cruise ship covid status

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Cruise Ship COVID Status Tracker (July 16): Daily Update Chart & News

Note: As of July 18, the CDC is no longer operating its voluntary Covid-19 program for cruise ships . This includes no longer updating the daily color status of ships. As such, we are no longer able to update this page.   If you have questions regarding cases on a ship you are sailing, the CDC website says passengers “have the option of contacting their cruise line directly regarding outbreaks occurring on board their ship.”

As cruising returns, it does so under dramatically different protocols than when trips were suspended back in March 2020. These new procedures are all designed to limit the number of cases on ships. 

For cruise passengers, that can create a number of questions. Is it safe to cruise? What are cruise ships doing to keep passengers healthy? Is there a way to track COVID cases on cruise ships?

Currently the Centers for Disease Control offers a voluntary program to follow for ships sailing in the United States (every major cruise ship is opted in). This includes everything from policies for testing crew members, to what to do if there are cases on a ship, to recommendations surrounding masking and distancing.

In addition, the health agency publishes regular updates about the status of cases on cruise ships using a color-coded system. While it doesn’t provide actual case numbers, it does tell the public which ships have possibly had bouts of the virus. This gives insight into what’s happening on all the ships either sailing or planning to sail from the United States.

In This Article...

Current Color Status of Ships

Below is the current status of all ships tracked by the CDC. While the CDC only provides the latest day’s update on its website , we’ve included past days so that you can see how the status of each vessel changes. We continue to update this table regularly to track each ship’s status over time. The CDC releases new data each weekday.

Data from July 15 (posted July 16) shows 95 of 95 ships the CDC tracks have “non-green” status, indicating the possibility of COVID cases during the past seven days. Keep in mind that the status changes from green with as little as one case. 

Note: A status other than green does not definitively mean cases were found on the ship, though it is most likely. “HV” stands for highly vaccinated cruise ship. More discussion of colors and vaccination status is covered in “What the Color-Coded Status Means” below.

(Click to Enlarge)

Recent Updates and Commentary

Today, 95 ships (100% of ships currently tracked) have “non-green” status. This figure has risen steadily in recent months. Currently, cruising is seeing the lowest number of “green” ships since we began tracking — including during the Omicron spike.

Zero ships are green as of the latest update. Zero ships are yellow. Ninety-five have orange status: 

Ships with status changes to or from “green” since last update:

Ships removed from list:

Ships added to list:

– During the course of the CDC’s tracking, the status of ships typically follows cases on land. The number of green ships bottomed and then rebounded sharply following the Omicron wave. However, there has been a downturn in the number of green ships in recent months. From a recent peak of 58 green ships in mid-March, the figure has fallen to zero vessels.

– The current count of zero green ships is lower than the previous low of nine ships during the peak of the Omicron wave . That doesn’t mean there are necessarily more total cases on cruise ships (case counts aren’t released), however, more ships are being impacted. 

Still, at the moment 100% of cruise ships are orange , meaning that all cruise ships tracked have possible Covid cases. We have not seen a green-status ship since late June.

– With the fall in the number of green ships, Cruzely offered some commentary on what passengers should know surrounding cruises and Covid. For example, case numbers could be higher than earlier in the pandemic, however, specific case numbers are not released. Meanwhile, cases do appear relatively mild according to comments from cruise lines and health departments.

– Even with all ships having orange status, we recently explained that protocols in travel — including on cruises — have trended toward being less restrictive. And while there is no definitive sign of it happening soon, we did discuss if a relaxing of the testing requirement to sail might be on the horizon .

What the Color-Coded Status Means

The table above tracks roughly 90 cruise ships across more than a dozen cruise lines. Each day cruise ships can voluntarily submit the “Enhanced Data Collection (EDC) During COVID-19 Pandemic Form” to the CDC. This gives the agency insight into COVID or COVID-like illness on the vessel.

The agency then assigns one of four colors — green, yellow, orange, and red — to each ship, depending on the daily reports. The table is updated several times a week, providing a simple color-coded way to see where there might be issues.

Updates to the Color Status Previously, the CDC’s color status varied from green, to orange, yellow, then red. Starting in mid-February, the new order is green, yellow, orange, then red. The agency said the orange and yellow colors were switched “to go in a more logical color order.”

As well, status now depends on the number of possible cases based on both passengers and crew. Previously, cases among either passengers or crew could lead to a different color status, depending on who was sick.

Now if there are cases but they are under 0.3% of combined passengers and crew on the ship, then yellow status is given. Cases above 0.3% of those onboard (3 cases out of 1,000 people onboard) earns orange status. Red is still available for higher spread.

Colors are assigned based on the number of possible cases and the ship’s current sailing status (sailing with passengers or crew only).

Green: No reports of COVID or COVID-like illness for seven days and on-time daily submission of EDC forms for the past week.

Yellow: COVID of COVID-like illness reported in the last seven days. If sailing with passengers, the level reported is less than 0.3% of passengers and crew. If sailing with crew only, then cases are less than 1% of all crew.

Orange: Cases for more than 0.3% of passengers and crew if sailing with passengers. If sailing crew only, then cases reported in more than 1% of crew. Failing to submit a daily EDC report on-time also gives orange status.

Red: Sustained transmission of illness or the potential for cases to overwhelm medical resources on the ship. Failing to submit a daily EDC report also gives red status.

Gray: Indicates no data for the ship due to it choosing not to comply with the CDC’s voluntary program.

White (N/A): Ships that either have recently left sailing from the U.S. or have just arrived to sail from the U.S. We have marked the days before or after CDC tracking as “N/A” since there is no data. We remove the ship from the table 10 days after it is no longer tracked. This status is not an official color designation by the CDC, but we use it to show which ships have recently arrived or left.

Vaccination Status for Ships In addition to changing the color status, the CDC also introduced different vaccination levels for ships to give the public more insight: 

Not Highly Vaccinated (NHV): These are ships sailing with less than 90% of passengers and 95% of crew fully vaccinated.

Highly Vaccinated (HV): Ships with at least 90% of passengers and 95% of crew fully vaccinated, but less than than those amounts considered “up to date” with their vaccines. “Up to date” means having a booster dose of the vaccine if eligible.

Vaccination Standard of Excellence (VSE): This new category encompasses ships that have at least 90% of passengers and 95% of crew “up to date” with their COVID vaccines, meaning eligible passengers have a booster shot.

What Cruise Ships Are Doing to Keep Passengers & Crew Healthy

While cruise ships are linked to the early days of the pandemic, they have taken extraordinary steps to limit the number of cases on board. In fact, while cases have been reported regularly on ships, the total numbers and spread appear to be small. Omicron did increase cases, however.

To keep passengers healthy, cruise lines are using vaccines and testing as the cornerstones of their plans. Ships sailing require vaccination for nearly all passengers who are eligible.

In addition to vaccines, cruise lines require tests for all passengers before boarding in the United States, even if they have the shot. 

While some lines are allowing a small number of unvaccinated passengers sail, more restrictions are usually placed on these guests. For instance, multiple tests are required before and during sailing. Travel insurance is required in many instances. Some areas of the ship may be off-limits if a passenger doesn’t have the shot.

Already we’ve seen the protocols change to adapt to variants. There will be more changes in store, depending on the direction of virus cases on land.

Is it Safe to Take a Cruise?

There is little doubt that unabated, illness can spread in the close confines of a cruise ship. That said, the measures taken by cruise lines and the CDC have helped to limit cases.

Royal Caribbean Group, for example, said toward the start of 2022 they had seen about 1.3 million passengers sail and reported 2,500 cases among them (crew cases were not disclosed). That comes out to about 0.2%.

Still, during the Omicron spike cases did rise on ships. Between December 15 and December 29, there were more than 5,000 cases on ships tracked by the CDC, according to The Washington Post , citing CDC data. (The CDC typically doesn’t release case numbers.) We’ve also seen the number of ships with possible cases rise since March.

The protocols in place still seem to keep cases lower than what may be seen on land, but all cruise ships right now appear to have cases onboard. Cases do seem to be more mild than with past variants. Still, there has been a rise in the number of orange ships that is worth noting for people who are risk-averse .

There’s little argument that if there are cases on land — of which there are plenty — then there can be cases on ships. The good news is that with the mitigation efforts put in place by cruise lines, these cases are also more likely to be found and contained, especially compared to other places like sports stadiums, airports, or land-based resorts. 

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I was on the NCL Bliss this past week (July 16-23). Were there any reported cases of Covid? I have had two boosters. I have cold symptoms (cough and sore throat)and wondering if I should get tested.

As of July 16, the CDC no longer updates the color status page, so there’s no easy way to know at a glance. You can contact the cruise line directly to ask, however, it’s not clear if they disclose that information.

Any one sailed on Independence of the Seas recently and come back with Covid?

Celebrity Crusie line from Seattle to Alaska July 8 to July 15 2022 with Abraham. wondering if anyone knows the infection rate status? thank you

Remember, with cruising comes travel to the ports. My wife and I traveled from Detroit to Seattle, leaving one very crowded airport and touching down in another very crowded airport for a layover. We also spent several days in Seattle prior to boarding the cruise ship – and did several tours in Seattle and spent the day in a very crowded Pike Street Market. Who is to say when someone is infected????

I felt safer on the Holland America cruise than I did at any of the airports, the hotel, the tours and restaurants between point A and B.

Recently took a Carnival cruise July 11-15 out of Port Canaveral and my son and I both tested positive for COVID-19 the day we returned. Have been sick ever since. We’re both fully vaccinated and I had the booster in December 2021. I definitely recommend getting a booster shot if you’re eligible 2-3 weeks before going on the cruise. I’m eligible for a second booster but didn’t get it. Wish I had.

Got on the Carnival Dream in May 2022.It started out great the first four days, then I started hearing people coughing here and there,then started seeing red bio-hazard bags in hallway.I figured at that moment that Covid was pretty rampant on the ship, but there was never a notification from staff, cruise director or anyone regarding or reiterating what was going on or increasing any safety measures. We tried to stay safe, took distant routes,and took stairs but there was pretty much no way around it with so many on board. After the cruise,we exited the ship.I noticed that on my Facebook group,I stopped seeing beach pictures and started seeing sick notification posts.People were posting that they were not feeling well and tested positive when they got home.It was well over 100 positive from the group that I know, I can only imagine what the total count would be as the ships total count. I was with a family member on this trip,in the same room on our eight day cruise.Afterwards, we drove four hours to get home.She was tired and had chills and a headache on the way home.She tested positive at home.We immediately quarantined at home.I didn’t have symptoms but I was sure I had to have it especially with all the day to day interactions.I have other family members in my home and I did not want to take a chance of spreading it to them. Surprisingly, I did not end up testing positive.All I can think of is that I received the booster fourteen days before boarding and I am sure that is what helped me. I had been debating on getting it, but glad that I did.My family member recovered but was very ill for a few days and still has a lingering light cough. In my opinion,the cruise lines should also have people boarding show that they have had a CURRENT booster at least 14-20 days before the cruise instead of just needing to show a negative test at boarding and proof of PAST vaccinations. I also found out that the cruise that went before us on The Carnival Dream as well as Carnival Vista had many cases as well and they continue to have many cases today. All I can say is , I Wish I knew then what I know now.Oh well.

My wife and I got Covid during our Alaska cruise on the Crown Princess last week, June 4-11. We all had the boosters and took every precaution. Didn’t matter. For several days we had 12 foot seas and 50 knot winds. They auto locked the balcony doors at that point and we were unable to get any outside fresh air. Air system the culprit?

We got off the NCL Sky on June 3 while in Covid quarantine. The whole thing was handled horribly by NCL. We left with at minimum a dozen other people in our quarantine group from our part of the hall. On the Facebook group for our roll call dozens are now positive since Friday. We were tricked into signing paperwork that they filled in meds after signing and prices. We froze our card on board after receiving $800 charges each for Paxlovid. We would have never signed for that. We actually signed that paper before even leaving our room to head to quarantine or receiving any Paxlovid. In fact we signed a paper saying everything medical on board was complimentary. They tried to not let us leave. Then they dropped us at a hotel they said they had an agreement with. They said they knew we were coming with Covid and had a room ready. We verified this with NCL before agreeing to be dropped there. None of it was true. Hotel had no idea and told us they continue to drop people there having told them this. We were dropped in a lobby full of unsuspecting guests with no place to be quarantined to keep them protected. The whole thing was horrible.

My boyfriend and I just debarked Carnival Horizon yesterday. We both started having mild symptoms Saturday and today we both test positive for covid. I’m vaccinated and boosted, he’s vaccinated. Our cruise director came down with covid two days into the cruise. This is our first time ever having covid. We both have been so careful and we let our guard down, and now are paying the price. I wish I didn’t go on the ship!

Hope you get to feeling better. No fun.

Carnival is scheduling more four and five day cruises because Omicron COVID symptoms take longer than four days to develop. I just came back from a four day cruise on the Carnival Miracle. After two days at home from the cruise the COVID hit me like a truck. Carnival does not report COVID rates from four day cruises and should be more honest about infection rates on ships. The Miracle was built in 2003 and I suspect many of the cabins share the same HVAC system thus spreading the virus from one cabin to several others. Carnival is operating under a ” don’t look up” attitude and on the basis that the Omicron variant is not that serious. A lot of jobs and profits are at stake , but that is no excuse to willfully spread a virus and not trying to pinpoint sources/data of the spread on ships such as which cabins are more dangerous. I would suspect inside cabins. Good news is that my doctor says I should be over the virus in 4-5 miserable days.

I don’t know if that’s the case. Right now the vast majority of ships — no matter what sort of cruises they sail — are orange. As well, even with shorter cruises the crew is still on the ship for longer times and crew case counts also impact the standing of ships.

It seems the U.S. is in another wave. Cruise passengers should know that there is a risk of Covid. The number of ‘green’ ships has fallen sharply since March.

Hope you get to feeling better soon!

Why is the Wonder of the Seas not listed? We were on the trans-Atlantic voyage beginning Apr20 from FLL and there were at least 30 cases of covid – I was one of them.

Since Wonder of the Seas left the U.S., it is no longer tracked by the CDC. When it returns later this year, it should be on the list.

It appears that the Koningsdam has Yellow for the last 2 weeks of November. We are debating whether to take our cruise of December 12th or postpone … Any thoughts appreciated

James, it’s impossible to say. It really depends on your personal situation and risk tolerance. I will say that yellow could mean as little as one case on the ship, if it’s with a member of the crew. Unfortunately, specific numbers aren’t shared, so we just don’t know.

The nice thing about cruises is that you do know everyone is vaccinated and tested before getting on the ship. Bottom line: cases no doubt can be found on ships, but there are also more rigorous protocols than just about anywhere else. It depends on if you’re comfortable or not with the situation.

Considering a cruise on a ship recently coded as yellow (Koningsdam). That could mean they haven’t submitted their daily report, or have a certain number of crew, or percentage of passengers sick. That could mean only one crew or two passengers or many more. How can I get a report of the exact number of suspected infections?

So that ship has now been turned back green — indicating no possible cases in the past seven days. Unfortunately, specific numbers of cases are not released to the public.

This color coding is so confusing. Orange is a blend of yellow and red. You’d think it meant something worse than yellow.

Why is the Sky Princess ship not listed? We’re interested in knowing the colors of that particular ship. Can you please assist us in getting this information? Thank you!

Looks like she doesn’t sail from the U.S. until November, so the ship isn’t under the CDC’s orders. Expect more insight in a few weeks.

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There's COVID-19 on nearly every cruise ship right now: Here's what cruisers need to know

Things are getting iffy again for cruisers -- at least for those with near-term bookings.

The ongoing surge in COVID-19 cases around the world is causing a growing number of disruptions to itineraries and even some last-minute cancellations of entire voyages.

The number of passengers being quarantined on ships (after testing positive for COVID-19) also is on the rise. And passengers who aren't COVID-19 positive are getting caught up in short-term quarantines for being "close contacts" of shipmates who are.

For more cruise guides, tips and news, sign up for TPG's cruise newsletter .

Meanwhile, just getting to ships is becoming increasingly stressful, as getting the pre-cruise COVID-19 test that's often required before cruising is getting more difficult . Plus, a "perfect storm" of soaring COVID-19 cases and rough winter weather has wreaked havoc with airline operations for weeks.

Still, the situation isn't anywhere near as dramatic or disruptive as what we saw at the start of the COVID-19 pandemic two years ago, when whole ships were being quarantined due to outbreaks of the illness and, eventually, the entire industry shut down.

As I saw myself during a cruise to Antarctica in recent weeks, many sailings are operating relatively normally, even when there are COVID-19 cases on board.

Here's a look at everything you need to know if you've got a cruise booked in the coming weeks -- or further out.

COVID-19 cases on ships are up a lot

While cruise ships have recorded relatively few cases of COVID-19 over the past year, in part due to unusually strict health protocols , the number of passengers and crew testing positive on ships has been rising sharply in recent weeks along with the greater surge on land.

At the end of December, the U.S. Centers for Disease Control and Prevention reported that 5,013 COVID-19 cases had been reported on cruise vessels operating in U.S. waters during the last two weeks of the month, up from just 162 cases during the first two weeks of the month.

That's a 3,094% increase.

Anecdotal reports are that the number of cases on ships is up even more in the first 10 days of the new year.

Notably, all 92 cruise vessels currently operating in U.S. waters have recorded at least a handful of COVID-19 cases in recent weeks, according to CDC data.

Still, it's important to note that most of these "cases" of COVID-19 are asymptomatic or mild, only discovered during routine testing. While some ships only are testing passengers who report feeling ill for COVID-19 (and close contacts of those who subsequently test positive), other ships are testing every single passenger at least once per voyage, sometimes more. One line, Viking , is testing every single passenger for COVID-19 every day.

Cruise lines also are testing all crew members regularly.

The result is the detection of many asymptomatic cases that otherwise would have gone undetected. This is a level of surveillance that is much greater than what is the norm for other travel venues such as land-based resorts or theme parks, and it can give the false impression that the positivity rate for COVID-19 on ships is unusually high as compared to other places.

If anything, the positivity rate is far lower on ships than on land, thanks to much stricter health protocols (more on that in a moment).

It's also important to note that the detection of COVID-19-positive passengers or crew on board your ship won't necessarily impact your sailing (unless you are among those testing positive).

Health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19. The current protocol on most ships is to isolate COVID-19-positive passengers and crew but otherwise continue on with voyages as planned.

Your itinerary could change

While health authorities no longer are quarantining whole ships when a few passengers or crew test positive for COVID-19, the presence of the illness on board a vessel still could result in notable disruptions to your itinerary.

Cruise lines in recent weeks have faced a growing number of ports that are balking at allowing ships with COVID-19-positive passengers or crew to dock.

Several ships recently had to skip port calls in Mexico , for instance, after passengers and crew on board the vessels tested positive for COVID-19. The ports have since reopened after Mexico's Health Department overruled the decisions of local port officials.

Cruise ships also have had to cancel stops recently at the islands of Aruba, Bonaire and Curaçao, and at San Juan, Puerto Rico, due to local worries about COVID-19-positive passengers and crew on board and/or tighter COVID-19-related entry requirements.

Lines also are dealing with a small but growing number of destinations -- India and Hong Kong, for example -- that are at least temporarily closing to cruising completely, even for ships where no one has tested positive for COVID-19.

Viking on Sunday was forced to announce a major revision of its soon-to-begin, 120-day world cruise after India notified the line it was closing to cruise ships. Viking's 930-passenger Viking Star will begin its world cruise this week by heading south from Los Angeles to Central America and South America instead of sailing westward toward Asia, where it was scheduled to spend a significant amount of time in India.

Your cruise could be canceled on short notice

A growing number of cruise lines are canceling sailings on short notice, citing the disruptions caused by COVID-19. The world's largest cruise operator Royal Caribbean on Friday canceled soon-to-depart sailings on four of its 25 ships, including the next three departures of the world's largest ship, Symphony of the Seas .

Norwegian Cruise Line on Wednesday canceled soon-to-depart voyages on eight of its 17 ships.

Other lines canceling one or more sailings in recent days include Holland America , Silversea , Atlas Ocean Voyages, Regent Seven Seas Cruises, MSC Cruises , Costa Cruises and Oceania Cruises .

The cancellations come as lines struggle to maintain adequate staffing levels on some ships due to crew members testing positive. When crew test positive, they and their close contacts must stop working and isolate, even if asymptomatic, leaving shipboard venues short-staffed.

You probably won't be quarantined, stranded or stuck

As noted above, health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19.

The current protocol on most ships is to quickly isolate COVID-19-positive passengers and their close contacts. But only the COVID-19-positive passengers are being isolated long term.

As my colleague Ashley Kosciolek experienced first-hand on a cruise in 2021, close contacts only are being isolated for a short period while they are tested for COVID-19. If they test negative, they typically are allowed out of their rooms to rejoin the rest of their fellow cruisers on board.

This means that many sailings are going ahead as planned, with little disruption, even when some passengers and crew on the trips test positive for COVID-19. I experienced this myself in late December when on a Silversea vessel where four passengers tested positive for COVID-19. Some passengers who were deemed close contacts of the passengers who tested positive were isolated for a short period while being tested for COVID-19. But the positive cases had little impact on most of the passengers on board the vessel, and the voyage went ahead as planned.

Such a protocol comes at the recommendation of the CDC, which has set guidelines for how cruise lines should respond to COVID-19-positive cases on board ships, and it has worked well for the past year .

Of course, if you do test positive for COVID-19 on a ship, you will, unfortunately, face what could be several days of isolation in a cabin on a ship or on land. If you are an American cruising overseas, you also won't be able to return to the U.S. until you have tested negative for COVID-19 (or until you recover from the illness and are cleared in writing to travel by a licensed healthcare provider or a public health official).

This is one of the biggest risks of taking a cruise right now, and one reason you may consider canceling a sailing scheduled in the short term (see the section on more-flexible cancellation policies below).

Most COVID-19 cases on ships aren't serious

Cruise lines are reporting that the vast majority of passengers testing positive for COVID-19 in recent weeks are asymptomatic or have mild symptoms.

All major cruise lines currently are requiring all or nearly all passengers to be fully vaccinated for COVID-19, with some also starting to require booster shots , to boot. This creates an onboard population that is far less likely to experience serious symptoms of COVID-19 than a cross-section of people on land, according to CDC data.

For all adults ages 18 years and older, the cumulative COVID-19-associated hospitalization rate is about eight times higher in unvaccinated persons than in vaccinated persons, according to the latest CDC data.

You'll face lots of new health protocols

If you haven't cruised since before the pandemic, you might be surprised by how many new health- and safety-related policies cruise lines have implemented to keep COVID-19 off ships.

For starters, there are the vaccine mandates noted above. No other segment of the travel industry has been as uniform in requiring almost every customer to be fully vaccinated against COVID-19.

Related: Will I need a COVID-19 vaccine to cruise? A line-by-line guide

As noted above, cruise lines also are requiring passengers to undergo COVID-19 tests before boarding ships -- a screening process that is keeping many COVID-19 positive people from ever stepping on board a vessel.

When COVID-19 is detected on a ship, cruise lines sometimes then test passengers multiple times to ensure it isn't spreading. On my recent trip to Antarctica, I underwent six COVID-19 tests in just eight days -- three in advance of stepping on board the vessel (including a PCR test required by Chile, where my trip began) and three while on board.

In addition, most cruise lines now are requiring passengers to wear masks at all times while in interior spaces of vessels, and they have stepped up cleaning regimens, improved air filtration systems on ships and made other onboard changes.

The CDC says to avoid cruising for now

On Dec. 30, the CDC added cruise ships to its list of "Level 4" destinations you should avoid visiting for now due to high levels of COVID-19.

For what it's worth, more than 80 countries around the world -- including a good chunk of all the places you might want to travel -- are on this list. So, the CDC is basically telling you that now isn't a good time to travel. Fair enough. But the warning shouldn't be seen as a call-out on any elevated risk to cruising as opposed to visiting other places, per se.

Places on the Level 4 list currently include Canada, much of Europe and nearly every country in the Caribbean.

The cruise industry has been highly critical of the designation, arguing that cruise ships are far safer places to be right now than almost anywhere else, given their strict health protocols.

"The decision by the CDC to raise the travel level for cruise is particularly perplexing considering that cases identified on cruise ships consistently make up a very slim minority of the total population onboard — far fewer than on land — and the majority of those cases are asymptomatic or mild in nature, posing little to no burden on medical resources onboard or onshore," the main trade group for the industry, the Cruise Lines International Association, said in a statement to TPG.

You can cancel if you're worried (in many cases)

If you're booked on a cruise in the coming weeks, and you're having second thoughts, there's a good chance you can get out of your trip. Many lines continue to be far more flexible than normal about cancellations.

Take cruise giant Carnival Cruise Line . Its current flexible cancellation policy allows passengers to cancel as long as a public health emergency remains in effect and receive 100% of the cruise fare paid in the form of a future cruise credit. Passengers are also able to cancel if they test positive for COVID-19. (Proof of a positive test result is required.)

Another large line, Norwegian, just last week extended its pandemic-era Peace of Mind policy to allow passengers to cancel any sailing taking place between now and May 31. For now, the cancellation needs to be done by Jan. 31, and the refund would come in the form of a future cruise credit to be used on any sailing that embarks through Dec. 31.

That means you could call the line right now to back out of a cruise that is just days away. In normal times, you'd lose all your money if you backed out of a seven-night Norwegian cruise with fewer than 31 days' notice.

Planning a cruise? Start with these stories:

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• The 5 most desirable cabin locations on any cruise ship
• The 8 worst cabin locations on any cruise ship
• A quick guide to the most popular cruise lines
• 21 tips and tricks that will make your cruise go smoothly
• 15 ways cruisers waste money
• What to pack for your first cruise

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Avoid cruises even if vaccinated, CDC tells Americans

The US Centers for Disease Control and Prevention has warned Americans to avoid cruises regardless of vaccination status due to concern over Covid-19.

On Thursday, the CDC said the virus can quickly spread in the confined spaces of a ship and that the likelihood of infection is high.

It has elevated its travel warning for cruise ships from level three to four - the agency's highest.

The CDC is currently monitoring over 90 cruise ships for Covid-19.

The agency said there has been an increase in cases on cruise ships since identification of the Omicron variant. It warned that even fully vaccinated passengers who have received a booster dose can spread the virus while onboard.

The CDC also recommended that cruise ship passengers be tested between one and three days prior to their voyage, and three to five days after, regardless of vaccination status.

It added that unvaccinated passengers should self-isolate for a week after disembarking.

On Wednesday, the CDC said it was monitoring 92 cruise ships for Covid-19 amid a spike in cases across the US.

It maintains a colour-coded chart for cruise ships on its website based on surveillance data from the previous seven days.

Ships that are marked "red status" are believed to contain a "sustained transmission" of the virus on-board.

As of Thursday, no vessels were marked with the red status. The vast majority were classified as yellow, meaning that at least one case of Covid-19 among crew has been detected.

Yellow status also means that a particular vessel meets the threshold for further CDC investigation.

Reuters reported on Thursday that one vessel - the Queen Mary 2 - will remain in Barbados and not return to New York as a precautionary measure as it brings on additional staff.

The cruise industry was one of the sectors worst hit by Covid-related shutdowns in 2020.

The industry's largest company, US giant Carnival, reported losses of $10bn (£7.4bn) in 2020 after revenues fell 73% during the pandemic.

Covid tests cause long queues for huge cruise ship

World's largest sailing cruise ship leaves harbour, first cruise ship since covid set to visit scotland.

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Every Cruise Line's Requirements for COVID Vaccines, Testing

A guide to every major cruise line's health requirements for safe sailing.

Cruise lines have shifted their requirements for passengers, making cruising accessible to practically everyone. Many popular cruise lines have eliminated the vaccine and pre-embarkation test as the industry is beginning to shift away from mandatory vaccines and testing.

The changes began shortly after the CDC ended a pandemic-era policy of publicly displaying COVID-19 cases onboard, different cruise lines to the public in July 2022. For those looking to check current COVID-19 trends onboard the CDC urges direct contact with the cruise line, and the organization will continue to monitor and offer guidelines to ships.

Below, we break down each line's list of regulations to sail as well as what travelers need to know to plan.

Avalon Waterways

Where they sail: These small-ship river cruises sail throughout Europe, Asia, South America, and down the Nile River in Egypt.

Who needs the vaccine: All international travelers from the U.S. must be fully vaccinated before boarding. Beginning March 2023 the vaccine is no longer required (but strongly encouraged).

What other safety measures are in place: All guests will undergo a health screening upon arrival and luggage will be disinfected. Avalon will provide COVID-19 testing for travelers who need to show proof of a negative test to return home at no extra cost. Depending on the location of the cruise a pre-departure COVID-19 test may or may not be required.

Find out more: Avalon Waterways

Where they sail : Azamara sails mid-size ships all over the world, to all seven continents.

Who needs the vaccine : All guests and crew 12 and older will be required to be fully vaccinated at least two weeks before boarding a ship. Beginning Dec. 1, 2022, the company plans to drop the vaccine requirement for departures from the U.S. and Europe.

What other safety measures are in place : Depending on the port of embarkation guests may or may not to pre-test to travel. For a full list of ports and whether they require a test guests can check online.

Azamara's ships have been upgraded with new HVAC filtration systems, and EPA-certified disinfectants are used to clean the ship.

Find out more : Azamara

Carnival Cruises

Where they sail: Carnival sails large ships around the world, including popular trips to the Caribbean. The company sailed its maiden voyage on the Mardi Gras out of Florida in July.

Who needs the vaccine: All guests are encouraged to be vaccinated but unvaccinated travelers, or vaccinated guests without proof of vaccination, will have to present the negative results of a PCR or antigen test taken no earlier than 3 days before sailing.

What other safety measures are in place: For cruises five days or less, there will no longer be pre-cruise testing for vaccinated passengers unless a specific port requires it. Itineraries including Bahamas, Bermuda, or Grand Cayman will still be required to test. All guests will also be required to fill out a health screening 72 hours before embarkation and undergo health screenings prior to boarding. Unvaccinated travelers on a cruise to Bermuda will be required to purchase travel insurance (children under 12 are exempt as long as they are traveling with vaccinated parents).

Both vaccinated and unvaccinated guests who have recovered from COVID-19 within three months of their sailing date, do not need the required pre-cruise COVID test before embarkation, only if they are at least 10 days past their COVID-19 infection, have no symptoms and present documentation of recovery from COVID-19 from their healthcare provider.

Find out more: Carnival Cruise Line

Celebrity Cruises

Where they sail: Celebrity Cruises sails all over the world.

Who needs the vaccine: The vaccine is no longer required to sail on cruises from the U.S. and Europe. A vaccine is required for sailings visiting Canada.

What other safety measures are in place: A pre-embarkation test is no longer required for vaccinated guests on sailings nine days or less. Unvaccinated passengers will still be required to test three days prior to sailing. Self-tests are acceptable from European and U.S. ports that don't stop in Bermuda or Canada.

Find out more : Celebrity Cruises

Where they sail: Cunard, which sails all over the world, is known for its transatlantic journeys aboard the Queen Mary 2.

Who needs the vaccine: All guests 18 and older must be fully vaccinated. Unvaccinated passengers under 18 will be required to undergo a PCR test within 72 hours of their departure.

What other safety measures are in place: Cunard has "enhanced" their onboard ventilation systems and implemented mandatory mask-wearing policies indoors. All guests aged 4 and older are required to have a negative COVID-19 test before boarding. Crew will be tested regularly while on board. Guests who have certain pre-existing medical conditions, including those who are on supplementary oxygen, will not be allowed to board.

Disney Cruise Line

Where they sail: Disney sails family-friendly journeys including to the Caribbean, Europe, and Alaska.

Who needs the vaccine: Vaccination is no longer required by highly suggested.

What other safety measures are in place: Unvaccinated guests must provide results of a COVID-19 test taken 1 to 2 days before sail date, at home tests are not accepted, this requirement will end Nov. 14. The Cruise line also has a full list of enhanced cleaning protocols.

Find out more: Disney Cruise Line

Grand Circle Cruise Line

Where they sail: Grand Circle Cruise Line sails small ships and river cruises all over the world, including an extensive list of European itineraries. The company plans to start sailing again in August, including to Greece, Turkey, and Italy.

Who needs the vaccine: All guests and crew are required to be fully vaccinated with the booster shot.

What other safety measures are in place: All ships have been equipped with High Efficiency Particular Air (HEPA) filters and buffets have been eliminated. The cruise line states some itineraries will require proof of a negative COVID-19 test prior to travel, and that instructors will be sent out 30 days prior to travel.

Find out mor e: Grand Circle Cruise Line

Holland America

Where they sail: Holland America sails large ships all over the world, including to the Mediterranean, Caribbean, Europe, and more.

Who needs the vaccine: Unvaccinated guests are welcome but will be required to self-test three days before cruising.

What other safety measures are in place: Vaccinated passengers traveling on ships for less than 16 days excluding itineraries with the Panama Canal, trans-ocean, and other selected itineraries will no longer be required to test.

Lindblad Expeditions

Where they sail: Lindblad Expeditions is known for its adventurous trips to hard-to-reach destinations like Antarctica and the Russian Far East, partnering with National Geographic to add to the experience.

Who needs the vaccine: All guests 12 and older need to be vaccinated before boarding. Boosters are recommended but not required.

What other safety measures are in place: Pre-departure testing will not be required unless for a specific destination.

Margaritaville at Sea

Where they sail: Margaritaville at Sea offers 3-day cruises to Grand Bahama Island departing from the port of Palm Beach. The cruise line also offers the opportunity to take the ship one way to the Bahamas to allow guests to stay at the Margaritaville resort, and then take the ship back to the Bahamas at a later date.

Who needs the vaccine: All guests are welcome regardless of vaccination status, according to the cruise line.

What other safety measures are in place: All crew members must be vaccinated for COVID-19 and the cruise line states there are vaccination requirements on board (but does not specify).

Find out more: Margaritaville at Sea

MSC Cruises

Where they sail: MSC Cruises sails large ocean cruises around the world, including throughout Europe, South America, the Persian Gulf, and the Caribbean. In August, the company started sailing to the Bahamas with a stop at its private island, Ocean Cay.

Who needs the vaccine: Vaccinations are recommended but no longer required.

What other safety measures are in place: Fully-vaccinated passengers are no longer required to show proof of a negative test unless it is required of the destination. Unvaccinated children must show proof of a negative PCR test.

Norwegian Cruise Line

Where they sail: Norwegian sails big ocean cruises all around the world, including popular itineraries all throughout the Caribbean and Greece.

Who needs the vaccine: All passengers may sail regardless of vaccination status.

What other safety measures are in place: Testing is no longer required for any passenger regardless of vaccination status with the exception of local government mandates.

Find out more : Norwegian Cruise Line

Oceania Cruises

Where they sail: Oceania Cruises sails all over the world, including offering several World Cruise itineraries.

Who needs the vaccine: All passengers regardless of vaccination status are allowed to sail.

What other safety measures are in place: Only unvaccinated guests will be required to show proof of a negative PCR or antigen test taken 72 hours prior to boarding. Unvaccinated children aged 12 years and younger are exempt.

P&O Cruises

Where they sail: The UK-based cruise line sails around Europe, including to the Canary Islands, as well as to the Caribbean from Southampton in the UK.

Who needs the vaccine: Although P&O Cruises' policy states that passengers over the age of 15 are required to be vaccinated, the latest update on its website says guests will be contacted directly in regards to vaccination protocol.

What other safety measures are in place: All guests are required to undergo a COVID-19 test at the terminal. Masks will be required on board indoors, and all shore excursions will be with vetted operators.

Princess Cruises

Where they sail: The global cruise line sails large ocean ships all around the world, from Australia to Alaska.

Who needs the vaccine: All guests are welcome on board, but unvaccinated passengers will be required to test and may need an additional medical exemption at some ports.

Regent Seven Seas Cruises

Where they sail: Regent Seven Seas offers all-inclusive luxury cruises around the globe, which include perks like free airfare, free excursions, and complimentary unlimited drinks on board.

Who needs the vaccine: All guests are now welcome. Unvaccinated passengers will be required to test 3-days before embarkation.

What other safety measures are in place: Pre-departure testing may not be necessary depending on the port. Currently cruises leaving from Bermuda, Canada, and Greece will require a test.

Royal Caribbean International

Where they sail: Royal Caribbean sails large ocean ships all over the world, including many popular itineraries throughout the Caribbean and Asia.

Who needs the vaccine: Everyone is welcome regardless of vaccination status, passengers traveling to Bermuda or Canada are required to be vaccinated.

W hat other safety measures are in place: On Royal Caribbean, unvaccinated travelers 12 and older leaving from a U.S. or Caribbean port still have to get tested within three days of embarkation,  according to the cruise line , vaccinated guests are exempt.

Royal Caribbean will accept a variety of tests as proof to board, including simply taking a photo of a self-administered home test.

Find out more : Royal Caribbean International

Where they sail: The British cruise line, exclusively for guests 50 and older, sails both ocean and river cruises around the globe.

Who needs the vaccine: All guests must be fully vaccinated, including a booster shot at least 14 days before boarding a ship. Saga was the first major cruise line to implement this vaccination policy.

What other safety measures are in place: Ocean Cruise guests will be required to get tested for COVID-19 in the terminal. Masks are required on bus transfers, in hotels, and on excursions.

Find out more : Saga

Where they sail: Seabourn's mid-size luxury cruises head all around the world, from Alaska to the Caribbean.

Who needs the vaccine: Vaccinations are not required on most cruise itineraries, unvaccinated guests will be required to present a negative test taken within three days of embarkation.

What other safety measures are in place: Masks are recommended onboard in most indoor venues and the casinos are frequently sanitized.

Where they sail: Silversea brings guests all around the world in luxury and style, including to the Galapagos and Antarctica.

Who needs the vaccine: All guests are welcome, however, unvaccinated guests may not be welcome on all sailings depending on local regulations.

What other safety measures are in place: Vaccinated guests do not need a pre-departure test unless local regulations such as cruises leaving from Australia, Bermuda, Canada, or Greece require it. Unvaccinated travelers will need a negative COVID-19 test within 72 hours of embarkation.

UnCruise Adventures

Where they sail: This small-ship company is known for its Alaska journeys as well as adventures in places like the Galapagos and island hopping in Hawaii.

Who needs the vaccine: As of April 7, all guests are welcome on board regardless of vaccination status.

What other safety measures are in place: Guests will no longer be required to present proof of vaccination or a COVID-19 test prior to, or during any point of sailing and the cruise line will no longer be running at limited capacity. These measures go into effect on April 7, until then guests 12 and older must provide proof of vaccination, and itineraries may sail at less then full capacity.

Masks are required in public spaces, according to the company "bandana" and "buff" face masks will not be accepted.

Victory Cruise Lines

Where they sail: Victory Cruise Lines is known for its Great Lakes cruises, providing all-inclusive sailings to see breathtaking sights from Niagara Falls to the iconic architecture of Chicago from Lake Michigan. Beyond the U.S., Victory Cruise Lines sails to Mexico's Yucatán Peninsula.

Who needs the vaccine: All guests and crew will be required to be vaccinated before boarding, and will be required to show physical proof prior to boarding.

What other safety measures are in place: Testing is no longer required on any river cruise.

Luggage is then disinfected before being brought onto the ship and staterooms cleaned with electrostatic fogging. Masks will be required during the embarkation process and while riding a shore excursion bus, but will not be required on board.

Viking Cruises

Where they sail: Viking sails ocean and river cruises all over the world, including throughout Europe. This summer, Viking will sail several voyages, including around England for UK residents, to Bermuda, and to Iceland in June.

Who needs the vaccine: All guests must be fully vaccinated to board a ship. Guests who are eligible must have a booster.

What other safety measures are in place: In addition to vaccines, all guests may be required to undergo a saliva PCR test at embarkation as well as "frequent" testing throughout the journey. All staterooms are equipped with independent air handling units.

Virgin Voyages

Where they sail: The brand-new cruise line is launching mini sailings from England for UK residents, and has cruises throughout the Caribbean, and transatlantic options.

Who needs the vaccine: All are welcome regardless of vaccination status, the cruise line removed all vaccine and testing requirements for all its ships in late October, according to the company.

What other safety measures are in place: Virgin Voyages was the first cruise line to eliminate pre-departure testing for vaccinated guests. The cruise line will continue to work with an advisory board to help ensure health and safety on board at all times, including the use of air filtration systems and sanitization of high touch surface areas.

Find out more : Virgin Voyages

Windstar Cruises

Where they sail: Windstar operates small-ship cruises and several sailing vessels all around the globe, including to places like Central America .

Who needs the vaccine: All guests will be required to be fully vaccinated at least 14 days before boarding one of Windstar's yachts. Boosters are highly encouraged and are recommended to be administered at least one week prior to travel.

What other safety measures are in place: Guests no longer need a pre-embarkation test unless a specific destination requires it.

Alison Fox is a contributing writer for Travel + Leisure. When she's not in New York City, she likes to spend her time at the beach or exploring new destinations and hopes to visit every country in the world. Follow her adventures on Instagram .

Related Articles

COVID-19 Spreads to 89 Cruise Ships, Prompting a U.S. CDC Investigation

T he U.S. Centers for Disease Control and Protection identified 89 cruise ships with COVID-19 cases on Tuesday, nearly all of which have met the threshold for a formal investigation.

Democratic Senator Richard Blumenthal urged cruise companies and health agencies to stop ships from sailing, saying they are “repeating recent history as petri dishes of Covid-19 infection.” Operators such as Carnival Corp. have implemented safeguards including mandatory masking and proof of vaccination, but the fast-spreading omicron variant has triggered an increasing number of infections and reports of ships being turned away at ports.

“Time for CDC & cruise lines to protect consumers & again pause—docking their ships,” Blumenthal said in a tweet.

Roger Frizzell, a spokesperson for Carnival, said in an email that “our health and safety protocols put in place have proven to be effective time and time again over the past year with our sailings being restarted across each of our brands.”

Of the 86 cruise ships under investigation by the CDC, Carnival operates 32, Royal Caribbean Cruises Ltd. operates 25 and Norwegian Cruise Line Holdings Ltd. operates 15. Four ships operated by Walt Disney Co.’s Disney Cruise Line are now also under watch, according to the CDC website. The list is rapidly changing and the next stage for ships with outbreaks could involve taking additional public health measures.

Royal Caribbean, Norwegian, Disney Cruise Line and Viking Cruises didn’t immediately respond to requests for comment.

More from TIME

“Health and safety is the cruise industry’s highest priority,” said Bari Golin-Blaugrund, a spokesperson for the Cruise Lines International Association trade group, in an email. “In fact, the latest data show that cases have occurred less frequently on cruise ships than on land, with a greater proportion of asymptomatic or mild cases.”

Shares of cruise operators rebounded Tuesday along with the travel sector. As of 12:35 p.m. New York time, Carnival was up 1.2%, Royal Caribbean gained 0.4% and Norwegian was little changed. Of the three, only Royal Caribbean shares have had positive returns this year and they have significantly trailed the broader market, up less than 6% year to date compared to a 27% gain in the S&P 500 Index.

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Cruise Ship Travel

While cruising is a popular way to travel, there are some health concerns to be aware of. Find out more about health issues on cruises and steps you can take to stay safe and healthy during your trip.

If you are feeling sick before your voyage, do not travel and ask your cruise line about rescheduling or reimbursement options. If you feel sick during your voyage, report your symptoms to the ship’s medical center and follow their recommendations.

Common Health Concerns During Cruise Travel and What You Can Do to Prevent Illness

• Respiratory viral illnesses like COVID-19 ,  flu , and RSV :  Follow core prevention strategies to protect yourself and others. Get your annual flu shot , stay  up to date on your COVID-19 vaccines , and check if you're eligible for an RSV vaccine . Check directly with your cruise line before travel about any health requirements. If you have a weakened immune system , talk with your healthcare provider about your cruise travel plans. Wash your hands frequently or use hand sanitizer . Stay home and away from others if you have respiratory virus symptoms. Do not travel until your symptoms are improving and you have not had a fever for 24 hours (without meds). For 5 additional days, take precautions including covering your nose and mouth with a tissue to prevent spreading germs when you cough or sneeze. Consider wearing a mask in crowded or poorly ventilated indoor areas or avoiding those areas all together.
• Gastrointestinal illness:  Symptoms of vomiting and diarrhea, primarily caused by outbreaks of norovirus , have been reported. To prevent gastrointestinal illness, wash your hands with soap and water before eating and after using the bathroom, changing diapers, or touching things that other people have touched, such as stair railings. Avoid touching your face. For more information, visit CDC’s  Vessel Sanitation Program  website.
• Seasickness:  Cruise ship passengers may experience seasickness or motion sickness. If you know you get seasick or think you may be likely to get seasick, talk to your healthcare provider about medicine to reduce your symptoms. Some common medications, including some antidepressants, painkillers, and birth control pills, can make seasickness worse.
• Sunburns:  Apply sunscreen with SPF 15 or higher when traveling. Protecting yourself from the sun isn’t just for tropical beaches—you can get a sunburn even if it’s cloudy or cold.
• Bug bites:  On your trip, use insect repellent and take other steps to avoid bug bites. Bugs, including mosquitoes and ticks, can spread diseases such as malaria, yellow fever, Zika, dengue, chikungunya, and Lyme. Many ships visit ports where these diseases are a concern.

Before Your Trip

Check CDC’s destination pages for travel health information . Check CDC’s webpage for your destination to see what vaccines or medicines you may need and what diseases or health risks are a concern at your destination.

Make sure you are up to date with all of your routine vaccines . Routine vaccinations protect you from infectious diseases that can spread quickly in groups of people. Outbreaks of chickenpox, flu, and COVID-19 have been reported on cruise ships.

Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries. Crew members and fellow travelers often board a cruise ship from destinations where some diseases are more common than in the United States or where vaccination is not routine.

Make an appointment with your healthcare provider or a travel health specialist  that takes place at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing your health concerns, itinerary, and planned activities with your provider allows them to give more specific advice and recommendations.

Plan for the Unexpected

Prepare for any unexpected issues during your cruise ship travels with the following steps:

Prepare a  travel health kit  with items you may need, especially those items that may be difficult to find at your destination. Include your prescriptions and over-the-counter medicines in your travel health kit and take enough to last your entire trip, plus extra in case of travel delays. Depending on your destination you may also want to pack a mask ,  insect repellent , sunscreen (SPF 15 or higher), aloe, alcohol-based hand sanitizer, water disinfection tablets, and your health insurance card.

Get travel insurance.  Find out if your health insurance covers medical care abroad. Travelers are usually responsible for paying hospital and other medical expenses out of pocket at most destinations. Make sure you have a plan to  get care overseas , in case you need it. Consider buying  additional insurance  that covers health care and emergency evacuation, especially if you will be traveling to remote areas.

If you need medical care abroad, see Getting Health Care During Travel .

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel. Avoid contact with other people while you are sick.

More Information

• Cruise Ship Travel in CDC Yellow Book
• Tips for Healthy Cruising
• Maritime Guidance

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Coronavirus Updates

Cdc drops its covid-19 risk advisory for cruise ship travel.

Jonathan Franklin

The Norwegian Gateway cruise ship is moored at PortMiami on Jan. 7 in Miami. The Centers for Disease Control and Prevention dropped its advisory warning Wednesday for cruise travel after more than two years of warning Americans. Joe Raedle/Getty Images hide caption

The Norwegian Gateway cruise ship is moored at PortMiami on Jan. 7 in Miami. The Centers for Disease Control and Prevention dropped its advisory warning Wednesday for cruise travel after more than two years of warning Americans.

The Center for Disease Control and Prevention has lifted its risk advisory for cruise ship travel Wednesday following two years of issuing warnings to travelers about the possibility of contracting COVID-19 onboard a cruise.

In an update posted online, the agency removed its "Cruise Ship Travel Health Notice," a notice that recommended individuals against traveling onboard cruise ships. Three months ago, the CDC increased its travel warnings for cruises to Level 4 — the highest level — following investigations of ships that had COVID outbreaks.

While the CDC has lifted its travel health notice, officials say it's up to the passengers to determine their own health risks before going onboard a cruise ship.

"While cruising will always pose some risk of COVID-19 transmission, travelers will make their own risk assessment when choosing to travel on a cruise ship, much like they do in all other travel settings," the agency said in a statement to NPR.

People should avoid cruise travel regardless of their vaccination status, the CDC says

The agency says it will continue to provide guidance to the cruise ship industry in order for cruise lines to operate in a way that will provide "safer and healthier" environments for crews, passengers and communities.

News of the CDC's decision to remove its travel health notice was praised by the Cruise Lines International Association, the industry's largest trade organization.

"Today's decision by the U.S. Centers for Disease Control and Prevention (CDC) to altogether remove the Travel Health Notice for cruising recognizes the effective public health measures in place on cruise ships and begins to level the playing field, between cruise and similarly situated venues on land, for the first time since March 2020. From the onset of the pandemic, CLIA's cruise line members have prioritized the health and safety of their guests, crew, and the communities they visit and are sailing today with health measures in place that are unmatched by virtually any other commercial setting."

A luxury cruise ship rerouted to the Bahamas over an arrest warrant for unpaid fuel

The CDC emphasizes that travelers should make sure they're up to date with their COVID-19 vaccines before taking a cruise, in addition to following their ship's requirements and recommendations against the virus.

Travelers are urged to check their cruise ship's COVID case levels and vaccination requirements online before traveling, the agency says.

• cruise ships
• CDC COVID-19 guidance

What’s it like to go on a cruise now? Here’s how COVID changed the onboard experience

Cruise passengers will see a lot of changes on the ship due to the pandemic.

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The cruise industry suffered its biggest financial blow in decades when the COVID-19 pandemic halted most sailings for months and made nervous cruise fans think twice about booking an ocean voyage.

But cruising is back and all signs point to a turn of the tide for the industry: More cruises are scheduled to depart the Port of Los Angeles next year than in 2019.

Carnival Corp., the world’s largest cruise company, reported that bookings for the second half of 2022 already surpassed bookings for 2019. Royal Caribbean cruises for 2022 are nearly at 2019 levels, the company’s chief financial officer, Jason Liberty, said on a recent earnings call.

Despite the shutdown, the world’s cruise lines have more than 100 new ships on order to set sail by 2027. The Majestic Princess, a ship designed to serve the Chinese market, made its maiden call from the Port of L.A. on Oct. 6. Some 200 cruises are scheduled to depart from there in 2022, up from 120 in 2019.

What are cruise lines requiring of passengers? How have boarding, dining and other activities on board changed? We gathered some information to answer common questions.

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Nov. 3, 2021

Do I have to be vaccinated to go on a cruise?

The U.S. Centers for Disease Control and Prevention recommends all passengers be fully vaccinated before boarding a cruise ship. The world’s largest cruise companies now require passengers leaving U.S. ports to be fully vaccinated, with limited exceptions. Vaccines are required for passengers on Carnival , Princess , Royal Caribbean and Celebrity cruise lines.

You will usually be required to show proof of vaccination at the terminal before boarding. Some cruise lines will also require passengers — whether vaccinated or not — to show proof of a COVID-19 test taken within two days of boarding a vessel. Check the requirements and protocols of your particular cruise.

Do I have to wear a mask at all times on the ship?

Passengers are strongly encouraged to wear masks in public spaces and are required to do so in such indoor areas as elevators, stores, casinos and dining halls, except when eating or drinking. You typically won’t be required to wear masks around the pool and hot tubs, but deck chairs are spaced farther apart than in the past to maintain physical distance.

What about shore visits and excursions?

To go onshore, you must meet the health protocols of the country the ship visits. The government of the Bahamas, for example, recently announced that all cruise visitors must be fully vaccinated, with the exception of travelers under age 12 and those with medical exemptions.

On some ships, such as Carnival Cruises, unvaccinated passengers are not allowed to go onshore except with a pre-booked “bubble tour,” in which passengers travel with friends and family in a controlled environment. On other cruise lines, such as Holland America, shore excursions managed by the ship are strongly encouraged.

Are ships sailing at full capacity?

Most ships are sailing at less than full capacity, partly to encourage physical distancing. The Majestic Princess left on its maiden voyage from the Port of Los Angeles at about 60% capacity. The cruise lines plan to increase capacity over the next few months.

Have any activities been eliminated because of COVID-19?

You won’t be lining up at the buffet for meals. Most self-serve buffets have been modified so that employees serve passengers to avoid unnecessary crowding. Indoor dancing, karaoke and nightclubs are no longer allowed on many ships, including the Majestic Princess, which converted its karaoke area into extra room for spa treatments. On some ships, passengers won’t be allowed to try on clothing for sale. Physical distancing is encouraged for all activities.

Will I need to make reservations for dining and other onboard activities?

To manage capacity and physical distancing, many onboard restaurants recommend reservations and will limit groups at dining tables to eight. On Princess Cruises, reservations can be made through the MedallionClass app. On Celebrity Cruises, reservations can be made on the Celebrity Cruises App.

What else do I need to know?

You won’t be required to assemble at a designated spot on the ship to hear the pre-departure safety instruction, also known as the “safety muster drill.” Instead, passengers can watch parts of the safety drill on their stateroom televisions or on a cruise ship app.

Spas and gyms remain open, but some cruise lines limit them to vaccinated guests. Hand sanitizer stations can be found throughout the ships.

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Jan. 19, 2022

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Every U.S. cruise with passengers has coronavirus cases on board

The CDC has opened investigations into 92 ships

Coronavirus cases have been reported on every cruise ship sailing with passengers in U.S. waters.

According to the Centers for Disease Control and Prevention, all 92 ships with passengers have met the threshold for investigation by the public health agency. In every case, the CDC has either started an investigation or has investigated and continues to observe the ship.

The number of ships under investigation had grown sharply in recent days, but it wasn’t until Tuesday’s update, using data submitted by cruise lines Monday, that every ship reached that level.

Last week, the CDC warned all travelers, including those who are vaccinated, to avoid cruise ships. The advice came after the agency said the number of cases skyrocketed from 162 in the first two weeks of December to 5,013 between Dec. 15 and 29.

CDC warns against cruise travel after 5,000 new cases in 2 weeks

“The virus that causes COVID-19 spreads easily between people in close quarters on board ships, and the chance of getting COVID-19 on cruise ships is very high, even if you are fully vaccinated and have received a COVID-19 vaccine booster dose,” the agency cautioned .

Cruise lines are requiring all crew and most, if not all, passengers to be fully vaccinated to sail. Passengers also need proof of a recent negative test before boarding.

In addition to the 92 ships with passengers on board, 18 vessels are in U.S. waters with crew only, according to the CDC. Of those, two have met the threshold for investigation, and three have reported cases but not enough to warrant an investigation. Thirteen crew-only ships have reported no cases, according to the data.

“As part of investigating cruise ships that meet the investigation threshold, CDC will obtain additional information from the cruise ship, such as case exposure histories, details about close contacts, traveler vaccination rates, and medical capacities,” CDC spokeswoman Caitlin Shockey said in an email.

She said the agency would work closely with cruise lines and “consider multiple factors” before moving ships from their current status — yellow — to the more serious red status, in which a ship would return to port right away or delay a sailing. To reach that mark, a ship must have sustained transmission of covid-19 or covid-like illness and the potential for “cases to overwhelm on board medical center resources,” the CDC says .

Cruise passengers on holiday trips deal with outbreaks: ‘We’re sailing on a petri dish’

Since late December, several cruises have been turned away from ports because of passengers or crew on board testing positive. Most have continued on their journeys, even when they were forced to skip the stops they had planned.

On Wednesday, however, Norwegian Cruise Line confirmed it was canceling a nine-day Caribbean voyage on Norwegian Getaway that was scheduled to leave Miami that day. The reason, according to the cruise line: “COVID related circumstances.”

The operator gave the same reason on Tuesday for bringing a ship, Norwegian Pearl, back to Miami after it left for an 11-night Panama Canal trip Monday. According to the Miami Herald , passengers were informed that the trip was ending after an unspecified number of crew tested positive; the company would not provide that number to The Washington Post. The vessel is scheduled to return to Miami on Thursday.

“We will never compromise on health and safety and we will of course, continue to take all appropriate action to ensure everyone’s well-being and to protect public health,” the company said in a statement .

More cruise news

Living at sea: Travelers on a 9-month world cruise are going viral on social media. For some travelers, not even nine months was enough time on a ship; they sold cars, moved out of their homes and prepared to set sail for three years . That plan fell apart, but a 3.5-year version is waiting in the wings.

Passengers beware: It’s not all buffets and dance contests. Crime data reported by cruise lines show that the number of sex crimes has increased compared to previous years. And though man-overboard cases are rare, they are usually deadly .

The more you know: If you’re cruise-curious, here are six tips from a newcomer. Remember that in most cases, extra fees and add-ons will increase the seemingly cheap price of a sailing. And if you happen to get sick , know what to expect on board.

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The C.D.C. tells travelers to avoid cruises, regardless of vaccination.

The move came as the number of outbreaks on ships has grown in recent weeks.

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By Todd Gregory Ceylan Yeginsu and Oscar Lopez

• Dec. 30, 2021

The Centers for Disease Control and Prevention on Thursday raised its Covid-19 warning level for cruise ships to 4, the highest, and issued a blunt warning: “Avoid cruise travel regardless of vaccination status.”

The move came as the number of outbreaks on ships has grown in recent weeks, causing some ports to turn away ships. Last week, dozens of people on a Royal Caribbean International ship tested positive after it set sail from Fort Lauderdale, Fla., and a Carnival Cruise Line ship returned to Miami on Sunday after positive tests among “a small number on board.”

Calling the C.D.C.’s decision “perplexing,” the cruise industry’s trade group, Cruise Lines International Association, said in a statement that the number of cases onboard made up a very slim minority of the total population and that “the majority of cases were asymptomatic or mild in nature, posing little to no burden on medical resources onboard or onshore.”

Before the C.D.C.’s warning on Thursday, Royal Caribbean Group, one of the biggest cruise companies, said its ships had carried 1.1 million guests since it had restarted U.S. operations in June, with 1,745 people testing positive. While the majority of passengers had mild or no symptoms, 41 people were hospitalized.

“Omicron is having a big short-term impact on everyone, but many observers see this as a major step towards Covid-19 becoming endemic rather than epidemic,” said Richard D. Fain, chairman and chief executive of Royal Caribbean Cruises.

Despite the increase in cruise ship cases, Mexico’s government announced this week that it would let cruise ships dock at its ports even if passengers have tested positive for the coronavirus, and also allow asymptomatic travelers to disembark on its shores.

The announcement came after two cruise ships with Covid outbreaks were refused permission by the authorities in Jalisco State in the last week to let passengers or crew disembark at Puerto Vallarta, a popular tourist destination on Mexico’s Pacific coast.

“Our country maintains its policy of solidarity and fraternity, as well as the principle of non-discrimination towards all people,” the government said in a statement . “The health and tourism authorities remain attentive to provide the necessary medical assistance to those who visit us.”

The coronavirus wreaked havoc on the cruise industry in the early stages of the pandemic , infecting hundreds of cruise passengers and workers and requiring the sector to shut down for 18 months. To begin sailing, cruise ships had to agree to the C.D.C.’s Conditional Sailing Order, which is valid until Jan. 15.

On most cruises out of U.S. ports, almost all crew members and adult passengers are vaccinated and masks are required indoors except for when passengers are eating or drinking.

Among the safety measures the order requires — beyond submitting the daily number of coronavirus cases — is a prevention and control plan for each cruise ship.

Most cruise companies do not publicly announce the number of coronavirus cases identified during sailings, but all cruise ships operating to and from U.S. ports must submit daily numbers to the C.D.C., which uses a color-coded system to inform the public whether the number of cases is above or below the agency’s threshold for an investigation.

Currently 88 cruise ships are being monitored by the C.D.C. because of reported coronavirus cases onboard. The agency does not publicly specify the number of cases on each ship.

Ceylan Yeginsu is a London-based reporter. She joined The Times in 2013, and was previously a correspondent in Turkey covering politics, the migrant crisis, the Kurdish conflict, and the rise of Islamic State extremism in Syria and the region. More about Ceylan Yeginsu

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Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

Weekly / March 27, 2020 / 69(12);347-352

On March 23, 2020, this report was posted online as an MMWR Early Release.

Please note: This report has been corrected .

Leah F. Moriarty, MPH 1 ; Mateusz M. Plucinski, PhD 1 ; Barbara J. Marston, MD 1 ; Ekaterina V. Kurbatova, MD, PhD 1 ; Barbara Knust, DVM 1 ; Erin L. Murray, PhD 2 ; Nicki Pesik, MD 1 ; Dale Rose, PhD 1 ; David Fitter, MD 1 ; Miwako Kobayashi, MD, PhD 1 ; Mitsuru Toda, PhD 1 ; start highlight Paul T. Cantey, MD 1 ; end highlight Tara Scheuer, MPH 3 ; Eric S. Halsey, MD 1 ; Nicole J. Cohen, MD 1 ; Lauren Stockman, MPH 2 ; Debra A. Wadford, PhD 2 ; Alexandra M. Medley, DVM 1 ,4 ; Gary Green, MD 5 ; Joanna J. Regan, MD 1 ; Kara Tardivel, MD 1 ; Stefanie White, MPH 1 ; start highlight Clive Brown, MD 1 ; end highlight Christina Morales, PhD 2 ; Cynthia Yen, MPH 2 ; Beth Wittry, MPH 1 ; Amy Freeland, PhD 1 ; Sara Naramore, MPH 3 ; Ryan T. Novak, PhD 1 ; David Daigle, MPH 1 ; Michelle Weinberg, MD 1 ; Anna Acosta, MD 1 ; Carolyn Herzig, PhD 1 ; Bryan K Kapella, MD 1 ; Kathleen R. Jacobson, MD 2 ; Katherine Lamba, MPH 2 ; Atsuyoshi Ishizumi, MPH, MSc 1 ; John Sarisky, MPH 1 ; Erik Svendsen, PhD 1 ; Tricia Blocher, MS 2 ; Christine Wu, MD 3 ; Julia Charles, JD 1 ; Riley Wagner, MPH 1 ; Andrea Stewart, PhD 1 ; Paul S. Mead, MD 1 ; Elizabeth Kurylo, MCM 1 ; Stefanie Campbell, DVM 1 ; Rachel Murray, MPH 1 ; Paul Weidle, PharmD 1 ; Martin Cetron, MD 1 ; Cindy R. Friedman, MD 1 ; CDC Cruise Ship Response Team; California Department of Public Health COVID-19 Team; Solano County COVID-19 Team ( View author affiliations )

What is already known about this topic?

Cruise ships are often settings for outbreaks of infectious diseases because of their closed environment and contact between travelers from many countries.

What is added by this report?

More than 800 cases of laboratory-confirmed COVID-19 cases occurred during outbreaks on three cruise ship voyages, and cases linked to several additional cruises have been reported across the United States. Transmission occurred across multiple voyages from ship to ship by crew members; both crew members and passengers were affected; 10 deaths associated with cruise ships have been reported to date.

What are the implications for public health practice?

Outbreaks of COVID-19 on cruise ships pose a risk for rapid spread of disease beyond the voyage. Aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.

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An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* ( 1 ). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness ( 2 ). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well ( 3 ). Passengers on certain cruise ship voyages might be aged ≥65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection ( 4 ). During February–March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.

During February 7–23, 2020, the largest cluster of COVID-19 cases outside mainland China occurred on the Diamond Princess cruise ship, which was quarantined in the port of Yokohama, Japan, on February 3 ( 3 ). On March 6, cases of COVID-19 were identified in persons on the Grand Princess cruise ship off the coast of California; that ship was subsequently quarantined. By March 17, confirmed cases of COVID-19 had been associated with at least 25 additional cruise ship voyages. On February 21, CDC recommended avoiding travel on cruise ships in Southeast Asia; on March 8, this recommendation was broadened to include deferring all cruise ship travel worldwide for those with underlying health conditions and for persons aged ≥65 years. On March 13, the Cruise Lines International Association announced a 30-day voluntary suspension of cruise operations in the United States ( 5 ). CDC issued a level 3 travel warning on March 17, recommending that all cruise travel be deferred worldwide. †

Diamond Princess

On January 20, 2020, the Diamond Princess cruise ship departed Yokohama, Japan, carrying approximately 3,700 passengers and crew ( Table ). On January 25, a symptomatic passenger departed the ship in Hong Kong, where he was evaluated; testing confirmed SARS-CoV-2 infection. On February 3, the ship returned to Japan, after making six stops in three countries. Japanese authorities were notified of the COVID-19 diagnosis in the passenger who disembarked in Hong Kong, and the ship was quarantined. Information about social distancing and monitoring of symptoms was communicated to passengers. On February 5, passengers were quarantined in their cabins; crew continued to work and, therefore, could not be isolated in their cabins ( 6 ). Initially, travelers with fever or respiratory symptoms and their close contacts were tested for SARS-CoV-2 by reverse transcription–polymerase chain reaction (RT-PCR). All those with positive test results were disembarked and hospitalized. Testing was later expanded to support a phased disembarkation of passengers, prioritizing testing of older persons, those with underlying medical conditions, and those in internal cabins with no access to the outdoors. During February 16–23, nearly 1,000 persons were repatriated by air to their home countries, including 329 persons who returned to the United States and entered quarantine or isolation. § , ¶

The remaining passengers who had negative SARS-CoV-2 RT-PCR test results,** no respiratory symptoms, and no close contact with a person with a confirmed case of COVID-19 completed a 14-day ship-based quarantine before disembarkation. Those passengers who had close contact with a person with a confirmed case completed land-based quarantine, with duration determined by date of last contact. After disembarkation of all passengers, crew members either completed a 14-day ship-based quarantine, were repatriated to and managed in their home country, or completed a 14-day land-based quarantine in Japan.

Overall, 111 (25.9%) of 428 U.S. citizens and legal residents did not join repatriation flights either because they had been hospitalized in Japan or for other reasons. To mitigate SARS-CoV-2 importation into the United States, CDC used temporary “Do Not Board” restrictions ( 7 ) to prevent commercial airline travel to the United States, †† and the U.S. Departments of State and Homeland Security restricted travel to the United States for non-U.S. travelers.

Among 3,711 Diamond Princess passengers and crew, 712 (19.2%) had positive test results for SARS-CoV-2 ( Figure 1 ). Of these, 331 (46.5%) were asymptomatic at the time of testing. Among 381 symptomatic patients, 37 (9.7%) required intensive care, and nine (1.3%) died ( 8 ). Infections also occurred among three Japanese responders, including one nurse, one quarantine officer, and one administrative officer ( 9 ). As of March 13, among 428 U.S. passengers and crew, 107 (25.0%) had positive test results for COVID-19; 11 U.S. passengers remain hospitalized in Japan (median age = 75 years), including seven in serious condition (median age = 76 years).

Grand Princess

During February 11–21, 2020, the Grand Princess cruise ship sailed roundtrip from San Francisco, California, making four stops in Mexico (voyage A). Most of the 1,111 crew and 68 passengers from voyage A remained on board for a second voyage that departed San Francisco on February 21 (voyage B), with a planned return on March 7 (Table). On March 4, a clinician in California reported two patients with COVID-19 symptoms who had traveled on voyage A, one of whom had positive test results for SARS-CoV-2. CDC notified the cruise line, which began cancelling group activities on voyage B. More than 20 additional cases of COVID-19 among persons who did not travel on voyage B have been identified from Grand Princess voyage A, the majority in California. One death has been reported. On March 5, a response team was transported by helicopter to the ship to collect specimens from 45 passengers and crew with respiratory symptoms for SARS-CoV-2 testing; 21 (46.7%), including two passengers and 19 crew, had positive test results. Passengers and symptomatic crew members were asked to self-quarantine in their cabins, and room service replaced public dining until disembarkation. Following docking in Oakland, California, on March 8, passengers and crew were transferred to land-based sites for a 14-day quarantine period or isolation. Persons requiring medical attention for other conditions or for symptoms consistent with COVID-19 were evaluated, tested for SARS-CoV-2 infection, and hospitalized if indicated. During land-based quarantine in the United States, all persons were offered SARS-CoV-2 testing. As of March 21, of 469 persons with available test results, 78 (16.6%) had positive test results for SARS-CoV-2. Repatriation flights for foreign nationals were organized by several governments in coordination with U.S. federal and California state government agencies. Following disinfection of the vessel according to guidance from CDC’s Vessel Sanitation Program, remaining foreign nationals will complete quarantine on board. The quarantine will be managed by the cruise company, with technical assistance provided by public health experts.

On February 21, five crew members from voyage A transferred to three other ships with a combined 13,317 passengers on board. No-sail orders §§ were issued by CDC for these ships until medical logs were reviewed and the crew members tested negative for SARS-CoV-2.

Additional Ships

The Diamond Princess and Grand Princess had more than 800 total COVID-19 cases, including 10 deaths. During February 3–March 13, in the United States, approximately 200 cases of COVID-19 were confirmed among returned cruise travelers from multiple ship voyages, including the Diamond Princess and Grand Princess, accounting for approximately 17% of total reported U.S. cases at the time ( 10 ). Cases linked with cruise travel have been reported to CDC in at least 15 states. Since February, multiple international cruises have been implicated in reports of COVID-19 cases, including at least 60 cases in the United States from Nile River cruises in Egypt ( Figure 2 ). Secondary community-acquired cases linked to returned passengers on cruises have also been reported (CDC, unpublished data, 2020).

Public health responses to COVID-19 outbreaks on cruise ships were aimed at limiting transmission among passengers and crew, preventing exportation of COVID-19 to other communities, and assuring the safety of travelers and responders. These responses required the coordination of stakeholders across multiple sectors, including U.S. Government departments and agencies, foreign ministries of health, foreign embassies, state and local public health departments, hospitals, laboratories, and cruise ship companies. At the time of the Diamond Princess outbreak, it became apparent that passengers disembarking from cruise ships could be a source of community transmission. Therefore, aggressive efforts to contain transmission on board and prevent further transmission upon disembarkation and repatriation were instituted. These efforts included travel restrictions applied to persons, movement restrictions applied to ships, infection prevention and control measures, (e.g., use of personal protective equipment for medical and cleaning staff), disinfection of the cabins of persons with suspected COVID-19, provision of communication materials, notification of state health departments, and investigation of contacts of cases identified among U.S. returned travelers.

Cruise ships are often settings for outbreaks of infectious diseases because of their closed environment, contact between travelers from many countries, and crew transfers between ships. On the Diamond Princess, transmission largely occurred among passengers before quarantine was implemented, whereas crew infections peaked after quarantine ( 6 ). On the Grand Princess, crew members were likely infected on voyage A and then transmitted SARS-CoV-2 to passengers on voyage B. The results of testing of passengers and crew on board the Diamond Princess demonstrated a high proportion (46.5%) of asymptomatic infections at the time of testing. Available statistical models of the Diamond Princess outbreak suggest that 17.9% of infected persons never developed symptoms ( 9 ). A high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew. SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted (Takuya Yamagishi, National Institute of Infectious Diseases, personal communication, 2020). Although these data cannot be used to determine whether transmission occurred from contaminated surfaces, further study of fomite transmission of SARS-CoV-2 aboard cruise ships is warranted.

During the initial stages of the COVID-19 pandemic, the Diamond Princess was the setting of the largest outbreak outside mainland China. Many other cruise ships have since been implicated in SARS-CoV-2 transmission. Factors that facilitate spread on cruise ships might include mingling of travelers from multiple geographic regions and the closed nature of a cruise ship environment. This is particularly concerning for older passengers, who are at increased risk for serious complications of COVID-19 ( 4 ). The Grand Princess was an example of perpetuation of transmission from crew members across multiple consecutive voyages and the potential introduction of the virus to passengers and crew on other ships. Public health responses to cruise ship outbreaks require extensive resources. Temporary suspension of cruise ship travel during the current phase of the COVID-19 pandemic has been partially implemented by cruise lines through voluntary suspensions of operations, and by CDC through its unprecedented use of travel notices and warnings for conveyances to limit disease transmission ( 5 ).

Acknowledgments

Staff members responding to COVID-19 outbreaks on cruise ships; Japan’s Ministry of Health, Labour and Welfare; California Department of Public Health; cruise ship passengers; Princess Cruises; Christina Armantas, Matthew Bacinskas, Cynthia Bernas, Brandon Brown, Teal Bullick, Lyndsey Chaille, Martin Cilnis, Gail Cooksey, Ydelita Gonzales, Christopher Kilonzo, Chun Kim, Ruth Lopez, Dominick Morales, Chris Preas, Kyle Rizzo, Hilary Rosen, Sarah Rutschmann, Maria Vu, California Department of Public Health, Richmond and Sacramento; Ben Gammon, Ted Selby, Solano County Public Health; Medic Ambulance Service; NorthBay HealthCare; Sutter Solano Medical Center; Kaiser Permanente Vallejo Medical Center; Kaiser Permanente Vacaville Medical Center start highlight ; field teams at repatriation sites; National Institute of Infectious Diseases, Japan end highlight .

CDC Cruise Ship Response Team

Casey Barton Behravesh, CDC; Adam Bjork, CDC; William Bower, CDC; Catherine Bozio, CDC; Zachary Braden, CDC; Mary Catherine Bertulfo, CDC; Kevin Chatham-Stephens, CDC; Victoria Chu, CDC; Barbara Cooper, CDC; Kathleen Dooling, CDC; Christine Dubray, CDC; Emily Curren, CDC; Margaret A. Honein, CDC; Kathryn Ivey, CDC; Jefferson Jones, CDC; Melissa Kadzik, CDC; Nancy Knight, CDC; Mariel Marlow, CDC; Audrey McColloch, CDC; Robert McDonald, CDC; Andrew Klevos, CDC; Sarah Poser, CDC; Robin A. Rinker, CDC; Troy Ritter, CDC; Luis Rodriguez, CDC; Matthew Ryan, CDC; Zachary Schneider, CDC; Caitlin Shockey, CDC; Jill Shugart, CDC; Margaret Silver, CDC; Paul W. Smith, CDC; Farrell Tobolowsky, CDC; Aimee Treffiletti, CDC; Megan Wallace, CDC; Jonathan Yoder, CDC.

California Department of Public Health COVID-19 Team

Pennan Barry, California Department of Public Health; Ricardo Berumen, III, California Department of Public Health; Brooke Bregman, California Department of Public Health; Kevin Campos, California Department of Public Health; Shua Chai, California Department of Public Health; Rosie Glenn-Finer, California Department of Public Health; Hugo Guevara, California Department of Public Health; Jill Hacker, California Department of Public Health; Kristina Hsieh, California Department of Public Health; Mary Kate Morris, California Department of Public Health; Ryan Murphy, California Department of Public Health; Jennifer F. Myers, California Department of Public Health; Tasha Padilla, California Department of Public Health; Chao-Yang Pan, California Department of Public Health; Adam Readhead, California Department of Public Health; Estela Saguar, California Department of Public Health; Maria Salas, California Department of Public Health; Robert E. Snyder, California Department of Public Health; Duc Vugia, California Department of Public Health; James Watt, California Department of Public Health; Cindy Wong, California Department of Public Health.

Solano County COVID-19 Team

Meileen Acosta, Solano County Department of Public Health; Shai Davis, Solano County Department of Public Health; Beatrix Kapuszinsky, Solano County Department of Public Health; Bela Matyas, Solano County Department of Public Health; Glen Miller, Solano County Department of Public Health; Asundep Ntui, Solano County Department of Public Health; Jayleen Richards, Solano County Department of Public Health.

Corresponding author: Leah F. Moriarty, [email protected] , 770-488-7100.

1 CDC COVID-19 Response Team; 2 California Department of Public Health; 3 Solano Public Health, Fairfield, California; 4 Epidemic Intelligence Service, CDC; 5 Sutter Medical Group of the Redwoods, Santa Rosa, California.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

* Not including river cruises.

† Warning level 3: avoid non-essential travel due to widespread ongoing transmission: https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-china .

§ Quarantine was used for persons who were exposed; isolation was used for persons who had positive test results for SARS-CoV-2.

¶ Movement for one person with resolved COVID-19 was not restricted.

** Based on Japanese testing procedures, which at the time included taking one oropharyngeal swab.

†† Travel restrictions were lifted when persons had either completed a 14-day monitoring period without symptoms or had met clinical criteria for release from isolation. https://japan2.usembassy.gov/pdfs/alert-20200227-diamond-princess.pdf .

§§ CDC has the authority to institute a no-sail order to prevent ships from sailing when it is reasonably believed that continuing normal operations might subject newly arriving passengers to disease.

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• Kakimoto K, Kamiya H, Yamagishi T, Matsui T, Suzuki M, Wakita T. Initial investigation of transmission of COVID-19 among crew members during quarantine of a cruise ship—Yokohama, Japan, February 2020. MMWR Morb Mortal Wkly Rep 2020;69:312–3. CrossRef PubMed
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• Mizumoto, K., Kagaya, K., Zarebski, A. and Chowell, G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance 2020;25. CrossRef
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Abbreviation: N/A = not applicable.

FIGURE 1 . Cumulative number of confirmed coronavirus disease 2019 (COVID-19) cases* by date of detection — Diamond Princess cruise ship, Yokohama, Japan, February 3–March 16, 2020

Source: World Health Organization (WHO) coronavirus disease (COVID-2019) situation reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/ .

* Decline in cumulative number of cases on February 13 and February 25 due to correction by WHO for cases that had been counted twice.

FIGURE 2 . Cruise ships with coronavirus disease 2019 (COVID-19) cases requiring public health responses — worldwide, January–March 2020

Suggested citation for this article: Moriarty LF, Plucinski MM, Marston BJ, et al. Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020. MMWR Morb Mortal Wkly Rep 2020;69:347-352. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e3 .

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