Guest and Crewmember Health, Safety & Security
Striving to be free of injuries, we continue to build on our commitment to protect the health, safety and security of our guests, employees and all others working on our behalf.
- In collaboration with the Cruise Lines International Association (CLIA) and North Carolina State University, we continued our support for the evaluation of products used to help manage norovirus. In 2017, this included completing a project to test a range of hand sanitizing products. The results suggested that the common types of hand sanitizers tested have limited efficacy against human norovirus. Thorough hand washing remains the most effective means of prevention, although hand sanitizers may still be useful as an adjunct.
- In response to an outbreak of plague in Madagascar, we developed prevention procedures to ensure potential risk to ships was effectively evaluated and managed.
FY2017 Health Performance
18 of our ships received a score of 100 from the Center For Disease Control and Prevention (CDC) Vessel Sanitation inspections.
Our response to the worldwide Zika virus outbreak continued with the implementation of a range of prevention measures including:
- Provision of health advice to passengers, crew, medical staff and port employees.
- Provision of appropriate insect repellents on board and during shore excursions.
- Application of mosquito prevention strategies both on board and in our ports.
During 2017, there were no significant health impacts reported on our ships or at the ports we own.
We continued to develop and implement a standard electronic health record (EHR) platform across our fleet. This program is enhancing many aspects of our medical operations and services. The implementation of this platform, known as SeaCare, is over 90% complete and is expected to be fully implemented fleet wide by mid-2018.
Crew Wellness Program
A clinic and medical wellness facility for Deck and Technical Officers has been established at the Arison Carnival Maritime Center (known as CSMART). A pilot executive health assessment program is being conducted by the clinic with one of our brands. The results of the pilot will be evaluated to determine whether this approach should be adopted as standard throughout the fleet. We anticipate that these regular health assessments, together with access to better personal health information and expert advice, will lead to longer term health improvements among crew over time. Additionally, the SeaCare electronic health records platform has been installed at CSMART. This will enable more effective use of personal health information by on board staff in order to help empower their long term health choices.
Mercy Ships Partnership
Costa Group (Costa Cruises, Costa Asia and AIDA Cruises) launched a partnership with Mercy Ships to support its humanitarian work, providing trained deck and engine officers to work on board the Mercy Ships. Mercy Ships is an international non-governmental organization that works to promote access to essential healthcare in developing nations. For additional details please view our community support highlight. For more information on Mercy Ships please visit www.mercyships.org
In response to an outbreak of plague in Madagascar, we developed prevention procedures to ensure any potential risk to ships was effectively evaluated and managed. No cases of the disease were associated with travel on cruise ships and the measures taken ensured compliance with the requirements of the international health authorities.
Health Records System Training
Training to support the SeaCare global health record system continued for new and existing medical staff. The training package consists of five modules focusing on an overview and overall introduction of the system, outpatient processing, inpatient processing, master service billing and communicable diseases.
Guest and Crew Care Team
Our CareTeam continues to provide compassionate care in the event of an emergency while on board. CareTeam employees have received specialized training on how to sensitively and appropriately support guests, crew and their families during an emergency. They are available 24 hours a day, seven days a week and respond to a variety of guest and crew emergencies, primarily medical related situations, and are dispatched to locations throughout our cruising regions to provide personalized support and assistance as needed to all of our brands. In 2017, our CareTeams across our brands collectively helped approximately 5,800 people including guests and their families, crew members and shoreside employees.
Throughout the year, we contributed to the review of a number of international heath procedures and guidance developed by various organizations. Some of these include:
- The updated CDC Vessel Sanitation Program Operations Manual and Construction Guidelines which will now be issued in spring 2018.
- The American College of Emergency Physicians annual Healthcare Guidelines for Cruise Ship Medical Facilities.
- The Caribbean Public Health Agency (CARPHA) – Regional guidance for managing issues of public health significance on cruise ships (vessel-based surveillance) coming to the Caribbean. This guidance is being developed to promote standardized surveillance and response to public health events across the Caribbean.
- SHIPSAN standard operating procedures for ship inspections. SHIPSAN is a European joint action for safeguarding health and preventing the spread of disease. They are now focused on developing an integrated strategy and a sustainable public health program.
As members of the Cruise Lines International Association (CLIA), we regularly discuss health matters and communicate with all member lines to share best practices. In 2017, we participated in the following CLIA health programs and initiatives:
- Continued to support a research project to test the efficiency of hand sanitizer products against human norovirus.
- Shared our plague prevention procedures with the industry.
- Contributed to the development of SHIPSAN and CARPHA health initiatives.
We participated in a Caribbean Public Health Agency (CARPHA) workshop which addresses the vulnerability of the Caribbean region to health, safety and environmental threats. This event focused on working with various stakeholders, including the cruise industry in order to develop a harmonized approach. The workshop progressed regional agreements on CARPHA’s tourism and health program’s early warning and response systems and reviewed the standardized regional guidelines (for cruise ships and hotels) developed to mitigate against and respond to tourism based heath crises.
We continue to develop and implement comprehensive health standards and procedures at the ports we own and operate. These ports include Puerta Maya, Cozumel, Mexico; Grand Turk Cruise Center, Turks & Caicos Islands; Amber Cove Cruise Center, Puerto Plata, Dominican Republic; and Mahogany Bay Cruise Center, Roatán, Honduras. The following is a summary of our main port health accomplishments in 2017:
- Started Mahogany Bay Cruise Center in-house water quality laboratory expansion. Project to be completed in 2018.
- Continued Zika prevention guidelines at all ports.
- Completed standardization of Integrated Pest Management at all ports.
We have continued to develop and introduce comprehensive health standards that go beyond regulatory requirements to help protect the health of our guests, crew and port employees. These standards are implemented and enforced by each of our brands and within the port facilities that we own and operate. As part of our commitment, we also lead and participate in health related cruise industry task forces and working groups.
We have taken a proactive role in addressing the quality of shipboard medical care. All of our medical personnel are expected to meet the qualification standards outlined in our medical procedures. Our on board facilities are designed to be able to provide emergency medical care for guests and crew, stabilize patients and initiate reasonable diagnostic and therapeutic intervention and facilitate the evacuation of seriously ill or injured patients when deemed necessary.
Our public health programs are developed from worldwide health and sanitation regulations, best practices and guidance. Our programs are audited both internally by public health specialists and externally by officers from health authorities worldwide. We coordinate cross brand Medical and Public Health Working Groups, which help to drive our ongoing health strategies and focus on continuous improvement. Through these forums we are able to leverage the extensive health expertise and experience that exists within our individual brands. In the U.S., we collaborate with the Centers for Disease Control and Prevention (CDC), an agency of the U.S. Department of Health and Human Services, which oversees health and sanitary conditions on all passenger vessels visiting U.S. ports. The CDC provides guidelines, reviews plans and conducts unannounced ship inspections. We continue to work with the CDC throughout a ship’s life to maintain safe standards through regular inspections, crew training and guest education.
One of our priorities remains promoting the prevention of gastrointestinal illness on board our ships and port facilities we own and operate. Our fleet wide Outbreak Prevention and Response Plan guides our actions to prevent and respond to outbreaks of illness on board our ships. The strategy detailed in the plan addresses health screening and surveillance measures, communication and provision of health advice, isolation of ill guests and crew, medical treatment, reporting to health authorities and use of proven sanitation and infection control measures.
Additionally, we collect health data on all cases of gastrointestinal illness and report this information to international health agencies. This helps with identification of types of infection, potential sources, and the likely methods of transmission, thereby allowing us to implement effective risk mitigation strategies.