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Coast Guard tells cruises to prepare to care for sick people for 'indefinite period'

Miami Herald logo Miami Herald 4/1/2020 By Alex Harris, The Miami Herald

Cruise ships are docked at PortMiami, Tuesday, March 31, 2020, in Miami. The U.S. Coast Guard said Tuesday that it's working with Holland America on a detailed docking plan that would require two ships carrying passengers and crew from an ill-fated cruise to handle all medical issues without impacting South Florida's already-stressed hospitals.  (AP Photo/Wilfredo Lee) © AP Photo/Wilfredo Lee Cruise ships are docked at PortMiami, Tuesday, March 31, 2020, in Miami. The U.S. Coast Guard said Tuesday that it's working with Holland America on a detailed docking plan that would require two ships carrying passengers and crew from an ill-fated cruise to handle all medical issues without impacting South Florida's already-stressed hospitals. (AP Photo/Wilfredo Lee) The U.S. Coast Guard is now directing ships registered in the Bahamas to seek aid from that country first — even if the ships are owned by Miami-based companies. It is also advising ships with more than 50 aboard that they may be sequestered “indefinitely.”

The Coast Guard issued that and other new rules this week in the face of an increasing number of requests to medically evacuate people from the dozen-plus cruise ships hovering off Miami’s coast, according to a public memo. The new framework requires cruise lines to arrange for private transportation for those who are sick rather than relying on the Coast Guard.

After the Miami Herald published this story on the memo, it became temporarily unavailable on the Coast Guard website. It is available now.

As calls pour in to ferry sick people to land, the district has had to improvise field hospitals “whose capacity for dealing with critical patients is unproven at this time,” read the memo signed by Rear Admiral E.C. Jones of the Seventh District, which includes Florida, Puerto Rico, Georgia and South Carolina.

The memo was posted on a Coast Guard website and directed toward passenger vessels registered in foreign countries — which includes nearly all cruise ships in the South Florida-based fleet.

The directive’s new rules for dealing with sick patients upends the processes now used by cruise lines for dealing with the increasing number of cases of COVID-19 aboard their ships.

Seventeen ships are lined up at Port Miami and Port Everglades, with more than a dozen others hovering miles offshore. Most have only crew aboard, but several still carrying passengers are steaming toward South Florida ports. In SEC filings Tuesday, Carnival said it has more than 6,000 passengers still at sea. New sailings were halted by all major lines on March 13.

Normally, when cruise ships have someone on board who is too ill for the ship’s medical team to care for, officers simply call the Coast Guard and get a medical evacuation to a nearby hospital. Now, sick passengers and crew could be sequestered indefinitely.

Under the new protocol, ships with more than 50 people aboard are being asked to stock up on medical supplies and medical staff, enough to care for patients “for an indefinite period of time.” All large ships have infirmaries equipped to deal with minor injuries and stabilize patients with more serious conditions.

“This is necessary as shore-side medical facilities may reach full capacity and lose the ability to accept and effectively treat additional critically-ill patients,” the memo said.

Cruise ships seeking to send a sick person to shore must first consult with the Coast Guard, which may now recommend keeping the passenger onboard instead. If the transfer is OK’d, the cruise line is now responsible for booking commercial transportation to shore, a private ambulance, and confirming that there is a hospital bed available for the patient.

The memo also mandates that all ships in U.S. seas report an updated count of sick and dead people aboard each day or face “civil penalties or criminal prosecution.” It refers to this as an “on-going requirement.” Most cruise lines have been reporting illnesses publicly, though not daily.

Ships “loitering” just outside U.S. territory, especially those flagged to the Bahamas, are now asked to seek aid first in the Bahamas, before “seeking support from the limited facilities in the U.S.” This applies to ships that are registered in the Bahamas but owned by Miami-based companies including Carnival Corp., Norwegian Cruise Line Holdings and Royal Caribbean Ltd. The Bahamian capital of Nassau is about 185 miles from Miami.

The new procedures come following the Monday medical evacuation in Port Everglades of two sick crew members from two different Royal Caribbean ships. A spokesperson for the company would not confirm if the patients were COVID-positive but said they had “respiratory issues.”

Another crew member was evacuated Tuesday morning from the Crown Princess, also docked near Port Everglades. It is owned by Carnival Corp. subsidiary Princess Cruises.

And there are more ships on the way. Tuesday afternoon, Broward County Commissioners debated allowing a Holland America Line ship, the Zaandam, to dock in Port Everglades later this week. No decision was reached.

Carnival Corp. Chief Maritime Officer Bill Burke told commissioners the company wanted to evacuate two COVID-positive passengers from Zaandam to Mexico today, but Mexico turned them away. He said Peru, Ecuador, Colombia, Martinique, Cuba, Guadeloupe and Barbados wouldn’t allow the ship to dock.

The plan for the Zaandam, as with most cruise ships near South Florida, is to treat passengers on board unless they get so sick they need to be taken to a local hospital.

Last week the Zaandam’s sister ship, the Rotterdam, took on hundreds of healthy passengers from the Zaandam after screening them for high temperatures. Cruise line officials said they hope to also bring the ship to Port Everglades.

The Coral Princess, a Princess Cruise ship, is also headed toward Port Everglades with multiple passengers aboard reporting flu-like symptoms.

Representatives from Carnival, Royal Caribbeans and Norwegian did not immediately respond to requests for comment on the memo’s new directives.

Miami Herald Reporter Taylor Dolven contributed to this story.

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