Cruise lines dropped COVID protocols. How did that impact cases on ships? We got the numbers.
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David Hancock spent his September break doing things he'd never done before. He went on a cruise for the first time, hugged a sloth at a wildlife park in Honduras, and likely contracted COVID-19 at some point during the trip.
The 36-year-old firefighter had avoided infection for two years but tested positive the morning after he and his wife Melissa, who had been celebrating their 15th wedding anniversary, returned home to Savannah, Tennessee.
But not even COVID could put a damper on her sailing at Royal Caribbean International. "I've been going all this time since COVID started without getting it ... so I went and got it on a cruise ship," he told USA TODAY.
"But because I was vaccinated and refreshed, my symptoms were mild," he said, adding that he would definitely go on a cruise again.
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David Hancock got up close and personal with a sloth during his September cruise.
Many of the recent policy changes for cruise lines reflect a shift in approach to the pandemic. Major cruise lines, including Royal Caribbean, Carnival Cruise Line and Norwegian Cruise Line International, halted their vaccination requirements on many cruises and eased testing rules in early September, about two weeks before Hancock set out on his seven-day voyage.
However, after the Centers for Disease Control and Prevention ended its cruise ship COVID-19 program in July and stopped updating its associated website, the spread of COVID has been a relative mystery amid the more relaxed approaches.
But data from the CDC obtained by USA TODAY through a Freedom of Information Act request sheds some light on the numbers cruise lines have reported to the agency after the rules were changed.
What COVID-19 case numbers have cruise lines reported to the CDC?
The numbers also only represent new COVID cases identified by positive virus tests on cruise ships sailing in or out of the United States. The data does not show the test positivity rate or the number of passengers on the departures.
►Norwegian began welcoming all passengers regardless of vaccination status on September 3 and dropped all pre-cruise testing requirements for vaccinated passengers aged 12 and over. In the weeks that followed, the shipping company reported numbers similar to those in the weeks before the rule change. For the week beginning September 4, the cruise line reported 138 new cases and the following week another 161. For the week of September 18, two weeks after the requirements were dropped, Norwegian reported 204 new cases and only 25 the following week .
The cruise line had previously reported 234, 164 and 184 cases, respectively, in the three weeks prior to the change.
►Carnival made similar changes on September 6, removing its requirement for unvaccinated passengers to request a vaccination waiver and further relaxing its pre-cruise testing rule for vaccinated passengers on many cruises.
The cruise line reported 193 new cases for both the weeks ending September 11 and the following week, and another 144 in the week beginning September 25.
Carnival had previously reported 214, 265 and an additional 214 new cases in the three weeks prior to the change, including the week of September 4th.
►Royal Caribbean has also begun to welcome all travelers regardless of vaccination status and has further simplified pre-cruise testing for vaccinated passengers for many cruises on September 5th.
The line reported 341 new cases for the week of September 11 and 306 for the week thereafter. The line then reported an additional 237 new cases for the week of September 25. In the weeks prior to the change, Royal Caribbean had reported 448, 311, and 348 new cases, respectively, including the week of September 4th.
dr Peter F. Rebeiro, assistant professor of medicine in the Department of Infectious Diseases at Vanderbilt University Medical Center, said that generally if unvaccinated passengers who test negative -- as was mandated at the time -- will be mixed with one in the predominantly vaccinated group the "overall risk doesn't increase very much," he said. However, he noted that vaccinated passengers can still spread the virus.
Rebeiro also noted that if transmission is lower in the general population at the time a passenger boards a cruise, they are less likely to spread the virus.
Anne Madison, a spokeswoman for the Cruise Lines International Association, the industry's leading trade group, stressed cruise safety.
"CLIA member cruise lines have a strong track record of effectively managing COVID-19 by making science-based and medically-informed decisions - and continue to have health protocols that surpass those of almost any other non-healthcare venue or travel sector," said them in an email statement.
Madison added that as a condition of membership, cruise lines must adhere to certain protocols, including "maintaining heightened public health measures to reduce the introduction or spread of COVID-19 on board ships" and sailing with high immunization levels among passengers and crew members, among others.
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What does this mean for passengers?
The data from other major cruise lines, including Celebrity Cruises, Princess Cruises and Holland America Line, did not show a consistent pattern in new cases either. Celebrity made similar changes on September 5, while Princess and Holland America did so on September 6.
Around the same period, the weekly COVID case rate per 100,000 people in the U.S. declined steadily, from 209 in the week of August 17 to 96.5 in the week of October 5, according to CDC data.
"CDC has determined that the cruise industry has access to the necessary tools to prevent and mitigate COVID-19 onboard," CDC spokesman Tom Skinner said in an emailed statement. “While CDC provides guidance to cruise lines operating in US waters under CDC jurisdiction, individual cruise lines will establish their own specific COVID-19-related cruise travel requirements. Any reduction in the volume or frequency of routine crew screening tests by cruise lines may result in a reduced number of asymptomatic cases."
Victoria Alvarez knew Carnival had relaxed its protocols when she embarked on her Caribbean cruise in late September. She lives in Florida, she said, and is used to looser rules.
But the risk of catching COVID crossed her mind during the trip. The 27-year-old operations manager said the ship was overcrowded, particularly in the dining and entertainment venues.
Alvarez, who is vaccinated and boosted, said she and her friends took some extra precautions themselves, such as wearing B. Eating outside when they could and avoiding the crowded pools. "We just saved our swimming for the islands," she said.
"I don't know if I haven't been in crowds like this in a while, but it's just been like that, it's a lot," she added of the experience.
What precautions can people take?
dr Anna Bershteyn, an assistant professor in the Department of Public Health at NYU Grossman School of Medicine, said there may be other factors that the data don't reflect, "but it doesn't appear that this guideline (amendment) has had a consistent impact on cruise lines." "
While there are still many COVID-related deaths across the country, she said, many people have been assessing their own risk tolerance. "It comes down to this decision, what are the precautions people should take instead of going back and living life?" Bershteyn said.
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While not all passengers have felt completely safe on cruises since many lines relaxed their rules, Hancock said he and his wife are planning another cruise with Royal Caribbean, even as the requirements have been eased further.
"I have a feeling that COVID is not going anywhere," Hancock said. “It's kind of with us in the long run. It's just a matter of the preparations people make and the risks they are willing to take.”
Bershteyn recommended travelers take steps to protect themselves by first keeping up to date on all vaccine doses they are entitled to. She also recommended they make a plan with their doctor in case they get sick and contact the cruise line to see what their options are.
Once travelers have taken those steps, she said, she would advise travelers looking to cruise to go ahead. "We can't put our lives on hold indefinitely, but we want those safety nets in place in case something happens," she said.
Bershteyn also advised travelers to look for ways to take extra precautions if it "won't detract from the experience," which she says can be different for each traveler. In her case, she wears a face mask when in crowded places like airports, while others choose to eat al fresco whenever possible.
Have you been on a cruise recently? How was your experience?
This article originally appeared on USA TODAY: Here's how many COVID cases cruise lines have reported after easing rules
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