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) Gastrointestinal Illness Task Force, we continued to support a research project with North Carolina State University to test the efficacy of disinfection products directly against human norovirus. In 2016, this included developing test protocols and testing a range of hand sanitizing products. The project has been conducting groundbreaking testing and uses a novel surrogate virus and other state of the art viral research techniques.
- We developed procedures to control and prevent the spread of ZIKA virus.
FY2016 Health Performance
In response to the Zika virus outbreak in the Caribbean, Central and South America, we immediately introduced prevention measures including provision of health advice to passengers, crew, medical staff and port employees. We also ensured provision of appropriate insect repellents on board and during shore excursions, and the application of mosquito prevention strategies both on board and in our ports.
We shared our prevention measures with our industry association CLIA, which were broadly adopted across the cruise industry. As the outbreak evolved, the preventive guidelines were revised and by end of 2016 there were no significant health impacts reported on our ships or the ports we own.
13 of our ships received a score of 100 from the Center of Disease Control (CDC) Vessel Sanitation inspections.
We continued to develop and implement a standard electronic health record (EHR) platform across our fleet, to enhance many aspects of our medical operations and services. The implementation of this platform is over 50% complete and is expected to be fully implemented fleet wide by mid-2018.
Health Record System Training
In support of the newly implemented global health record system, known as eSeaCare, onboard ships across the company, a training package was developed to support new and existing medical staff. The eSeaCare training package consists of five modules focusing on system overview and overall introduction, outpatient processing, inpatient processing, master service billing and communicable diseases.
Throughout the year we contributed to the review of a number of heath procedures developed by various organizations. Some of these include:
- CDC Vessel Sanitation Program Operations Manual and Construction Guidelines. The new manuals are scheduled to be issued in 2017.
- American College of Emergency Physicians annual Healthcare Guidelines for Cruise Ship Medical Facilities.
- SHIPSAN health and sanitation manual. SHIPSAN, is an European joint action for safeguarding health and preventing the spread of disease. We continued to support their pilot inspection program, which is focused on an integrated strategy and 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. A member of our Health Policy team acts as the co-vice-chair of the CLIA Gastrointestinal Illness Task Force. We participated in the following CLIA health programs and initiatives:
- Conducted an assessment of new and emerging prevention technologies to further develop strategies for the prevention and control of gastrointestinal outbreaks.
- Continued to support a research project to test the efficacy of disinfection products against
- Shared our Zika prevention procedures with the industry.
We participated in the Global Health Security Agenda (GHSA) Roadmap Workshop for the Caribbean region. This was conducted by the United States Agency of International Development’s Health Finance and Governance project in coordination with Caribbean Community Market, the Caribbean Public Health Agency and the Pan-American Health Organization. It included drafting a five-year GHSA roadmap for the Caribbean, which focuses on strengthening health security across the region and supporting Caribbean nations in their efforts to meet the requirements of the International Health Regulations.
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 2016:
- Updated the public health procedures for all ports.
- Implemented quarterly Health, Environment, Safety and Security (HESS) self-assessments.
- Opened Amber Cove’s in-house water quality laboratory, thereby achieving a goal of implementing water quality laboratories’ in all ports.
- Implemented Zika prevention guidelines.
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 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.
We have supported the Global Health Security Agenda (GHSA), which is an international initiative of nearly 50 countries intended to enhance global capacities to prevent, detect, and rapidly respond to infectious disease threats and to achieve measurable health targets. The overall aim of the agenda is to accelerate progress toward a safer world and promote global health security as a priority.
One of our top 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.