USCG Asks Florida Cruise Ships to Keep COVID-19 Cases on Board

The U.S. Coast Guard is calling upon cruise ships off the coast of Florida to increase their medical capabilities in order to deal with COVID-19 cases on board, reducing the burden on the local medical system on shore. That burden is becoming unsustainable, according to the Coast Guard's Seventh District, which has responsibility for Florida, Georgia, South Carolina, Puerto Rico and the USVI. 

With operations suspended, large numbers of foreign-flagged cruise ships are berthed in Florida or anchored or drifting nearby, awaiting further developments. Many have full or nearly-full crew complements on board, and illness among crewmembers has been reported on multiple idled cruise ships. Crewmembers with respiratory issues have recently been evacuated to Florida hospitals from the Oasis of the Seas, Symphony of the Seas, Costa Favolosa and Costa Magica.

"The recent increase in [medevacs] has placed, and is expected to increase, strains on local medical resources throughout the Seventh District AOR. Medical facilities in the port of Miami, for example, are no longer accepting medevac patients due to limited hospital capacity and it is expected that neighboring counties will follow suit," wrote Seventh District commander Rear Adm. Eric C. Jones. "The demand for medical services . . . is leading to the establishment of improvised field hospitals, whose capacities for dealing with critical patients is unproven at this time."

Miami's Jackson Health System reported Wednesday that it already has 82 COVID-19 patients, and Baptist Health reports an additional 102 cases, according to the Miami Herald. Baptist Health is now preparing for a surge of cases in late April or early May. 

Given the situation at area hospitals, Jones advised, it is possible that foreign-flag cruise ship patients may be better served on board than on shore. He advised that foreign passenger vessels within the Seventh District AOR with more than 50 people on board should increase their supply of medical equipment and their complement of medical personnel in order to support persons with an influenza-like illness (ILI) for an "indefinite period." 

"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," Jones said. 

Going forward, cruise ship medevacs for people with influenza-like illness must be coordinated with JRCC Miami or JRCC San Juan, and the operator must confirm hospital space availability and contract with a private operator to evacuate the patient. Many of the foreign-flagged cruise ships that normally operate out of Florida are flagged in The Bahamas, and some are now waiting in international waters, outside of U.S. territorial seas; Rear Adm. Jones advised these ships to request support from their flag state first before appealing to the USCG. 

Vessels located within the 12-nm line are required to report illnesses and fatalities to the Coast Guard, and Rear Adm. Jones admonished cruise ships within Seventh District's waters to do so daily. He reminded masters that if they fail to report illnesses and casualties on board, they may be subject to criminal or civil penalties. 

Rear Adm. Jones' request comes as the cruise ship Zaandam makes her way to Port Everglades, Florida with eight confirmed COVID-19 cases on board. The estimate of the number of those with flu-like symptoms stands at about 200, including with 45 with mild symptoms as of Wednesday. According to operator Holland America, "an estimated fewer than 10" people on board require immediate critical care, and the cruise line has secured treatment availability for them in Florida. It expects that none of the others currently require local care. 

Florida Gov. Ron DeSantis told the AP Wednesday that the state will allow only those Zaandam passengers who are Florida residents to disembark. “My concern is simply that we have worked so hard to make sure we have adequate hospital beds,” he said.