How should a Cruise Line Handle a Viral Outbreak on a Ship?

With all the hype of CoVid-19 as of late, and the cruise industry at ground zero for all of this, I have been thinking about the best way a cruise line could manage a potential future outbreak (of some sort). Here are my thoughts, and I would like this to be a positive discussion on potential strategies to both contain the outbreak as well as prevent a full-blown quarantine on a "ghost ship".

It seems that when there is an outbreak it falls into two (2) different types: Known Contagion and Unknown/New Contagion. I'll address these separately as I feel they should be handles a bit differently.

Known Contagion
In this case, the stats (infection rates, incubation period, transmission type, vaccinations, etc...) would be a known quantity. In this case, there would also be known protocols for a land-based outbreak. Taking those into effect, I see the best compromised solution would be:

• The on-board hospital transmits its medical diagnoses and findings electronically to the WHO
  
• Engage the WHO medical establishment to assemble a mobile rapid deployment containment crew
  
• Determine the closest docking port that is easily isolated from its local population and cordon off the area (the treatment port)
  
• Dispatch the mobile medical team to the cordoned off area via fastest transport (enlisting the military transport and logistics arm)
  
• Prioritize (based upon the known infection rates) the most likely candidates of the ship passengers and crew who would be the most susceptible to the worst effects to the least susceptible people
  
• Quarantine the passengers and non-essential crew to their quarters until docking can be completed at the treatment port
  
• Dock the ship safely as quickly as possible at the treatment port, using a minimal ground crew (who would be pre-tested and dressed appropriately as a precaution)
  
• Begin evacuation of the passengers and crew based upon the priority level (which includes close quarters friends/families)
  
• The evacuees are taken into medical care and treated with the established protocol for that strain
  

Unknown Contagion
In this case, the stats (infection rates, incubation period, transmission type, vaccinations, etc...) would be unknown. In this case, there would be no known protocols for a land-based outbreak. Taking this into effect, I see the best compromised solution would be:

• The on-board hospital transmits its medical diagnoses and findings electronically to the WHO
  
• The ship begins immediate full quarantine of the passengers and non-essential crew to their quarters until the contagion can be isolated and classified by the WHO, working in conjunction with the ship hospital
  
• Once a safe protocol can be determined, engage the WHO medical establishment to assemble a mobile rapid deployment containment crew
  
• Determine the closest docking port that is easily isolated from its local population and cordon off the area (the treatment port)
  
• Dispatch the mobile medical team to the cordoned off area via fastest transport (enlisting the military transport and logistics arm)
  
• Prioritize (based upon the elderly, very young, and immuno-compromised) the most likely candidates of the ship passengers and crew who would be the most susceptible to the potential worst effects to the least susceptible people
  
• Quarantine the passengers and non-essential crew to their quarters until docking can be completed at the treatment port
  
• Dock the ship safely as quickly as possible at the treatment port, using a minimal ground crew (who would be pre-tested and dressed appropriately as a precaution)
  
• Begin evacuation of the passengers and crew based upon the priority level (which includes close quarters friends/families) AND the cabin type (being the inside cabins first and ending with the suite cabins since the comfort levels will help folks from attempting to escape early
  
• The evacuees are taken into medical care and isolated for transport to the closest advanced medical facility (or facilities) such as a military base, or an easily isolated hotel, etc...
  
• Once all the passengers and crew are evacuated, the ship is taken out of service for a full sanitation protocol and cleaning. It can only return to service once the WHO has been aboard and ran tests for safety (at this point the known lifespan of the contagion on a surface would be known and can be assured that no live culture remains.
  

In this way, the passengers are not quarantined for an unknown time frame and sailing around looking for a port as a ghost ship. The WHO can work with the major world ports that fit that description and establish medical services in locally central areas for deployment purposes.

Now. who will pay for all of this?

The U.N., the cruise lines (via port tax and contracts with the ports that cannot be legally passed on to the passengers to pay more than 50% of that cost per stateroom), the WHO, the CDC, and any private donations.


Well, these are my thoughts for a solution, as opposed to just complaining about the problem. I welcome your civil and non-political feedback and ideas that make sense.

a reply to: Krakatoa

Simple low cost and effective

a reply to: Krakatoa

Just took a cruise a couple weeks ago. If you're obviously sick, there would be issues getting on board. Otherwise, they make you sign a declaration of health. Not much more they can do. If something were to break out, I'm sure there obligated by various governing authorities to report it to appropriate agencies. I would be more concerned about airports. You could infect a lot of people without even checking in

Most cost effective way to contain the virus is scuttle the ship at sea with all passengers & crew aboard, settle with the families, maybe use the excuse it was an act of god or other some such nonsense as to avoid larger liability claims.

Not recommended.

ganjoa

a reply to: Krakatoa

Torpedo. Followed closely by nuking from orbit.

a reply to: Krakatoa

Well typically being trapped on a cruise ship with infected people is perhaps the worst situation for a non infected person to be in, Air Conditioning may not always be filtered and so the air could be passed through a communal air conditioning system that may spread air born and aerosol virus very effectively while the infected have time to become infectious and the uninfected have there potential for contracting such a virus increased exponentially as a result.

My opinion a Cruise line should disembark passengers from two sister ship's, move seemingly well passengers into isolation AWAY from the plague ship onto one of these holding ship's and keep those potential carriers in isolation until they are cleared, as a last precautionary measure after this the people whom still show no sign's of infection should then be moved to a third ship.

Patient's whom recover from the virus should have blood taken and antibody's to the virus that they have developed synthesized and tested with the best candidates (only those anti body's tailored to attack the virus) being then mass synthesized and given in serum form to infected patient's to help there body's fight off the virus - though there own immune system may attack the serum antibody's if enough enter there blood stream it may retard the virus and give them time to recover while a weakened form of the virus (sterile so it is inert and will not infect cell's so will not reproduce in the body) should then be developed fast and mass cultivated to be given as a viral inoculation to prepare the general populace for the spread of virus and so when it does get into these population areas the general populace would then have a level of immunity in place to slow down or even halt it's spread.

Virus mutate and adapt, enough people infected it may be that this new virus could indeed become a new seasonal flu, over time we will develop an immunity but in the mean time the death toll is going to be massive until the population has both developed and inherited that immune response to this new flue type virus, that can for us take generations just as it has with ordinary flue which also once killed millions when it first appeared (and still does but far less than when it was new to our immune systems).

Actually JAPAN is responsible for several death's because of there quarantine method, they should have provided shore based facility's to act in the manner outlined here for the two ship's with secure areas instead, as a result they have missed a potential to be among the first to develop an effective method to combat the spread of the virus so have effectively cut off there own noses' to spite there own face as far as there understandable but incorrect response is concerned, they should NEVER have left uninfected patient's or patent's showing no symptom's and testing negative on board that ship but should have put them into a two or even three stage secure quarantine for both there own safety and to prevent the very thing there actions causes, uninfected passengers becoming infected because they were trapped in quarantine on board an infected ship.

Lastly that ship after all has been dealt with should be completely sterilized, not an easy task and it may be better to ground it in a dry dock and take out soft furnishing's for incineration until the entire vessel is scrubbed stem to stern and it's air conditioning system most importantly.

Either way I assume that the ship's insurance will cover the bill and if not then the cruise line must cough up and pay the costs, they should also be held accountable for the sickness there passengers have endured since under duty of care they were responsible for the safety of these passengers (and with Japan's lack of action should themselves have brought in those two other ship's).

Lastly we need to get back to proper health care, real nurses and doctors and proper sanitation which has seemingly slipped into the past these day's.

In the old day's linen's were boiled THREE TIME's, pressed and then returned, every ward had an autoclave (a Very high temperature medical pressure cooker that was used for sterilization) these day's most cleaning in most hospitals is done by third party company's that simply are not good enough or rigorous enough.

Quite frankly I am both shocked and saddened by the mistakes that Japan made in there quarantine procedure, they rightly put there own population first BUT they did so in a manner that has caused and is responsible for several people whom were uninfected actually becoming infected by trapping them on a plague ship with infected people.

turn off their recently upgraded WiFI

Aka 5g

originally posted by: pressident
turn off their recently upgraded WiFI

Aka 5g

Then the people on board would die of boredom.

An Exocet. Or two. In fact, sink em all out at sea...just in case.

Cruise ships and nora virus might as well be the same word

I'll bet once the dust settles they will say ncov will be found to primarily spread from touch in particularly from stick staff members and the buffet style food

Your on a floating resturant with no replaceable staff and buffet lines anything that can transmit oral fecal route will spread like wildfire

The dishwasher's will get it off the plates from people eating than spread it to the clean dishes than back to the customers to infect more people round and round it goes because it's in the food sorce at that point

The only solution at this point is to have all food and water be brought in from the outside than quarantine procedures should work properly since the sorce has been cut off

a reply to: AugustusMasonicus

It’s the only way to be sure.

a reply to: Krakatoa

I think we will all be looking at new protocols involving cruise ships. I mean, can you actually imagine taking one now, in these times?

Cruise liners will probably have to build quarantine quarters with an airlock with negative pressure and one large enough that several cots could be set up in the area. People that are sick need to be quarantined in a manner in which they can get treatment, food and fluids without risking spread to the rest of the ship. In-cabin quarantine is probably not enough.

Cruis ships should be required to have an onboard medical team and procedures for transferring and treating patients such that the risk to the rest of the ship is minimized and such that the patients can be transferred safely off -ship once it arrives at the end destination.

originally posted by: argentus
a reply to: Krakatoa

I think we will all be looking at new protocols involving cruise ships. I mean, can you actually imagine taking one now, in these times?

Cruise liners will probably have to build quarantine quarters with an airlock with negative pressure and one large enough that several cots could be set up in the area. People that are sick need to be quarantined in a manner in which they can get treatment, food and fluids without risking spread to the rest of the ship. In-cabin quarantine is probably not enough.

Cruis ships should be required to have an onboard medical team and procedures for transferring and treating patients such that the risk to the rest of the ship is minimized and such that the patients can be transferred safely off -ship once it arrives at the end destination.

Modern cruise ships do have a full hospital on-board with full medical staff. One additional protocol could be to require the medical staff to be specifically certified in viral containment and treatment as well as standard medical procedures. In addition, having a portable containment pod (which do exist) that can be deployed in a secure area should be mandatory on all vessels with a passenger+crew of 2000 or more. And to take my OP another step further after additional thought. perhaps having the major home ports for these ships to be required to have the ability to rapidly transfer ill passengers to the local medical facility in an isolated manner.

a reply to: Krakatoa
Cruise bookings are down an amazing 95% world-wide. The cruise lines are (reportedly) cancelling some cruises all-together, and making excuses to keep more than 50% of what each passenger paid.

a reply to: argentus

The ship is the quarantine quarters, the biggest problem with disease and close quarters is the incubation period. Even if it's a disease that shows symptoms fairly rapidly the chances are the cat is well out of the bag and chasing mice around the ship.

With a disease like coronavirus it would be very difficult to keep under control. I imagine it's a lot like influenza in that by the time you've became ill you've already spread it around.

Isolation is the only realistic approach, the full ship. Then sort it out from their.