1. Cruise Ship Travel in the Era of Coronavirus Disease 2019 (COVID-19): A Summary of Outbreaks and a Model of Public Health Interventions
- Author
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Jared Reynolds, Cindy R. Friedman, Rachel B. Slayton, Hannah Wolford, Ryan E. Wiegand, Aimee Treffiletti, Laura A S Quilter, Joanna J. Regan, Andrea Rodriguez, Hilary K. Wall, Stefanie B. White, Keisha Jenkins, Martin S. Cetron, Rena Fukunaga, Kara Tardivel, Lauren Ahart, Clive Brown, Ryan T. Novak, Stephanie Morrison, Pragati V. Prasad, Michael A. Johansson, Amy L. Freeland, Isabel Griffin, and Sarah Anne J. Guagliardo
- Subjects
Microbiology (medical) ,cruise ship ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cruise ,Crew ,Psychological intervention ,Rate ratio ,01 natural sciences ,Disease Outbreaks ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Major Article ,Humans ,Medicine ,030212 general & internal medicine ,0101 mathematics ,Ships ,Travel ,SARS-CoV-2 ,business.industry ,010102 general mathematics ,mathematical modeling ,COVID-19 ,Outbreak ,United States ,AcademicSubjects/MED00290 ,Infectious Diseases ,Transmission (mechanics) ,outbreaks ,Public Health ,business ,Demography - Abstract
Background Cruise travel contributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission when there were relatively few cases in the United States. By 14 March 2020, the Centers for Disease Control and Prevention (CDC) issued a No Sail Order suspending US cruise operations; the last US passenger ship docked on 16 April. Methods We analyzed SARS-CoV-2 outbreaks on cruises in US waters or carrying US citizens and used regression models to compare voyage characteristics. We used compartmental models to simulate the potential impact of 4 interventions (screening for coronavirus disease 2019 (COVID-19) symptoms; viral testing on 2 days and isolation of positive persons; reduction of passengers by 40%, crew by 20%, and reducing port visits to 1) for 7-day and 14-day voyages. Results During 19 January to 16 April 2020, 89 voyages on 70 ships had known SARS-CoV-2 outbreaks; 16 ships had recurrent outbreaks. There were 1669 reverse transcription polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infections and 29 confirmed deaths. Longer voyages were associated with more cases (adjusted incidence rate ratio, 1.10, 95% confidence interval [CI]: 1.03–1.17, P Conclusions SARS-CoV-2 outbreaks on cruises were common during January–April 2020. Despite all interventions modeled, cruise travel still poses a significant SARS-CoV-2 transmission risk.
- Published
- 2021