CDC’s role in helping cruise ship travelers during the COVID-19 pandemic

Outbreaks of infectious diseases can happen on cruise ships because people spend time close together and with travelers from many countries. The current scientific evidence suggests that cruise ships pose a greater risk of COVID-19 transmission than other settings because of the high population density onboard ships, which are typically more densely populated than cities or most other living situations. While this is one contributing factor, CDC’s surveillance data show that drastically decreasing population onboard without additional mitigation measures does not end transmission.

Other factors likely contributing to onboard transmission are crew living and working in close quarters in a partially enclosed environment where social distancing may prove challenging, even with a limited number of people. Additionally, mild illnesses and asymptomatic infections make case detection and isolation and quarantine practices based on clinical presentation alone challenging. Thus, unrecognized spread of infection among crew may keep the virus circulating from one voyage to the next. Disease can spread between ships when crew members from a ship with an outbreak transfer to other ships. Infected people may also travel on cruise ships between countries.

CDC had a No Sail Order in place from March 14 to October 29, 2020 that suspended cruise ship passenger operations in the United States. From July 20 through September 21, 2020, CDC invited public commentsexternal icon on specific questions regarding interventions, methods, protocols, and procedures for protecting the public’s health as well as the health of prospective passengers, crew members, and industry-related service providers. The majority of respondents (approximately 75%) expressed support for resuming passenger operations in a way that mitigates the risk of spreading COVID-19. Most respondents also expressed the need for increased public health measures and accommodations for travelers, including health screening, testing, mask use, social distancing, travel insurance, and refunds.

As of October 30, 2020, CDC will take a phased approach to resuming passenger operations. The initial phases will consist of testing and additional safeguards for crew members. CDC will ensure cruise ship operators have adequate health and safety protections for crew members while they build the onboard laboratory capacity needed to test crew and future passengers. Subsequent phases include simulated (mock) voyages with volunteers playing the role of passengers to test cruise ship operators’ ability to mitigate COVID-19 risk, certification for ships that meet specific requirements, and return to passenger voyages in a manner that mitigates COVID-19 risk among passengers, crew members, and communities. The phases are subject to change based on public health considerations and cruise ship operators’ ability to mitigate COVID-19 risk.

CDC’s Framework for Conditional Sailing Order replaces CDC’s No Sail Order. This Order introduces a phased approach for the resumption of passenger cruises. It also provides a basis for the issuance of additional technical instructions and orders. This Order describes requirements for testing crew and developing onboard testing capacity. Future orders will address additional activities to help cruise lines prepare for and return to passenger operations in a way that mitigates the risk of spreading COVID-19.

What is the Framework for Conditional Sailing Order?

The Framework for Conditional Sailing Order, effective October 30, 2020, describes the phases of resuming passenger operations on cruise ships in a way that mitigates the risk of spreading COVID-19. During the initial phases as described in this Order, cruise ship operators must demonstrate adherence to testing, quarantine and isolation, and social distancing requirements to protect crew members, before passenger travel will be allowed to resume in later phases. Cruise ship operators must also build the onboard laboratory capacity needed to test crew and future passengers.

Passenger operations continue to be suspended during the initial phases of this Order. Cruise ship operators must continue to follow the COVID-19 response plans they developed under CDC’s No Sail Order and the COVID-19 Color Coding System requiring preventive measures for crew on board based on the ship’s status. Cruise ship operators must also follow CDC’s Technical Instructions.

How long is the Framework for Conditional Sailing Order in effect?

The Order is effective upon signature and shall remain in effect until the earliest of

1. the expiration of the Secretary of Health and Human Services’ declaration that COVID-19 constitutes a public health emergency;
2. the CDC Director rescinds or modifies the order based on specific public health or other considerations; or
3. November 1, 2021.

Why did CDC establish the Framework for Conditional Sailing Order?

CDC established the Framework for Conditional Sailing Order to protect the public, cruise ship passengers, cruise ship crews, other industry workers, and federal partners (i.e., Customs and Border Protection and the U.S. Coast Guard). Given the continued spread of COVID-19 worldwide and increased risk of COVID-19 on cruise ships, a careful approach is needed to resume passenger operations. During the initial phases of this Order, cruise ship operators must take adequate safeguards for crew, as demonstrated through laboratory testing for COVID-19 and other measures, to prevent, mitigate, and respond to the risk of COVID-19 onboard cruise ships.

Which cruise ships does the Framework for Conditional Sailing Order cover?

The Framework for Conditional Sailing Order applies to all cruise ships, which the Order defines as commercial passenger ships with the capacity to carry more than 250 people and where an overnight stay onboard by passengers or crew is anticipated. This Order applies to all cruise ships operating in U.S. waters as well as cruise ships operating outside of U.S. waters if the cruise ship operator intends for the ship to return to U.S. waters while the Order remains in effect. This Order does not apply to non-cruise ships such as cargo ships.

What does the Framework for Conditional Sailing Order mean for my upcoming trip?

Passengers who plan to travel by cruise ship should contact their cruise line companies directly for further information concerning their itineraries.

CDC has issued a Level 4 Travel Health Notice with a clear recommendation to avoid all cruise travel due to ongoing spread of COVID-19 and the increased risk of person-to-person spread of infectious diseases on cruise ships.

What was the No Sail Order?

On March 14, 2020, CDC issued a No Sail Order and Suspension of Further Embarkationexternal icon for cruise ships in waters subject to U.S. jurisdiction; the No Sail Order was extended on April 9, 2020, July 16, 2020, and September 30, 2020. During the No Sail Order period, cruise ship operators were required to suspend passenger operations and not embark passengers. The No Sail Order required that cruise ship operators develop plans to prevent, mitigate, and respond to the spread of COVID-19 onboard cruise ships to protect crew. CDC’s Framework for Conditional Sailing Order, effective October 30, 2020, replaces the No Sail Order.

What is CDC doing to help cruise ships with crew still onboard?

CDC is committed to helping cruise lines provide for the safety and well-being of their crew members while onboard and as they disembark.

The process for crew disembarkation required during the No Sail Order period remains the same during the initial phases of the Framework for Conditional Sailing Order.

Crew members on ships in U.S. waters who have questions or concerns about COVID-19 on their ship can contact CDC by sending an email to [email protected].