CLIA members have taken a proactive role in addressing the quality of shipboard medical care, and many cruise ship physicians are members of the American College of Emergency Physicians (ACEP) and serve on that organization's Cruise Ship and Maritime Medicine Section.
As a result of cooperative efforts between experienced cruise ship physicians and ACEP, CLIA ocean-going cruise lines worldwide carrying 100 or more persons on board traveling on itineraries to international waters, have agreed to meet or exceed the requirements of the ACEP Health Care Guidelines for Cruise Ship Medical Facilities as revised January 2019. ACEP's guidelines address the facilities, staffing, equipment and procedures for medical infirmaries on cruise ships traveling outside territorial waters of the coastal state. Patients requiring more comprehensive facilities or treatment are typically referred to a shoreside medical facility.
These guidelines are not intended to constitute medical advice, nor to establish standards of care applicable to the industry as a whole. They reflect consensus among members of the facilities and staffing needs considered appropriate aboard cruise vessels, within the recognized limitations of the sea environment. However, the practices of individual cruise lines and shipboard physicians may vary depending upon passenger and crew demographics, itinerary, ship's construction and other circumstances.
The guidelines are generally intended to foster the following objectives:
- To provide reasonable emergency medical care for passengers and crew aboard cruise vessels
- To stabilize patients and/or initiate reasonable diagnostic and therapeutic intervention
- To facilitate the evacuation of seriously ill or injured patients when deemed necessary by a shipboard physician
The ACEP guidelines can be viewed here.
As part of their commitment to passenger and crew safety in the context of communicable diseases, CLIA’s members have adopted the following policy for all oceangoing vessels:
General Pre-Boarding Health Screening
All embarking persons are to receive pre-boarding health screening, to assist in preventing the spread of communicable diseases.
Phased Implementation of Comprehensive COVID-19 Policy Requirements
CLIA Members have adopted policy requirements related to resumption of operations which were suspended due to the COVID-19 Pandemic. Some of the protocols are relevant to crew care only, while others are only relevant once passenger service operations begin. The expectation is that these policy requirements will be phased in over time depending on where vessels operate and in which manner they are operating. For example, policies applicable to crew members should be implemented immediately, when crew members are onboard, whereas policies applicable to passengers should be implemented as operations begin.
CLIA Member Principles for COVID-19 Mitigation
CLIA Member Principles for COVID-19 Mitigation (adopted July 2022)
In light of the extensive guidance and instructions for cruise operators issued by cognizant health authorities worldwide, CLIA cruise line members have adopted a set of member principles that foster the industry’s commitment to preserving healthy conditions on board, while at the same time recognizing that there is no “one size fits all” approach due to wide variations in ship designs and capacities, itineraries and voyage lengths, and customer demographics.
The following member principles are intended to complement individual cruise line protocols and applicable guidance from cognizant health authorities. Notwithstanding these principles, member cruise lines should always comply with requirements issued by health authorities in their flag states and in ports / destinations where they operate.
- For as long as the COVID-19 pandemic/ endemic persists, maintain appropriate elevated Public Health measures to effectively limit the impact of any introduction and/or spread of the virus on board cruise ships.
- Cruise lines should be prepared to adjust company and pre-embarkation/on board procedures as needed commensurate with risk levels. Risk levels may be influenced by specific operational profiles (e.g., longer voyage lengths or more exotic itineraries in remote locations may require more stringent measures) and /or prevailing public health conditions in the operating region.
- Cruise lines should also continue to maintain comprehensive COVID-19 response and management capabilities that are adjusted as warranted to reflect the specific circumstances on board a particular vessel.
- Maintain the capability to access shoreside medical support, if needed, without unduly burdening local resources.
- Recommend guests be fully vaccinated and up to date as eligible, and that cruise lines continue to operate at vaccination levels that are equal to or better than the general population.
- Crew should be fully vaccinated and up to date (boosted) in a reasonable time once eligible (excluding lawful exemptions) as part of each cruise line’s standard operating procedures.
- Coordinate with ports and destinations to ensure consistency with local requirements, including the submission of health reports as required.