CDC Order to Dock Cruise Ships was Substantially Weakened

Published Oct 29, 2020

What happened: In an unusual move during late September, the White House blocked a science-based order from the Centers for Disease Control and Prevention (CDC) extending a no-sail order for cruise ships until mid-February. Instead, the White House allowed for a much shorter extension to keep cruise ships docked, until the end of October.

Why it matters: The CDC’s order was based on firm scientific evidence from early in the pandemic, when several cruise ships emerged as major COVID-19 hotspots. When political officials decide to ignore firm scientific evidence and sideline the agency’s top scientists for political considerations during a deadly pandemic, it endangers the health and safety of the entire population.

Top White House officials blocked the Centers for Disease Control and Prevention (CDC) from issuing a science-informed order that would have kept cruise ships docked until mid-February. Instead, the White House greenlit a plan that had been advocated by the cruise ship industry, to allow cruise ships to sail at the end of October. During a Coronavirus Task Force meeting on September 29, Robert Redfield, the director of the CDC, had recommended a CDC plan to extend a no-sail order for cruise ships until mid-February because of the high risk that cruise ships will once again turn into major sources of COVID-19 outbreaks. During the meeting, Redfield had been overruled by other members of the task force. The CDC announced the next day that the no-sail order had only been extended to the end of October.

Cruise ships had some of the earliest examples during the pandemic of superspreading events. For instance, the outbreak on the Diamond Princess cruise ship was traced to one infected person embarking on January 20, which resulted in over 700 cases of COVID-19 in passengers and crew members. According to data gathered by the CDC, from March 1 through September 29, at least 3,689 COVID-19 or COVID-like illness cases occurred on cruise ships in US waters, in addition to at least 41 reported deaths.

In the press statement announcing the no-sail extension order till October 31, the CDC expressed considerable alarm about restarting the cruise ship industry at this point in the pandemic. “Recent outbreaks on cruise ships overseas provide current evidence that cruise ship travel continues to transmit and amplify the spread of SARS-CoV-2, the virus that causes COVID-19,—even when ships sail at reduced passenger capacities—and would likely spread the infection into U.S. communities if passenger operations were to resume prematurely in the United States.” The CDC noted that foreign countries that have resumed cruise ship operations continued to have outbreaks despite having extensive health and safety protocols, and that it further burdened public health authorities “by creating the need for additional SARS-CoV-2 testing, isolation of infected travelers, contact tracing, and quarantine of exposed people.”

According to ProPublica, CDC scientists had to fight to get the original March no-sail order in place. Back in March, Dr. Martin Cetron, the CDC’s veteran director of global migration and quarantine, and his team had worked feverishly to map every cruise ship at sea with COVID-19 patients in order to provide scientific evidence for a no-sail order that could prevent more outbreaks. Cetron wrote to Redfield in an email that, “These cruise ships are the equivalent of mass gatherings of hundreds if not thousands of the most vulnerable populations” at risk for severe illness or death from COVID-19, and that any of these passengers could seed the virus in their communities when they returned home. Due to industry pressure, the first CDC no-sail order issued on March 14 had excluded the majority of cruise operators and even praised the actions of a cruise ship trade association. Cetron worked on stronger no-sail order that laid bare the cruise industry’s failures to adhere to science-based measures and told Redfield that a stronger order was “urgently needed.” Officials at the Department of Homeland Security had refused to accept this stronger CDC order for at least four days but when they finally agreed, they censored and softened Cetron’s language. For instance, a section of the order that was originally titled “Failure of Cruise Ship Industry to Develop and Implement a Response Plan” later became “Critical Need for Further Cooperation and Response Planning.” This newer, more extensive no-sail order was issued on April 9 and was later renewed on July 16.

Due to the high level of crowding and frequent contact between passengers and crew members, cruise ships represent one of the most susceptible places in the world for a superspreading COVID-19 event. In the past, cruise ships have been the sites of major outbreaks of other infectious diseases – for instance the CDC identified eight different outbreaks of norovirus on international cruise ships in 2019. By ignoring CDC scientists and allowing cruise ships to sail much earlier, the White House has shown that it is willing to take actions that elevate politics over science, thereby endangering people’s health and safety during a deadly pandemic.