Now that cruise ships have once again been visiting Orkney and ports around the UK what happens when there are positive Covid cases on board? What happens to the recording of these cases and the tracing of contacts ? And who is responsible for the health and safety of passengers, crew and the communities they visit?

On Monday 20th of September 2021, two cruise ships visited Orkney, both had positive Covid cases on board. The Marella Explorer 2 had 4 cases and the Celebrity Silhouette had 1 case. One elderly gentleman was so ill he required to be hospitalised and was transported to the Balfour Hospital, Kirkwall by the local ambulance.

There were 1339 passengers and 866 crew on board the Celebrity Silhouette and 785 passengers  674 crew on the Marella Explorer 2.

The Marella Explorer 2 anchored in Kirkwall Bay and those visiting Mainland, Orkney were transported by shuttle ferry service to Kirkwall. The Celebrity Silhouette tied up at Hatston pier, Kirkwall. According to information received from Orkney Islands Council ‘All known close contacts were also isolated on board the vessels and enhanced sanitisation procedures were in place.’

Anyone who was in Kirkwall on Monday will know how busy the town was that day and clearly many (but not all) cruise ship passengers were wearing masks. As well as the cruise ship organised tour buses, taxis were also to be seen filled with cruise ship visitors and the public bus service suffered delays as it struggled to cope with the increase in passengers.

Enquires made with Public Health Scotland(PHS) reveal that:

“The management of COVID-19 cases on ships is a matter for the ship’s captain. When they dock in port, the Port Health Authorities are informed and support the management of cases, clusters and outbreaks if required.”

PHS also said that: “It is not unusual for illness to occur on ships, including cruise ships, and they have processes in place for managing such cases.”

A spokesperson for PHS went on to say:

“Public Health Scotland does not regularly report on such incidents, these are for individual Health Protection Teams to support and advise on.

“We provide local Health Protection Teams with support on occasion, but Public Health Scotland is not informed of all cases.“

In our islands , Orkney Islands Council takes the lead on the management of Covid Cases on Cruise ships when they are visiting – not NHS Orkney Public Health. Their spokesperson told The Orkney News:

“The response to the cruise ships is being led by the Orkney Islands Council.“

In his statement on 21st of September following the revelation that there were Covid cases onboard the visiting ships, Jim Buck, Head of Marine Services, Transportation and Harbour Master, admitted that there had also been previous positive Covid cases on visiting cruise ships. He said:

“We have played host to 23 ships since the resumption of the cruise industry in July, including many thousands of passengers and crew, and there have only been a handful of confirmed cases during this time. These isolated incidents have been contained very quickly without further spread, so the procedures in place by both the vessels and the Port side have worked well.”

In his role, Jim Buck is the person responsible for the management of the Covid containment from Cruise ships visiting Orkney.

Jim Buck said:

“No one can ever guarantee a situation can be 100 per cent secure, particularly when dealing with a virus that has an incubation period, however, we are confident that the measures which are in place have done as they were designed to do.”

“There have been a very small number of positive cases, but these have been contained extremely quickly and have not led to further spread.”

The public were not informed of these cases.

The cruise ship sector (like all of us) was hit really hard by the travel restrictions imposed due to the pandemic. It also suffered because of the role it played in the onward transmission of the virus when the British-registered Diamond Princess was the first cruise ship to have a major outbreak on board. The ship was quarantined at Yokohama from 4 February 2020 for approximately one month. Of 3711 passengers and crew, around 700 people became infected and 9 people died.

The UK Government states that domestic cruise operators require all passengers to present a negative COVID-19 test before boarding.

COVID-19 vaccinations for passengers and crew (UK Government Guidance)

Domestic cruise operators will have a COVID-19 vaccination policy for passengers and crew.

A person is considered fully vaccinated when they have completed a full course of immunisation through the UK vaccination programme, more than 14 days before joining the cruise.

People under the age of 18, people with a medical exemption, or people involved in COVID-19 vaccination trials are not expected to be vaccinated.

Operators should encourage crew to get vaccinated. They should facilitate the access of crew to vaccinations, so that full immunisation can be received as soon as possible.

On board the cruise ships the Captain has full responsibility of the management of Covid and for contact tracing. This is for passengers and crew – some of whom will not be from the UK.

Clear communication with the destination port authority is key.

There will be an exchange of information between the port of call and the cruise ship operator, including clear arrangements for both embarkation and disembarkation at ports. The cruise ship operator should share information from within the COVID-19 Management Plan with the prospective port of call, and the port will share its COVID-19 port management plan.

Framework for UK Cruise Operators during Covid

Somewhere along the line the clear exchange of information did not happen on Monday 20th of September when previously cancelled visits to top Orkney visitor sites from a cruise ship were changed, much to the surprise of some of those sites.

In the case of an outbreak onboard a cruise ship, operators are to have prior arrangements established with designated key ports identified for each voyage which are able to handle the disembarkation of passengers with COVID19. The designated ports should be identified, agreed with the relevant authorities and recorded within the voyage plan in line with the International Health Regulations. The designated key ports should have the capability of providing appropriate public health emergency response, by establishing and maintaining a public health emergency contingency plan. Repatriation requirements will also be considered.

Framework for UK Cruise Operators during Covid

Before any cruise ship can arrive the number of Covid cases onboard must be reported to the destination port. This means that, Orkney Islands Council, is fully aware before any ship comes in, of how many passengers or crew onboard have Covid and how many are self isolating.

At the same time the cruise ship has to inform the Foreign, Commonwealth and Development Office (FCDO) Global Response Centre who will in turn inform the Department of Transport ‘and others within the UK Government.’

Public Health Scotland is not informed of all cases.

Onboard the cruise ship, even if only 1 person is suspected of having contracted Covid then both that person and any close contacts they have had are to self isolate whilst tests are carried out. This includes, over two days prior to feeling ill, passengers and crew, everywhere the person has been and the laundry used etc.

The ship also has to carry enough PPE (personal protection equipment) to deal with an outbreak.

But it is the nature of such mass tourism transport that outbreaks of Covid will occur.

How many Covid cases onboard a ship would constitute it not being able to disembark its visitors?

In Iceland – it is 1.

Viking Sky, who are running limited cruises in Iceland this year because of Covid, have very stringent measures in place to avoid the spread of the virus. As well as being double vaccinated, all crew and passengers have to have a daily PCR test and wear an electronic contact tracing medallion. Those measures are way beyond anything the UK cruise ships are doing. Nevertheless it only took 1 positive test result for ports in Iceland to refuse entry.

The population of Iceland is 368,792 and 76.9% of Icelanders are fully vaccinated. There have been 33 Covid deaths in total. And it clearly wants to keep those figures as low as possible.

The UK Cruise ships, of course, don’t just come to Orkney.

After visiting here the Marella Explorer 2 went on to Newcastle arriving there on 21st of September and the Celebrity Silhouette sailed to Invergordon on 20th of September then onwards to Liverpool arriving there on 23rd.

Finding out how many Covid cases are occurring onboard UK cruise ships is impossible to determine because of the way the data is being collected (or not).

On 7th of September 2021 the Liverpool Echo reported cases of suspected Covid-19 on the MSC Virtuosa docked on Liverpool’s waterfront.

It seems quite extraordinary that Public Health Scotland, and therefore the Scottish Government Health Minister, Humza Yousaf, do not know, and are not informed about, positive covid cases on cruise ships arriving at our ports.

The information does go to the destination port authority and in the case of Orkney it is Orkney Islands Council who makes the decision on permitting passengers and crew to disembark.

The cruise ship season is coming to a close but in 2022, Orkney Islands Council is expecting perhaps as many as 200 calling in. Will Covid be over by then? Unlikely as the pandemic is still waging a relentless death toll around the world, most of which is still unvaccinated, giving the virus lots of opportunities to mutate.

Collection of data on Covid-19 spread and where it occurs are crucial in tracking and preventing the onward spread of this lifechanging and potentially deadly virus. For Public Health Scotland not to have data of Covid cases occurring on cruise ships where thousands of visitors then disembark into small island communities is quite astonishing.

I hope all our visitors (however they arrive) and islanders stay safe, that people enjoy their visit to Orkney, but above all that we continue to limit the spread of Covid-19 into our communities.

Fiona Grahame