On Friday afternoon, the Centers for Disease Control and Prevention (CDC) lifted the “no sail” order and entered a “conditional sails” order as I expected on Friday morning.
The CDC gives the cruise a thumbs up during a deadly pandemic
The order begins by mentioning that without the FDA-cleared vaccine, COVID-19 continues to spread rapidly around the world. At the date of the order, Over 44,000,000 people have been reported infected with coronavirus and around 1,200,000 people have died worldwide. There have been 8,800,000 COVID-19 cases and over 227,000 deaths in the United States. The CDC concluded that, based on the evidence discussed in the first four “No-Sail” orders, there is “ample evidence” that cruise lines have the potential to worsen and exacerbate the spread of the coronavirus. In fact, the CDC states that cruise lines pose a “greater risk” to COVID-9 transmission than other attitudes.
Cruise ships exacerbate the global spread of the virus
The CDC cited a study in a medical travel diary that the baseline reproduction rate (R0) for COVID-19 on the Diamond Princess cruise ship was an astronomical 14.8, meaning that anyone infected with COVID-19 on Princess Cruises’ ship was the Disease to almost 15 other people. This rate was more than four times the rate of transmission from people at the epicenter of the outbreak in Wuhan, China. The CDC stresses that without mitigation efforts, coronavirus transmission from one guest / crew to another on a cruise would significantly outperform transmissions elsewhere.
Studies show that one reason for the increased transmission rate on a cruise ship is the high population density. However, drastically reducing the number of guests and crew alone will not prevent the broadcast. Other facts Contributing to the transmission are crew members who live and work in confined spaces in a partially enclosed environment where social distancing is difficult.
The CDC continues to do without Washington
A federal health agency focused solely on protecting the health and safety of the public could easily have concluded that the US cruise ban should have been extended indefinitely to 2021. It is clear, however, that outside political influences and the emphasis on restarting cruises at all costs have undermined the agency’s ability to be guided by scientific principles and the empirical evidence listed in the four previous unsailed missions .
In its 40-page sequence, the CDC laid out certain damage control measures to prevent further transmission of the virus to cruise ships. You can see the details of the order here.
A few points should now be made regarding the details of the order:
The CDC takes a “step-by-step” approach. The CDC informed USA TODAY “The first cruises to leave US ports will be simulation sails designed to show that ships and crews meet CDC standards and can contain the spread of COVID-19 on board.” First, cruise ships must “demonstrate compliance with testing, quarantine and isolation, and social distancing requirements to protect crew members while building the laboratory capabilities necessary to test crew and prospective passengers.”
Crew members and “volunteer” passengers are used as guinea pigs
Cruise ships are required to sail on a “simulated” or series of “simulated” voyages in which “volunteer” passengers participate in “unproven and untested health and safety protocols”. The CDC essentially requires cruise lines and volunteer passengers to be used as guinea pigs to test that the untested protocols actually work.
Volunteers will not be representative of normal passenger demographics
The “volunteer” passengers must receive a written certificate from a health care provider that they “do not have any pre-existing medical conditions that would increase the risk of COVID-19 for these people”. This is a bizarre and self-destructive requirement. A significant part of the typical cruise passenger group are older travelers (over 70 years old). Many have underlying conditions like heart disease, chronic lung disease, and diabetes, so if they contract COVID-19, they are at increased risk for serious illness. These individuals could not obtain the required written certification that they are not at high risk. This would result in all simulated cruises involving volunteer passengers who are not representative of the health of many cruise people.
Forms with consent contain illegal exclusions of liability
Volunteers, who must be at least 18 years old, are required to sign a consent form stating that “Sailing during a pandemic is an inherently risky activity”. Health authorities rarely require informed consent, which is primarily a mechanism for businesses to try to limit their liability based on consumer negligence claims. The question arises whether these so-called declarations of consent contain a language that exempts the cruise line from liability. If the forms contain any type of disclaimer that the volunteer passengers must acknowledge, federal law prohibits enforcement of such an agreement.
Cruise ship disclaimers violate 46 USC Section 30509, which prohibits contractual provisions that seek to limit the shipowner’s liability for “personal injury or death caused by the negligence or fault of the owner or the owner’s employees or agents”. We were handling a case about nine years ago where the Eleventh Circle Court of Appeals ruled that a Royal Caribbean disclaimer was invalid and unenforceable. Since then, Royal Caribbean has required passengers to sign such agreements in the hopes that their guests will not understand that the forms are illegal and unenforceable. We expect all cruise lines to include such unenforceable language in the consent forms.
Who pays for evacuation, hospital, medical and travel expenses if passengers are infected?
The CDC urges cruise lines to enter into agreements with “healthcare facilities” that will regulate the evacuation of guests and / or crew members with COVID-19 to onshore hospitals for medical care. Cruise ships are also required to enter into “housing contracts” with “shore isolation and quarantine facilities for COVID-19 cases and close contacts”. However, the order does not mention who will be responsible for the evacuation, hospitalization and medical treatment of the passengers and crew members infected with the virus. Neither does the CDC Explain who will pay the housing, food and livelihoods for those who need to be isolated and quarantined. Unless there is a clear need for the cruise lines to bear these costs, these costs should be borne by the consumer. Most health insurances usually do not cover medical problems on board, especially during a pandemic.
Designed by Royal Caribbean for sailing out of Singapore, the Royal Promise states that the cruise line covers “COVID-19 related costs up to USD 25,000 (USD 20,000) per person in your tour group for onboard medical expenses. Costs for the required quarantine and travel home. Royal Caribbean claims that “we will never stop looking after you.” But precisely under the terms of the Royal Promise, Royal Caribbean promises that it will absolutely cease to take care of the guests who become infected and require medical expenses, evacuation and quarantine on board that exceed USD 20,000, which is probably not enough to cover such an emergency cost. The “pledge” relates only to medical expenses on board and does not appear to cover shore medical expenses or hospital expenses. Furthermore, there are no financial obligations at all in the CDC conditional sail condition.
The CDC also requires the cruise line to notify its guests if a “threshold for COVID-19 is detected” prior to purchasing their cruises. The cruise ends immediately and returns the cruise ship to the U.S. port of embarkation. The cruise line must also notify guests that “their homes may be restricted or delayed”. The CDC regulation does not define what constitutes a “threshold” for the disease. The CDC order does not specify who is responsible for the flight, transportation and hotel costs incurred by literally thousands of guests as a result of a cruise canceled due to COVID-19. The CDC is expected to assume that consumers will also bear all costs of evacuation, quarantine and travel due to a COVID-19 cruise.
Premonition of things to come – Another cruise ship in Europe has a COVID-19 outbreak
Just before the conditional sail order was announced on Friday afternoon, it was revealed that another cruise ship from Italy was one Covid19 outbreak. The French newspaper LeMonde reported that 13 people on the luxury cruise ship Le Jacques Cartier tested positive for Covid-19. The outbreak has been reported by a few travel publications or cruise bloggers who instead focused on the CDC’s conditional sailing order. To date, over 180 passengers and crew on cruise lines in Europe have been infected since cruising on that continent was resumed.
There’s more to come
I will be discussing further details of the CDC’s mitigation efforts in the next few days. I’m particularly interested in the public’s reaction to the CDC, which is essentially requiring cruise lines and volunteer passengers to act as guinea pigs to see if unproven and untested health and safety protocols are actually working.
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Photo Credits: CDC Logo – Centers for Disease Control and Prevention – Public Domain, Commons / Wikimedia; Port of Miami (above) – Marc Averette – CC BY 3.0, Commons / Wikimedia; CDC Building – James Gathany, – Public Domain, Commons / Wikimedia; Port of Miami (center) – Florida Politics; Vice President Pence, Governor DeSantis, and Senator Rick Scott – AP Photo / Gaston De Santis via Palm Beach Post; Costa Diadema – Z thomas – CC BY-SA 4.0 Commons / Wikimedia; Jacques Cartier – on LeMonde.