can you board a cruise ship with covid

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Here's what you can expect if you get COVID-19 on a cruise ship according to a Royal Caribbean passenger who was given the option to quarantine on the ship even after the cruise ended

• Numerous cruise ships have lifted their COVID-19 vaccine and masking requirements.
• If a passenger contracts the virus, cruise ships offer medical treatment and future cruise credits.
• The CDC advises travellers to stay in their cabin and notify the onboard medical team if they get COVID-19.

With travel restrictions easing, cruise ships lifting their COVID-19 vaccine and masking requirements, and some cruise ships that our own Insider reporters found quite crowded , it begs the question: What happens if you contract the virus during your time aboard the ship?

Insider spoke with Matt Hochberg who has been on hundreds of cruises and runs a website called RoyalCaribbeanBlog.com that shares travel tips and advice for those interested in booking a cruise. The website has no affiliation with the cruise line of the same name. 

In June, Hochberg was sailing on a Royal Caribbean ship in Alaska with his family when he began to have a scratchy throat. He brought his own COVID tests — something he advises passengers to do — and tested positive. He informed the cabin crew immediately and was then relegated to his cabin for the remainder of the trip.

The US Centers for Disease Control and Prevention advises travelers to stay in their cabin and notify the onboard medical team if symptoms of the virus occur.

Hochberg told Insider that the treatment he received during his time on the ship was fantastic. In less than an hour, a medical team consisting of a doctor and nurse tested him again as well as his family who tested negative. Both the medical team and the guest services team called him regularly to check on him. Doctors provided him with over-the-counter medication and the guest services team helped him plan his disembarkment process. 

Because Hochberg became sick toward the end of his trip, he only had to isolate in his cabin for one day. Guest services provided him with numerous options for his disembarkment plan, including allowing him to stay on board and finish his quarantine until he tested negative. Hochberg decided to disembark where the ship was docked, in Vancouver, Canada, and drive his rental car back to the US.

While contracting COVID can happen anywhere, Hochberg's advice for those boarding a cruise is to be aware of the cruise line's policies and risks. 

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"It's important to understand what could possibly happen because I think ignorance is not an excuse for anything at this point," he told Insider. 

Medical attention and complimentary amenities on various cruise lines

Guests who test positive for COVID-19 on a Carnival cruise will need to isolate until their medical team says it is safe to resume activities, according to the company's website . Carnival offers regular visits from medical staff either in-person or through teleconsultation and guests will have access to complimentary amenities like Wi-Fi and room service.

Royal Caribbean

Depending on when you booked your cruise, passengers on Royal Caribbean ships will have access to varying COVID-19 assistance at no extra charge. For guests who made a reservation on or after August 8, 2022, Royal Caribbean will cover the costs of COVID-19-related medical treatments onboard if you test positive.

The company will also offer a pro-rated cruise fare refund if a cruise is cut short for reasons related to COVID-19, for cruises departing on or before September 30, 2022.

On October 21, Princess cruise line updated its COVID policy to welcome all guests, regardless of vaccination status. Anyone presenting symptoms of the virus during their time on board will be tested and reviewed by the company's medical staff.

According to the company's website , a positive case, that does not require admission to the ship's medical center or medical disembarkation, will be moved to a different cabin during the isolation period. 

Celebrity cruises offer rapid testing and on-site medical teams. In the event that a guest contracts the virus on their vacation, the company will cover the cost of medical treatment onboard, and the person and their party can stay on the ship for free to complete any required quarantine plans.

Future cruise credits

Most cruise lines offer future cruise credits if a passenger gets sick with COVID-19, but Hochberg said that process has been challenging. Since his trip in June, he's only partially received his refund. 

Despite getting the virus, he characterized his experience as positive. 

"If you get sick on a cruise, they're going to take care of you. The care that I received was complimentary," he said.

In July, The Centers for Disease Control and Prevention ended its  COVID-19 Program for Cruise Ships , putting the onus on cruise lines to create their own standards.

On Monday, Australian health authorities confirmed COVID-19 cases on the Coral Princess, one of the first major cruise liners to dock in Western Australia in over two years, according to The Australian Broadcasting Corporation .  

Watch: This is what it takes to be a cruise ship performer

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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.

American Queen Voyages

Where they sail:

American Queen Voyages is known for its Mississippi River cruises as well as sailings down other U.S. rivers like the Columbia and Snake rivers, using classic paddle wheeler ships for a throwback, romantic vibe.

Who needs the vaccine: All guests and crew must be fully vaccinated (14 days after their final shot).

What other safety measures are in place: Luggage is then disinfected before being brought onto the ship and staterooms cleaned with electrostatic fogging.

Find out more : American Queen Voyages

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.

Find out more: Cunard

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. 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.

Find out more: Holland America

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.

Find out more : Lindblad Expeditions

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.

Find out more: MSC Cruises

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.

Find out more : Oceania Cruises

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.

Find out more : P&O Cruises

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.

Find out more : Princess Cruises

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.

Find out more : Regent Seven Seas Cruises

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: Vaccinated travelers will no longer need a negative test on sailings shorter than 10 nights. Unvaccinated travelers aged 5 and older will need to take a test within 3 days of boarding. Self-administered tests are accepted.

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.

Find out more : Seabourn

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.

Find out more : Silversea

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: All guests 12 and older must be fully vaccinated at least 14 days before boarding. At least one booster is required to sail.

What other safety measures are in place: Guests are not required, but requested to test before departing from home (this policy is subject to change as COVID-19 trends change,) as the company states passengers should test to "be a good citizen". Each ship can perform rapid molecular tests on board. The cruise states they will not visit any destinations where vaccine rates are low.

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

Find out more : UnCruise Adventures

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.

Find out more : Victory Cruise Lines

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.

Find out more : Viking Cruises

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, unvaccinated passengers must have a negative COVID-19 test taken within 72 hours of embarkation.

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.

Find out more : Windstar Cruises

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 .

5 Things I Wish I’d Known Before I Caught COVID on a Cruise

Many countries are dropping covid entry requirements and ships are sailing in full force once again. covid-19, however, still lingers in the air—literally..

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Here’s everything you need to know about protecting yourself from COVID on your next cruise.

Photo by Steve Heap/Shutterstock

With COVID cases continuing to fall across the United States, many people are feeling much less apprehensive about travel, including about a mode of transportation that was off-limits during much of the pandemic: cruising. But as Murphy’s Law states, “Anything that can go wrong will go wrong”—so it’s best to be prepared when things do go south.

In 2019, my dad lucked out on a raffle and won an Alaskan cruise for four. My mother, father, husband, and I planned to sail in the fall of 2020, but obviously, that didn’t quite work out—cruising had been fully halted by the U.S. Centers for Disease Control and Prevention (CDC) at that point—and we postponed the trip.

After bumping back the cruise a few more times ( Things will look better in the spring! Maybe next fall! Maybe next year! ), we finally decided we were going to set sail in August 2022—infection rates were dropping and we were all vaccinated and boosted. Worryingly, the CDC stopped monitoring COVID-19 outbreaks on cruise ships just a month before our excursion, a move that allowed cruise lines to set their own policies of how they would handle cases aboard their vessels. Prior to that, there were more exacting requirements. Passengers and crew were previously required to be up-to-date on vaccines (or show proof of a negative COVID-19 test) before embarkation, and there were also stringent plans outlined for ships to follow in response to any cases that might occur onboard.

However, I was (perhaps naively) feeling pretty good—I’d gotten the Johnson & Johnson vaccine, two doses of the Moderna vaccine, and a booster (not the newer, recently released bivalent booster which targets omicron). I also habitually wore a mask in public places and hadn’t gotten sick yet. What could go wrong?

Three days into our seven-night Alaskan cruise, which began in Seattle and sailed up to Juneau with several stops on the way, things were going according to plan—we’d left the port of Seattle, tramped around Sitka National Historical Park , and rode the White Pass Railroad in Skagway . But on the fourth day, I awoke with the dreaded dry cough and the chills. The at-home rapid tests that I’d brought with me confirmed what I suspected: I had COVID-19. After a quick visit to the ship’s infirmary, I soon found myself in a new quarantine room—away from my family, who all tested negative—where I would remain for the rest of the cruise until all other passengers had disembarked from the vessel.

Here are five tips to keep in mind prior to any upcoming cruise so that you can be prepared should COVID come a-knockin’. (Hopefully, it doesn’t, of course—but knowledge and good planning are power.)

Staying up to date on COVID boosters is one of the best ways to stay safe on a cruise.

Photo by LookerStudio/Shutterstock

Stay up to date on your vaccinations—and wear a mask if you’re worried

Before considering a cruise, infectious disease experts recommend that travelers make sure they are up to date on their COVID-19 vaccines and boosters.

“COVID-19 vaccines have consistently shown that they reduce the chance of severe infection and death,” Amira Roess , professor of global health and epidemiology at George Mason University, explained in an email. “The new bivalent booster is expected to be even better at reducing the chance of infection and, if you do get infected, the duration and severity of COVID-19. Getting the booster about two to three weeks before you travel will give your body a chance to develop antibodies and increase your protection against infection and severe disease.”

For those who are concerned about getting sick, it’s also smart to wear a mask in certain settings since there’s still a chance you can get sick even if you are vaccinated and boosted.

“It is a good idea to wear a mask when you are in crowded indoor settings with people you don’t know, especially if you are vulnerable to severe infection,” wrote Roess. “Those who are vulnerable to severe infection could also modify their behavior while traveling to protect themselves. They could wear good-quality masks, travel during less popular times, avoid crowds particularly when eating or doing things we know increase exposure.”

There’s almost no way to avoid being in tight quarters with strangers on a cruise ship unless you decide to take all your meals in your room and greatly inconvenience yourself during any port stops. And if you’re going to a cold-weather destination like Alaska or Antarctica, you’ll likely be spending most of your time inside.

Of course, wearing a mask isn’t a guarantee that you won’t get infected either. But since most people are probably not willing to wear a mask for a week during a vacation (especially as COVID cases continue to fall), it might be wise to keep one handy just in case—especially if you’re at higher risk of developing severe complications .

For those who want the utmost protection, the CDC and infectious disease experts recommend an N95 or KN95-grade mask.

For extra peace of mind throughout your trip, bring a few at-home rapid test kits.

Photo by Helen Sushitskaya/Shutterstock

Be prepared—and don’t expect the ship to have everything you will need if you get sick

Don’t be surprised if the ship’s infirmary is woefully incapable of handling a COVID outbreak. At the nurse’s station, I was given another rapid test, and I tested positive again. Afterwards, I was whisked away to quarantine and given a six-ounce container of generic Mucinex, a box of acetaminophen, and some cherry cough drops. Even though I was vaccinated and boosted, I got pretty sick—that dry cough evolved into a feverish, phlegmy hack (which ended up lingering for more than a month) and I had trouble breathing, especially when lying down. But when I called to inform the doctor on board that I was having trouble breathing, I was told there wasn’t much they could do for me.

Given my experience, there are several things that I wish I had brought with me:

• Thermometer . My temperature was only taken once on board during my one and only visit to the nurse’s station. But my fever actually lasted for a few days, and it would have been helpful to continue to track it myself.
• Pulse oximeter . Pulse oximeters monitor blood oxygen levels. If you’re COVID positive and having trouble breathing, this can be a vital piece of equipment to have— any reading below 90 percent is considered concerning and could bring about bouts of confusion and dizziness, according to the CDC.
• Extra rapid tests . When I went to the infirmary to confirm that I was positive, I was told that if I tested negative, I would have to pay $150 for the appointment. (If I was positive, all my COVID-related expenses would be covered by the cruise line.) Though it was necessary to have the positive test to be admitted into quarantine, it’s good to have a few of your own on hand to double-check if you’re infected without incurring a huge bill at the nurse’s station.
• Additional cough medicine . More than likely, the ship’s infirmary will not have antiviral drugs like Paxlovid on board (which require a prescription), so be prepared with over the counter meds like fever reducer ibuprofen and cough suppressants like dextromethorphan.
• Extra clothes . I’m usually a big fan of traveling with just one carry-on bag , but since the CDC recommends a five-day quarantine, I opted to continue my isolation on land in Seattle. Usually, I don’t mind washing my underthings in the bathtub or sink, but I didn’t enjoy doing that when I was at my sickest. It might be a good move to pack a little extra—just in case.

Passengers who test positive will likely be asked to quarantine from other guests.

Photo by Belinda Fewings/Unsplash

Get ready for some alone time

After I tested positive in the infirmary, I was asked to quickly pack my things in the stateroom (within 15 minutes) that I shared with my husband and was promptly moved to a separate cabin on the third deck of the ship in a hall where other COVID patients were kept behind a water-tight door. (There was a pretty sizable outbreak onboard, so nearly all the approximately 30 rooms in the corridor were occupied.)

Unlike my previous stateroom, this room didn’t have a balcony (thankfully, there was at least a porthole window so I could take in some of the scenery) and I was not allowed to leave—and no one was allowed to visit me—until the ship was ready to disembark COVID patients at the end of the cruise in Seattle, which only occurred after all other guests had left the vessel. In Juneau, on the fifth day of the cruise, my husband was able to find my room’s porthole window and we had a conversation on the phone while he ate a takeaway dinner on the dock. But that would be the last I would see of him until I flew home by myself five days later (he went home on the flight we had originally booked).

I also had minimal contact with staff. The infirmary would occasionally call me to see how I was doing, but otherwise food (I was able to order what I wanted through a digital form I submitted daily) was left outside my door three times a day. Meals were delivered on the dot at 7:00 a.m. (no sleeping in here), 1:00 p.m., and 7:00 p.m. I was also able to request an extra comforter to keep me warm during the worst of my fever, which was a blessing since the thermostat in my room was broken.

Internet on cruise ships can be pricey, but once I tested positive, I was thankfully given free internet access. However, satellite internet access on cruise ships is notoriously spotty, so I occasionally indulged in watching the on-board television, and I must say, Hallmark comfort movies just hit different when you’re hacking up a lung and battling fatigue. Phone calls to other rooms on board the ship were also free and I was able to speak to my parents and my husband without racking up a bill. But truthfully, most of my time was spent napping until we disembarked. After we left the ship, we boarded a bus that dropped us off at the hotels of our choice where we would stay for the remainder of our quarantine.

Before booking, check if a cruise line will compensate you for a COVID-19 infection.

Photo by evan_huang/Shutterstock

Check the cruise line’s COVID compensation policies

Since the CDC is not monitoring or regulating COVID guidelines on ships any longer, ships are setting their own protocol for how they handle outbreaks on board. On the cruise that I sailed, I elected to extend my time on land to meet the CDC’s recommended five-day quarantine —my hotel stay and food expenses were all covered by the cruise line, and I should also be compensated for cruising days I lost to isolation. Check to see what your cruise line will cover in the event of COVID-19 infection.

Buy travel insurance and book with airlines that accommodate flight changes without penalty

Mercifully, my extended quarantine on land was later reimbursed by the cruise line, but if I hadn’t had that option, it would have been handy to have travel insurance. It’s a good idea to have a back-up plan in place to ensure that you have peace of mind in the event that you’re forced to quarantine in an unfamiliar place or cancel a trip—and a way to pay for that back-up plan. When buying travel insurance , you might want to look into a CFAR (which stands for “cancel for any reason”) add-on to your package since travel complications due to the pandemic are now considered to be “foreseeable events.” If you have a travel credit card , check to see what your card may cover—you could be compensated for travel delays and cancellations.

On a related note, it’s useful to make sure that your flights have a flexible rescheduling policy should you need to quarantine on land. Thankfully, I had booked a Southwest flight home ( its policy allows you to rebook your flight up to 10 minutes before your scheduled departure without a change fee), so I was easily able to change my plans. Over the course of the pandemic, all of the major U.S. airlines dropped their flight change fees , offering travelers more flexibility should something go awry.

Have Fun. Be Safe.

• Have Fun. Be Safe. Guidelines

Cruising with Carnival is easy! Vaccines and testing are not required for most U.S. and European departures.*

Guests sailing to and from Australia must visit the Australia Have Fun. Be Safe. page for protocols specific to those cruises.

VACCINATION & TESTING

Although vaccines are not required, we encourage all guests, 5 years of age and older, to be up to date with their COVID-19 vaccines, when eligible, and carry proof of vaccination. Testing is not required for either vaccinated or unvaccinated guests. However, we encourage all guests, 5 years and older, to take a pre-cruise COVID-19 test within three days of their cruise.

*Carnival Luminosa - 9/14/2023: This Carnival Journeys Transpacific voyage will be calling on certain destinations (including Australia) which are still observing COVID-19 protocols. Below are more details regarding vaccination and testing requirements for this voyage:

• Guests, aged 12 years and older, must be fully vaccinated to sail. Additionally, we strongly recommend that guests get a booster, if eligible.
• All guests, aged two years and above, regardless of vaccination status, are required to take a self-administered Rapid-Antigen Test (RAT) within 24 hours of boarding or a PCR test within 48 hours prior to boarding. Evidence of a negative result is required to cruise.
• Vaccine exemptions are required for guests, aged 12 years and older, with medical conditions preventing vaccination. If you, or a member of your party, meet the criteria for a vaccine exemption, you may apply here .
• Full details regarding vaccination and testing requirements and FAQs are available on the Australia Have Fun. Be Safe. page .

DESTINATION REQUIREMENTS

We will continue to monitor the protocols and requirements of the destinations we visit and will update our guests directly and this page of any changes.

Have questions? Check out our Have Fun. Be Safe. FAQs for all sailings, except Carnival Luminosa’s 09/14/2023 voyage.

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Are Cruise Ships Safe Again?

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Key Takeaways

• The risk of a COVID-19 outbreak is higher when a lot of people share a common space, like a cruise ship.
• Most cruise lines have dropped vaccination and testing requirements.
• Consider your risk level based on your health status before booking a cruise, and take precautions while on board to avoid getting sick.

A cruise ship carrying 800 Covid-positive passengers recently docked in Sydney after being hit with a major COVID-19 outbreak—a scenario eerily reminiscent of the early pandemic days. It was a stark reminder that the pandemic is not over, and that cruising still presents a certain level of COVID-19 risk.

So is it safe to go on a cruise now? What are some things you can consider before deciding whether to board one this holiday season?

According to Brian Labus, PhD, MPH , an assistant professor in epidemiology at the University of Nevada, Las Vegas, said it’s important to consider whether you feel comfortable with the risks associated with cruising based on your health status.

“When a lot of people share any common space, like a cruise ship, the risk of an outbreak goes up,” Labus told Verywell. “When an outbreak does occur on a cruise ship, the high-density environment means a lot of people can get sick in a very short period of time.”

For example, Labus said, you may not want to go on a cruise that will place you in the middle of the ocean and away from any hospital for several days if you’re at high risk of severe illness.

However, we may have a skewed perception of the actual risk of cruise ship outbreaks. Thousands of cruises travel and disembark each week without incident, but we don’t hear about them, Labus said. We only hear about the occasional outbreaks on the news, so we might think they happen all the time.

How to Avoid Getting Sick on Cruise Ships

Like other businesses, cruise lines have mostly dropped their vaccination and/or testing requirements. But cruise lines still have safety protocols in place to prevent and control COVID-19 outbreaks on board, Labus said.

Since the specifics can vary depending on the cruise, you can look up a cruise line’s COVID-19 protocols on its website. Carnival Cruise Line, for example, may require guests who test positive for COVID-19 and their close contacts to quarantine in their rooms until a medical team determines it’s safe to resume their activities.

Leading up to your cruise vacation, it’s a good idea to limit your exposure to people outside of your household, wear a mask in crowded settings, practice good hand hygiene, and take a rapid test before you go. Making sure to get an updated COVID-19 booster and a flu shot at least two weeks before your trip is also extremely important, Labus said.

Though you might not be able to socially distance as much as you’d like while on a cruise, Labus said you can still practice the same COVID-19 precautions on board.

“Protecting yourself from disease on a cruise is no different than protecting yourself anywhere else,” he said.

If you get word of an outbreak on board, don’t panic, Labus said. Listen closely to the crew’s instructions, as every ship and every situation is different. Trust that the ship has protocols that are developed by medical professionals, he added, and these measures will allow them to respond appropriately and provide the best protection to everyone on board.

“If you do get sick, make sure to report your illness to the crew,” Labus said. “Trying to hide your illness just puts everyone around you at risk.”

What This Means For You

If you’re considering booking a cruise this holiday season, assess your risk level based on your health status. If you do decide to set sail on a ship, take precautions before and during your trip to avoid getting sick. In the occasion of an outbreak on board, listen closely to instructions. If you feel sick, be sure to report your illness to the crew.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our  coronavirus news page .

By Mira Miller Miller is a journalist specializing in mental health, women's health, and culture. Her work is published in outlets ranging from Vice to Healthnews.

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What Happens If You Get COVID on a Cruise

Are you curious about what happens if you test positive for COVID while on a cruise ? During my last few cruises, it has certainly weighed on me and is not something I would want first-hand experience with. Fortunately for you, reader, my new cruise friends Fain and Laura ( Travel Spree ) documented their COVID experience after Laura tested positive on their recent cruise on the Royal Caribbean Symphony of the Seas.

Getting COVID on Royal Caribbean Symphony of the Seas

So what exactly happens when you test positive for COVID on a cruise? I’ve broken down Travel Spree’s 23-minute video into chapters that will help answer any COVID cruise-related questions you might have. You can find the chapter list below the video.

COVID on Cruise Breakdown. What Happens Next?

• 0:37 – Tests positive for COVID-19 after feeling chest congestion
• 1:30 – Someone comes to move you to a different room and tests your travel companion
• 1:48 – Guests services takes pictures of your passport and vaccination cards, as well as provides general info on the process of COVID lockdown
• 2:26 – Fain explains the paperwork left by Guests Services that details what happens next
• 3:30 – A little unsure what is happening next since they still haven’t come to test Fain or move them to a new room yet
• 4:27 – Both get moved to the same room despite Fain not being tested for COVID
• 5:10 –  Crew helps Fain & Laura with their bags as they get moved to the COVID floor, aka. Quarantine floor, aka. the 3rd floor
• 5:24 –  They are escorted through the crew/freight elevator to avoid other guests
• 6:22 –  They arrive in their new room, which is not an inside room. There’s a window, king-size bed, TV, etc
• 6:38 –  They leave a disinfectant cleaner and red biohazard bags for all trash
• 7:55 –  Room service in the quarantine rooms seems to be entirely complimentary
• 10:00 – Their first room service order arrives individually wrapped
• 12:56 – The crew does a welfare check to make sure everyone is ok
• 14:10 –  The process begins for them to depart at Port Miami
• 14:35 –  The to-go breakfast arrives, and Fain shows what’s inside
• 15:50 –  Fain explains that if you have COVID on a cruise, you won’t be the first to depart
• 16:22 –  Something I’m sure Royal Caribbean doesn’t want anyone to see is the hallway full of contaminated bags from all the COVID cruisers on the 3rd floor
• 17:05 –  Those with COVID depart the ship from a different section of the boat
• 17:24 – The crew are dressed in protective gear when checking COVID passengers off the ship
• 18:08 – A car takes them to the car lot where they parked during the duration of their cruise
• 18:38 –  Reporting live from ‘COVID Hell,’ Laura shares her experience after testing positive on Symphony of the Seas

Huge thanks to Travel Spree for sharing their COVID cruise story with the world. Though unfortunate, these are the stories that will help push the cruise industry even further with safety. 

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Cruise Ship Travel

CDC Respiratory Virus Guidance has been updated. The content of this page will be updated soon.

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 illnesses like influenza , COVID-19 , and the common cold. Get your annual flu shot and get up to date on your COVID-19 vaccines . Check directly with your cruise line about their COVID-19 testing or vaccination protocols before travel. 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 . When you cough or sneeze, cover your nose and mouth with a tissue to prevent spreading germs. Consider wearing a mask in crowded or poorly ventilated indoor areas.
• Norovirus. Symptoms of vomiting and diarrhea, primarily caused by outbreaks of norovirus, have been reported. To prevent norovirus , 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, influenza, 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 (SPF15 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

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The best way to minimise illness risk on cruises, after Grand Princess COVID and gastro outbreak

A cruise ship that docked in Adelaide this week has garnered national headlines due to a simultaneous outbreak of COVID-19 and gastroenteritis.

Despite the dual illnesses, health authorities declared the outbreak over when the cruise liner docked, while only a handful of passengers, on a ship that can hold 4,000, became ill. 

As Australia approaches the summer holiday period, the fate of the Grand Princess has brought holiday illness into the spotlight. 

Epidemiologist Professor Catherine Bennett says there are many steps holiday-goers can take to minimise the risk of illness during their time off.

What can you do to mitigate personal risk?

Chair in epidemiology at Deakin University Professor Catherine Bennett says cruising is like any other form of holiday, and people should think about the specific risks and what they could do to stay well.

She said there were steps people could take to reduce their risk of contracting infections while on board cruise ships.

"Keeping distance where you can, staying outdoors on the ship as often as you can rather than being in shared indoor settings, avoiding crowded areas within indoors on ships," she said.

Professor Bennett said it was important that people did not ignore symptoms and were responsible for their individual behaviour to moderate risks to others.

"If they do have symptoms … go and see the ship's doctor, they have guidance in place about who might need to quarantine," she said.

"I do think cruise ships are safer now than they were before the pandemic, and I hope the same is true for other dense population holiday areas."

Government says cruise ships pose higher risk of illness

The Department of Health described cruise ships as a higher-risk setting for communicable diseases such as gastroenteritis and respiratory infections, including influenza and COVID-19.

In a statement from its Australian Health Protection Principal Committee (AHPPC), the department said these viral infections could be serious, particularly for people who were at higher risk of severe illness.

"The risk is higher on-board cruise ships than in the general community due to the high numbers of people mixing in relatively closed spaces, and the typically longer duration of cruises compared to other transport," the statement said.

However, Professor Bennett said risks were not confined to cruise ships, but can affect any settings where people mingle in close quarters.

"Whether that's prisons, boarding schools, aged care, for example, they're all places where if there is an outbreak it is of concern, so we tend to document it more than we would in, say, a hotel or resort," she said.

"Ships [are another] key one where we have, in the past, also had foodborne disease or other person-to-person outbreaks being reported, even before the pandemic."

She said that the COVID-19 pandemic had, however, brought some positive changes to cruise ship health protocols, including better ventilation.

"I think ships are now quite prepared for this, and hopefully that means that outbreaks that were occurring before this pandemic are also managed in better ways so that fewer passengers are impacted," she said.

Industry insists passenger wellbeing is a top priority

Princess Cruises' website states that the safety of passengers is the company's top priority.

"All of our onboard medical facilities meet or exceed the standards established by the American College of Emergency Physicians," it read.

"Our onboard medical facilities are staffed by full-time registered doctors and nurses."

"In addition to twice-daily office hours, they are available 24 hours a day in the event of an emergency."

Health authorities say a dual outbreak of COVID-19 and gastroenteritis onboard a cruise liner is now over after it docked in Adelaide with only a handful of sick passengers.

Bridget Hancock has worked as a performer on cruise ships for almost seven years and said cruise ships had serious health protocols in place.

She said during outbreaks of illness, all staff including performers were required to help with sanitisation and cleaning roles.

"[Outbreaks] are about as common as they are everywhere in the world on land, it's just that they tend to get reported more on ships," she said.

"Honestly, it's one of the most hygienic places in the world."

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Guidance for Cruise Ships on Management of Acute Respiratory Illness (ARI) due to Viral Infection

CDC Respiratory Virus Guidance has been updated. The content of this page will be updated soon.

Describing and Defining Passengers and Crew with Acute Viral Respiratory Illness (ARI)

Reducing the spread of viral respiratory infections, vaccination of crew and passengers, managing passengers or crew with ari upon disembarkation, medical evaluation and management, diagnostic tests for acute viral respiratory illness (ari), respiratory and hand hygiene, outbreak control, infection prevention and control.

• Additional Resources

Attribution Statement

Outbreaks of influenza, COVID-19, r espiratory syncytial virus (RSV) , and other viral respiratory infections can occur at any time of the year among cruise ship passengers and crew members. Many cruise ship travelers are older adults or have underlying medical conditions that put them at increased risk of complications from these respiratory virus infections. Early detection, prevention, and control of such acute viral respiratory infections are important, not only to protect the health of passengers and crew members on cruise ships, but also to avoid spread of these viruses into communities.

This document provides guidance for cruise ships originating from or stopping in the United States to help prevent, diagnose, and medically manage acute respiratory illness (ARI) caused by SARS-CoV-2 (the virus that causes COVID-19), influenza virus, or RSV. This guidance to cruise ship clinics will be updated as needed. CDC recognizes that cruise ships travel worldwide, necessitating awareness of, and responsiveness to, local jurisdictional requirements. Cruise ship management and medical staff need to be flexible in identifying and caring for people with ARI. The healthcare provider’s assessment of a patient’s clinical presentation and underlying risk factors is always an essential part of decisions about the need for further medical evaluation, testing, and treatment.

This document also provides guidance for preventing spread of ARI during and after a voyage, including personal protective measures for passengers and crew members and control of outbreaks.

Signs and symptoms of ARIs can include acute onset of some or all of the following:

• fever or feeling feverish
• nasal congestion
• sore throat
• shortness of breath
• difficulty breathing
• muscle or body aches
• fatigue (tiredness)
• loss of taste or smell

For cruise ship surveillance purposes, CDC defines ARI as an illness of presumed viral etiology with at least two of the following symptoms : fever/feverishness, cough, runny nose, nasal congestion, or sore throat and excluding:

• Confirmed acute respiratory infection diagnoses other than COVID-19 [1] , influenza [2] , or RSV [3] (e.g., Streptococcal pharyngitis, Epstein-Barr virus infection), *
• Diagnoses of bacterial pneumonia: either clinical or test-positive (e.g., by urine Legionella antigen, urine Streptococcus pneumoniae antigen), and
• Non-infectious conditions as determined by the ship’s physician (e.g., allergies)

Fever (a temperature of 100°F [37.8°C] or higher) will not always be present in people with influenza, COVID-19, or RSV. Cruise ship medical personnel should consider someone as having a fever if the sick person feels warm to the touch, gives a history of feeling feverish, or has an actual measured temperature of 100°F (37.8°C) or higher.

*Other respiratory viruses—for which point-of-care diagnostic tests are not available—may also cause ARI (e.g., rhinovirus, adenovirus, enterovirus, human parainfluenza viruses, human metapneumoviruses).

[1] Confirmed COVID-19 means laboratory confirmation for SARS-CoV-2, the virus that causes COVID-19, by viral test.

[2] Confirmed influenza means laboratory confirmation for influenza A or B by viral test.

[3] Confirmed RSV means laboratory confirmation for RSV by viral test.

Commercial maritime travel is characterized by the movement of large numbers of people in enclosed and semi-enclosed settings. Like other close-contact environments, these settings can facilitate the transmission of respiratory viruses from person to person through droplets and small particles or potentially through contact with contaminated surfaces.

CDC recommends that efforts to reduce the spread of respiratory viruses on cruise ships focus on encouraging crew members and passengers:

• 6 months and older to get vaccinated annually for influenza
• 6 months and older to stay up to date with their COVID-19 vaccines
• who are 60 years and above  to discuss and consider RSV vaccination  with their healthcare provider
• To follow recommendations for babies and young children  and if applicable, to receive monoclonal antibody products to prevent severe RSV
• To avoid contact with ill people prior to scheduled cruising
• To postpone travel if sick with an acute respiratory illness (passengers)
• To take steps to protect themselves and others while traveling
• To consider wearing a mask  in crowded or poorly ventilated indoor areas.

Cruise ship management should include:

• Encouraging good respiratory hygiene and cough etiquette
• Early identification and isolation of crew members and passengers with ARI
• Use of antiviral medications for treatment of people with suspected or confirmed influenza or COVID-19 with severe or complicated illness, or at increased risk of severe illness or complications
• Use of antiviral chemoprophylaxis for post-exposure prophylaxis (PEP) or during influenza outbreaks, if indicated, for people at increased risk of complications

All passengers and crew are also recommended to be up to date with all routine vaccines .

Influenza : CDC recommends that all people 6 months of age and older be vaccinated each year with the influenza vaccine. Crew members should be vaccinated yearly. Vaccination of passengers, especially those at high risk for influenza complications, is recommended at least 2 weeks before cruise ship travel, if influenza vaccine is available and the person has not already been vaccinated with the current year’s vaccine. For more information on influenza vaccine recommendations, see Seasonal Influenza Vaccination Resources for Health Professionals .

COVID-19: CDC recommends that all people 6 months of age and older be up to date with their COVID-19 vaccines. In addition to the protection COVID-19 vaccines provide to individual travelers in preventing severe illness or death from COVID-19, having a high proportion of travelers on board who are up to date with COVID-19 vaccines reduces the likelihood that cruise ships’ medical centers will be overwhelmed by cases of COVID-19. For more information on COVID-19 vaccine recommendations, see COVID-19 Vaccination Clinical and Professional Resources .

RSV : CDC recommends adult travelers ages 60 years and older discuss RSV vaccination with their healthcare provider prior to cruise travel. These new vaccines—which are the first ones licensed in the U.S. to protect against RSV—have been available since the fall of 2023. Babies and young children should follow recommendations and if applicable, receive monoclonal antibody products to prevent severe RSV. For more information, see For Healthcare Professionals: RSV (Respiratory Syncytial Virus) .

Pre-embarkation COVID-19 Testing

To reduce the likelihood of onboard transmission of SARS-CoV-2, pre-embarkation testing is recommended for all passengers, including those on back-to-back sailings [4] . Completion of testing closer to the time of embarkation (within 1 to 2 days) maximizes the benefit of preventing introduction of infectious persons onboard. Ships that choose to use COVID-19 antigen tests should follow FDA guidance .

[4] Back-to-back sailing refers to passengers who stay on board for two or more voyages.

Viral ARI Screening Procedures for Embarking Passengers

Cruise ship operators should consider screening embarking passengers for viral ARI symptoms, a history of a positive COVID-19 viral test within the 10 days before embarkation, and a history of exposure to a person with COVID-19 within the 10 days before embarkation.

Cruise ship operators should consider performing viral testing (e.g., COVID-19, influenza, RSV) for passengers with ARI before they embark. Ships that choose to use COVID-19 antigen tests should follow FDA guidance .

Cruise ship operators should consider denying boarding for passengers who test positive for infectious viral etiologies during pre-embarkation screening, as well as those who tested positive for COVID-19 within 10 days before embarkation. If boarding is permitted, see guidance for isolation and other measures provided below .

If the cruise ship operator chooses to test for other infectious etiologies and testing identifies an alternate etiology (e.g., Legionella , Epstein-Barr virus, Streptococcal pharyngitis) through laboratory testing, routine infection control precautions specific to the diagnosis should be followed.

For asymptomatic passengers who have a known COVID-19 close-contact exposure within the 10 days before embarkation, considerations for allowing boarding can include:

• being up to date with COVID-19 vaccines,
• having a negative result on a COVID-19 viral test conducted on the day of boarding, or
• having documentation of recent recovery [5]  from COVID-19

People who are up to date with COVID-19 vaccines are less likely to have severe outcomes if they develop COVID-19 after boarding. Testing is generally not recommended for asymptomatic people who recovered from COVID-19 in the past 30 days. If exposed passengers are allowed to board, see information below regarding recommendations for management onboard .

[5] Documentation of recent recovery from COVID-19 can include the following:

• Paper or electronic copies (including documentation of at-home antigen results) of their previous positive viral test result dated no less than 10 days and no more than 30 days before date of embarkation
• A positive test result dated less than 10 days before embarkation accompanied by a signed letter from a licensed healthcare provider indicating symptom onset more than 10 days before the voyage

Managing Cruise Travelers with ARI and Contacts while on Board

Travelers with ARI who board, as well as those who become sick with ARI onboard, should be identified and tested as soon as possible to minimize transmission of respiratory viruses. The table below provides disease-specific recommendations for persons on board with COVID-19, influenza, or RSV and those exposed (i.e., contacts).

§ The day of last exposure to a case is counted as day 0. Additional testing prior to day 6 can identify new cases earlier. Cruise ship operators may consider this strategy in situations where exposures may have occurred in crowded settings, if unsure of the date of exposure, or if there is difficulty identifying index cases, as often occurs in the cruise ship environment.

^ Individual should properly wear a respirator or well-fitting mask  at all times when outside of cabin indoors until 10 days after the last close contact with someone with COVID-19 (the date of last exposure to a case is considered day 0). During this time, these individuals should have in-cabin dining (with food trays placed and collected outside of cabins) and also wear a respirator or well-fitting mask inside their cabin if any other person (such as a crew cleaning staff) enters the cabin.

† Contacts with high risk of influenza complications should be identified in order to offer post-exposure prophylaxis (PEP)

Crew members with ARI, even if mild, should take the following additional steps—regardless of their COVID-19, influenza, or RSV vaccination status:

• Notify their supervisors.
• Report to the medical center for evaluation and testing, if indicated, according to shipboard protocols.
• Continue to practice respiratory hygiene, cough etiquette, and hand hygiene after returning to work, because respiratory viruses may be shed after the isolation period ends.

Disembarking cruise ship passengers or crew members who have ARI should continue to take recommended precautions after disembarkation. If a passenger or crew member with viral ARI is taken to a healthcare facility off the ship, the facility should be informed before arrival. Medical transport providers should also be notified in advance.

Medical centers on cruise ships can vary widely depending on ship size, itinerary, length of cruise, and passenger demographics.

• Cruise ship medical centers are recommended to follow the operational guidelines  published by the American College of Emergency Physicians (ACEP) as well as disease-specific clinical guidelines (see links provided at the bottom of this section).
• PPE should include surgical masks and NIOSH Approved® N95® filtering facepiece respirators or higher, eye protection such as goggles or disposable face shields that cover the front and sides of the face, and disposable medical gloves and gowns.
• Antiviral agents and other therapeutics for COVID-19 , influenza , and RSV (if commercially available), and other antimicrobial medications
• Antipyretics (e.g., acetaminophen and ibuprofen), oral and intravenous steroids, supplemental oxygen
• Onboard capacity to conduct viral tests for SARS-CoV-2 and influenza, and RSV, as well as other infections that may be in the differential diagnosis (e.g., group A Streptococcus , Streptococcus pneumoniae, Legionella )
• Medical center staff should adhere to standard and transmission-based precautions when healthcare personnel are caring for patients with suspected or confirmed COVID-19, influenza, RSV, or other communicable diseases.

For more information, read updated resources for clinicians and guidance on the medical evaluation and management of people with COVID-19 , influenza , or RSV  are available on CDC’s websites.

Respiratory specimens for ARI testing should be collected immediately upon illness onset, with the understanding that repeat testing may be indicated based on the viral etiology or state of the COVID-19 pandemic. In general, molecular tests are recommended over antigen tests because of their greater sensitivity; multiplex assays are available that can detect SARS-CoV-2, influenza A and B, and RSV.

Healthcare providers should understand the advantages and limitations of rapid diagnostic tests, and proper interpretation of negative results of any antigen diagnostic tests. Rapid antigen diagnostic tests have a lower sensitivity compared with RT-PCR, and false negative results can occur frequently. In symptomatic persons, negative rapid antigen diagnostic test results do not exclude a diagnosis of COVID-19, influenza, or RSV; clinical diagnosis of these illnesses should be considered; however, positive test results are useful to establish a viral etiology and to provide evidence of infection in passengers and crew members aboard ships.

People with ARI should be advised of the importance of covering coughs and sneezes and keeping hands clean because respiratory viruses may be shed after the isolation period ends.

Cruise operators should ensure passengers and crew have access to well-stocked hygiene stations with soap and water and/or hand sanitizer, tissues, paper towels, and trash receptacles.

Respirators or well-fitting masks should be readily available and symptomatic passengers and crew should be encouraged to use them if they have to be outside their cabins.

Passengers and crew members should be reminded to wash their hands often with soap and water, especially after coughing or sneezing. If soap and water are not available, they can use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Used tissues should be disposed of immediately in a disposable container (e.g., plastic bag) or a washable trash can.

For more information on respiratory hygiene, see Coughing and Sneezing .

A combination of measures can be implemented to control ARI outbreaks, including isolation of infected people, increased infection prevention and control efforts, antiviral chemoprophylaxis of influenza-exposed people, crew member and passenger notifications, and active surveillance for new cases.

Recommendations when a voyage’s crew or passenger ARI attack rate reaches 2% ‡

• Provide all crew members with respirators or well-fitting masks and provide crew with information on how to properly wear, take off , and clean (if reusable)
• Minimize the number of crew members sharing a cabin or bathroom to the extent possible.
• Instruct crew members to remain in cabins as much as possible during non-working hours.
• Cancel nonessential face-to-face employee meetings as well as group events (such as employee trainings) and social gatherings.
• Close all crew bars, gyms, and other group settings.
• Close indoor crew smoking areas.
• Maximize the introduction of outdoor air and adjust HVAC systems to increase total airflow to occupied spaces. For additional information on ventilation, see Ventilation in Buildings
• Maximize air circulation in crew outdoor smoking areas.
• Expedite contact tracing (including the use of wearable technology, recall surveys, and the onboarding of additional public health staff).
• Consider serial viral (antigen or NAAT) screening testing of crew every 3–5 days. The onboarding of additional laboratorians may be needed to facilitate the testing process.
• If an influenza outbreak, antiviral chemoprophylaxis  can be considered for prevention of influenza in exposed people depending on their risk for complications, or could be given to all contacts on a cruise ship when the threshold is met or exceeded.

Recommendations when a voyage’s crew or passenger ARI attack rate reaches 3% ‡

• Provide all passengers with respirators or well-fitting masks and provide crew with information on how to properly wear, take off , and clean (if reusable)
• Position posters educating passengers on how to properly wear respirators or well-fitting masks  in high traffic areas throughout the ship.
• Eliminate self-serve dining options at all crew and officer messes.
• Reduce the dining cohort size for crew, and shorten dining times to avoid crowding.
• Send written notification to passengers on the current, previous, and subsequent voyages informing them of the ARI conditions and measures being taken to reduce transmission on board.
• Cancel crew shore leave.
• Implement a “working quarantine” policy for all crew (i.e., crew perform job duties then return to cabin).
• Require use of respirators or well-fitting masks and provide crew with information on how to properly wear, take off , and clean (if reusable)
• Test all passengers for COVID-19 prior to the end of the voyage, regardless of their vaccination status. Advise those who test positive or have known exposure to follow guidance following disembarkation .

‡ Sources of data should include medical center records and other established surveillance systems for passengers and crew (e.g., employee illness reports).

Considerations for Suspending Passenger Operations

In some circumstances, additional public health precautions, such as returning to port immediately or delaying the next voyage, may be considered to help ensure the health and safety of onboard travelers or newly arriving travelers.

A ship should consider suspending operations based on the following factors:

• 15% or more of the passengers have met ARI criteria; or
• 15% or more of the crew have met ARI criteria; or
• 15% or more of total travelers have met ARI criteria. [6]
• Shortages of supplemental oxygen or other medical supplies related to management of patients with ARI, or
• 3 or more deaths due to ARI in passengers and/or crew during a voyage.
• Evaluate symptomatic travelers and their close contacts,
• Conduct diagnostic and screening testing of travelers,
• Conduct routine medical checks of travelers in isolation, or
• Conduct contact tracing of close contacts, if applicable
• Testing equipment,
• Antipyretics (fever-reducing medications such as acetaminophen and ibuprofen),
• Antivirals and other therapeutics for COVID-19, influenza, and RSV (if commercially available),
• Oral and intravenous steroids, or
• Supplemental oxygen
• Inadequate onboard capacity to fulfill minimum safe manning or minimal operational services, including but not limited to housekeeping and food and beverage services
• A novel respiratory virus or SARS-CoV-2 variant of concern or a new or emerging SARS-CoV-2 variant with potential for increased severity or transmissibility identified among cases on board

[6] These thresholds are subject to change based on the characteristics of the dominant COVID-19 variant or a novel respiratory virus in the United States or elsewhere.

CDC requests that cruise ships submit a cumulative ARI report (even if no ARI cases have occurred) preferably within 24 hours before arrival in the U.S. [7] , and sooner if a voyage’s crew or passenger ARI attack rate reaches 3% [8] . These reports are requested by completing the Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form. Access to the online reporting form has been provided to cruise lines by CDC. Cruise lines that do not have access may contact CDC (email [email protected] ).

In addition, CDC emphasizes that any deaths—including those caused by or suspected to be associated with influenza, COVID-19, RSV, or ARI—that occur aboard a cruise ship destined for a US port must be reported to CDC immediately. Report ARI deaths by submitting an individual  Maritime Conveyance Illness or Death Investigation Form [PDF – 4 pages] for each death.

Vessel captains may request assistance from CDC to evaluate or control ARI outbreaks as needed. If the ship will not be arriving imminently at a U.S. seaport, CDC maritime staff will provide guidance to cruise ship officials regarding management and isolation of infected people and recommendations for other passengers and crew members. CDC staff may also help with disease control and containment measures, passenger and crew notification, surveillance activities, communicating with local public health authorities, obtaining and testing laboratory specimens, and provide additional guidance as needed.

[7] For international voyages with >1 U.S. port (e.g., Canada to multiple Alaskan ports), please submit report to CDC within 24 hours before arrival in the final U.S. port.

[8] For international voyages with >15 days prior to arrival in the U.S., the time period for calculating this attack rate begins at day 15 prior to arrival at a U.S. port.

Infection prevention and control (IPC) are critical to reducing the spread of ARI. Each cruise ship should maintain a written  Infection Prevention and Control Plan (IPCP)  that details standard procedures and policies to specifically address infection control and cleaning/disinfection procedures to reduce the spread of ARI.

To reduce the spread of ARI, cruise ship operators should include the following as part of a written IPCP:

• Duties and responsibilities of each department and their staff for all passenger and crew public areas
• A graduated approach for escalating infection prevention and control measures in response to ARI cluster or outbreaks during a voyage with action steps and criteria for implementation
• Procedures for informing passengers and crew members that a threshold of ARI has been met or exceeded, and of any recommended or required measures to prevent spread of infection
• Crew members entering cabins or other areas where people with confirmed or suspected COVID-19 are should be limited, and crew should wear an NIOSH Approved® N95® filtering facepiece respirator or higher in accordance with the Occupational Safety and Health Administration’s (OSHA) Respiratory Protection standard   (29 CFR 1910.134 )
• Disinfectant products or systems used, including the surfaces or items the disinfectants will be applied to, concentrations, and required contact times
• Safety data sheets (SDSs)
• PPE recommendations for crew, which may include surgical masks or NIOSH Approved® N95® filtering facepiece respirators or higher, eye protection such as goggles or disposable face shields that cover the front and sides of the face, and disposable medical gloves and gowns in addition to those recommended by the disinfectant manufacturer in the SDS; for information on health hazards related to disinfectants used against viruses, see Hazard Communication for Disinfectants Used Against Viruses .
• Health and safety procedures to minimize respiratory and dermal exposures to both passengers and crew, when recommended
• Graduated procedures for returning the vessel to normal operating conditions after a threshold of ARI has been met, including de-escalation of cleaning and disinfection protocols

Frequent, routine cleaning and disinfection of commonly touched surfaces with an Environmental Protection Agency (EPA)-registered disinfectant is recommended. For COVID-19, EPA-registered disinfectant  effective against coronaviruses is strongly recommended.

• Isolation and Precautions for People with COVID-19
• COVID-19 Treatments and Medications
• Seasonal Influenza Prevention
• Seasonal Influenza Treatment: What You Need to Know
• Infectious Diseases Society of America guidelines for controlling institutional influenza outbreaks
• Symptoms and Care of RSV (Respiratory Syncytial Virus)
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• Preventing RSV (Respiratory Syncytial Virus)

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5 Illnesses You Can Get on a Cruise Ship (Besides COVID)

Plus, tips on how to avoid getting sick while at sea and ports of call.

Rachel Nania and Nicole Gill Council,

Concerns over the spread of COVID-19 have loomed over the travel industry for the last three years, but with the public health emergency coming to an end and a robust menu of preventive tools and treatments available, many of those fears are fading.

A new  AARP survey  shows 81 percent of adults 50-plus who plan to travel in 2023 believe it’s safe to do so now, up from 77 percent in 2021. And while interest in cruising is down slightly among the 50-plus population this year compared to last, a recent AAA survey finds that, overall, the share of travelers considering a cruise vacation in 2023 is up.

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However, the return to the skies and seas does not mean COVID-19 is no longer a threat.

“Indoor densely populated places where we’re exchanging exhaled breath with one another is still going to be a concern for me,” says Wilbur Chen, M.D., adult infectious disease physician and director of the University of Maryland, Baltimore Travel Medicine Practice.

That concern isn’t limited to COVID, either. Flu spreads in a similar way, Chen points out.

It’s important to note, though, that since the start of the pandemic, many cruise lines have invested in better air circulation systems with medical-grade HEPA filters , says travel expert Pamela Kwiatkowski, cofounder and chief insurance officer at Goose Insurance Services in Vancouver, British Columbia. “I think that’s the first step they’ve taken in terms of improving the air filtration system, which removes almost all of the airborne pathogens,” she says.

Still, plenty of bugs can lurk on busy boats. Read on to discover some common illnesses you can pick up on a cruise — and what you can do to help keep yourself healthy on your next getaway. 

1. Flu and other respiratory illnesses

Flu season spiked early this year in the U.S., along with another  respiratory illness  that can be particularly dangerous for older adults, respiratory syncytial virus, which is known as RSV . Cases of flu and RSV have declined from fall’s peak, data from the Centers for Disease Control and Prevention (CDC) shows, but the viruses that cause these two illnesses are still circulating in the U.S. and other parts of the globe.

“Influenza is complicated during cruise travel because, of course, people on a cruise ship — both the passengers and the crew — may come from different parts of the world, which means that the rates of influenza for your particular country may not necessarily be the same as in other places,” says Jose Lucar, M.D., an infectious disease physician and associate professor of medicine at the George Washington University School of Medicine and Health Sciences in Washington, D.C.

According to the CDC, flu season in the southern hemisphere, which includes Australia and parts of South America and Africa, typically runs April through September. In the tropics, flu flares up throughout the year.

Staying healthy:  If you haven’t rolled up your sleeve for the flu shot yet, make sure you get it at least two weeks before going on a cruise, Lucar says. The same applies to the latest  COVID booster . When it comes to RSV, there isn’t a vaccine yet, but the FDA could approve one soon.

A few other tips: If you’re at high risk for  flu complications , talk to your doctor about antiviral treatment and prevention before your trip, the CDC recommends. Don’t forget about high-quality face masks, which can help to tamp down the spread of respiratory illnesses. And be sure to make — and pack — a list of all the medications you take, in case you wind up needing medical care on board. “That just makes it easier for everyone, so that if there is an emergency, if you’re not able to talk really well, you can at least hand the sheet over and it’s done,” Chen says.

2. Norovirus

This is one of the most well-known bugs that can foil fun on a ship. Norovirus — marked by diarrhea , vomiting, nausea and stomach pain — is to blame for more than 90 percent of diarrheal disease outbreaks on cruises, according to the CDC. That said, norovirus outbreaks on ships account for only 1 percent of all such reported cases.

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“This infection is very contagious,” Lucar says. The virus is also a “hearty” one, Chen points out. It can survive for long periods of time on surfaces and is resistant to common disinfectants.

Close living quarters, shared bathrooms, populated pools, busy buffet lines and rapid turnover of passengers make it difficult to control the spread of the virus once it hits a ship. “It’s just really the perfect scenario for transmission of highly contagious GI [gastrointestinal] pathogens,” Lucar says.

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According to the Cruise Lines International Association, the risk each year of getting laboratory-confirmed norovirus during a ship outbreak is about 1 in 5,500. The association, which says it is the largest cruise industry trade association in the world, noted on its website that crew members use strict sanitation and cleaning practices created with the CDC’s Vessel Sanitation Program. Cabins are cleaned once a day, and other common areas, such as elevators and pools, are cleaned multiple times a day.

In late February, more than 300 people aboard a Princess Cruises ship fell ill with diarrhea and vomiting, according to the CDC, though the agency didn’t cite the cause of the illness that sickened the 284 passengers and 34 crew. The  Ruby Princess  increased disinfection and cleaning procedures in the wake of the outbreak.

Other bugs that have popped up on boats include salmonella and E. coli. One to keep an eye on is shigella, which the CDC notes has been behind GI outbreaks on cruise ships. This bacterium causes an infection known as shigellosis, which can cause fever, stomach pain and diarrhea that can be bloody or prolonged.

Typically, the infection is treated with antibiotics, Chen says, but the CDC recently  issued a warning  that antibiotic-resistant strains are circulating in the U.S. Chen isn’t aware of any outbreaks of the resistant varieties on cruise ships, but it’s something to monitor.

Staying healthy:  To avoid getting a GI bug, be sure to wash your hands with soap and water before eating and after going to the bathroom and coming into contact with high-touch surfaces, like doorknobs and stair railings. Hand sanitizers don’t work well against norovirus, Lucar notes.

Travel expert Kwiatkowski also recommends  drinking plenty of water  to keep your body running at its best. However, she advises passengers stay away from the water at ports, particularly if a passenger is vulnerable to gastrointestinal illnesses.

“Handwashing, cleaning your stateroom, watching what you eat and how much you eat, and making sure that you stay hydrated will go a long way in preventing these illnesses, from you catching them even if they are there,” she says.

Talk to a doctor or pharmacist about any medications you should pack, such as loperamide (Imodium) to help treat diarrhea or dimenhydrinate (Dramamine, Gravol) for nausea. If your immune system is compromised, your doctor may want to prescribe something ahead of your trip.

Although less common than respiratory and GI illnesses, measles, along with chicken pox and other  vaccine-preventable diseases , can circulate on cruise ships.

Measles, a highly contagious virus that can linger in the air even hours after an infected person leaves the room, was declared eliminated from the U.S. in 2000, thanks to a successful vaccine program. But cases still pop up in the States, and the virus is common in many countries around the world.

If an unvaccinated or under-vaccinated passenger or crew member contracts the virus and brings it on board, other vulnerable people can get sick, Chen explains. (A ship was quarantined off the coast of St. Lucia in 2019 when measles was reported on board.) The same goes for chicken pox (varicella), which is similarly caused by a highly contagious virus that can circulate among unvaccinated people.

Staying healthy:  To avoid these and other vaccine-preventable diseases, make sure you’re up to date on your routine vaccines before traveling. Two doses of the chicken pox vaccine are more than 90 percent effective at preventing the disease, and two doses of MMR (measles, mumps, rubella) are about 97 percent effective at preventing measles.

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4. Seasickness

Is the motion of the ocean getting to you? Seasickness, while not contagious or related to an infection, can make you feel downright miserable. The good news: Most people recover quickly from seasickness, formally known as motion sickness, and there are medications that can help.

Motion sickness — which can cause dizziness, nausea and vomiting whether you’re on a boat, in a car or on a roller coaster — occurs when the movement you see is different from what your inner ear senses. Interestingly, adults 50 and older are less susceptible than younger adults and children, the CDC notes.

Staying healthy:  If you’re prone to going a little green when you travel, talk to your doctor ahead of your trip about medications that can help with symptoms. Prescription and over-the-counter antihistamines — like dimenhydrinate (Dramamine), for example — are most frequently used to treat motion sickness. 

However, antihistamines can interact with other medications and often cause drowsiness and decreased mental alertness, and the nonsedating ones appear to be less effective, the CDC says. Your doctor may also prescribe or recommend a patch that can help prevent nausea and vomiting caused by motion sickness.

Another tip: Have your physician review your current list of medications, since common pills — including some antidepressants and painkillers — can make seasickness worse, according to the CDC. 

A few other things that can help with seasickness:

• Try lying down on your stomach, shutting your eyes or looking off into the horizon.
• Avoid the upper levels of the boat.
• Stay hydrated and limit alcohol and caffeine consumption.
• Avoid smoking . Even short-term cessation reduces your susceptibility to motion sickness, the CDC says.
• Distract yourself with music, controlled breathing or aromatherapy (try mint or lavender). Sucking on a flavored lozenge (some experts recommend a hard ginger candy) may also help, the CDC says.
• While the CDC says the scientific data on acupressure for seasickness is lacking, it works for some. You can find wrist bands for motion sickness in many drugstores.

5. Burns and bites

A word of advice from Lucar and Chen: Don’t forget the SPF when packing for your cruise. A burn on vacation can ruin your fun in the sun  and  put you at higher risk for  skin cancer .

“Also, if you’re going to places that have a lot of insects and mosquitoes, make sure you wear your insect repellent so that you don’t get a bunch of bites, because we also are worried about malaria, dengue, chikungunya, Zika — those sorts of things — at ports of call,” Chen says.

Staying healthy:  Opt for a sunscreen with an SPF of at least 15, the CDC recommends, and be sure your bottle says “blocks UVA and UVB” or “broad spectrum” on the label.

When it comes to insect repellent, look for a spray that’s registered with the Environmental Protection Agency. Layering it with sunscreen? Put the repellent on second, over the sunscreen, the CDC advises.

To ease any health-related concerns you might have before booking a cruise, Kwiatkowski suggests using a travel agent who is a cruise line expert or contacting the cruise line to ask about their cleaning protocols and track record. “I know it sounds like a lot of work,” she says, “but travel is a big investment, and you really want to travel worry-free.”

Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.

Nicole Gill Council is a writer and editor of travel and diversity, equity and inclusion content for aarp.org. Previously, she was a digital planning manager and a news editor at  USA Today  and Gannett News Service, and a copy editor at the  Los Angeles Times  and  Newsday.​

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10 Things You Won’t Be Able to Do on Cruises Anymore

Get on board with these cruising changes.

I t seems like just yesterday that the cruise industry was shut down completely. Now, every cruise line has a full fleet of ships on the water, and they’re dropping COVID restrictions and testing requirements. In July, the CDC also stopped tracking COVID cases on ships. As a result, the demand for cruises has soared, with eager travelers booking their favorite cruises —from couples cruises and  singles cruises to family-friendly options . If you’re one of those travelers, you should be aware of a few cruising changes before you set sail.

While the changes directly related to the pandemic tend to get all the attention, they’re not the only ones you need to know about. Others may seem subtle in comparison, but they’re actually incredibly significant for passengers, as well as for the health of the planet. Here’s what you can expect, from what kind of cruise you can book to what you’ll be drinking once you’re on board. When you’re up to speed, this info on cruise ship code words , hidden cruise ship features and the  things polite people never do on cruises will also come in handy.

Use a plastic straw

The Muster Station, a popular website for cruise tips , has calculated that the average cruiser uses five straws per day. With around 420,000 people cruising at any given time, that means more than 2 million straws are used on cruise ships every day—which works out to 750 million every year! Now, most of the straws you’ll see on cruises won’t be plastic. In 2018, the Norwegian coastal cruise line Hurtigruten announced its plan to become the world’s first plastic-free cruise company. Since then Royal Caribbean has also eliminated plastic straws, as have Carnival and Disney.

While straws may seem like a small step, they’re an important one. Around 27 million tons of plastic goes to landfills every year, while more than 11 million tons ends up in the ocean, with as many as 8.3 billion plastic straws polluting the world’s beaches. You may also want to invest in your own reusable straws and add them to your cruise packing list .

Consult a paper daily planner

One of the tiny joys of cruising is returning to your cabin after dinner and a show to find a towel animal and tomorrow’s schedule of events printed and placed on the edge of your bed. This is what cruising on Carnival was like for decades, but last summer, their ships stopped distributing the Fun Times program, pushing guests toward its HUB app to access show times, events and daily schedules. While the paper version is no longer placed in rooms each night, you can get a pared-down version from Guest Services. Other ships on the best cruise lines are following suit, and while it’s an environmentally sound decision, some cruisers miss referring to a tangible schedule to plan their days.

Cruise to nowhere

Once upon a time, you could board a cruise ship and drift off to international waters for a few days without a destination on the itinerary or a port of call to be called upon. It was called a cruise to nowhere, and it was quite popular for a short, inexpensive and thoroughly relaxing getaway. This is something you will not be able to experience again on a cruise, unless the ship has an all-American crew, which isn’t the case on big lines like Carnival, Norwegian and Royal Caribbean.

The reasoning is complicated, but it has to do with the U.S. Department of Homeland Security attempting to better enforce immigration laws and working visas often held by cruise ship members. As a result, foreign-flagged ships (those registered in the Bahamas, for example) can no longer sail without stopping at a foreign port at some point on their itinerary. Instead of a cruise to nowhere, you can take short vacations at sea that make just one port stop, including some of these all-inclusive cruises .

Take pictures with a drone

While the photo opportunities on cruises are delicious, drones are now off-limits on most cruise ships for the safety of the captain, the ship itself, the crew and other passengers. In fact, Carnival just jumped on the anti-drone bandwagon in May 2022. “There have been some instances where these drones have caused problems,” Carnival brand ambassador John Heald explained on Facebook. “We also had one recently where a drone pilot crashed very close to the ship in a port.”

Drones are also restricted in many ports, including Florida’s Port Canaveral and Port Miami. If you’re caught flying a drone in these areas, you could be slapped with a $5,000 fine and your drone could be destroyed by local authorities. You may still be able to fly your drone on smaller ships, including some of the most scenic America river cruises , but check with the cruise line first.

Contribute to overtourism

Overtourism is one of the silent problems of the travel industry. Back in 2018 at an industry conference, top executives at two of the biggest cruise lines, Carnival and Royal Caribbean, announced they were working with local communities to gain more insight into the impact of cruise tourism on their cities, town, infrastructure, people and nature environments. Because of this, cruise lines are now partnering with destinations to stagger the number of visitors.

This is smart business for the cruise industry too, as no passenger wants to step off a port into an unmanageable crowd. The goal of the cruise industry is to make destinations, especially those in the islands and shore excursions offered there, more sustainable. Royal Caribbean, in fact, employs only locals in their private Labadee Haiti port of call. It also provides space for Haitian craftspeople to sell their wares, boosting the local economy and providing well-paying, long-lasting employment for hundreds on the island. Here are more ways you can be a sustainable traveler .

Drink from a single-use plastic bottle

Norwegian has eliminated single-use plastic bottles, which once numbered more than 6 million per year across their ships. Instead, they now use JUST Water, which comes in fully recyclable paper cartons with a sugarcane-based plastic cap. The cruise line is also making an effort to stop using plastic shampoo and conditioner bottles. These moves are part of the company’s Sail & Sustain Environmental Program, which aims to minimize waste sent to landfills, reduce carbon emissions and invest in technologies to reduce its environmental footprint. Princess Cruises is also taking  steps toward sustainability , eliminating plastic, Styrofoam, paper napkins and more from their ships and private resort destination, Princess Cays.

Leave your cabin lights on all day

Like most European hotels, many cruise ships now employ a key-card system to operate the lights and power outlets in their cabins. This environmental measure means that you will need to insert your room key when entering your cabin to be able to flip on the lights and charge your devices. When you leave and take your key out, the room goes dark and energy is conserved. You may want to bring along a portable charger to make sure your devices are fully powered up when you’re out and about.

Know that fellow passengers are vaccinated against COVID

Starting in September on select Royal Caribbean cruises, unvaccinated individuals will be permitted to cruise, though they may be required to take a test and receive a negative result before boarding. And Norwegian, Oceania and Regent Seven Seas will completely end vaccination requirements in September as well. Princess is also adjusting how it handles unvaccinated guests: “Unvaccinated travelers 5 years old and older on voyages less than 16 days will have to get a PCR test or perform a home rapid antigen test within three days of sailing and upload proof of that negative test before boarding.”

Assume that everyone has tested negative for COVID

Similarly, many lines are ending their previous pre-embarkation testing requirements. In July 2022, Virgin Voyages was the first to no longer require proof of a negative COVID test to board, and Norwegian and Royal Caribbean quickly followed. While cruise lines still encourage passengers to test if they feel sick , and not sail if positive, the requirement to show proof of a negative test is being eliminated en masse.

Cruise on a ship operating at half capacity

Vaccinated cruisers willing to wear a mask and be brave in the months after the cruising industry restarted in earnest in the summer of 2021 were treated to a rare experience: fully functioning ships with a full crew but a fraction of the passengers. This meant that travelers enjoyed wide, open promenades, no waits for restaurants, few lines at the buffet and easy access to theatrical shows, live music, art auctions and more. As the CDC eliminates its COVID-related cruising requirements, several companies—including Celebrity, Royal Caribbean and Virgin Voyages—have dropped their pandemic-era capacity restrictions. That means those ships won’t set sail with half or fewer of the maximum passenger load, and you won’t have the ship practically all to yourself. Still, on the best adults-only cruises, family cruises and more, you truly won’t mind.

Cruises see a fair amount of overboard incidents: Are ships equipped?

Mental health crises can happen anywhere. But what happens if you're stuck in the middle of the ocean?

Between 2009 and 2019, there were 212 overboard incidents – when a guest or crew member goes over the edge of a ship – according to  statistics compiled for Cruise Lines International Association  by consulting firm G.P. Wild (International) Limited. "In discussions with cruise line representatives, they indicated that in every case where the cause of the (overboard) was established following a careful investigation it was found to be the result of an intentional or reckless act," the report said, noting that motives could not be determined in some cases.

There were also numerous reports of suspected suicides among crew trapped at sea during the COVID-19 pandemic. And while cruise lines have protocols and services in place to support to guests and crew members, some experts say they are lacking.

Cruise ships feature a range of amenities, from roller coasters and go-kart tracks to spas and dining, but passengers may not always know where to find mental health resources on board.

‘It’s really, really, really needed’

Cruise ships may be designed to prioritize fun and relaxation, but not everyone responds the same to that approach.

For some passengers, being around family members or away from their day-to-day routine can be stressful, said Dr. Tia Dole, Chief 988 Suicide & Crisis Lifeline Officer at Vibrant Emotional Health. “But for other people who might have been struggling with their mental health … going on a vacation actually takes you out of your environment, it makes you feel better,” she said.

The widespread presence of alcohol and gambling in onboard casinos may also prove challenging for some travelers, said Dr. Michelle Riba, a clinical professor at the University of Michigan Medical School's Department of Psychiatry and former president of the American Psychiatric Association.

"People have to be self-reflective and talk to their loved ones about how problematic it might be to be on a ship where there's easy access to that," she said.

And when it comes to the kinds of overboard incidents that appear in news reports with some frequency, she said jumping into the water has perhaps been featured prominently in films and TV shows, and cruises may provide another "access point" to impulsive suicides.

Travis Heggie, a professor at Bowling Green State University who studies tourist health and safety issues, said it's difficult to draw concrete comparisons, however, between rates at sea and on land due to a lack of comprehensive statistics. Riba added that it would be hard to compare the two, given varying demographics and other factors.

Still, suicide on cruise ships is a “growing concern” for Heggie, among both guests and crew. He has recommended adding mental health care to cruise ship infirmaries in his research .

“It’s really, really, really needed,” he said.

Dole also emphasized that “the reasons why people die by suicide are as unique as a fingerprint” and said it’s important not to generalize.

"The circumstances that lead up to completed suicide, and the things that sort of push people over the edge are incredibly unique," she said.

Do cruise ships have mental health resources?

If passengers find themselves in need of mental health support during a cruise, some lines do have resources available.

Passengers sailing with Carnival Corp., the parent company of brands including Carnival Cruise Line, Princess Cruises and Holland America Line, can contact onboard medical staff “who are available 24/7 for mental health support and other medical needs,” a spokesperson for the company said in an email.

“With a referral from the shipboard medical team, guests may also access tele-psychiatrist services for face-to-face consultations with these licensed specialists within 24 hours if needed,” the spokesperson added. The consultations are offered through a third-party company that connects passengers with U.S.-based psychiatrists (the company did not respond to USA TODAY’s request for comment).

While training in mental health care varies among onboard medical staff, they can “fulfill recommendations made by the psychiatrists.” There is a pharmacy on board with many medications used to treat mental health problems, and those not carried on the vessel can be ordered in a port.

Like other medical care, passengers have to pay for any costs associated with mental health services. “Travel insurance coverage varies by provider and typically covers acute-need services but usually includes limitations for pre-existing illnesses,” the spokesperson said. “We urge travelers to contact travel insurance providers directly for specific terms and conditions.”

Crew members can also see psychiatrists via telehealth with a referral from the onboard medical team. The company also has an employee assistance program that allows them to access free mental health services.

Royal Caribbean Group, another major cruise line operator, and Cruise Lines International Association, the industry’s leading trade group, did not answer questions regarding onboard mental health resources before publishing. Norwegian Cruise Line Holdings Ltd. did not respond to a request for comment.

Cruise ships may also quarantine passengers deemed to be a threat to themselves or others, according to Michael Winkleman, a maritime attorney with Lipcon, Margulies & Winkleman, P.A.

“Our team of onboard medical professionals safeguards the health and well-being of our guests and crew (including mental health), which may include placing a patient under secure watch in the medical center or in a cabin depending on the risk,” the Carnival Corp. spokesperson said.

While there are major differences – namely, being in the middle of the ocean – Winkleman said there are some commonalities between cruise lines’ approach and that of hotels or resorts, which often do not have on-site mental health providers. “They are just expecting to provide a fun, safe vacation for their guests,” he said.

Crises on cruises, like an overboard incident, for example, may also get outsized attention given their setting, Heggie added. "People are expecting to go and have a good time and have the vacation or holiday mindset, and, 'Oh, something bad happened.' "

However, Winkleman said he thinks cruise lines “could do a lot more” to provide mental health support to crew, many of whom work rigorous schedules on months-long contracts.

How passengers can care for their mental health

Travelers can take proactive steps to care for their mental health before a trip if need be. If passengers have a mental health provider, Dole recommends speaking with them beforehand and making sure they have any medication they might need.

Passengers can also reach out to their therapists mid-cruise to schedule a session as needed – though state laws regarding telehealth vary and could prevent them from accessing care. “But generally speaking, it's really about where the person resides,” Dole said. “So (if) you're on a work trip, and you're like, ‘I need to see my therapist,’ they'll see you.”

Riba noted that it may be more difficult to coordinate than at home with spotty cell service and possible time differences.

The 9-8-8 Suicide & Crisis Lifeline also works in U.S. states as well as territories like Puerto Rico and the U.S. Virgin Islands.

How safe are cruise stops?: Travel advisories are only one marker for destinations

Checking in with your fellow travelers can also be helpful. Dole said, “One of the biggest clues someone is struggling” is a change in behavior. Typically, that takes the form of withdrawal, but it could also manifest in people engaging in risky or dangerous behaviors.

“‘I noticed something is different,’” she suggested saying. “‘Is there something happening that you feel comfortable talking to me about?’ And that that's not going to make people be defensive as much as, ‘What's wrong? Are you okay? What's happening?’”

Dole recommended framing the question in a way that avoids sounding judgmental or accusatory. “But actually asking the question, especially for young people, can save someone's life,” she said.

If you or someone you know may be struggling with suicidal thoughts, you can call  988  any time day or night, or chat online.   Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.

Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. You can reach him at [email protected].

Crying Myself to Sleep on the Biggest Cruise Ship Ever

Seven agonizing nights aboard the Icon of the Seas

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MY FIRST GLIMPSE of Royal Caribbean’s Icon of the Seas, from the window of an approaching Miami cab, brings on a feeling of vertigo, nausea, amazement, and distress. I shut my eyes in defense, as my brain tells my optical nerve to try again.

The ship makes no sense, vertically or horizontally. It makes no sense on sea, or on land, or in outer space. It looks like a hodgepodge of domes and minarets, tubes and canopies, like Istanbul had it been designed by idiots. Vibrant, oversignifying colors are stacked upon other such colors, decks perched over still more decks; the only comfort is a row of lifeboats ringing its perimeter. There is no imposed order, no cogent thought, and, for those who do not harbor a totalitarian sense of gigantomania, no visual mercy. This is the biggest cruise ship ever built, and I have been tasked with witnessing its inaugural voyage.

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“Author embarks on their first cruise-ship voyage” has been a staple of American essay writing for almost three decades, beginning with David Foster Wallace’s “A Supposedly Fun Thing I’ll Never Do Again,” which was first published in 1996 under the title “Shipping Out.” Since then, many admirable writers have widened and diversified the genre. Usually the essayist commissioned to take to the sea is in their first or second flush of youth and is ready to sharpen their wit against the hull of the offending vessel. I am 51, old and tired, having seen much of the world as a former travel journalist, and mostly what I do in both life and prose is shrug while muttering to my imaginary dachshund, “This too shall pass.” But the Icon of the Seas will not countenance a shrug. The Icon of the Seas is the Linda Loman of cruise ships, exclaiming that attention must be paid. And here I am in late January with my one piece of luggage and useless gray winter jacket and passport, zipping through the Port of Miami en route to the gangway that will separate me from the bulk of North America for more than seven days, ready to pay it in full.

The aforementioned gangway opens up directly onto a thriving mall (I will soon learn it is imperiously called the “Royal Promenade”), presently filled with yapping passengers beneath a ceiling studded with balloons ready to drop. Crew members from every part of the global South, as well as a few Balkans, are shepherding us along while pressing flutes of champagne into our hands. By a humming Starbucks, I drink as many of these as I can and prepare to find my cabin. I show my blue Suite Sky SeaPass Card (more on this later, much more) to a smiling woman from the Philippines, and she tells me to go “aft.” Which is where, now? As someone who has rarely sailed on a vessel grander than the Staten Island Ferry, I am confused. It turns out that the aft is the stern of the ship, or, for those of us who don’t know what a stern or an aft are, its ass. The nose of the ship, responsible for separating the waves before it, is also called a bow, and is marked for passengers as the FWD , or forward. The part of the contemporary sailing vessel where the malls are clustered is called the midship. I trust that you have enjoyed this nautical lesson.

I ascend via elevator to my suite on Deck 11. This is where I encounter my first terrible surprise. My suite windows and balcony do not face the ocean. Instead, they look out onto another shopping mall. This mall is the one that’s called Central Park, perhaps in homage to the Olmsted-designed bit of greenery in the middle of my hometown. Although on land I would be delighted to own a suite with Central Park views, here I am deeply depressed. To sail on a ship and not wake up to a vast blue carpet of ocean? Unthinkable.

Allow me a brief preamble here. The story you are reading was commissioned at a moment when most staterooms on the Icon were sold out. In fact, so enthralled by the prospect of this voyage were hard-core mariners that the ship’s entire inventory of guest rooms (the Icon can accommodate up to 7,600 passengers, but its inaugural journey was reduced to 5,000 or so for a less crowded experience) was almost immediately sold out. Hence, this publication was faced with the shocking prospect of paying nearly $19,000 to procure for this solitary passenger an entire suite—not including drinking expenses—all for the privilege of bringing you this article. But the suite in question doesn’t even have a view of the ocean! I sit down hard on my soft bed. Nineteen thousand dollars for this .

The viewless suite does have its pluses. In addition to all the Malin+Goetz products in my dual bathrooms, I am granted use of a dedicated Suite Deck lounge; access to Coastal Kitchen, a superior restaurant for Suites passengers; complimentary VOOM SM Surf & Stream (“the fastest Internet at Sea”) “for one device per person for the whole cruise duration”; a pair of bathrobes (one of which comes prestained with what looks like a large expectoration by the greenest lizard on Earth); and use of the Grove Suite Sun, an area on Decks 18 and 19 with food and deck chairs reserved exclusively for Suite passengers. I also get reserved seating for a performance of The Wizard of Oz , an ice-skating tribute to the periodic table, and similar provocations. The very color of my Suite Sky SeaPass Card, an oceanic blue as opposed to the cloying royal purple of the standard non-Suite passenger, will soon provoke envy and admiration. But as high as my status may be, there are those on board who have much higher status still, and I will soon learn to bow before them.

In preparation for sailing, I have “priced in,” as they say on Wall Street, the possibility that I may come from a somewhat different monde than many of the other cruisers. Without falling into stereotypes or preconceptions, I prepare myself for a friendly outspokenness on the part of my fellow seafarers that may not comply with modern DEI standards. I believe in meeting people halfway, and so the day before flying down to Miami, I visited what remains of Little Italy to purchase a popular T-shirt that reads DADDY’S LITTLE MEATBALL across the breast in the colors of the Italian flag. My wife recommended that I bring one of my many T-shirts featuring Snoopy and the Peanuts gang, as all Americans love the beagle and his friends. But I naively thought that my meatball T-shirt would be more suitable for conversation-starting. “Oh, and who is your ‘daddy’?” some might ask upon seeing it. “And how long have you been his ‘little meatball’?” And so on.

I put on my meatball T-shirt and head for one of the dining rooms to get a late lunch. In the elevator, I stick out my chest for all to read the funny legend upon it, but soon I realize that despite its burnished tricolor letters, no one takes note. More to the point, no one takes note of me. Despite my attempts at bridge building, the very sight of me (small, ethnic, without a cap bearing the name of a football team) elicits no reaction from other passengers. Most often, they will small-talk over me as if I don’t exist. This brings to mind the travails of David Foster Wallace , who felt so ostracized by his fellow passengers that he retreated to his cabin for much of his voyage. And Wallace was raised primarily in the Midwest and was a much larger, more American-looking meatball than I am. If he couldn’t talk to these people, how will I? What if I leave this ship without making any friends at all, despite my T-shirt? I am a social creature, and the prospect of seven days alone and apart is saddening. Wallace’s stateroom, at least, had a view of the ocean, a kind of cheap eternity.

Worse awaits me in the dining room. This is a large, multichandeliered room where I attended my safety training (I was shown how to put on a flotation vest; it is a very simple procedure). But the maître d’ politely refuses me entry in an English that seems to verge on another language. “I’m sorry, this is only for pendejos ,” he seems to be saying. I push back politely and he repeats himself. Pendejos ? Piranhas? There’s some kind of P-word to which I am not attuned. Meanwhile elderly passengers stream right past, powered by their limbs, walkers, and electric wheelchairs. “It is only pendejo dining today, sir.” “But I have a suite!” I say, already starting to catch on to the ship’s class system. He examines my card again. “But you are not a pendejo ,” he confirms. I am wearing a DADDY’S LITTLE MEATBALL T-shirt, I want to say to him. I am the essence of pendejo .

Eventually, I give up and head to the plebeian buffet on Deck 15, which has an aquatic-styled name I have now forgotten. Before gaining entry to this endless cornucopia of reheated food, one passes a washing station of many sinks and soap dispensers, and perhaps the most intriguing character on the entire ship. He is Mr. Washy Washy—or, according to his name tag, Nielbert of the Philippines—and he is dressed as a taco (on other occasions, I’ll see him dressed as a burger). Mr. Washy Washy performs an eponymous song in spirited, indeed flamboyant English: “Washy, washy, wash your hands, WASHY WASHY!” The dangers of norovirus and COVID on a cruise ship this size (a giant fellow ship was stricken with the former right after my voyage) makes Mr. Washy Washy an essential member of the crew. The problem lies with the food at the end of Washy’s rainbow. The buffet is groaning with what sounds like sophisticated dishes—marinated octopus, boiled egg with anchovy, chorizo, lobster claws—but every animal tastes tragically the same, as if there was only one creature available at the market, a “cruisipus” bred specifically for Royal Caribbean dining. The “vegetables” are no better. I pick up a tomato slice and look right through it. It tastes like cellophane. I sit alone, apart from the couples and parents with gaggles of children, as “We Are Family” echoes across the buffet space.

I may have failed to mention that all this time, the Icon of the Seas has not left port. As the fiery mango of the subtropical setting sun makes Miami’s condo skyline even more apocalyptic, the ship shoves off beneath a perfunctory display of fireworks. After the sun sets, in the far, dark distance, another circus-lit cruise ship ruptures the waves before us. We glance at it with pity, because it is by definition a smaller ship than our own. I am on Deck 15, outside the buffet and overlooking a bunch of pools (the Icon has seven of them), drinking a frilly drink that I got from one of the bars (the Icon has 15 of them), still too shy to speak to anyone, despite Sister Sledge’s assertion that all on the ship are somehow related.

Kim Brooks: On failing the family vacation

The ship’s passage away from Ron DeSantis’s Florida provides no frisson, no sense of developing “sea legs,” as the ship is too large to register the presence of waves unless a mighty wind adds significant chop. It is time for me to register the presence of the 5,000 passengers around me, even if they refuse to register mine. My fellow travelers have prepared for this trip with personally decorated T-shirts celebrating the importance of this voyage. The simplest ones say ICON INAUGURAL ’24 on the back and the family name on the front. Others attest to an over-the-top love of cruise ships: WARNING! MAY START TALKING ABOUT CRUISING . Still others are artisanally designed and celebrate lifetimes spent married while cruising (on ships, of course). A couple possibly in their 90s are wearing shirts whose backs feature a drawing of a cruise liner, two flamingos with ostensibly male and female characteristics, and the legend “ HUSBAND AND WIFE Cruising Partners FOR LIFE WE MAY NOT HAVE IT All Together BUT TOGETHER WE HAVE IT ALL .” (The words not in all caps have been written in cursive.) A real journalist or a more intrepid conversationalist would have gone up to the couple and asked them to explain the longevity of their marriage vis-à-vis their love of cruising. But instead I head to my mall suite, take off my meatball T-shirt, and allow the first tears of the cruise to roll down my cheeks slowly enough that I briefly fall asleep amid the moisture and salt.

I WAKE UP with a hangover. Oh God. Right. I cannot believe all of that happened last night. A name floats into my cobwebbed, nauseated brain: “Ayn Rand.” Jesus Christ.

I breakfast alone at the Coastal Kitchen. The coffee tastes fine and the eggs came out of a bird. The ship rolls slightly this morning; I can feel it in my thighs and my schlong, the parts of me that are most receptive to danger.

I had a dangerous conversation last night. After the sun set and we were at least 50 miles from shore (most modern cruise ships sail at about 23 miles an hour), I lay in bed softly hiccupping, my arms stretched out exactly like Jesus on the cross, the sound of the distant waves missing from my mall-facing suite, replaced by the hum of air-conditioning and children shouting in Spanish through the vents of my two bathrooms. I decided this passivity was unacceptable. As an immigrant, I feel duty-bound to complete the tasks I am paid for, which means reaching out and trying to understand my fellow cruisers. So I put on a normal James Perse T-shirt and headed for one of the bars on the Royal Promenade—the Schooner Bar, it was called, if memory serves correctly.

I sat at the bar for a martini and two Negronis. An old man with thick, hairy forearms drank next to me, very silent and Hemingwaylike, while a dreadlocked piano player tinkled out a series of excellent Elton John covers. To my right, a young white couple—he in floral shorts, she in a light, summery miniskirt with a fearsome diamond ring, neither of them in football regalia—chatted with an elderly couple. Do it , I commanded myself. Open your mouth. Speak! Speak without being spoken to. Initiate. A sentence fragment caught my ear from the young woman, “Cherry Hill.” This is a suburb of Philadelphia in New Jersey, and I had once been there for a reading at a synagogue. “Excuse me,” I said gently to her. “Did you just mention Cherry Hill? It’s a lovely place.”

As it turned out, the couple now lived in Fort Lauderdale (the number of Floridians on the cruise surprised me, given that Southern Florida is itself a kind of cruise ship, albeit one slowly sinking), but soon they were talking with me exclusively—the man potbellied, with a chin like a hard-boiled egg; the woman as svelte as if she were one of the many Ukrainian members of the crew—the elderly couple next to them forgotten. This felt as groundbreaking as the first time I dared to address an American in his native tongue, as a child on a bus in Queens (“On my foot you are standing, Mister”).

“I don’t want to talk politics,” the man said. “But they’re going to eighty-six Biden and put Michelle in.”

I considered the contradictions of his opening conversational gambit, but decided to play along. “People like Michelle,” I said, testing the waters. The husband sneered, but the wife charitably put forward that the former first lady was “more personable” than Joe Biden. “They’re gonna eighty-six Biden,” the husband repeated. “He can’t put a sentence together.”

After I mentioned that I was a writer—though I presented myself as a writer of teleplays instead of novels and articles such as this one—the husband told me his favorite writer was Ayn Rand. “Ayn Rand, she came here with nothing,” the husband said. “I work with a lot of Cubans, so …” I wondered if I should mention what I usually do to ingratiate myself with Republicans or libertarians: the fact that my finances improved after pass-through corporations were taxed differently under Donald Trump. Instead, I ordered another drink and the couple did the same, and I told him that Rand and I were born in the same city, St. Petersburg/Leningrad, and that my family also came here with nothing. Now the bonding and drinking began in earnest, and several more rounds appeared. Until it all fell apart.

Read: Gary Shteyngart on watching Russian television for five days straight

My new friend, whom I will refer to as Ayn, called out to a buddy of his across the bar, and suddenly a young couple, both covered in tattoos, appeared next to us. “He fucking punked me,” Ayn’s frat-boy-like friend called out as he put his arm around Ayn, while his sizable partner sizzled up to Mrs. Rand. Both of them had a look I have never seen on land—their eyes projecting absence and enmity in equal measure. In the ’90s, I drank with Russian soldiers fresh from Chechnya and wandered the streets of wartime Zagreb, but I have never seen such undisguised hostility toward both me and perhaps the universe at large. I was briefly introduced to this psychopathic pair, but neither of them wanted to have anything to do with me, and the tattooed woman would not even reveal her Christian name to me (she pretended to have the same first name as Mrs. Rand). To impress his tattooed friends, Ayn made fun of the fact that as a television writer, I’d worked on the series Succession (which, it would turn out, practically nobody on the ship had watched), instead of the far more palatable, in his eyes, zombie drama of last year. And then my new friends drifted away from me into an angry private conversation—“He punked me!”—as I ordered another drink for myself, scared of the dead-eyed arrivals whose gaze never registered in the dim wattage of the Schooner Bar, whose terrifying voices and hollow laughs grated like unoiled gears against the crooning of “Goodbye Yellow Brick Road.”

But today is a new day for me and my hangover. After breakfast, I explore the ship’s so-called neighborhoods . There’s the AquaDome, where one can find a food hall and an acrobatic sound-and-light aquatic show. Central Park has a premium steak house, a sushi joint, and a used Rolex that can be bought for $8,000 on land here proudly offered at $17,000. There’s the aforementioned Royal Promenade, where I had drunk with the Rands, and where a pair of dueling pianos duel well into the night. There’s Surfside, a kids’ neighborhood full of sugary garbage, which looks out onto the frothy trail that the behemoth leaves behind itself. Thrill Island refers to the collection of tubes that clutter the ass of the ship and offer passengers six waterslides and a surfing simulation. There’s the Hideaway, an adult zone that plays music from a vomit-slathered, Brit-filled Alicante nightclub circa 1996 and proves a big favorite with groups of young Latin American customers. And, most hurtfully, there’s the Suite Neighborhood.

I say hurtfully because as a Suite passenger I should be here, though my particular suite is far from the others. Whereas I am stuck amid the riffraff of Deck 11, this section is on the highborn Decks 16 and 17, and in passing, I peek into the spacious, tall-ceilinged staterooms from the hallway, dazzled by the glint of the waves and sun. For $75,000, one multifloor suite even comes with its own slide between floors, so that a family may enjoy this particular terror in private. There is a quiet splendor to the Suite Neighborhood. I see fewer stickers and signs and drawings than in my own neighborhood—for example, MIKE AND DIANA PROUDLY SERVED U.S. MARINE CORPS RETIRED . No one here needs to announce their branch of service or rank; they are simply Suites, and this is where they belong. Once again, despite my hard work and perseverance, I have been disallowed from the true American elite. Once again, I am “Not our class, dear.” I am reminded of watching The Love Boat on my grandmother’s Zenith, which either was given to her or we found in the trash (I get our many malfunctioning Zeniths confused) and whose tube got so hot, I would put little chunks of government cheese on a thin tissue atop it to give our welfare treat a pleasant, Reagan-era gooeyness. I could not understand English well enough then to catch the nuances of that seafaring program, but I knew that there were differences in the status of the passengers, and that sometimes those differences made them sad. Still, this ship, this plenty—every few steps, there are complimentary nachos or milkshakes or gyros on offer—was the fatty fuel of my childhood dreams. If only I had remained a child.

I walk around the outdoor decks looking for company. There is a middle-aged African American couple who always seem to be asleep in each other’s arms, probably exhausted from the late capitalism they regularly encounter on land. There is far more diversity on this ship than I expected. Many couples are a testament to Loving v. Virginia , and there is a large group of folks whose T-shirts read MELANIN AT SEA / IT’S THE MELANIN FOR ME . I smile when I see them, but then some young kids from the group makes Mr. Washy Washy do a cruel, caricatured “Burger Dance” (today he is in his burger getup), and I think, Well, so much for intersectionality .

At the infinity pool on Deck 17, I spot some elderly women who could be ethnic and from my part of the world, and so I jump in. I am proved correct! Many of them seem to be originally from Queens (“Corona was still great when it was all Italian”), though they are now spread across the tristate area. We bond over the way “Ron-kon-koma” sounds when announced in Penn Station.

“Everyone is here for a different reason,” one of them tells me. She and her ex-husband last sailed together four years ago to prove to themselves that their marriage was truly over. Her 15-year-old son lost his virginity to “an Irish young lady” while their ship was moored in Ravenna, Italy. The gaggle of old-timers competes to tell me their favorite cruising stories and tips. “A guy proposed in Central Park a couple of years ago”—many Royal Caribbean ships apparently have this ridiculous communal area—“and she ran away screaming!” “If you’re diamond-class, you get four drinks for free.” “A different kind of passenger sails out of Bayonne.” (This, perhaps, is racially coded.) “Sometimes, if you tip the bartender $5, your next drink will be free.”

“Everyone’s here for a different reason,” the woman whose marriage ended on a cruise tells me again. “Some people are here for bad reasons—the drinkers and the gamblers. Some people are here for medical reasons.” I have seen more than a few oxygen tanks and at least one woman clearly undergoing very serious chemo. Some T-shirts celebrate good news about a cancer diagnosis. This might be someone’s last cruise or week on Earth. For these women, who have spent months, if not years, at sea, cruising is a ritual as well as a life cycle: first love, last love, marriage, divorce, death.

Read: The last place on Earth any tourist should go

I have talked with these women for so long, tonight I promise myself that after a sad solitary dinner I will not try to seek out company at the bars in the mall or the adult-themed Hideaway. I have enough material to fulfill my duties to this publication. As I approach my orphaned suite, I run into the aggro young people who stole Mr. and Mrs. Rand away from me the night before. The tattooed apparitions pass me without a glance. She is singing something violent about “Stuttering Stanley” (a character in a popular horror movie, as I discover with my complimentary VOOM SM Surf & Stream Internet at Sea) and he’s loudly shouting about “all the money I’ve lost,” presumably at the casino in the bowels of the ship.

So these bent psychos out of a Cormac McCarthy novel are angrily inhabiting my deck. As I mewl myself to sleep, I envision a limited series for HBO or some other streamer, a kind of low-rent White Lotus , where several aggressive couples conspire to throw a shy intellectual interloper overboard. I type the scenario into my phone. As I fall asleep, I think of what the woman who recently divorced her husband and whose son became a man through the good offices of the Irish Republic told me while I was hoisting myself out of the infinity pool. “I’m here because I’m an explorer. I’m here because I’m trying something new.” What if I allowed myself to believe in her fantasy?

“YOU REALLY STARTED AT THE TOP,” they tell me. I’m at the Coastal Kitchen for my eggs and corned-beef hash, and the maître d’ has slotted me in between two couples. Fueled by coffee or perhaps intrigued by my relative youth, they strike up a conversation with me. As always, people are shocked that this is my first cruise. They contrast the Icon favorably with all the preceding liners in the Royal Caribbean fleet, usually commenting on the efficiency of the elevators that hurl us from deck to deck (as in many large corporate buildings, the elevators ask you to choose a floor and then direct you to one of many lifts). The couple to my right, from Palo Alto—he refers to his “porn mustache” and calls his wife “my cougar” because she is two years older—tell me they are “Pandemic Pinnacles.”

This is the day that my eyes will be opened. Pinnacles , it is explained to me over translucent cantaloupe, have sailed with Royal Caribbean for 700 ungodly nights. Pandemic Pinnacles took advantage of the two-for-one accrual rate of Pinnacle points during the pandemic, when sailing on a cruise ship was even more ill-advised, to catapult themselves into Pinnacle status.

Because of the importance of the inaugural voyage of the world’s largest cruise liner, more than 200 Pinnacles are on this ship, a startling number, it seems. Mrs. Palo Alto takes out a golden badge that I have seen affixed over many a breast, which reads CROWN AND ANCHOR SOCIETY along with her name. This is the coveted badge of the Pinnacle. “You should hear all the whining in Guest Services,” her husband tells me. Apparently, the Pinnacles who are not also Suites like us are all trying to use their status to get into Coastal Kitchen, our elite restaurant. Even a Pinnacle needs to be a Suite to access this level of corned-beef hash.

“We’re just baby Pinnacles,” Mrs. Palo Alto tells me, describing a kind of internal class struggle among the Pinnacle elite for ever higher status.

And now I understand what the maître d’ was saying to me on the first day of my cruise. He wasn’t saying “ pendejo .” He was saying “Pinnacle.” The dining room was for Pinnacles only, all those older people rolling in like the tide on their motorized scooters.

And now I understand something else: This whole thing is a cult. And like most cults, it can’t help but mirror the endless American fight for status. Like Keith Raniere’s NXIVM, where different-colored sashes were given out to connote rank among Raniere’s branded acolytes, this is an endless competition among Pinnacles, Suites, Diamond-Plusers, and facing-the-mall, no-balcony purple SeaPass Card peasants, not to mention the many distinctions within each category. The more you cruise, the higher your status. No wonder a section of the Royal Promenade is devoted to getting passengers to book their next cruise during the one they should be enjoying now. No wonder desperate Royal Caribbean offers (“FINAL HOURS”) crowded my email account weeks before I set sail. No wonder the ship’s jewelry store, the Royal Bling, is selling a $100,000 golden chalice that will entitle its owner to drink free on Royal Caribbean cruises for life. (One passenger was already gaming out whether her 28-year-old son was young enough to “just about earn out” on the chalice or if that ship had sailed.) No wonder this ship was sold out months before departure , and we had to pay $19,000 for a horrid suite away from the Suite Neighborhood. No wonder the most mythical hero of Royal Caribbean lore is someone named Super Mario, who has cruised so often, he now has his own working desk on many ships. This whole experience is part cult, part nautical pyramid scheme.

From the June 2014 issue: Ship of wonks

“The toilets are amazing,” the Palo Altos are telling me. “One flush and you’re done.” “They don’t understand how energy-efficient these ships are,” the husband of the other couple is telling me. “They got the LNG”—liquefied natural gas, which is supposed to make the Icon a boon to the environment (a concept widely disputed and sometimes ridiculed by environmentalists).

But I’m thinking along a different line of attack as I spear my last pallid slice of melon. For my streaming limited series, a Pinnacle would have to get killed by either an outright peasant or a Suite without an ocean view. I tell my breakfast companions my idea.

“Oh, for sure a Pinnacle would have to be killed,” Mr. Palo Alto, the Pandemic Pinnacle, says, touching his porn mustache thoughtfully as his wife nods.

“THAT’S RIGHT, IT’S your time, buddy!” Hubert, my fun-loving Panamanian cabin attendant, shouts as I step out of my suite in a robe. “Take it easy, buddy!”

I have come up with a new dressing strategy. Instead of trying to impress with my choice of T-shirts, I have decided to start wearing a robe, as one does at a resort property on land, with a proper spa and hammam. The response among my fellow cruisers has been ecstatic. “Look at you in the robe!” Mr. Rand cries out as we pass each other by the Thrill Island aqua park. “You’re living the cruise life! You know, you really drank me under the table that night.” I laugh as we part ways, but my soul cries out, Please spend more time with me, Mr. and Mrs. Rand; I so need the company .

In my white robe, I am a stately presence, a refugee from a better limited series, a one-man crossover episode. (Only Suites are granted these robes to begin with.) Today, I will try many of the activities these ships have on offer to provide their clientele with a sense of never-ceasing motion. Because I am already at Thrill Island, I decide to climb the staircase to what looks like a mast on an old-fashioned ship (terrified, because I am afraid of heights) to try a ride called “Storm Chasers,” which is part of the “Category 6” water park, named in honor of one of the storms that may someday do away with the Port of Miami entirely. Storm Chasers consists of falling from the “mast” down a long, twisting neon tube filled with water, like being the camera inside your own colonoscopy, as you hold on to the handles of a mat, hoping not to die. The tube then flops you down headfirst into a trough of water, a Royal Caribbean baptism. It both knocks my breath out and makes me sad.

In keeping with the aquatic theme, I attend a show at the AquaDome. To the sound of “Live and Let Die,” a man in a harness gyrates to and fro in the sultry air. I saw something very similar in the back rooms of the famed Berghain club in early-aughts Berlin. Soon another harnessed man is gyrating next to the first. Ja , I think to myself, I know how this ends. Now will come the fisting , natürlich . But the show soon devolves into the usual Marvel-film-grade nonsense, with too much light and sound signifying nichts . If any fisting is happening, it is probably in the Suite Neighborhood, inside a cabin marked with an upside-down pineapple, which I understand means a couple are ready to swing, and I will see none of it.

I go to the ice show, which is a kind of homage—if that’s possible—to the periodic table, done with the style and pomp and masterful precision that would please the likes of Kim Jong Un, if only he could afford Royal Caribbean talent. At one point, the dancers skate to the theme song of Succession . “See that!” I want to say to my fellow Suites—at “cultural” events, we have a special section reserved for us away from the commoners—“ Succession ! It’s even better than the zombie show! Open your minds!”

Finally, I visit a comedy revue in an enormous and too brightly lit version of an “intimate,” per Royal Caribbean literature, “Manhattan comedy club.” Many of the jokes are about the cruising life. “I’ve lived on ships for 20 years,” one of the middle-aged comedians says. “I can only see so many Filipino homosexuals dressed as a taco.” He pauses while the audience laughs. “I am so fired tonight,” he says. He segues into a Trump impression and then Biden falling asleep at the microphone, which gets the most laughs. “Anyone here from Fort Leonard Wood?” another comedian asks. Half the crowd seems to cheer. As I fall asleep that night, I realize another connection I have failed to make, and one that may explain some of the diversity on this vessel—many of its passengers have served in the military.

As a coddled passenger with a suite, I feel like I am starting to understand what it means to have a rank and be constantly reminded of it. There are many espresso makers , I think as I look across the expanse of my officer-grade quarters before closing my eyes, but this one is mine .

A shocking sight greets me beyond the pools of Deck 17 as I saunter over to the Coastal Kitchen for my morning intake of slightly sour Americanos. A tiny city beneath a series of perfectly pressed green mountains. Land! We have docked for a brief respite in Basseterre, the capital of St. Kitts and Nevis. I wolf down my egg scramble to be one of the first passengers off the ship. Once past the gangway, I barely refrain from kissing the ground. I rush into the sights and sounds of this scruffy island city, sampling incredible conch curry and buckets of non-Starbucks coffee. How wonderful it is to be where God intended humans to be: on land. After all, I am neither a fish nor a mall rat. This is my natural environment. Basseterre may not be Havana, but there are signs of human ingenuity and desire everywhere you look. The Black Table Grill Has been Relocated to Soho Village, Market Street, Directly Behind of, Gary’s Fruits and Flower Shop. Signed. THE PORK MAN reads a sign stuck to a wall. Now, that is how you write a sign. A real sign, not the come-ons for overpriced Rolexes that blink across the screens of the Royal Promenade.

“Hey, tie your shoestring!” a pair of laughing ladies shout to me across the street.

“Thank you!” I shout back. Shoestring! “Thank you very much.”

A man in Independence Square Park comes by and asks if I want to play with his monkey. I haven’t heard that pickup line since the Penn Station of the 1980s. But then he pulls a real monkey out of a bag. The monkey is wearing a diaper and looks insane. Wonderful , I think, just wonderful! There is so much life here. I email my editor asking if I can remain on St. Kitts and allow the Icon to sail off into the horizon without me. I have even priced a flight home at less than $300, and I have enough material from the first four days on the cruise to write the entire story. “It would be funny …” my editor replies. “Now get on the boat.”

As I slink back to the ship after my brief jailbreak, the locals stand under umbrellas to gaze at and photograph the boat that towers over their small capital city. The limousines of the prime minister and his lackeys are parked beside the gangway. St. Kitts, I’ve been told, is one of the few islands that would allow a ship of this size to dock.

“We hear about all the waterslides,” a sweet young server in one of the cafés told me. “We wish we could go on the ship, but we have to work.”

“I want to stay on your island,” I replied. “I love it here.”

But she didn’t understand how I could possibly mean that.

“WASHY, WASHY, so you don’t get stinky, stinky!” kids are singing outside the AquaDome, while their adult minders look on in disapproval, perhaps worried that Mr. Washy Washy is grooming them into a life of gayness. I heard a southern couple skip the buffet entirely out of fear of Mr. Washy Washy.

Meanwhile, I have found a new watering hole for myself, the Swim & Tonic, the biggest swim-up bar on any cruise ship in the world. Drinking next to full-size, nearly naked Americans takes away one’s own self-consciousness. The men have curvaceous mom bodies. The women are equally un-shy about their sprawling physiques.

Today I’ve befriended a bald man with many children who tells me that all of the little trinkets that Royal Caribbean has left us in our staterooms and suites are worth a fortune on eBay. “Eighty dollars for the water bottle, 60 for the lanyard,” the man says. “This is a cult.”

“Tell me about it,” I say. There is, however, a clientele for whom this cruise makes perfect sense. For a large middle-class family (he works in “supply chains”), seven days in a lower-tier cabin—which starts at $1,800 a person—allow the parents to drop off their children in Surfside, where I imagine many young Filipina crew members will take care of them, while the parents are free to get drunk at a swim-up bar and maybe even get intimate in their cabin. Cruise ships have become, for a certain kind of hardworking family, a form of subsidized child care.

There is another man I would like to befriend at the Swim & Tonic, a tall, bald fellow who is perpetually inebriated and who wears a necklace studded with little rubber duckies in sunglasses, which, I am told, is a sort of secret handshake for cruise aficionados. Tomorrow, I will spend more time with him, but first the ship docks at St. Thomas, in the U.S. Virgin Islands. Charlotte Amalie, the capital, is more charming in name than in presence, but I still all but jump off the ship to score a juicy oxtail and plantains at the well-known Petite Pump Room, overlooking the harbor. From one of the highest points in the small city, the Icon of the Seas appears bigger than the surrounding hills.

I usually tan very evenly, but something about the discombobulation of life at sea makes me forget the regular application of sunscreen. As I walk down the streets of Charlotte Amalie in my fluorescent Icon of the Seas cap, an old Rastafarian stares me down. “Redneck,” he hisses.

“No,” I want to tell him, as I bring a hand up to my red neck, “that’s not who I am at all. On my island, Mannahatta, as Whitman would have it, I am an interesting person living within an engaging artistic milieu. I do not wish to use the Caribbean as a dumping ground for the cruise-ship industry. I love the work of Derek Walcott. You don’t understand. I am not a redneck. And if I am, they did this to me.” They meaning Royal Caribbean? Its passengers? The Rands?

“They did this to me!”

Back on the Icon, some older matrons are muttering about a run-in with passengers from the Celebrity cruise ship docked next to us, the Celebrity Apex. Although Celebrity Cruises is also owned by Royal Caribbean, I am made to understand that there is a deep fratricidal beef between passengers of the two lines. “We met a woman from the Apex,” one matron says, “and she says it was a small ship and there was nothing to do. Her face was as tight as a 19-year-old’s, she had so much surgery.” With those words, and beneath a cloudy sky, humidity shrouding our weathered faces and red necks, we set sail once again, hopefully in the direction of home.

THERE ARE BARELY 48 HOURS LEFT to the cruise, and the Icon of the Seas’ passengers are salty. They know how to work the elevators. They know the Washy Washy song by heart. They understand that the chicken gyro at “Feta Mediterranean,” in the AquaDome Market, is the least problematic form of chicken on the ship.

The passengers have shed their INAUGURAL CRUISE T-shirts and are now starting to evince political opinions. There are caps pledging to make America great again and T-shirts that celebrate words sometimes attributed to Patrick Henry: “The Constitution is not an instrument for the government to restrain the people; it is an instrument for the people to restrain the government.” With their preponderance of FAMILY FLAG FAITH FRIENDS FIREARMS T-shirts, the tables by the crepe station sometimes resemble the Capitol Rotunda on January 6. The Real Anthony Fauci , by Robert F. Kennedy Jr., appears to be a popular form of literature, especially among young men with very complicated versions of the American flag on their T-shirts. Other opinions blend the personal and the political. “Someone needs to kill Washy guy, right?” a well-dressed man in the elevator tells me, his gray eyes radiating nothing. “Just beat him to death. Am I right?” I overhear the male member of a young couple whisper, “There goes that freak” as I saunter by in my white spa robe, and I decide to retire it for the rest of the cruise.

I visit the Royal Bling to see up close the $100,000 golden chalice that entitles you to free drinks on Royal Caribbean forever. The pleasant Serbian saleslady explains that the chalice is actually gold-plated and covered in white zirconia instead of diamonds, as it would otherwise cost $1 million. “If you already have everything,” she explains, “this is one more thing you can get.”

I believe that anyone who works for Royal Caribbean should be entitled to immediate American citizenship. They already speak English better than most of the passengers and, per the Serbian lady’s sales pitch above, better understand what America is as well. Crew members like my Panamanian cabin attendant seem to work 24 hours a day. A waiter from New Delhi tells me that his contract is six months and three weeks long. After a cruise ends, he says, “in a few hours, we start again for the next cruise.” At the end of the half a year at sea, he is allowed a two-to-three-month stay at home with his family. As of 2019, the median income for crew members was somewhere in the vicinity of $20,000, according to a major business publication. Royal Caribbean would not share the current median salary for its crew members, but I am certain that it amounts to a fraction of the cost of a Royal Bling gold-plated, zirconia-studded chalice.

And because most of the Icon’s hyper-sanitized spaces are just a frittata away from being a Delta lounge, one forgets that there are actual sailors on this ship, charged with the herculean task of docking it in port. “Having driven 100,000-ton aircraft carriers throughout my career,” retired Admiral James G. Stavridis, the former NATO Supreme Allied Commander Europe, writes to me, “I’m not sure I would even know where to begin with trying to control a sea monster like this one nearly three times the size.” (I first met Stavridis while touring Army bases in Germany more than a decade ago.)

Today, I decide to head to the hot tub near Swim & Tonic, where some of the ship’s drunkest reprobates seem to gather (the other tubs are filled with families and couples). The talk here, like everywhere else on the ship, concerns football, a sport about which I know nothing. It is apparent that four teams have recently competed in some kind of finals for the year, and that two of them will now face off in the championship. Often when people on the Icon speak, I will try to repeat the last thing they said with a laugh or a nod of disbelief. “Yes, 20-yard line! Ha!” “Oh my God, of course, scrimmage.”

Soon we are joined in the hot tub by the late-middle-age drunk guy with the duck necklace. He is wearing a bucket hat with the legend HAWKEYES , which, I soon gather, is yet another football team. “All right, who turned me in?” Duck Necklace says as he plops into the tub beside us. “I get a call in the morning,” he says. “It’s security. Can you come down to the dining room by 10 a.m.? You need to stay away from the members of this religious family.” Apparently, the gregarious Duck Necklace had photobombed the wrong people. There are several families who present as evangelical Christians or practicing Muslims on the ship. One man, evidently, was not happy that Duck Necklace had made contact with his relatives. “It’s because of religious stuff; he was offended. I put my arm around 20 people a day.”

Everyone laughs. “They asked me three times if I needed medication,” he says of the security people who apparently interrogated him in full view of others having breakfast.

Another hot-tub denizen suggests that he should have asked for fentanyl. After a few more drinks, Duck Necklace begins to muse about what it would be like to fall off the ship. “I’m 62 and I’m ready to go,” he says. “I just don’t want a shark to eat me. I’m a huge God guy. I’m a Bible guy. There’s some Mayan theory squaring science stuff with religion. There is so much more to life on Earth.” We all nod into our Red Stripes.

“I never get off the ship when we dock,” he says. He tells us he lost $6,000 in the casino the other day. Later, I look him up, and it appears that on land, he’s a financial adviser in a crisp gray suit, probably a pillar of his North Chicago community.

THE OCEAN IS TEEMING with fascinating life, but on the surface it has little to teach us. The waves come and go. The horizon remains ever far away.

I am constantly told by my fellow passengers that “everybody here has a story.” Yes, I want to reply, but everybody everywhere has a story. You, the reader of this essay, have a story, and yet you’re not inclined to jump on a cruise ship and, like Duck Necklace, tell your story to others at great pitch and volume. Maybe what they’re saying is that everybody on this ship wants to have a bigger, more coherent, more interesting story than the one they’ve been given. Maybe that’s why there’s so much signage on the doors around me attesting to marriages spent on the sea. Maybe that’s why the Royal Caribbean newsletter slipped under my door tells me that “this isn’t a vacation day spent—it’s bragging rights earned.” Maybe that’s why I’m so lonely.

Today is a big day for Icon passengers. Today the ship docks at Royal Caribbean’s own Bahamian island, the Perfect Day at CocoCay. (This appears to be the actual name of the island.) A comedian at the nightclub opined on what his perfect day at CocoCay would look like—receiving oral sex while learning that his ex-wife had been killed in a car crash (big laughter). But the reality of the island is far less humorous than that.

One of the ethnic tristate ladies in the infinity pool told me that she loved CocoCay because it had exactly the same things that could be found on the ship itself. This proves to be correct. It is like the Icon, but with sand. The same tired burgers, the same colorful tubes conveying children and water from Point A to B. The same swim-up bar at its Hideaway ($140 for admittance, no children allowed; Royal Caribbean must be printing money off its clientele). “There was almost a fight at The Wizard of Oz ,” I overhear an elderly woman tell her companion on a chaise lounge. Apparently one of the passengers began recording Royal Caribbean’s intellectual property and “three guys came after him.”

I walk down a pathway to the center of the island, where a sign reads DO NOT ENTER: YOU HAVE REACHED THE BOUNDARY OF ADVENTURE . I hear an animal scampering in the bushes. A Royal Caribbean worker in an enormous golf cart soon chases me down and takes me back to the Hideaway, where I run into Mrs. Rand in a bikini. She becomes livid telling me about an altercation she had the other day with a woman over a towel and a deck chair. We Suites have special towel privileges; we do not have to hand over our SeaPass Card to score a towel. But the Rands are not Suites. “People are so entitled here,” Mrs. Rand says. “It’s like the airport with all its classes.” “You see,” I want to say, “this is where your husband’s love of Ayn Rand runs into the cruelties and arbitrary indignities of unbridled capitalism.” Instead we make plans to meet for a final drink in the Schooner Bar tonight (the Rands will stand me up).

Back on the ship, I try to do laps, but the pool (the largest on any cruise ship, naturally) is fully trashed with the detritus of American life: candy wrappers, a slowly dissolving tortilla chip, napkins. I take an extra-long shower in my suite, then walk around the perimeter of the ship on a kind of exercise track, past all the alluring lifeboats in their yellow-and-white livery. Maybe there is a dystopian angle to the HBO series that I will surely end up pitching, one with shades of WALL-E or Snowpiercer . In a collapsed world, a Royal Caribbean–like cruise liner sails from port to port, collecting new shipmates and supplies in exchange for the precious energy it has on board. (The actual Icon features a new technology that converts passengers’ poop into enough energy to power the waterslides . In the series, this shitty technology would be greatly expanded.) A very young woman (18? 19?), smart and lonely, who has only known life on the ship, walks along the same track as I do now, contemplating jumping off into the surf left by its wake. I picture reusing Duck Necklace’s words in the opening shot of the pilot. The girl is walking around the track, her eyes on the horizon; maybe she’s highborn—a Suite—and we hear the voice-over: “I’m 19 and I’m ready to go. I just don’t want a shark to eat me.”

Before the cruise is finished, I talk to Mr. Washy Washy, or Nielbert of the Philippines. He is a sweet, gentle man, and I thank him for the earworm of a song he has given me and for keeping us safe from the dreaded norovirus. “This is very important to me, getting people to wash their hands,” he tells me in his burger getup. He has dreams, as an artist and a performer, but they are limited in scope. One day he wants to dress up as a piece of bacon for the morning shift.

THE MAIDEN VOYAGE OF THE TITANIC (the Icon of the Seas is five times as large as that doomed vessel) at least offered its passengers an exciting ending to their cruise, but when I wake up on the eighth day, all I see are the gray ghosts that populate Miami’s condo skyline. Throughout my voyage, my writer friends wrote in to commiserate with me. Sloane Crosley, who once covered a three-day spa mini-cruise for Vogue , tells me she felt “so very alone … I found it very untethering.” Gideon Lewis-Kraus writes in an Instagram comment: “When Gary is done I think it’s time this genre was taken out back and shot.” And he is right. To badly paraphrase Adorno: After this, no more cruise stories. It is unfair to put a thinking person on a cruise ship. Writers typically have difficult childhoods, and it is cruel to remind them of the inherent loneliness that drove them to writing in the first place. It is also unseemly to write about the kind of people who go on cruises. Our country does not provide the education and upbringing that allow its citizens an interior life. For the creative class to point fingers at the large, breasty gentlemen adrift in tortilla-chip-laden pools of water is to gather a sour harvest of low-hanging fruit.

A day or two before I got off the ship, I decided to make use of my balcony, which I had avoided because I thought the view would only depress me further. What I found shocked me. My suite did not look out on Central Park after all. This entire time, I had been living in the ship’s Disneyland, Surfside, the neighborhood full of screaming toddlers consuming milkshakes and candy. And as I leaned out over my balcony, I beheld a slight vista of the sea and surf that I thought I had been missing. It had been there all along. The sea was frothy and infinite and blue-green beneath the span of a seagull’s wing. And though it had been trod hard by the world’s largest cruise ship, it remained.

This article appears in the May 2024 print edition with the headline “A Meatball at Sea.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

clock This article was published more than  2 years ago

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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Standby Cruising: A New Option for Bargain Seekers

Are you a flexible traveler? Holland America’s standby cruises may be for you. The cost: $49 a day, excluding fees, taxes and extras. The catch: It might be a hair-raising, last-minute scramble.

By Elaine Glusac

Elaine Glusac is the Frugal Traveler columnist, focusing on budget-friendly tips and journeys.

In February, Barb McGowan took a seven-day cruise on Holland America Line, visiting the Bahamas, Turks and Caicos, and the Dominican Republic for just $343, or $49 a day, excluding taxes, port fees and extras. By comparison, Holland America currently lists a seven-day Caribbean itinerary in October from about $700.

The catch: She had just 48 hours’ notice.

Ms. McGown, a 64-year-old from Naples, Fla., who runs a restaurant franchise, took one of the line’s new standby cruises , which are aimed at travelers who live near departure ports and intended to fill ship vacancies.

“I look for deals, and this was an especially good experience,” Ms. McGowan said, praising the food and entertainment. “I was impressed enough to put down a deposit on a future cruise.”

A way to keep ships full

Holland America introduced its standby program last August to maximize ship occupancy, knowing that cancellations are inevitable. So far, the rest of the cruise industry has not followed its lead.

“If cancellations are within a week or two of sailing, it’s difficult to resell that space in the open market,” said Dan Rough, the vice president of revenue management at Holland America.

In the same way that airlines oversell seats, cruise lines may compensate for cancellations by overselling staterooms. Filling in with standbys, however, reduces Holland America’s reliance on overselling, which runs the risk of bumping passengers to distant departures or potentially offering generous cash incentives to coax volunteers to cancel.

Though the company does not heavily promote the new practice, it has attracted a following among the thrifty by dangling a bargain rate — $49 a person, whether sharing a cabin or traveling solo, before taxes and fees — on a web page that lists available departure dates to attract flexible travelers. Standbys should expect an inside cabin, according to the company, though ocean-view and veranda cabins have been assigned. (The company declined to say how many standby cabins it has offered.)

“Forty-nine dollars per person, per day is pretty exceptional,” said Colleen McDaniel, the editor of CruiseCritic.com , a website that reviews cruises, noting that the price covers all meals and entertainment. “You can’t find a cheaper rate at a land resort for what’s included.” (In 2023, the average nightly rate for a hotel room in the United States was nearly $156, according to STR, a data analytics firm that monitors the hospitality industry.)

To participate, travelers choose an itinerary from the standby list on the website — current embarkation ports include Boston; Fort Lauderdale, Fla.; Montreal; Quebec City; San Diego; Seattle; Vancouver, British Columbia; and Whittier, Alaska — and pay for the trip in advance by calling Holland America or booking through a travel adviser.

There are no refunds for standby cruisers who want to back out. However, if the gamble fails to pay off, and the cruise line cannot offer a cabin to someone on the standby list, it issues a refund.

The company says standby offerings are added on a rolling basis and usually lists itineraries within two to three months of departure. Current offerings include seven-day sailings in Alaska’s Inside Passage from April through September and seven-to-11-day trips cruising the coast of New England and Canada’s Maritime Provinces between May and October.

Proximity is a bonus

Standby cruisers don’t learn of their acceptance or denial until a week to two days before departure, complicating transportation arrangements.

“Last-minute airfare could offset the savings on a cruise,” wrote Crystal Seaton, the owner of Road to Relaxation Travel , a travel agency based in Raleigh, N.C., in an email. Though she has not booked a client on a standby sailing yet, she surmised that it is intended for travelers who can drive to a port.

“We were lucky; we found out Tuesday we were going on a Friday 3 p.m. sailing,” said Sheila Valloney, 66, of Clermont, Fla., who with her husband spent nine days aboard a Holland America ship in the southern Caribbean in February by going standby.

Before being cleared, she reserved a parking spot near the ship dock in Fort Lauderdale, which would have set her back about $6 if she canceled. She also kept their vacation clothes ready to go at the last minute for the three-and-a-half-hour drive to port.

Booking a refundable airline ticket — or at least one that guarantees a credit in loyalty points or cash in the event of cancellation — is one way travelers who must fly can take advantage of the deal.

For her standby sailing, Ms. McGowan drove 90 minutes from her home to the ship in Fort Lauderdale. But her travel companion was coming from Indiana, so when she joined the standby list a few months before the departure date, she booked her friend a Southwest Airlines flight using frequent flier points that would be refunded if the last-minute cruise didn’t come through.

Avoiding extra charges

Once on board, charges for extras like cabin upgrades, Wi-Fi, alcohol and shore excursions can inflate the bill, though the thriftiest travelers try to avoid them.

Ms. McGowan sprang for the $17.50-a-day charge for an upgraded drink package (basic nonalcoholic drinks are included in the cruise) and took one shore excursion, focused on coffee growing, which she deemed a good value at $89.

On their Caribbean cruise, the Valloneys asked around for recommendations for good beaches, where they went to relax on port days, and waited until they were on land to check emails, in order to avoid paying for Wi-Fi on the ship.

“We didn’t miss it at all,” Ms. Valloney said. “For beverages, we would wait until happy hour, when it was buy one, get one free.”

Will other companies follow suit?

To date, no other cruise lines have adopted standby programs.

Princess Cruises said it did not plan to offer cabins on a standby basis, but noted that it already offers last-minute deals , which tend to run about $50 to $60 per passenger per day. For example, a seven-day Alaska sailing from Vancouver to Anchorage departing on May 8 is listed at $399 a person in a double-occupancy cabin.

Several other major cruise lines did not respond to inquiries about potentially adopting standby programs, though operators like Royal Caribbean and Norwegian Cruise Line also offer last-minute deals on their websites.

“We would be surprised to see many mainstream cruise lines begin to adopt a similar model” to the standby system, wrote Kimberly Coyne, the head of sales and content strategy for Cruiseline.com , a cruise review site, in an email. She said the standby fares might be financially unsustainable for cruise lines and cited the potential that travelers might become too accustomed to late-booking deals.

More ways to save

With the recent surge in cruise bookings, companies are discounting less, said Ms. McDaniel of CruiseCritic.com.

She identified more reliable ways to get a deal compared with going standby, such as booking during “ wave season ,” a sales period that generally runs January through March, or taking a repositioning cruise, in which a ship relocates from one region to another seasonally. A repositioning itinerary might sail in the fall from Alaska to the Caribbean via the Panama Canal.

“It’s not unusual to see a repositioning cruise at less than $75 per night,” Ms. McDaniel, said, noting that other expenses such as an airline itinerary into one city and returning from another may cost more than a standard round-trip ticket.

Repositioning cruises tend to stop at fewer ports and add more shipboard enrichment programs, such as lectures and activities like cake decorating classes and craft spirits tastings.

“For a lot of people the ship is the destination and this is the perfect activity for people who like to be on the ship,” she said.

Follow New York Times Travel on Instagram and sign up for our weekly Travel Dispatch newsletter to get expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places to Go in 2024 .

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Cruise line responds after Garden City couple among those left behind on African island

HORRY COUNTY, S.C. (WMBF) - A local couple’s dream vacation turned into a nightmare at sea this week.

Jill and Jay Campbell live in Garden City, but are currently on a small island off the coast of Africa after their cruise ship left without them.

“We were waiting for the tender boats to come back and get us because our boat was anchored off the harbor, but they didn’t come back to get us so we’re stranded here,” said Jay Campbell.

The Campbells were 8 days into a 21-day cruise, which started in South Africa and stopped on the island of São Tomé.

“We were on a tour of the island but we had an issue on the tour and they didn’t get us back in time,” said Jay.

Despite help from the the island’s coast guard the cruise ship refused to let them and several others back on board, leaving some without their money, medicine, vaccination certificates required by immigration, and all other belongings left in their cabins.

We’re told seven American passengers and two Australian passengers were left on the island.

The Campbells say a number of those passengers are elderly with one having a heart condition, one a paraplegic as well as a pregnant woman.

They say one of the elderly passengers suffered a concussion, multiple injuries and amnesia while on a Norwegian Cruise Lines-sponsored tour of the island.

In a statement sent to WMBF News on Saturday, Norwegian Cruise Line said the passengers were left on the island “on their own or with a private tour” and missed the all-aboard time.

“While this is a very unfortunate situation, guests are responsible for ensuring they return to the ship at the published time, which is communicated broadly over the ship’s intercom, in the daily communication and posted just before exiting the vessel,” a spokesperson for the cruise line said.

The spokesperson added that Norwegian Cruise Line is in communication with those left behind, but added those guests are responsible for any travel costs to rejoin the ship at the next port of call.

The Campbell family is now trying to reunite with the ship at another African port, but admit the process has been more complicated than they would have liked.

“We’re trying to get written permission from the cruise line to re-board if we do make it to Gambia,” said Jill Campbell.

Despite the issues, the forgotten passengers are hopeful they can finish their trip.

“We paid a lot for this trip to Africa so we hope to make it through the rest of this trip and end in Spain,” said Jay.

All the passengers have tried reaching out to Norwegian Cruise Line, but have yet to get any help with re-embarking the ship.

“We’ve got our flights booked to Gambia however we don’t know if we’ll be able to get into the country and get back on the ship,” said Jill.

Norwegian’s full statement to WMBF News

“On the afternoon of March 27, 2024, while the ship was in Sao Tome and Principe, an African island nation, eight guests who were on the island on their own or with a private tour missed the last tender back to the vessel, therefore not meeting the all aboard time of 3 p.m. local time. While this is a very unfortunate situation, guests are responsible for ensuring they return to the ship at the published time, which is communicated broadly over the ship’s intercom, in the daily communication and posted just before exiting the vessel. Guests are responsible for any necessary travel costs to rejoin the ship at the next available port of call. When the guests did not return to the vessel at the all aboard time, their passports were delivered to the local port agents to retrieve when they returned to the port. Our team has been working closely with the local authorities to understand the requirements and necessary visas needed if the guests were to rejoin the ship at the next available port of call. We are in communication with the guests and providing additional information as it becomes available.” Norwegian Cruise Line

Stay with WMBF News for updates.

Copyright 2024 WMBF. All rights reserved.

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What happens if you're quarantined on a cruise ship?

Here at The Points Guy, I routinely hear from readers that the main reason they're hesitant to cruise right now isn't fear of COVID-19; it's what a quarantine or isolation situation on board would mean for their vacation and their ability to return home afterward.

What happens if you test positive for COVID-19 on your voyage or you're exposed to someone who's positive? Here, I'm pulling back the curtain, based on my own experience in cruise ship quarantine and a play-by-play from Steven Episcopo, a TPG reader who had to isolate after testing positive for COVID-19 on a recent voyage.

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

What is the difference between isolation and quarantine?

Before we dive too deeply into the particulars, it's important to establish what these two terms mean. They aren't interchangeable. The U.S. Centers for Disease Control and Prevention lays out the differences between them on its website.

Isolation: Isolation separates sick people with a contagious disease from people who are not sick.

Quarantine: Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

In Episcopo's case, he tested positive but his girlfriend did not. Episcopo was moved to isolation, while his girlfriend was quarantined in their cabin for 24 hours.

What happens in cruise ship quarantine?

In the event that cases of COVID-19 are detected on board, cruise ships have a complex contact tracing system that allows them to track who might have been exposed.

In June 2021, on my first cruise back after the 2020 shutdown, I was exposed during a shore excursion to two asymptomatic passengers who later tested positive as part of a routine onboard screening.

If you are identified as a close contact — if you've been in the same space as an infected person for 15 minutes or more — you will be asked to return to your cabin and stay there. Someone from the ship's medical center will be sent to test you. You will need to remain in quarantine in your room at least until your results come back negative but possibly longer, depending on your circumstances and the ship's policies.

During your quarantine, crew will do all they can to make sure you're comfortable and entertained. This could include offering you free Wi-Fi, in-cabin movie rentals and complimentary room service, since you won't be able to leave for meals. During my confinement, which lasted 13 hours, I was also sent a bottle of sparkling wine and some chocolate-covered strawberries as a nod to the inconvenience.

When your results come back, you will be permitted to leave your stateroom if your results are negative. If they are positive, you might be given another test to rule out false positive results.

In some cases, you might be asked to remain in quarantine until all close contacts have been tested. Why? Should one of those contacts test positive, it would be necessary to start contact tracing all over again. In that case, it's best for the cruise operator to keep all initial contacts away from the general ship population until they are all cleared as negative.

Where do cruise ships isolate passengers?

Following changes to the CDC's regulations for cruise ships, passengers who test positive are now allowed to remain in the cabins they booked if they are disembarking within 36 hours from returning a positive result and if they're the only person staying in the stateroom.

However, in most cases, if you test positive for COVID-19, you will be relocated from your booked room to a cabin in an area known on some ships as the "Red Zone," near the vessel's medical facilities. Most of those cabins fall into the ocean view category, so although they don't offer fresh air, they do provide natural light. These rooms employ a negative-pressure airflow system to keep particulates from escaping in the air when the doors to those rooms are opened.

In cases that require relocation, you cannot stay in your own cabin if you test positive, no matter how nice, expensive or big a cabin you booked. On the cruise when I ended up in quarantine, I booked a balcony cabin figuring that I'd at least have fresh air if I became ill. I didn't realize that, if I had tested positive (which, thankfully, I didn't), I would have been moved to a different cabin.

Cruise ship crew members take all necessary precautions when moving a COVID-19-positive passenger from their room to an isolation cabin.

"The transfer to the Red Zone was like something out of a movie," Episcopo said. "Two crew members in full PPE escorted me, while the one behind me used some sort of airborne sanitizer.... There were crew members at every possible turn, making sure that no other guests on the ship could see this happening. (Stairs were blocked off and the elevator waiting for me was one without windows.)

"They took me down to the fourth deck and escorted me through a closed hallway fire door. On the other side was a plastic divider they had to remove... They dropped me off at my room, which was a standard ocean view stateroom."

The cabin change was disappointing for Episcopo, who had originally booked an inside cabin on a canceled voyage, opted for 120% future cruise credit and ended up with an Owner's Suite (for just $640 total, for two people) after placing an upgrade bid on the sailing where he was moved to an isolation cabin.

What happens in cruise ship isolation?

Passengers in cruise ship isolation have little, if any, contact with other people in an effort to curtail the spread of COVID-19. The only people you're likely to see are the ship's doctors and nurses, who can check on you if warranted. However, most of the time, they will simply call your cabin each day to see if you're feeling OK and to make sure you have everything you need as you recover. They only show up in person when necessary.

You're not likely to see housekeeping or room service staff, either. "Inside my new room, there were some cleaning supplies like what the housekeeping crew uses because they weren't allowed to come clean my room," Episcopo said. "There were red 'biohazardous waste' bags that I had to put all of my garbage in to leave outside my door."

Regular room service meals also will be deposited outside your door. "There was a piece of paper with QR codes for each day on it," Episcopo said. "This is how I ordered my food. I just scanned the next day's QR code, filled out the form before 9 p.m., and the food came at almost the exact time I entered for each meal. (There were half-hour windows to choose from.)"

The cruise lines understand that life in isolation is likely to be boring and frustrating. They tend to offer extras like Wi-Fi and movies to passengers in isolation to help pass the time.

"[The cruise ship] provided me [with] access to Wi-Fi and the on-demand movie catalog for free," Episcopo said. "Over the next 2.5 days, I read an entire book, watched several movies [and] watched hopelessly out the window as people explored the ports of call."

In addition to testing capabilities, ship medical facilities are now equipped with ventilators and oxygen, which allow for a higher level of care for COVID-19 passengers than what was possible prior to the 2020 shutdown. Should your health situation become more serious after you test positive during your sailing, lines have agreements in place with ports on their itineraries to allow for shoreside care if necessary.

What happens after quarantine or isolation on a cruise ship?

Depending on the length of your sailing, you will either serve out your quarantine or isolation and return to your cabin and regular ship activities, or you will stay in confinement until the voyage ends.

At that time, if your isolation is complete, you can return home as normal. If it's not, you will be sent by private transportation to finish your isolation either in a hotel or at home. The only exception is if you live nearby and drove to the port. In that case, you will be permitted to use your own car to get back home.

Check with your cruise line to see whether they will cover the cost of any necessary hotel stays or charter flights home. Most will, but some require passengers to carry travel insurance that covers them in the event medical evacuation is needed.

Things to bring on your cruise with you, just in case

If you're someone who likes to plan ahead, it might be a good idea to pack a few things that will help you pass the time if you do end up quarantined or isolated. Here are a few quick recommendations:

• A tablet preloaded with shows you've been meaning to binge, movies you've been wanting to watch and books you'd like to read.
• Coloring books with plenty of colored pencils or crayons for both kids and adults.
• A deck of cards or other small, portable games.
• Small craft projects like knitting or crocheting.
• Resistance bands so you can stretch and work out while in a small space.
• Packaged snacks for eating between meals, since you might not be able to order food on a whim.
• Extra clothing, just in case you're required to isolate for a few days after your sailing ends.
• Your work laptop (if you're able to work remotely), which will come in handy if your return home is delayed.
• Extra prescription medicine in case your isolation extends the length of your trip.

Featured graphic by filo/Getty Images.