The cruise industry has been front and center from the beginning of the COVID-19 pandemic; ships with cases of the disease acted as early harbingers of what the pandemic would bring -- outbreaks, mandates, quarantine and travel restrictions -- long before the world even knew what it was dealing with.
The question of whether the cruise industry has been treated unfairly over the course of the two-year-plus COVID-19 pandemic seems to be a largely ignored elephant in the room, however.
For those in the cruise industry, it's been less of a matter of question and more a matter of fact -- a sentiment that only deepened Wednesday evening when the U.S. Centers for Disease Control and Prevention released detailed guidance for their new voluntary COVID-19 Program for Cruise Ships -- guidance that includes harsh mandatory quarantine, surveillance and testing requirements that far outstrip anything the CDC recommends of Americans on land.
The Cruise Lines International Association, the collective body representing over 90 member lines (Royal Caribbean Group, Carnival Corporation, Disney Cruise Line and Norwegian Cruise Line Holdings among the biggest), made no haste in stating its dismay. Its statement called out the CDC for "ignoring empirical evidence that the industry's protocols have provided a greater level of COVID mitigation than most any other setting."
Although CLIA and the cruise industry have continually cooperated with the CDC and its Conditional Sail Order recommendations, the association has remained vocal about the unequal treatment of the cruise industry throughout the pandemic, especially when compared with other forms of travel and leisure.
The cruise industry was in a 673-day battle with the CDC over its Conditional Sail Order. The long-standing order finally expired on January 15, 2022, to be replaced with a new, voluntary program announced by the CDC. The new voluntary program was seen as a positive, logical next step between the CDC and the industry, a way to extend and enhance the protocols that the cruise lines have put in place during the pandemic -- vaccine requirements, testing and masking when needed -- that have proven effective.
Instead, the CDC slammed the cruise industry with more punitive guidance than before, threatening to reinstate a No Sail Order for ships that don't join the "voluntary" program -- effectively, another shutdown of cruise by any other name.
CDC's Cruise Ship No Sail Order is the Only Regulation of Its Kind
Throughout the pandemic, cruising has been often singled out as the lone high-risk travel or leisure option. It was the first -- and only -- sector of travel to be completely shut down by the U.S. government, despite evidence of transmission in a plethora of other settings.
The argument isn't that cruise lines are being treated unfairly simply because they have been required to follow COVID-19 protocols. Rather, it is because the majority of comparable venues like airlines, hotels, theme parks, sporting arenas and other forms of travel or large-scale events within the United States have not been required (or even asked) to follow the same level of protocols.
Cruise ships have always been the only form of travel in the U.S. held to multiple required, demonstrable, cohesive COVID-19 protocols, including enhanced health and safety measures, vaccination mandates, testing requirements, masking requirements, physical distancing, lowered capacity levels, dedicated onboard quarantine and medical facilities, and more.
All of these protocols, in tandem, have been required on a federal level in order to cruise, and every cruise operator has complied. Yet, restaurants, bars, stadiums, concert halls and other forms of travel have had little to no federal mandates placed on them.
The U.S. aviation industry, for example, pushed back against vaccination requirements for domestic flights, even as other countries, like Canada, swiftly implemented similar legislation, requiring proof of vaccination to board any airplane, train or long-distance bus in the country.
In the case of U.S. airlines, the CDC swiftly abandoned its own recommendations, stating only that masks are to be worn while in the country's airports or on planes.
Cruises are also the only form of travel and leisure that has been given a Level 4: Do Not Travel warning from the CDC. The CDC has shown its hypocrisy during the pandemic as it doled Level 4: Do Not Travel designations, the highest warning level available, to the majority of countries globally, even as domestic cases in the U.S. continued to skyrocket.
The Floating Petri Dish Comparison and Influence of the Media
The adage that even bad press is good press doesn't take into account the long-standing effect and misfortune of having some of the first major outbreaks during a pandemic. Before SARS-CoV-2 was even declared a pandemic, cruise ships had already, yet again, been pegged as "floating petri dishes" by the media.
Brian Labus, associate professor of public health at the University of Las Vegas, believes the early media coverage of outbreaks on cruise ships at the very start of the pandemic might be to blame for the continued negative focus on the cruise industry.
"If you had people on a ship that were COVID-19 positive, countries didn't want to allow those ships to come ashore," Labus said. "So, right there, it gave the entire industry a bad name, regardless of what the true risk was. I think that mindset is still there -- that cruise ships are tied to these big outbreaks -- and that's a problem without looking at the actual risk."
And therein lies the rub: How does one calculate actual risk when the data set is incomplete?
A Lack of Data for Industries Outside Cruise
To get a better understanding of the risk associated with cruising during the pandemic, and how it compares with other forms of leisure such as flying, going to a concert or sporting event, or vacationing at a resort, we spoke with Labus as well as Winfred Just, a researcher in mathematical epidemiology at Ohio University, and author of "COVID-19 Unmasked: The News, the Science, and the Common Sense."
Both professional experts acknowledged a critical piece of the equation is missing when it comes to calculating and comparing risk: data.
"Without reliable and trusted data, one cannot assess the relative risk," Just said.
That data -- or lack thereof for other sectors of the travel industry -- is part of the challenge the cruise industry faces.
"There is a disproportionate focus on cruise cases because we're the only industry for which such data is reported or even available," Anne Madison, senior vice president of communications and marketing for CLIA, told Cruise Critic. "Given the fact that no other industry reports daily to the CDC, it stands to reason that the positivity rate for any other industry is unknown."
This also means the actual risk and transmission rates associated with flying, going to concerts, taking the train and other travel and leisure activities is unknown.
Without data, there can be no statistics. And it is in this void that the impression of safety grows.
"We only have a partial understanding of what the positive rate (of COVID-19 infection) is on land by region," Madison said. "Even then, we only know about people who have been tested and results reported."
Much of the Recent COVID-19 Data Available Favors the Cruise Industry
Madison also told us that if cruises must be singled-out, it should be to serve as a model for others.
"Our industry should be held up high for demonstrating leadership in health and safety protocols," she said.
A similar compliment for the cruise industry came in January 2022 from an unlikely figure: CDC Director Rochelle Walensky.
During a Senate hearing addressing the then-new omicron variant of COVID-19, Wallensky was praising the cruise industry for "stepping up" efforts to keep people safe. Walensky remarked on how cruise lines often exceeded CDC recommendations for the Conditional Sail Order even without it necessarily having to be in place -- a comment that seems to contradict the stricter guidelines of the new voluntary program that followed.
In response to the CDC's Level 4: Do Not Travel warning for cruising, placed just days before Walensky made the statements above, CLIA released a statement via its website to remind the public that cruise vaccination rates "are upwards of 95%" on board most ships, compared with U.S. vaccination numbers on land (which, as of this writing, are only at 64.5%).
Additionally, CLIA shared that the cruise industry administers about 10 million tests per week -- a testing rate that is a whopping 21 times more than that the entire U.S. testing rate on land.
CLIA's Madison further shared that "in the first two weeks of January, less than 10% of the U.S. population was tested, compared to the cruise lines testing nearly 100% of the population on board cruise ships."
The result? CLIA says the cruise industry's higher testing numbers have translated to positivity rates that are 33% lower than those found on land.
Madison also pointed out that hospitalizations are rare onboard cruise ships, noting that, overall, hospitalization rates "provide a more accurate picture of the effectiveness of mitigation strategies."
There are Inherent Risks During a Pandemic
There are inherent risks of doing anything during a pandemic, and cruise is certainly not excluded.
"If you're sitting at dinner and the people near your table have COVID, it doesn't matter whether you're on a cruise ship, or you're in a restaurant or a hotel," Labus said. "Risk is going to be the same for all of those individual sorts of things. Same thing with going to a show or sitting by the pool or something like that -- all those individual risks are going to be the same."
Labus said he doesn't look at cruise ships as a "super high risk compared to anything else," but noted that having so many people in close quarters on a cruise ship over an extended period can create a higher risk in some circumstances. Plus, he added that most people don't go on a cruise ship to hang out in their cabins; they are out doing different things, usually around a lot more people than they would be at home. "So that's going to add some additional risks you wouldn't get in other situations."
Just acknowledged that while cruises are at a disadvantage because of the density of people -- less of an issue with cruise lines capping occupancy at around 50% -- they are also at an advantage because of the much higher vaccination rates, testing requirements and quarantining facilities.
In fact, Just said he believes time spent at sports stadiums or concerts is "presumably more dangerous" than the same amount of time spent on a cruise ship -- but again, he cites the lack of data needed to make a reliable, scientific assessment.
The Cruise Industry's COVID-19 Catch-22
"I wish travel operators, the CDC, et cetera, would be more transparent about their data," Just said. "In the long run, the economic health of the travel business will depend on people developing a more rational relationship to risk. Individuals can make rational decisions only if trustworthy and unbiased epidemiological data are readily available."
Just adds that even if data were to be published that supports the conclusion that cruises are safer than, say, a general resort hotel, most people could still react to information of confirmed cases on cruise ships in an "irrational, panicky way instead of trying to contextualize" the data.
"On the other hand, if the data are not publicly accessible, the understandable reaction is suspicion that the cruise lines are hiding something and trying to mislead people," he says.
"That is the Catch-22."