This page collects observations, interpretations, and consequences for action about Cruise Ships and SARS-CoV2. Please observe the structure of the page, when you add your content. Please use references where possible. Remember to find the relevant page. For example, if your observation is about transmission routes, please use that page, instead of posting your content here.
What is already known
- On 20 January 2020, an 80-year-old passenger from Hong Kong embarked on the Diamond Princess in Yokohama, sailed one segment of the itinerary, and disembarked in Hong Kong on 25 January. He visited a local Hong Kong hospital, six days after leaving the ship, where he later tested positive for COVID-19 on 1 February. On its next voyage, 4 February, the ship was in Japanese waters when 10 passengers were diagnosed with COVID-19 during the 2019–20 coronavirus pandemic.
- On 15 February 2020, Malaysia confirmed three more cases, including an American passenger from the cruise ship MS-Westerdam flying from Cambodia, bringing the total number to 22.
- On 17 February 2020, Japan confirmed seven new cases, bringing the total of infected people not aboard Diamond Princess to 66. Diamond Princess in Japan confirmed 99 new coronavirus cases, bringing the total number of infected people on the cruise ship to 454.
What is the protocol during a Pandemic?
- On 7 March, 36 days after WHO declares a PHEIC under IHR and 4 days before WHO admits a Pandemic, the MS Zaandam of the Holland America Line started a new itinerary of 31 days, one-way from Buenos Aires to Fort Lauderdale. 
- Port Health Authorities may decide to quarantine a ship if serious risk through spread of an infection to the general population is expected. .
Analysis and interpretation
- We could not find international regulations that guide shipping lines on the decision to start new itineraries during a PHEIC. With the benefit of hindsight, we can ask the question if cruise ships should not have been restricted after 31 January (WHO declares PHEIC), or after 11 March (WHO declares Pandemic).
Consequences for action
- It deserves attention to consider guidelines for cruise ships and group travel organizers related to IHR and a declaration of PHEIC.
- Diamond Princess Update- Updated February 27, 2020 Guest Disembarkation Complete + Team Member Quarantine
- Coronavirus: Cases double on Diamond Princess overnight, still in lockdown
- Coronavirus cases on Diamond Princess soar past 500, site of most infections outside China- USA Today
- Malaysia confirms 2 more cases of COVID-19- website=CNA; 15 February 2020
- Malaysia confirms two more coronavirus cases. 15 February 2020. CNN
- U.S. woman previously on Westerdam cruise ship tests positive for new coronavirus. 15 February 2020.
- Diamond Princess cruise ship in Japan confirms 99 new coronavirus cases. The Guardian. 17 February 2020
- Cruise mapper - MS Zaandam.
- Handbook for management of public health events on board ships. World Health Organization. ISBN 978 92 4 154946 2 (NLM classification: WA 670)