vaccinated people, the embarkation testing is an OR (i.e. cruiselines can accept the 2-days-prior testing to meet both pre embarkation and embarkation requirements, so it can be just one test for 2 purposes).

      Reply
  2. Tracey Smith

    Thanks for sharing. This is a lot of information.
    It looks like the only thing that is different than what Disney is currently doing is allowing “removal of the mask for extended meal service or beverage consumption”. Does this mean they are in violation now or that they would be in violation if they opted to participate? But then it also says the ship can allow passengers to not wear masks at all if 95% or more are vaccinated. I am very curious as to how only 1 out of 4 ships is considered highly vaccinated given the current requirements.

    Reply
    1. Kevin K.

      I think the highly vaccinated status depends on the number of children under 5 (those who cannot be vaccinated at this time) are on the ship. The more under age 5 then the percentage of vaccinated passengers drops.

      Reply
  3. Brett B.

    I read this three times, it reads so confusing to me. While this may make sense to DCL and other Lines. For the layman it is a congested assembly of data that does not read cohesively. The most confusing is “removal of the mask for extended meal service or beverage consumption would constitute a violation of this Order.” So what are we supposed to do when dining in Remy or Palo?

    Reply

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.