Hospital Ships, Residential Ships, and Quarantine Ships Oh My!

[rimmit]

These thoughts are all sporadically spread throughout other threads and I thought I would consolidate all the ideas and thoughts about the current CDC requirements for cruising here, especially logistics and thoughts regarding what it would take for the cruiselines to start operating.

 

For those that haven’t read it, below is a link to the CDC document outlining what they need to see to life the no sail order.  While there is a 100 day limit on this, unless these conditions are met this will almost assuredly be extended.

https://www.cdc.gov/quarantine/pdf/No-Sail-Order-Cruise-Ships_Extension_4-9-20-encrypted.pdf
 

The CDC basically wants the cruiselines to function as an independent nation independent of any reliance on US government, coast guard, navy or really any support whatsoever.  They want the cruiselines to be able to contain any outbreaks and quarantine without drawing on other countries resources.  They want there to be hospital ships, residential ships and quarantine ships to assist for outbreaks.

 

In order to that, IMO, The entire cruising industry would have to band together,  And each donate at least 3 ships if not more Based on the size of their fleet (one for quarantine, one hospital, one for residential) and these ships would have to be on standby and ready to deploy in the event of an outbreak at a moments notice.  This fleet would need to be stationed on both coasts and if Asia, Europe, Oceania also decided to follow the CDC they would need to have some quarantine fleets there as well.  Given they likely have extra ships sitting around this could be a quick solution.  
 

In order for a cruise ship to have a full fledged hospital on board they would need to staff at least two intensivists, respiratory therapy, nursing and buy multiple ventilators per ship and expand the med bay and equip them with negative pressure rooms.   This is definitely doable.
 

The cruiselines would basically need to be an autonomous nation with its own healthcare rules, etc.  Only relying on nations for refueling and resupply including medical equipment.

 

One other forum member mentioned some type of healthcare tax being added onto the cruises in order to support this endeavour.  That would be one way to fund this.

The logistical operation of this is massive and not one that can be done quickly.  By the time they implement this it is likely a vaccine will be here by then.  however, for those that believe that cruises are going to be sailing June, July, Aug, or whatever month you pick, this is what the CDC wants to see done before they are sailing out of the US again.  I would be shocked if other countries did not follow suit.  Especially after the Ruby Princess debacle.  

 

Curious as to what other solutions people may come up with to this dilemma to get the cruiselines operating sooner.  Repurposing current cruises ships into quarantine, hospital and residential vessels seems like the fastest solution.  Finding medical staff to staff these ships maybe the harder part. 

Given the rate that quarantines were popping up at the end of March the medical fleet may have to be quite sizable.

 

Personally, I think the cruiselines will likely wait it out in hopes of a vaccine, but they may try to comply with the CDC.  Thoughts?

Edited April 14, 2020 by rimmit

[John&LaLa]

It could be like NATO and Warsaw Pack

Royal and her allies could be NATO

Carnival and her allies could WP

 

NCL, MSC, etc.. would have to pick a side

[adidas5676]

Yeah, I think they would basically have to redesign and repurpose some ships for medical if they want any chance of cruising late summer 2020. But that's just 1 small part of the big picture, in which airline operations to get leisure travelers to-and-from, Drs notes for travelers, worldwide port and excursion staff protocols, etc etc would have to figure out their own pieces. The logistics of all this are overwhelming.  It will take months for all these sectors to figure out how to proceed, and that is AFTER we start seeing declines in new cases.  Right now in Florida we still see 800-1000 NEW cases every single day and an average of 30 new deaths per day.  Given Florida has several cruise ports until Florida sees some positive news in terms of new cases and deaths I'm not holding my breath.  Right now we are projected to hit our peak deaths in the first 2 weeks of May ONLY IF we continue to follow the stay-at-home guidelines THROUGH May.  If anything starts reopening, which I fear is the case, before that then we can just keep sabotaging ourselves for an even longer delay for normal life, and even higher cost of human life expected.

Edited April 14, 2020 by adidas5676

[flyguyjake]

Even the World ship stopped sailing

 

https://www.forbes.com/sites/maddieberg/2020/03/16/the-worlds-largest-luxury-yacht-suspends-operations-amid-coronavirus/#1093ea55f787

 

Even the world’s most luxurious cruise ship isn’t safe.

The World, the planet’s largest luxury residential ship, has put itself out of service for more than two months amid ongoing fears of the spread of the coronavirus, proving that even the decadently rich are not immune to the fallout from the global pandemic. By Tuesday, March 17, all residents and guests are mandated to leave their residences aboard the ship.

The 644-foot-long ship operated by ROW management, headquartered in Fort Lauderdale, Florida, had criss-crossed the globe 365 days a year for 18 years, until now. The ship has 165 apartments, and residents have to have assets north of $10 million to buy one. The smallest, a 260-square-foot studio, costs about $2 million, while the largest, at 3,500 square feet, costs closer to $15 million. Maintenance fees add as much as $900,000 a year.

[Ourusualbeach]

This gives Empress and Majesty some hope of still sailing. 

[bluesea321]

45 minutes ago, rimmit said:

For those that haven’t read it, below is a link to the CDC document outlining what they need to see to life the no sail order.  While there is a 100 day limit on this, unless these conditions are met this will almost assuredly be extended.
https://www.cdc.gov/quarantine/pdf/No-Sail-Order-Cruise-Ships_Extension_4-9-20-encrypted.pdf

 

The CDC Order mandates that a very comprehensive plan has to be in place in 7 days from the signing day of the Order (4/9) for the ships to be allowed to remain in US waters.  That is by Thu April 16 and I see little chance that the industry will have such a plan in two days.  So either the CDC softens its mandate (unlikely) or all the ships now offshore will be moving away and will not be allowed in.  There is a large number of ships around S. Florida or in port in Miami.

[livingonthebeach]

1 hour ago, bluesea321 said:

 

The CDC Order mandates that a very comprehensive plan has to be in place in 7 days from the signing day of the Order (4/9) for the ships to be allowed to remain in US waters.  That is by Thu April 16 and I see little chance that the industry will have such a plan in two days.  So either the CDC softens its mandate (unlikely) or all the ships now offshore will be moving away and will not be allowed in.  There is a large number of ships around S. Florida or in port in Miami.

 

Yes, I live on the beach and I see them from my terrace -- a large number of "ghost ships".  I'm amazed at the number of people who think cruises are going to resume this Summer or Fall.  The magnitude of the health requirements alone imposed by the CDC are going to be one monumental hurdle to overcome.  Cruising as we knew it will cease to exist and will never go back to the way it was.  Some form of it will likely evolve but this year doesn't look very promising. 

[rimmit]

10 minutes ago, livingonthebeach said:

 

Yes, I live on the beach and I see them from my terrace -- a large number of "ghost ships".  I'm amazed at the number of people who think cruises are going to resume this Summer or Fall.  The magnitude of the health requirements alone imposed by the CDC are going to be one monumental hurdle to overcome.  Cruising as we knew it will cease to exist and will never go back to the way it was.  Some form of it will likely evolve but this year doesn't look very promising. 

I am not sure if people have their heads in the sand or what, but I agree.   The endless threads of “What are the chances of my June cruise happening?  Or should I book an Alaskan cruise this July are mind blowing?  I don’t think most people understand or realize just how dire the situation is for the cruise industry is right now.

 

The fact that the media backed off after the Grand Princess despite the fact ship after ship after ship was having an outbreak I think caused most people to not realize just how big of an issue this is. All most people are aware of is the Grand and Diamond Princess.  Many haven’t heard of the Zaandam, Coral Princess, and the kicker of them all, the Ruby Princess.  Plus all the continued outbreaks on other ships.  It’s just a disaster.

 

Cruising can ONLY recover with an effective vaccine. There is NO OTHER way.  The medical fleets MAY give them some help on the 1/1000000 chance they go that route but a vaccine is the only way to even get close to the “good ole days.”

Edited April 14, 2020 by rimmit

[Billy Baltic]

Just being devils advocate but why single out cruise ships? Several weeks back there was a hotel in Tenerife which made the news here as it had an outbreak of the coronavirus. The guests were quarantined to their rooms while the hotel figured out what to do. There is no reason that scenario can’t happen again but will the CDC insist on hotels or resorts having their own hospital facilities on site?

[rimmit]

12 minutes ago, Billy Baltic said:

Just being devils advocate but why single out cruise ships? Several weeks back there was a hotel in Tenerife which made the news here as it had an outbreak of the coronavirus. The guests were quarantined to their rooms while the hotel figured out what to do. There is no reason that scenario can’t happen again but will the CDC insist on hotels or resorts having their own hospital facilities on site?

The reason the cruise ships are singled out is the same reason as prisons, nursing homes, and even aircraft carriers.  The population density is so high and people use common facilities so regularly that people become infected incredibly fast.

 

Tenerife did not have a mass breakout of 700 infections that I am aware of from that one resort.  The resort did not just randomly dump 5000 pax and crew into a random port requiring repatriation.  I do not believe the hotel overwhelmed The local healthcare system.  I could be wrong but I don’t remember that happening.

 

Cruise ships breed disease at an incredibly fast rate.  Much faster than land based resorts from what we have seen thus far.

[Billy Baltic]

8 minutes ago, rimmit said:

The reason the cruise ships are singled out is the same reason as prisons, nursing homes, and even aircraft carriers.  The population density is so high and people use common facilities so regularly that people become infected incredibly fast.

 

Tenerife did not have a mass breakout of 700 infections that I am aware of from that one resort.  The resort did not just randomly dump 5000 pax and crew into a random port requiring repatriation.  I do not believe the hotel overwhelmed The local healthcare system.  I could be wrong but I don’t remember that happening.

 

Cruise ships breed disease at an incredibly fast rate.  Much faster than land based resorts from what we have seen thus far.

From your examples I don’t believe nursing homes or prisons would be denied access to hospital services if required. 
If I remember the scenario in Tenerife correctly the hotel had people leave who weren’t displaying symptoms. It was very early in the European experience and they probably used that to their advantage. Had it happened later they wouldn’t have been allowed to presume no symptoms meant no virus. 
What happens when a large hotel or complex has a positive case this Summer or Autumn?
 

 

[rimmit]

17 minutes ago, Billy Baltic said:

From your examples I don’t believe nursing homes or prisons would be denied access to hospital services if required. 
If I remember the scenario in Tenerife correctly the hotel had people leave who weren’t displaying symptoms. It was very early in the European experience and they probably used that to their advantage. Had it happened later they wouldn’t have been allowed to presume no symptoms meant no virus. 
What happens when a large hotel or complex has a positive case this Summer or Autumn?
 

 

The nursing homes and resorts pay taxes to the country they are located.  They do not fly foreign flags to circumvent local labor laws and taxes.  They pay for the right to have access to the local healthcare system via taxes.  In theory the ships need to go to the Bahamas, Liberia, malta, etc to receive the support as that is the flag they fly.

[Billy Baltic]

And what happens in the scenario of the large hotel or complex which has a case of coronavirus? Are the CDC going to segregate the guests by nationality and only treat the ones who have contributed to local healthcare?

[rimmit]

23 minutes ago, Billy Baltic said:

And what happens in the scenario of the large hotel or complex which has a case of coronavirus? Are the CDC going to segregate the guests by nationality and only treat the ones who have contributed to local healthcare?

Same thing we do now.

 

Asymptomatic people go home and self quarantine for 14 days.  If they are at a resort And flew there They would likely have to quarantine there for 14 days.  If you drove to the resort you can go home and self quarantine there.  This is already happening EVERYWHERE right now in case you haven’t noticed.  
 

The difference is that a cruise ship is a mini city dumping thousands of people into an area where most do not live remotely near where the cruise ship is and There is a mucH higher likelihood of infection rate than a land based resort.  A land based resort just has more SPACE.  In theory if they had to, like Tenerife, they can use the land based resort to be a quarantine facility or need be.  Unlike the cruise ships, where A quarantine Leads to a large number of transmissions (I.e. Diamond princess) Thus far land based resorts do not seem to spread the disease like cruise ships do.  Again, likely due to SPACE and possibly different styles of ventilation systems.

 

A single land based resort room is about the size of 5 inside cabins on a cruise ship.  And that’s already lowballing a land based resort room size.

 

The other big difference in cruise ships is that they are ill equipped to handle Covid.  At a land based resort you just call 911 for a medical transfer via an AMBULANCE.  On a ship, you can’t just call 911.  You need the coast guard or a medical evacuation to get the patient off the ship.  Logistically it’s just a little more difficult.

 

Before covid not such a big deal.  In the post covid world....  much bigger deal.

Edited April 14, 2020 by rimmit

[livingonthebeach]

3 minutes ago, Billy Baltic said:

And what happens in the scenario of the large hotel or complex which has a case of coronavirus? Are the CDC going to segregate the guests by nationality and only treat the ones who have contributed to local healthcare?

 

The CDC does not have jurisdiction outside the United States.  It is not out of the question that mandates for US hotels, stadiums, concert halls, churches and large gathering places will be issued once they are allowed to reopen. 

[suzyluvs2cruise]

2 hours ago, Billy Baltic said:

Just being devils advocate but why single out cruise ships? Several weeks back there was a hotel in Tenerife which made the news here as it had an outbreak of the coronavirus. The guests were quarantined to their rooms while the hotel figured out what to do. There is no reason that scenario can’t happen again but will the CDC insist on hotels or resorts having their own hospital facilities on site?

 

A land based hotel or resort has local hospitals available to send ill patients to for treatment. IMHO there's no comparison . Will the CDC have guidelines for hotels and resorts remains to be seen.

 

Edited April 15, 2020 by suzyluvs2cruise

[LMaxwell]

Ships can't be converted fast enough; the business model can't sustain having empty chaser ships.  I agree this is a massive problem to overcome.  How comfortable is the average US citizen in departing a US port aboard a ship and being told by US Coast Guard and US Navy "Don't call us". That's a deeply unsettling reality. For many people who cruise in the Caribbean or along the eastern or western coasts of the United States they have always known in the back of their head they could rely on United States for assistance, if within distance. 

 

 

[chengkp75]

15 hours ago, bluesea321 said:

 

The CDC Order mandates that a very comprehensive plan has to be in place in 7 days from the signing day of the Order (4/9) for the ships to be allowed to remain in US waters.  That is by Thu April 16 and I see little chance that the industry will have such a plan in two days.  So either the CDC softens its mandate (unlikely) or all the ships now offshore will be moving away and will not be allowed in.  There is a large number of ships around S. Florida or in port in Miami.

No, it does not mandate that the ship have to leave US waters.  The order specifically refers to controlling the "operations" of cruise ships, and then further defines "operations" as follows:

 

"Operations" for purposes of this order means any action by a cruise ship operator to bring or cause a cruise ship to be brought into or transit in or between any international, interstate, or intrastate waterways (e.g. shifting berths, moving to anchor, discharging waste, making port, or embarking or disembarking passengers or crew) subject to the jurisdiction of the United States.

 

Nowhere does it say a ship cannot remain at a berth, nor at anchor in the jurisdiction of the United States. 

 

 

[chengkp75]

9 hours ago, LMaxwell said:

Ships can't be converted fast enough; the business model can't sustain having empty chaser ships.  I agree this is a massive problem to overcome.  How comfortable is the average US citizen in departing a US port aboard a ship and being told by US Coast Guard and US Navy "Don't call us". That's a deeply unsettling reality. For many people who cruise in the Caribbean or along the eastern or western coasts of the United States they have always known in the back of their head they could rely on United States for assistance, if within distance. 

 

 

Despite the many headlines saying this, this is not what the USCG MSIB says.  It says that before a decision by the USCG to assist a vessel is made, considerations will be made as to whether the ship has contacted the flag state, or whether the ship has made sufficient arrangements for transport or hospitalization on land.  The USCG cannot, by policy, abrogate one of the 11  statutory missions given to it by Congress, which is the aid to vessels and mariners in distress.

[gatour]

17 hours ago, rimmit said:

The nursing homes and resorts pay taxes to the country they are located.  They do not fly foreign flags to circumvent local labor laws and taxes.  They pay for the right to have access to the local healthcare system via taxes.  In theory the ships need to go to the Bahamas, Liberia, malta, etc to receive the support as that is the flag they fly.

The vast majority of passengers sailing from US ports are US citizens.  Being US citizens they pay taxes, so should they be denied healthcare.

[rimmit]

35 minutes ago, gatour said:

The vast majority of passengers sailing from US ports are US citizens.  Being US citizens they pay taxes, so should they be denied healthcare.

You are missing the argument.  The previous poster was stating that resorts aren’t denied access to hospitals, why should cruise ships be denied.   It’s not the passengers being denied access to hospitals. It’s the passengers being denied access to the country.    Big difference.  Once in the country, most likely the country would assist the passengers on a healthcare front whether they are a Citizen or not and sort the bill out later.  However, they are being blocked at the gate.

 

They aren’t being denied healthcare, they are being denied either coastguard, naval, or other extraordinary assistance.  If they got to the US they wouldn’t be denied healthcare.  This issue is getting into the US as since these are foreign flagged boats the US is not so eager to let them dock with a ship full of infected people and ports are closing to cruise ships whether people are infected or not. 

At this point the people who boarded the boat knowingly during a pandemic are knowingly subjecting themselves to a high level of risk and possible quarantine.  The CDC is basically saying at this point, unless you abide by our rules we aren’t bailing you out anymore.  The issue at hand is that cruise ships are drawing a lot of resources every time they require quarantine and repatriation which is becoming incredibly common place and cruise ships are banking on the USN and USCG to continually bail them out when Covid strikes their ships.

[bluesea321]

5 hours ago, chengkp75 said:

No, it does not mandate that the ship have to leave US waters.  The order specifically refers to controlling the "operations" of cruise ships, and then further defines "operations" as follows:

 

"Operations" for purposes of this order means any action by a cruise ship operator to bring or cause a cruise ship to be brought into or transit in or between any international, interstate, or intrastate waterways (e.g. shifting berths, moving to anchor, discharging waste, making port, or embarking or disembarking passengers or crew) subject to the jurisdiction of the United States.

 

Nowhere does it say a ship cannot remain at a berth, nor at anchor in the jurisdiction of the United States. 

 

The CDC Order is attached for those interested in reading.  Page 6 specifically says (among many other requirements):

 

1. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, cruise ship operators shall immediately develop, implement, and within seven (7) days of the signing of this Order operationalize, an appropriate, actionable, and robust plan to prevent, mitigate, and respond to the spread of COVID-19 on board cruise ships.
2. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, the cruise ship operator shall make the plan described in paragraph 1, above, available to HHS/CDC and USCG personnel within seven (7) days of the signing of this Order.

 

The Order was signed on April 9 and therefore the cruise ships have until tomorrow, April 16, to comply.  Seems pretty clear to me.

 

No-Sail-Order-Cruise-Ships.pdf

Edited April 15, 2020 by bluesea321

[Coopdog08]

12 minutes ago, bluesea321 said:

 

The CDC Order is attached for those interested in reading.  Page 6 specifically says (among many other requirements):

 

1. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, cruise ship operators shall immediately develop, implement, and within seven (7) days of the signing of this Order operationalize, an appropriate, actionable, and robust plan to prevent, mitigate, and respond to the spread of COVID-19 on board cruise ships.
2. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, the cruise ship operator shall make the plan described in paragraph 1, above, available to HHS/CDC and USCG personnel within seven (7) days of the signing of this Order.

 

The Order was signed on April 9 and therefore the cruise ships have until tomorrow, April 16, to comply.  Seems pretty clear to me.

 

No-Sail-Order-Cruise-Ships.pdf 107.47 kB · 0 downloads

What happens when/if they don’t comply by tomorrow?

[bluesea321]

1 minute ago, Coopdog08 said:

What happens when/if they don’t comply by tomorrow?

 

I don't know.  The CDC will have to determine what to do, give the cruise lines more time or sanction them in some way ???

[chengkp75]

25 minutes ago, bluesea321 said:

 

The CDC Order is attached for those interested in reading.  Page 6 specifically says (among many other requirements):

 

1. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, cruise ship operators shall immediately develop, implement, and within seven (7) days of the signing of this Order operationalize, an appropriate, actionable, and robust plan to prevent, mitigate, and respond to the spread of COVID-19 on board cruise ships.
2. As a condition of obtaining controlled free pratique to continue to engage in any cruise ship operations in any international, interstate, or intrastate waterways subject to the jurisdiction of the United States, the cruise ship operator shall make the plan described in paragraph 1, above, available to HHS/CDC and USCG personnel within seven (7) days of the signing of this Order.

 

The Order was signed on April 9 and therefore the cruise ships have until tomorrow, April 16, to comply.  Seems pretty clear to me.

 

No-Sail-Order-Cruise-Ships.pdf 107.47 kB · 0 downloads

And, if you read above this in the order, it defines the term "operations", which I then quoted.  Significantly, while it lists several "operations" it does not list merely sitting at a dock or at anchor as an "operation", and it also makes a distinction between arriving at port ("making port") and leaving port, and only "making port" is restricted.  The two paragraphs you mention have reference to "free pratique", which is the process where a ship declares itself healthy and requests clearance to enter port, or move within a port.  Ships that are already in a US port, have received pratique, and therefore unless they wish to "shift berths, move to anchorage, or embark or disembark passengers or crew", they do not need to apply for pratique again.