Canada’s cruise ship instructional reference tool

Objective
Pre-boarding measures to prevent transmission of COVID-19 including vaccination and testing
Measures to prevent and limit transmission of COVID-19 onboard
Measures to prevent transmission of COVID-19 during shore excursion and/or port visits
Preparedness and response for suspected/confirmed cases of COVID-19

Objective

As we continue with the ongoing management of COVID-19, our collective and individual actions will continue to mitigate risks to the health and safety of people entering Canada. COVID-19 will still occur and will continue to spread at different levels in communities. It is strongly recommended that cruise ship operators maintain appropriate public health measures to minimize the spread of COVID-19 on board vessels and during port visits. Cruise ship operators are strongly encouraged to have a COVID-19 Management Plan as outlined in Transport Canada’s Ship Safety Bulletin 10/2023.

This Instructional Reference Tool is a reference list of publicly available guidance to support the development or update of a COVID-19 Management Plan , if implemented. It is intended to facilitate COVID-19 outbreak prevention on board cruise ships and provides general public health guidance relevant to the Canadian context. Some of the guidance provided may require adaptation by cruise ship operators for their specific COVID-19 Management Plans. Operators should implement a layered approach in their COVID-19 Management Plan by using a combination of measures to minimize the risks of, and to reduce the spread of COVID-19.

Cruise ship operators should continuously monitor scientific evidence, evolving public health recommendations and regulatory requirements (if and when applicable) to inform and improve their plan on an ongoing basis.

Topic	Considerations	Related Resources
1. Pre-boarding measures to prevent transmission of COVID-19 including vaccination and testing
1.1 Implementation of the COVID-19 Management Plan	Operators are strongly encouraged to implement a COVID-19 Management Plan. It is recommended that the Plan: Integrate any Federal, Provincial and Territorial public health requirements in place at the time of sailing. Detail the specific Public Health Measures (PHMs) that the cruise ship company (the Company) will implement to help reduce the spread of COVID-19 on board the vessel and during port visits. PHAC encourages using the tool for operators to reduce COVID-19 risk in community settings and the Prevention and Risk page to inform the Plan.	Reducing COVID-19 risk in community settings: A tool for operators (canada.ca) COVID-19: Prevention and risks COVID-19 mask use: Advice for community settings COVID-19: Cleaning and disinfecting COVID-19: Provincial and territorial resources - Canada.ca Summary of evidence supporting COVID-19 public health measures Help reduce the spread of COVID-19 COVID-19: What to do if you or someone in your home is sick COVID-19 mask use: Types of masks and respirators COVID-19: Travel, testing and borders
1.2 Resources, equipment and personnel	It is recommended that the operator’s COVID-19 Management Plan should identify Personal Protective Equipment (PPE) and any other supplies necessary to facilitate the implementation of the Plan and respond to a COVID-19 outbreak and have procedures in place to maintain a continuous supply during the cruise.	Personal protective equipment (COVID-19): Overview - Canada.ca Hard-surface disinfectants and hand sanitizers (COVID-19) - Canada.ca COVID-19 medical masks and respirators: Overview - Canada.ca COVID- 19: Prevention and risks - Canada.ca COVID-19: Social media and promotional resources for Health Canada and Public Health Agency of Canada
1.3 Staff education and training	Where applicable, it is recommended that the COVID-19 Management Plan include details of crew training on knowledge and understanding of the Public Health Measures.	Reducing COVID-19 risk in community settings: A tool for operators COVID-19 mask use: Advice for community settings COVID-19 mask use: Types of masks and respirators COVID-19 mask use: How to make your mask fit properly COVID-19 mask use: How to choose, use and care for a mask COVID- 19: Prevention and risks - Canada.ca Public health measures: video, factsheets and infographics (multilingual products available) COVID-19: Cleaning and disinfecting COVID-19: What to do if you or someone in your home is sick
1.4 Vaccination	It is strongly recommended that the COVID-19 Management Plan outline how the Company will verify that crew members and travellers have completed an appropriate COVID-19 immunization series prior to embarking.	Vaccines for COVID-19 - Canada.ca COVID-19: Travel, testing and borders
1.5 Pre-boarding testing and screening	It is recommended that the COVID-19 Management Plan: Include procedures to inform passengers about the Company’s COVID-19 policies upon booking, and require them to have an understanding of the COVID-19 protocols prior to boarding the ship. Include procedures for the Company to assess any individuals boarding the cruise ship for signs and symptoms of COVID-19 and for testing individuals with signs and symptoms of COVID-19 at any time throughout the voyage. The Plan should include procedures to identify and adapt to any changes to Canada’s border requirements.	COVID-19: Symptoms and treatment - Canada.ca COVID-19 testing, screening and contact tracing - Canada.ca COVID-19: Travel, testing and borders - Travel.gc.ca Coronavirus disease (COVID-19): Outbreak update - Canada.ca Updated: Public health management of cases and contacts associated with COVID-19 - Canada.ca
1.6 Pre-boarding education for passengers and crew	It is recommended that the COVID-19 Management Plan include: Procedures to provide information to passengers and crew about COVID-19 and its health risks including who is at most risk of more severe disease, and the risks of traveling aboard a cruise ship. Procedures to provide passengers and crew with information about the use of individual public health measures to help reduce the spread of COVID-19, including: Mask wearing, improving ventilation, using caution in closed spaces and crowded spaces, hand hygiene and respiratory etiquette, cleaning and disinfection; For those who are at risk of more severe disease or outcomes – physical distancing; Actions to take in case COVID-19 compatible symptoms develop while onboard the ship, including staying in own cabin, limiting contact with others, and wearing a respirator (or if not available, a well-fitted medical mask), even if COVID-19 symptoms are mild. Procedures to provide information to passengers and crew regarding how to conduct a personal risk assessment and to make informed decisions about the use of individual public health measures. Protocols for managing passengers and crew who are non-compliant with ship COVID-19 protocols, and communicate these protocols clearly to everyone on board.	Coronavirus disease (COVID-19): Prevention and risks - Canada.ca COVID-19: Symptoms and treatment - Canada.ca COVID-19 mask use: Advice for community settings People who are at risk of more severe disease or outcomes from COVID-19 COVID-19: What to do if you or someone in your home is sick
2. Measures to Prevent and Limit Transmission of COVID-19 Onboard
2.1 Onboard screening	It is strongly recommended that the COVID-19 Management Plan include a regular SARS-CoV-2 testing program for crew; testing for crew and passengers with signs and symptoms of COVID-19; and mechanisms to ensure passengers and crew are aware of signs, symptoms and exposure of COVID-19 for self- assessments.	COVID-19 testing, screening and contact tracing - Canada.ca National polymerase chain indication guidance for COVID-19 - Canada.ca Interim guidance on the use of for the identification of SARS-CoV-2 infection - Canada.ca COVID-19: Symptoms and treatment - Canada.ca COVID-19: Prevention and risks
2.2 Mask use	It is recommended that the COVID-19 Management Plan include: Details specifying when the use of a mask is recommended for crew and passengers, including recommendations for their use while in public indoor settings. Procedures for the distribution of masks to passengers and crew. The development and provision of health promotion resources about the importance of wearing a mask, including when to wear a mask, what type of respirator or mask to choose, the importance of fit, and the need to be respectful of people’s personal choices. As applicable, procedures to notify passengers and crew about local regulations on mask use at port locations.	COVID-19 mask use: Types of masks and respirators COVID-19 mask use: How to choose, use and care for a mask - Canada.ca COVID-19 mask use: Advice for Community settings. - Canada.ca COVID-19 mask use: How to make your mask fit properly
2.3 Heating Ventilation and Air Conditioning systems (HVAC)	It is recommended that the COVID-19 Management Plan include: Procedures to confirm that the HVAC systems are functioning effectively, and are appropriate for the type, setting activity, number of occupants and length of time the space will be occupied Steps to maintain and improve indoor ventilation to reduce levels of infectious particles The Plan should include procedures for routine assessment and maintenance of the HVAC systems Procedures for educating passengers and crew about improving ventilation Consideration of using portable air filtration devices with high-efficiency particulate air (HEPA) as an additional protection .	COVID-19: Improving indoor ventilation - Canada.ca COVID-19: Guidance on indoor ventilation during the pandemic - Canada.ca Ventilation helps protect against the spread of COVID-19 (printable poster)
2.4 Physical distancing	It is recommended that the COVID-19 Management Plan include: Procedures to encourage individuals who are at risk of more severe disease or outcomes to keep the greatest distance possible when interacting with those outside of their immediate travelling party, and using a layered approach with multiple public health measures. Recognition of areas where physical distancing could be more difficult to implement. For these areas, it is recommended that the Plan identify, where appropriate, alternative measures.	Coronavirus disease (COVID-19): Prevention and risks -Canada.ca Summary of evidence supporting COVID-19 Public health measures COVID-19 mask use: Advice for community settings - Canada.ca
2.5 Cruise Ship Activities	It is recommended that the COVID-19 Management Plan include specific public health measures to reduce the spread of COVID-19 in the context of different activities. The Company’s identification of different strategies for these settings should be based on a risk assessment for dining rooms, entertainment venues, recreational facilities and other places that passengers and crew congregate to prevent the transmission of COVID-19.	Reducing COVID-19 risk in community settings: A tool for operators (canada.ca) Coronavirus disease (COVID-19): Prevention and risks -Canada.ca Restaurant and Food Services Indoor Pools Personal Services (Salons, spas, hairdressers, barbers, etc.) Retail Daycares Amusement, Theme, and Water Parks Gyms and Fitness Clubs Casinos
2.6 Hygiene measures	It is recommended that the COVID-19 Management Plan should include: Procedures for making health promotion material (e.g. posters, videos, etc.) available throughout the ship that promote the importance of and procedures for hand hygiene and respiratory etiquette. Procedures to verify that supplies are readily available to enable proper hand hygiene and respiratory etiquette by passengers and crew.	COVID-19: Prevention and risks -Canada.ca Hand washing and staying healthy - Canada.ca Public health measures: video, factsheets and infographics (multilingual products available)
2.7 Cleaning and disinfection	It is recommended that the COVID-19 Management Plan should include a schedule of routine cleaning and disinfection practices put in place by the operator, and the appropriate products and techniques to be used.	COVID-19: Cleaning and disinfecting - Canada.ca Hard-surface disinfectants and hand sanitizers (COVID-19): List of disinfectants with evidence for use against COVID-19 - Canada.ca
3. Measures to Prevent Transmission of COVID-19 during Shore Excursion and/or Port Visits
3.1 Port visits, shore based activities and excursions	It is strongly encouraged that the COVID-19 Management Plan be shared with local public health authorities and port authorities in each port of call prior to the commencement of cruising so that awareness of the Plan and knowledge of its contents is widely understood. Additionally, it is recommended that the Plan include: Mechanisms to inform all persons leaving the vessel to visit a port of the recommendations and restrictions of the local public health authority at that destination (as applicable) as well as the current COVID-19 situation. Procedures to log passenger and crew activities in port to facilitate case and contact management whenever possible.	COVID-19: Provincial and territorial resources - Canada.ca Updated: Public health management of cases and contacts associated with COVID-19 - Canada.ca Reducing COVID-19 risk in community settings: A tool for operators (canada.ca) Coronavirus disease (COVID-19): Prevention and risks -Canada.ca
3.2 Regulatory Requirements	The Plan should detail how the operator will meet the reporting and any other applicable requirements of the Quarantine Act, and the current Transport Canada Ship Safety Bulletin. * Reporting of illnesses on board a cruise ship upon entry into Canada should be made with the Maritime Declaration of Health via the online portal. Instructions and links can be found in Transport Canada’s Ship Safety Bulletin No. 10/2023. If required, PHAC’s Central Notification System (CNS) may be contacted directly at 1-833- 615-2384 and cns-snc@phac-aspc.ca	COVID-19: Travel, testing and borders - Travel.gc.ca
4. Preparedness and Response for Suspected/Confirmed Cases of COVID-19
4.1 Management of ill passengers and crew	It is recommended that the COVID-19 Management Plan: Specify how suspected or confirmed cases will safely isolate in a suitable location that is well ventilated, including information on how to isolate, as well as precautions for co-living individuals. Include recommended infection prevention and control precautions for individuals caring for a suspected or confirmed case to reduce the risk of COVID-19 transmission. Include procedures for medical evacuation of ill COVID-19 travellers, should it be required.	National case definition: Coronavirus disease (COVID- 19) - Canada.ca Updated: Public health management of cases and contacts associated with COVID-19 - Canada.ca Infection prevention and control for COVID-19: Interim guidance for acute healthcare settings Ambulatory and outpatient care setting COVID-19 infection prevention and control: Interim guidance - Canada.ca COVID-19: What to do if you or someone in your home is sick
4.2 Management of contacts of COVID- 19 cases	It is recommended that the COVID-19 Management Plan: Include measures to facilitate rapid identification of contacts of COVID-19 cases and implement public health measures as appropriate recognizing that transmission of SARS-CoV-2 can occur from cases who are symptomatic, pre-symptomatic, or asymptomatic. Include a mechanism to classify contacts as either high or low risk, depending on their type of exposure and other risk factors, for the purposes of determining recommended actions for the contact. Information on how to quarantine should be provided to all contacts of cases.	Updated: Public health management of cases and contacts associated with COVID-19 - Canada.ca COVID-19: What to do if you or someone in your home is sick
4.3 Outbreak preparedness and response	It is recommended that the COVID-19 Management Plan include: An Outbreak Management Plan for the prevention and control of possible cases of COVID-19 on board the ship, including procedures to respond to a potential COVID-19 outbreak and establish programs for drills and exercises to prepare for such an outbreak. A means to identify and inform passengers of possible exposure to facilitate case management and contact tracing, and this information should be available for outbreak response and epidemiological analysis.	Updated: Public health management of cases and contacts associated with COVID-19 - Canada.ca COVID-19 testing, screening and contact tracing - Canada.ca Personal protective equipment and medical supplies - Canada.ca COVID-19: What to do if you or someone in your home is sick
4.4 Repatriation of persons	It is recommended that the COVID-19 Management Plan detail the procedures for repatriating ill passengers (and their dependants) and crew to their home communities, reflecting any COVID-19 guidance for managing air travellers.	COVID-19 information for the transportation industry (canada.ca)

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Canada’s cruise ship instructional reference tool

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