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Advice for Restarting Cruise Ship Operations After Lifting Restrictive Measures in Response to the COVID-19 Pandemic

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Advice for Restarting Cruise Ship Operations After Lifting Restrictive Measures in Response to the COVID-19 Pandemic Advice for restarting cruise ship operations after lifting restrictive measures in response to the COVID-19 pandemic Version 2 April 2021 * The revised version incorporates the following changes: • Definitions of contacts and cases • Diagnostic testing policy for crew and passengers • Use of face masks • Considerations for vaccinations * The EU HEALTHY GATEWAYS Joint Action has received funding from the European Union, in the framework of the Third Health Programme (2014-2020). The content of this document represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains. Suggested Citation: Barbara Mouchtouri, Martin Dirksen-Fischer, Mauro Dionisio, Miguel Dávila-Cornejo, Brigita Kairiene, Peter Otorepec, Boris Kopilovic, Nina Pirnat, Finán Ó Gallchobhair, Lemonia Anagnostopoulou, Elina Kostara, Leonidas Kourentis, Jan Heidrich, Galina Kokosharova, Charalampbos Vasileiou, Thijs Veenstra, Agoritsa Baka, Eeva Broberg, Orlando Cenciarelli, Massimo Ciotti, Margot Einoder- Moreno, Pete Kinross, Katrin Leitmeyer, Angeliki Melidou, Daniel Palm, Diamantis Plachouras, Paul Riley, Marc Struelens, Carl Suetens, Svetla Tsolova, Klaus Weist, Emma Wiltshire, Carmen Varela Santos, Christos Hadjichristodoulou and Consultation Group*. EU HEALTHY GATEWAYS Advice for restarting cruise ship operations after lifting restrictive measures in response to the COVID-19 pandemic. April 2021. EU HEALTHY GATEWAYS joint action (Grant agreement Number – 801493); 2021. Available at: https://www.healthygateways.eu/ 1 Table of Contents 1. Introduction ......................................................................................................................... 5 2. Purpose ................................................................................................................................. 5 3. Essential prerequisites ...................................................................................................... 7 3.1. Monitoring of epidemiological situation, rules and restrictions worldwide ................... 8 3.2. Written contingency plan/outbreak management plan for COVID-19 ............................ 8 3.3. Arrangements for medical treatment and ambulance services ....................................... 8 3.4. Arrangements for repatriation .......................................................................................... 8 3.5. Arrangements for quarantine of close contacts (exposed passengers or crew members with negative RT-PCR test results for SARS-CoV-2) ...................................................................... 9 3.6. Arrangements for isolation of passengers or crew members positive for SARS-CoV-2 10 3.7. Adequate testing capacity for SARS-CoV-2 infection on board or in cooperation with shore-based laboratories ............................................................................................................. 10 3.8. Training of crew about COVID-19 .................................................................................... 11 3.9. Commitment for immediate reporting to the next port of call of any possible and confirmed cases ............................................................................................................................ 11 3.10. Isolation and quarantine capacity on board cruise ships ............................................... 12 3.11. Focused inspection on COVID-19 prevention and control for resuming cruise ship voyages by EU HEALTHY GATEWAYS ........................................................................................... 12 4. Options for measures to prevent COVID-19 infectious passengers from starting holidays ....................................................................................................................................... 13 4.1. Vaccination of passengers ................................................................................................ 13 4.2. Diagnostic testing or other measures in accordance with the requirements for incoming travellers to the country of embarkation .................................................................... 13 4.3. Exclusion policy ................................................................................................................ 14 4.3.1. Exclusion policy information ........................................................................................ 14 4.4. High risk groups ................................................................................................................ 14 5. Preparedness for responding to COVID-19 events on board cruise ships ............. 15 5.1. Information, education and communication .................................................................. 15 5.2. Contingency planning on board ....................................................................................... 17 5.3. Supplies and equipment .................................................................................................. 19 6. Crew vaccination and testing .......................................................................................... 20 6.1. Vaccination of crew members ......................................................................................... 20 2 6.2. Testing of crew members before resuming operations and incoming crew members . 20 6.3. Routine testing of crew members ................................................................................... 21 7. Options for measures to prevent COVID-19 infectious travellers (passengers and crew) from boarding cruise ships .......................................................................................... 21 7.1. Screening at embarkation ................................................................................................ 21 7.2. Diagnostic testing of passengers the day of embarkation .............................................. 22 8. Measures for preventing and limiting transmission of COVID-19 on board cruise ships ............................................................................................................................................. 23 8.1. Health monitoring and diagnostic testing ....................................................................... 23 8.2. Surveillance of black water for SARS-CoV-2 .................................................................... 23 8.3. Limiting interaction .......................................................................................................... 24 8.4. Physical distancing ........................................................................................................... 25 8.5. Personal hygiene measures ............................................................................................. 25 8.6. Respiratory etiquette ....................................................................................................... 26 8.7. Preventing droplet transmission by the use of face masks ............................................ 26 8.8. Adequate ventilation ....................................................................................................... 28 8.9. Cleaning and disinfection ................................................................................................. 29 8.10. Special considerations for cabins ..................................................................................... 29 8.11. Food safety rules .............................................................................................................. 30 8.12. Reducing face-to-face interactions .................................................................................. 32 8.13. Special considerations at reception ................................................................................. 32 8.14. Nursery and play areas for children ................................................................................ 33 8.15. Entertainment venues ...................................................................................................... 34 8.16. Casinos .............................................................................................................................. 34 8.17. Hairdressers and beauty salons ....................................................................................... 35 8.18. Gyms ................................................................................................................................. 36 8.19. Potable water ................................................................................................................... 37 8.20. Sewage and grey water .................................................................................................... 37 8.21. Recreational water facilities ............................................................................................ 38 8.22. Decorative fountains ........................................................................................................ 39 8.23. Commercial stores inside the accommodation facility ................................................... 39 8.24. Other public spaces (indoor and outdoor) ...................................................................... 39
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