The value of universal screening for COVID-19 cases on cruise ships during outbreaks

Adam Capon; Sandra Chaverot; Anthea Katelaris; Mark Ferson; Natalie Klees; Christine Selvey; Vicky Sheppeard

doi:10.1071/phrp3342338

RESEARCH ARTICLE (Open Access)

The value of universal screening for COVID-19 cases on cruise ships during outbreaks

Adam Capon ^A ^B ^* , Sandra Chaverot ^A , Anthea Katelaris ^A , Mark Ferson ^A ^C , Natalie Klees ^D , Christine Selvey ^D and Vicky Sheppeard ^A ^B

+ Author Affiliations

- Author Affiliations

^A South Eastern Sydney Local Health District, NSW, Australia

^B Faculty of Medicine and Health, University of Sydney, NSW, Australia

^C School of Population Health, UNSW Sydney, Australia

^D Health Protection NSW, NSW Health, Sydney, Australia

^* Correspondence to: adam.capon@health.nsw.gov.au

Public Health Research and Practice 33, e3342338 https://doi.org/10.17061/phrp3342338

Published: 6 December 2023

2023 © Capon et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objectives:To describe the impact of universal screening for coronavirus disease 2019 (COVID-19) on passengers on cruise ships docking in Sydney, Australia, during 2022 that experienced a significant outbreak of COVID-19. Type of program or service: Cruise ship disease surveillance Methods: Case series, based on analysis of cruise ship voyages where universal screening of passengers was requested by a NSW health authority and undertaken by the cruise ship. Results: Of 111 voyages in 2022, three fit the definition for this study. Universal screening during these voyages resulted in the detection of up to 1.8 times the number of existing COVID-19 cases, increasing attack rates of the three voyages from 14% to 24%; 13% to 28%; and 3% to 8% respectively. Case demographics showed an even gender distribution, with a majority 70 years or older. Asymptomatic case percentage ranged from 2% to 54%, with age and gender not associated with symptomatic status. Almost all cases were reported as being fully vaccinated. Genomic testing of cases showed multiple lineages of COVID-19 circulating in all three voyages. Lessons learnt: Public health authorities, the cruise industry and passengers should be aware that a large number of unidentified cases of COVID-19 may disembark from a cruise ship that has experienced a large outbreak of the virus. These cases can seed the infection into vulnerable communities. Universal screening as part of the response to a significant outbreak will help identify cases and limit the spread of COVID-19.