RC Health Plan - Health and Safety Panel Report are now released

[livingonthebeach]

6 minutes ago, Milwaukee Eight said:

Was this addressed?  I didn’t see it. 

I see this as a hurdle. 
 

M8

 

Evacuation Scenarios

 

All cruise operators should have a well-thought-out and detailed plan for the unplanned debarkation of individual guests or crew that allows them to travel quickly and safely to their appropriate destination (e.g., hotel, home, onshore medical facility). In a confined outbreak, the individuals affected could be debarked while the cruise continues. However, in the unlikely but most concerning situation where an outbreak has reached a sufficient level that there is a high risk of exceeding onboard medical capacity, or there is uncertainty about the level of community spread or a lack of confidence in the ability to contain the outbreak, cruise operators must have a plan in place to debark all guests and impacted crew. Healthy individuals who have had no contact with individuals with a confirmed SARS-CoV-2 infection N/A *Quarantine during full ship quarantine Exposed (as defined earlier) to individuals with a confirmed SARS-CoV-2 infection Quarantine Individuals who have tested positive for SARSCoV-2 or who are experiencing symptoms consistent with a SARSCoV-2 infection

 

Isolation  

 

In any of the scenarios above, specific plans and protocols should be in place to swiftly and safely execute the required evacuation. Crew members who will be responsible for executing these debarkations should be well-trained in these protocols to ensure safe debarkation for all involved, and specifically to make sure that debarkation events and processes do not undo the good work of the isolation and quarantine measures described previously. Debarkation Scenarios In the event that an individual or group of individuals needs to debark from the ship, robust plans should be put in place in advance. Many potential SARS-CoV-2 infections can likely be detected, contained, and treated on board the ship, given the plans for enhanced medical capabilities and staffing, until infected individuals can be safely transported home or to a medical facility. Detailed planning and exercises to test debarkation protocols are highly recommended well in advance of any individuals needing to debark. These kinds of exercises are critically important in testing whether evacuation plans are operationally feasible and responsive to the issues likely to arise in these scenarios. Additionally, they create the opportunity for cruise operators to work through as many of the unknowns and unclear areas as possible in advance of actually needing to use the plan, and also to practice making decisions and pivoting quickly when needed.

 

Recommendation

 

50: Cruise operators should have a thorough mobilization response plan in place prior to sailing to address the various scenarios that may require individuals with confirmed SARSCoV-2 infection (guests or crew), and their close contacts, to debark from the ship. Early in the pandemic, there were instances where full-scale debarkations were required, but unfortunately had not been planned for or practiced in advance. This led to significant delays and caused cruise operators and government officials to expend significant resources to manage the situation. While unlikely, a full-scale debarkation is a highly complex operation for which detailed emergency planning is warranted. The Panel therefore recommends planning, practicing, and revising operational plans to best prepare for this unlikely but resource-intensive scenario. Importantly, all protocols and preparations should ensure that the cruise operators are prepared to provide for a fullscale debarkation without burdening the resources of any federal, state, or local governments. Specifically, full-scale debarkation plans should be sure to account for onshore care delivery (and transportation to the appropriate care facility) should the situation/individual medical condition warrant it. In a full-scale debarkation, all guests (including individuals with a SARS-CoV-2 infection and those who are healthy) will be removed from the ship and safely transported to the appropriate destination. Impacted crew should be debarked for self-isolation, treatment, or self-quarantine ashore until they can safely return to the vessel. Healthy crew may remain on board in order to conduct a full decontamination of the vessel. The designation of crew members as “impacted” or “healthy” is done through full ship testing and medical assessments, in addition to the contact tracing identification of close contacts. Essential to this operational planning is the distinction between smaller- and larger-scale debarkation scenarios. An important part of planning will be to define in advance the low-, moderate-, and high-risk scenarios that may occur and what plans will be put into action at each level. While a specific number of cases may be too rigid to define in advance, the Panel recommends that cruise operators develop general parameters or ranges for each scenario. 

 

Recommendation

 

51: Cruise operators should define the criteria for small-, moderate-, and large-scale debarkation scenarios in advance of cruising, including a clear decision-making process to guide thinking about when the threshold has been met for each risk level. As a general matter, a low-risk situation would be one in which there are a low number of cases, no known onboard transmission, and a high degree of confidence of that assessment based on contact tracing and other onboard surveillance measures. The next level, moderate risk, is reached when there is an increased number of cases, limited onboard transmission is suspected or observed, there are potential gaps in contract tracing, and there is a risk of exceeding onboard resource availability. The highest risk scenario, which would necessitate a full ship debarkation and cancellation of the cruise, would be reached in the event of a high number of cases, extensive onboard transmission, contact tracing capacity being exceeded, and onboard resource capabilities being exceeded. In all these cases, advance contracting with third-party providers will be needed to ensure that government resources (whether international, U.S. federal, or state/local) are not overburdened in addressing a cruise line-based COVID-19 outbreak (though collaborative decision-making with federal agencies such as CDC on the specifics of a debarkation may be appropriate). The Panel also emphasizes the importance of timely and accurate contact tracing, testing, and other surveillance methods on the ship. If test results are not available rapidly or contact tracing takes a significant amount of time, precious time will be lost in identifying other persons who should be quarantined, and the scope of an outbreak may not be reliably determined. Even with appropriate guidance in place, the decisions around debarking an entire ship are complex, and the inputs are many. While the Captain and medical team on board the ship will have the most timely, first-hand information about any cases on board, as a situation escalates the Panel recommends that use of a shoreside central command function would be prudent.

 

Recommendation

 

52: Cruise operators should establish offsite incident management with designated medical professionals’ advice to respond rapidly and to aid in decision-making. Coordinated emergency response planning by governments and the private sector routinely follows such a model that enables centralized leadership and decision-making and effective delegation of responsibilities. A well-executed central command function should enable a rapid and coordinated response, with high-level liaison functions to facilitate informed decision-making capability and guidance to vessels. In addition to ensuring that protocols are being followed and that information is being shared with all necessary parties, centralizing response would allow for learning and process improvement each time these situations arise. As noted above, one of the most critical aspects of an effective evacuation plan is maintaining controls to reduce the spread of SARS-CoV-2. The Panel recommends that individuals who have tested positive for SARS-CoV-2, their close contacts, and anyone under investigation be separately debarked from the ship and transported using privately contracted transportation methods to a medical facility, home, or designated quarantine or isolation location to avoid exposing individuals off the ship to SARS-CoV-2. Recommendation 53: In any debarkation scenario, individuals with confirmed SARS-CoV-2 infection, close contacts, and persons under investigation should be kept separate from any healthy individuals (i.e., those not identified through contact tracing or those who have tested negative).

 

50 A safe path home or to medical treatment is the goal of any debarkation, whether small- or large-scale. In order to implement the recommendation of appropriately separating infectious and healthy individuals, it is very important that arrangements be made in advance for potential quarantine and treatment facilities, as well as privately contracted transportation that keeps infected individuals, close contacts, and suspected cases from using commercial means of transportation and potentially spreading infections during transport. The panel discussed and felt that in any scenario, including in a full-scale debarkation, it would be appropriate for healthy individuals not identified through contact tracing, or who have tested negative for SARS-CoV-2, to use commercial transportation. The Panel recognizes that in a full-scale debarkation scenario, crew who are well may stay on board the ship and continue to work to keep the vessel operating or return it to a state that is safe for the resumption of cruising. Crew who are not being used for this purpose, however, should remain in their cabins until decontamination takes place and they are notified that wider movement is allowable. Finally, communication remains critical in the event of a debarkation caused by COVID-19. The Expert Panel recommends that crew and guests on board are given timely and accurate information about SARS-CoV-2 infections on board the ship whether the cruise is ongoing or guests have already transported home. In many situations, it may be appropriate for cruise operators to standardize communications to ensure consistency of the information received.

 

Recommendation

 

54: Cruise operators should establish a communications plan, and assign a communications lead in advance, to share timely, relevant information with crew and guests on board the ship in the event of a SARS-CoV-2 infection during or after the cruise. Additionally, cruise operators should have systems in place to coordinate information about SARS-CoV-2 infections to relevant health authorities. Transmission of accurate and timely information will be critical for all guests and crew in the event of a SARS-CoV-2 infection on board a ship. Cruise operators should be thoughtful about the best messages and distribution methods to ensure crew and guests can take the appropriate precautionary measures, understand when and how to seek medical evaluation if they suspect they may have been exposed or are feeling unwell, and modify their behavior and activities according to their risk level. Additionally, transmission of this information will be needed if a cruise operator needs to activate response protocols, including limitations on certain activities and—in the event of a high-risk situation— an order for guests and non-essential crew to stay in their cabins. Additionally, ongoing communication with guests is recommended following the conclusion of a cruise if the cruise operator learns of a postdisembarkation SARS-CoV-2 infection. Timely, accurate, and regular communication with the relevant local health authorities is another important component of communications. Federal regulations already require ships destined for a U.S. port to report immediately a death or certain illnesses among ship guests or crew. In addition to communicating with CDC, cruise operators should also notify the other relevant health authorities about cases on board or discovered after disembarkation.

Edited September 21, 2020 by livingonthebeach

[molly361]

8 minutes ago, Milwaukee Eight said:

Was this addressed?  I didn’t see it. 

I see this as a hurdle. 
 

M8

I believe it was addressed here

[boscobeans]

Just now, Sunshine3601 said:

I had a test done in June and Labcorp emailed me the results a little under 48 hours.  I have heard that is common procedure with at least labcorp and quest labs in my area.

 

My wife and I had  finger sticks done in April ( State ordered for Pharmacists) and had the results sent to our emails the next day. (both Negative).

 

LabCorp, here, will test only with a physician's order. ( $ ?? $)

Quest has a DIY test that you do in the presence of a tech and is done BY APPOINTMENT, without a physician's order. ($119.)

 

I will have my test done at my Dr.'s office and then have the results printed out OR SENT TO ???????????????

 

I wonder if these procedures are different in other places.?

 

[Milwaukee Eight]

5 minutes ago, livingonthebeach said:

Specifically, full-scale debarkation plans should be sure to account for onshore care delivery (and transportation to the appropriate care facility) should the situation/individual medical condition warrant it. In a full-scale debarkation, all guests (including individuals with a SARS-CoV-2 infection and those who are healthy) will be removed from the ship and safely transported to the appropriate destination.

This doesn’t say much. Still doesn’t address the CDC’s previous concerns. They keep mentioning should have plans in place. What are those plans?

 

Its unfair to healthcare workers and their families to have infected people on a cruise, which is not essential, dumped off into their healthcare facilities. IMO

 

M8

[livingonthebeach]

Just now, Milwaukee Eight said:

This doesn’t say much. Still doesn’t address the CDC’s previous concerns. They keep mentioning should have plans in place. What are those plans?

 

Its unfair to healthcare workers and their families to have infected people on a cruise, which is not essential, dumped off into their healthcare facilities. IMO

 

M8

 

Exactly!!! They say they should have this...they should have that... but they don't outline what this and that are.  Hopefully, they have a more detailed response plan they are submitting to the CDC.

[reallyitsmema]

2 hours ago, molly361 said:

Thanks  Also just a quick scan.  Masks and ship sponsored excursions only    COVID test needed.  BUMMER

 

The excursion thing is not good but I would want them to define this:

 

"During the initial return to sailing, cruise operators should only allow guests debarking from a ship at a destination port to participate in cruise line-sponsored or verified excursions as a way of limiting potential exposures in the destinations they visit. "

 

If I can still book an excursion privately that has been "verified", that would be great.  We have Alaska booked and have already purchased one excursion in Icy Strait Point.  There are only a total of 7 people on the boat if fully booked, the Captain plus 6 passengers.  I will have to reach out to them so they are aware of these restrictions.  They are a great company that I bet would want to get verified if there was a way they can.  They only have two small boats.  I bet they will be on top of this anyway.

[Milwaukee Eight]

7 minutes ago, boscobeans said:

LabCorp, here, will test only with a physician's order. ( $ ?? $)

Quest has a DIY test that you do in the presence of a tech and is done BY APPOINTMENT, without a physician's order. ($119.)

In Florida, anybody for any reason may get tested. No Dr order required. I don’t believe those without insurance are charged. What State is doing this?

 

M8

Edited September 21, 2020 by Milwaukee Eight

[Sunshine3601]

5 minutes ago, boscobeans said:

 

My wife and I had  finger sticks done in April ( State ordered for Pharmacists) and had the results sent to our emails the next day. (both Negative).

 

LabCorp, here, will test only with a physician's order. ( $ ?? $)

Quest has a DIY test that you do in the presence of a tech and is done BY APPOINTMENT, without a physician's order. ($119.)

 

I will have my test done at my Dr.'s office and then have the results printed out OR SENT TO ???????????????

 

I wonder if these procedures are different in other places.?

 

I'm in PA and did not need a doctors order to get my test done at labcorp and it was free.  They had a special tent set up outside to walk up to.   Also one of our local cvs stores you go to their drive thru window for a test no doctors order needed.

Quest is charging something like $125 in my area.

 

[Sunshine3601]

4 minutes ago, reallyitsmema said:

 

The excursion thing is not good but I would want them to define this:

 

"During the initial return to sailing, cruise operators should only allow guests debarking from a ship at a destination port to participate in cruise line-sponsored or verified excursions as a way of limiting potential exposures in the destinations they visit. "

 

If I can still book an excursion privately that has been "verified", that would be great.  We have Alaska booked and have already purchased one excursion in Icy Strait Point.  There are only a total of 7 people on the boat if fully booked, the Captain plus 6 passengers.  I will have to reach out to them so they are aware of these restrictions.  They are a great company that I bet would want to get verified if there was a way they can.  They only have two small boats.  I bet they will be on top of this anyway.

I have 6 future cruises booked and do not want to book any excursions till I know we are actually sailing and what the rules/restrictions will be in place for that particular cruise.  Too soon to book any excursions for next summer unless they are fully refundable.

[reallyitsmema]

Just now, Sunshine3601 said:

I have 6 future cruises booked and do not want to book any excursions till I know we are actually sailing and what the rules/restrictions will be in place for that particular cruise.  Too soon to book any excursions for next summer unless they are fully refundable.

 

That is your choice.  We chose to book since we have used this vendor in the past and love their excursion.  I have had multiple emails from the vendor welcoming us back and another thanking us for a full boat referral.  It is not too soon to book excursions for this port at all.

[aichambaye]

1 hour ago, livingonthebeach said:

 

Maybe the 15 minute Abbott tests will be more readily available by then -- fingers crossed for you 🤞

That's certainly my hope. I love that everyone will be tested. I think that's great. But the problem is tests are taking FOREVER to come back. 24 hours is a pipe dream. 5 days is already fast. hubs is tested twice a week and even that is delayed like 5-7 days. 

[ipeeinthepool]

16 minutes ago, molly361 said:

I believe it was addressed here

 

If you look closely, you can see this person isn't wearing a mask.

[Sunshine3601]

2 minutes ago, reallyitsmema said:

 

That is your choice.  We chose to book since we have used this vendor in the past and love their excursion.  I have had multiple emails from the vendor welcoming us back and another thanking us for a full boat referral.  It is not too soon to book excursions for this port at all.

I understand that. I am sure they want you back as travel industry is suffering.  I am booked on a june alaska cruise.  I am simply saying with all the unknown and the fact other cruise lines that have been operating for last 6 weeks are Not allowing anyone to do their own private excursions.  Of course book what you want.  Just make sure it will be fully refundable if you have to prepay.  Noone has any idea what cruising rules will be next summer.  Enjoy!  Planning is alot of fun

 

[jean87510]

13 minutes ago, reallyitsmema said:

 

The excursion thing is not good but I would want them to define this:

 

"During the initial return to sailing, cruise operators should only allow guests debarking from a ship at a destination port to participate in cruise line-sponsored or verified excursions as a way of limiting potential exposures in the destinations they visit. "

 

If I can still book an excursion privately that has been "verified", that would be great.  We have Alaska booked and have already purchased one excursion in Icy Strait Point.  There are only a total of 7 people on the boat if fully booked, the Captain plus 6 passengers.  I will have to reach out to them so they are aware of these restrictions.  They are a great company that I bet would want to get verified if there was a way they can.  They only have two small boats.  I bet they will be on top of this anyway.

Im assuming that the planned excursions will have their protocols in place. Im already seeing some companies and hotels show this in the Caribbean. 

[boscobeans]

23 minutes ago, Milwaukee Eight said:

In Florida, anybody for any reason may get tested. No Dr order required. I don’t believe those without insurance are charged. What State is doing this?

 

M8

Comrade Cuomo's New York. In Florida you have a Governor not a tyrant.

Don't know why LabCorp is requiring doctor's orders when Quest isn't, but that was their recorded answer this morning.

 

Edited September 21, 2020 by boscobeans

[boscobeans]

11 minutes ago, aichambaye said:

That's certainly my hope. I love that everyone will be tested. I think that's great. But the problem is tests are taking FOREVER to come back. 24 hours is a pipe dream. 5 days is already fast. hubs is tested twice a week and even that is delayed like 5-7 days. 

Add at least another day or two because of Murphy's Law and your results could arrive while you are standing on the dock waving goodbye to you friends onboard.

[reallyitsmema]

3 minutes ago, jean87510 said:

Im assuming that the planned excursions will have their protocols in place. Im already seeing some companies and hotels show this in the Caribbean. 

 

I have no doubt this company will be on it too.  They are wonderful to work with.  They run two excursions a day from their boats.  They have their own van that transports people to the dock that was absolutely immaculate, looked like it had been fully detailed that morning.  They clean the boats between groups already, so I am sure they will just up what they do a bit.  I just hope they can go through whatever procedure they need to with the cruise line to be "verified" so they can continue to operate as they do now.

[kruzinkel]

Feels like these recommendations are "vague", as some think, because this panel was developed for Royal AND NCL, and would likely be used be other cruise lines as well.  

If they want me to get tested, I will get tested.  If they want me to wear a mask in the theater and elevator, I will do that, too.  I am comfortable with all these recommendations and will do whatever they say to be on a ship again.  Looking forward to reduced capacity as well!

[Milwaukee Eight]

5 minutes ago, boscobeans said:

Comrade Cuomo's New York.

Don't know why LabCorp is requiring doctor's orders when Quest isn't, but that was their recorded answer this morning.

 

I guess the charge $ and Dr Order requirement is a way to artificially keep the number of cases low. 😇

 

In Florida, we had many places available for testing and our number of cases were high. There was no charge. Now, available testing locations are fewer and not as convenient. Guess what, our number of cases is down and dropping. How about that?

 

M8

[Milwaukee Eight]

11 minutes ago, boscobeans said:

Comrade Cuomo's New York.

Don't know why LabCorp is requiring doctor's orders when Quest isn't, but that was their recorded answer this morning.

 

Another thing.....  Previously, anyone coming into Florida from NY/NJ/CT, required a 14 day quarantine. I’m not sure that requirement has been removed yet??

 

Would you follow those requirements if they are still in place?

 

Asking for a friend. 
 

M8

[yogimax]

Forget the details for a moment.  After reading this my entire perspective has changed.

 

Previously, I was looking forward to returning to a cruise.  Again, forget the timeline.

 

Seeing this spelled out in detail is depressing and has changed my outlook.

 

It now looks like the ONLY solution (for me) is an effective and safe vaccine!

[TheMastodon]

59 minutes ago, Milwaukee Eight said:

I still don’t see what plans they have if an outbreak onboard occurs and how they plan to deal with those sick during and the end of the cruise. Pretty sure the CDC doesn’t want them dumping sick off in US Ports. To me, this is a key sticking point. They ignored it before and seem to be avoiding this possible Scenario again. 
 

M8

 

Yes good point.

 

Surprised no quick saliva test for us debarking so we aren't walking around asymptomatic giving it to other people potentially. 

 

[jean87510]

17 minutes ago, reallyitsmema said:

 

I have no doubt this company will be on it too.  They are wonderful to work with.  They run two excursions a day from their boats.  They have their own van that transports people to the dock that was absolutely immaculate, looked like it had been fully detailed that morning.  They clean the boats between groups already, so I am sure they will just up what they do a bit.  I just hope they can go through whatever procedure they need to with the cruise line to be "verified" so they can continue to operate as they do now.

One online excursion company offers a reserve option that you can cancel up to 48 hours before. I'd do that if hesitant about your cruise ship excursions. 

[ILCTCRUISER]

Not sure when cruising will resume, but I have a very good idea where we’re headed.

 

Given the difficulty of these decisions, the Panel recommends that cruise lines favor ports with low infection rates where risky contact points can be minimized. One way to do that would be to, on a temporary basis, sail primarily to the cruise operator’s privately owned and operated destinations, especially when first resuming passenger operations.
 

[firefly333]

3 minutes ago, TheMastodon said:

 

Yes good point.

 

Surprised no quick saliva test for us debarking so we aren't walking around asymptomatic giving it to other people potentially. 

 

By next spring some people will have had it and be immune and some will be vaccinated. 

 

Waste of their money for some to be tested if they have proof of vaccination.