My Christmas Cruise Would Have Been a 2020 Nightmare

Christmas with Carnival Cruises, 2018

Before my I very nearly died during our 2019 Atlantic crossing, my husband and I had become frequent cruisers. The ports of Ft. Lauderdale and Miami are a short drive from our South Florida home, and we enjoyed cruises through the Caribbean, on the Mediterranean, and on the Baltic Sea.

Two years ago, my husband and I sailed the Caribbean over the Christmas holidays. From over-the-top decorations to hilarious ugly sweater contests to heartwarming musical interludes, it was a celebratory week. Others may have prepared by creating wonderfully tacky sweaters, but we made a statement by wearing crazy Walmart hats and jingle bell slippers to breakfast on Christmas morning. “Nice hat,” a passenger said. “You with the guy in the other hat?” Yep, I have one very good sport of a husband.

That memory was nearly wiped out by my dramatic illness in 2019. Had we been in the middle of the ocean instead of docked in Amsterdam when I took ill, my story would have ended abruptly. We’ve kept an eye on the cruise industry this year, shuddering as ships became floating Coronavirus incubators in the spring.

The Centers for Disease Control and Prevention ended cruising in March and forced the industry to develop new protocols to protect crew and guests from COVID-19 when sailings resume. It all means new challenges for the on-board medical team.

Pandemic cancelled Cruising

There was no cruising for anyone these holidays. The CDC issued a “no sail” order on March 13, that infamous Friday last spring when the reality of the coronavirus was suddenly unavoidable.

Just before Thanksgiving, the CDC issued its highest warning against cruise travel, according to a USA Today article by Morgan Hines. Passenger operations out of the United States continue to be suspended, and the CDC recommends avoiding travel on any cruise ship worldwide.

Industry and florida suffer economic losses

South Florida is home to the cruise industry, which has suffered record losses during the shutdown, and hundreds of employees of support organizations have lost their jobs, including longshoremen, travel agents, shuttle systems. The economic impact on the industry has also been felt in Miami-Dade County, as these harmonious quotes demonstrate.

A ship can be safer than anywhere else in the world.

Frank Del Rio, CEO, Norwegian Cruise Line Holdings said in May

A cruise is a hotel in the middle of the ocean that the doors and windows open all the time, and we have an incredible amount of wind coming in and out making it a safer place.

Rebeca Sosa, Miami-Dade County Commissioner

Cruise industry covid protocols

The Miami Herald reported that the 74 recommended protocols submitted to the CDC by the cruise industry include testing all passengers and crew before boarding, requiring social distancing and masks, and expanding medical capabilities on cruise ships. A protocol that was floated [pardon the pun] in March would have barred passengers over 70 years old, who are particularly vulnerable to the effects of COVID-19. It was scrapped. We old people are huge component of the cruise industry’s customer base.

As Cassie Shortsleeve recently wrote in Condé Nast Traveler, the job of medical crews will take on new urgency once passengers are once again allowed on board. Medical staff will be more involved in pre-screening protocols. Passengers with respiratory symptoms — like I had during our Baltic Sea voyage and that my husband and hundreds more came down with bronchitis on our 2019 Atlantic crossing — will be quarantined in their rooms. Medical facilities will be separated into a control area — for those with infectious diseases — and an area for non-infectious patients. Some ships will strip down passengers rooms to create isolation units.

It’s hard to square these images with the true ER/ICU centers that saved my life in Amsterdam last year.

But are we ready?

Morgan Hines writes that there is pent-up demand for cruising. The industry continues to build new products to entice us to re-board.

The Carnival Mardi Gras, which has been under construction in Finland, will enter service in early 2021, sailing from Port Canaveral. Among the features of Carnival’s largest ship, with the maximum capacity of nearly 7000, is a roller coaster.

That seems like a really unnecessary addition. We’ve been terrified for months. Why would we go on vacation and purposely put ourselves into the very situation we’ve been trying to escape from? After a year like 2020, do we really need more ups and downs?

Nah. I’m sitting with the images of holiday cruises past, waiting for the day when the harsh 24/7 ER light of 2020 has shifted into the benign healthy glow of a sunset at sea.

Cruising? No, thanks, not yet.

The global cruise industry expected to carry 32 million passengers and taken $71 billion in revenue this year. This will fall by at least 50% this year.

Euromonitor International

According to a recent article in USA Today, cruising has been postponed until September 15, but there are a lot of us former fans who won’t be dockside again until there’s a vaccine.

Their entire business model is based on large group social activity. Americans’ failure to wear masks and follow social distancing guidelines pretty much guarantees that we’d party like frat boys given the opportunity to hop aboard.

No, thanks.

We were huge fans of the cruise travel business, in part because of our proximity to the industry’s South Florida base. We can be dockside in an hour’s drive, feeling very grateful to avoid the hassles of flying and overnight stays in order to be ready to board. We’ve had great Caribbean trips out of Ft. Lauderdale and Miami.

But it’s images like this one that will keep us off ships until there is a vaccine.

As part of their response to the pandemic, cruise lines are looking to explore enhanced passenger and crew screening, social distancing, modifying or eliminating buffet dining options, enhanced medical capability, new training for crew members and pre-arranged medical evacuation options with consideration to local health care.

Notice how the medical capability line is buried in their press kit?

In an article that puts a Happy Face on reality, USA Today said that cruisers are ready to resume their seagoing lifestyle. The conditions required to reopen the industry do not include equipping ships with rigorous medical facilities. Damn the virus, full speed ahead.

Prior to last year, we hadn’t given a cruise ship’s medical support a whole lot of thought. We knew of ships on which illness had become rampant, but we sanitized early and often. I came down with a bad cold on the Baltic Sea, but that seemed a small price for such a stellar tour.

It was not until last year’s fateful Atlantic crossing, destination Amsterdam, that the medical risks became crystal clear.

We sailed easily through the first week and made our first landfall in Portugal’s Azores.

But by the time we pulled away from the Azores headed to mainland Europe, my husband had caught a bad cold, and it quickly blossomed into full blown bronchitis with a wracking cough that prevented him from sleeping. The ship’s doctor gave him aspirin and lozenges, recommending he seek medical attention ashore for anything stronger. He also mentioned that about half the ship had bronchitis.

In Amsterdam, my husband got medication.

[However, I became a patient when an undiagnosed abdominal aneurysm ruptured. Had I taken ill two hours later, we would have been back aboard the ship. I would not have made it.]

But, back to this story. Bronchitis is downright benign compared to coronavirus.

In February, cruise ships became an early symbol of how rapidly the coronavirus could spread in confined spaces, when more than 700 passengers on the Diamond Princess became infected as the ship idled off Japan. As social distancing grew more common in February and early March, cruises were among the first activities Americans started avoiding.

David Yaffe- Bellany, NYT

By March 13, the last day we were out in the world as we knew it, Americans were shocked by the seriousness of the coronavirus pandemic and complied with government’s stay-at-home orders. I wrote that hopping on a cruise ship with limited medical support was unthinkable. Two months later, Governor Ron DeSantis announced Florida was re-opening. I wrote that the data simply didn’t support that decision, that we were flying blind into the storm. And here we are, another two months into the pandemic and Florida’s cases are growing at record rates, causing other states to impose quarantines on travelers who would venture out. Florida’s failures part of the reason that Americans are being blocked from travel to Europe.

Vacationing seems awfully far away.

One of the things that we’ve seen from crises in general is that the industry is very resilient and that we rebound fairly quickly.

Laurie Pennington Gray, Tourism Crisis Management Initiative

Norwegian is installing medical grade air filters and adding medical staff. Carnival is raising the temperature in its washers and dryers to make sure napkins and sheets are fully sanitized. They are staggering boarding times, expanding dining times ,eliminating buffets, requiring masks.

They are also incentivizing group behavior with offers of free food, free drinks, free shore excursions.

And, only now, there is mention of improving medical capacity on board.

In a recent article for the Miami Herald, reporter Taylor Dolven writes that Royal Caribbean and Norwegian Cruise Line have organized a panel of experts to develop safety protocols for the COVID-19 era when (if?) cruising resumes.

The industry is operating its ships — with no guests and reduced staff — under protocols for limiting the spread of COVID-19 control monitored by the Centers for Disease Control and Prevention. With mask-wearing, social distancing, and quarantine in place, nearly a quarter of the ships now at sea still have confirmed cases aboard.

It astounds me that it has taken six months of pandemic for this business- and life-saving collaboration to arise, and that the initiative does not include all the businesses in the industry. And that it is only now that I am seeing the mention of ventilators.

The guest profile on typical cruise ship voyages matches those at greatest risk for severe illness which may require hospitalization and need for respiratory support.

Centers for Disease Control and Prevention

My heart goes out to cruise staff who must remain aboard. For the rest of us, let’s stay ashore.

It seems like a logistical nightmare to me.

Tara Smith, Professor of Epidemiology, Kent State University