MSC cruise passengers posed ‘medium risk.’ CDC cleared them to disembark in Miami anyway.
Three days after thousands of passengers walked off the MSC Meraviglia ship in Miami without medical screenings despite a positive COVID-19 test from a previous cruiser, the agencies involved are still pointing fingers.
A review of the incident indicates that gaps in the patchwork of authority overseeing Florida’s response to the COVID-19 pandemic may be to blame. Involved were federal and state health agencies, the cruise line and Miami-Dade County.
The decision to allow 3,877 possibly exposed passengers to disperse across the country without even a temperature check was the responsibility of the U.S. Centers for Disease Control and Prevention, said Miami-Dade County seaport spokesperson Andria Muniz-Amador.
When the ship approached PortMiami early Sunday morning with clearance from the CDC, Port Director Juan Kuryla and Mayor Carlos Gimenez had no idea a passenger who got off the ship a week earlier had tested positive, Muniz-Amador said.
Neither did the Florida Department of Health, said Helen Ferré, spokesperson for Governor Ron DeSantis.
Cruise company MSC Cruises, based in Geneva, Switzerland, with U.S. headquarters in Broward County, said it notified the CDC about the test result. The CDC said it alerted the state health department and the World Health Organization of the “medium risk posed by returning passengers and crew” and decided to clear the ship to dock in Miami because there was no evidence of widespread illness on board.
“The situation in the United States is evolving, both with increasing community transmission and an increasing number of cruise ships coming in to port,” CDC spokesperson Marcus Hubbard said via email. “CDC is continuing to reevaluate how we approach returning cruise ships.”
MSC Meraviglia vs. Grand Princess
The difference between how health authorities handled the MSC Meraviglia in Miami on March 15 and the California quarantine of the Grand Princess that began March 6 shows how dramatically the U.S. response has evolved in just two weeks.
When California faced a positive COVID-19 test result from a previous passenger on the Grand Princess, the state airlifted test kits and held the ship off shore for several days until the results came back. California and federal health officials then disembarked all 2,422 passengers and quarantined American ones in military bases and hotels across the country for two weeks. More than half of the 1,111 crew members were flown home, Princess Cruises said, and many face quarantines in their home countries. The other half of the crew remain on board.
Decisions about land-side procedures, testing and quarantine were made jointly by federal and state officials, said Brian Ferguson, a spokesperson for the California Office of Emergency Services. California officials made it clear to the federal government that the situation needed to be handled in a way that ensured Californians’ safety, Ferguson said.
“We knew that COVID-19 was on board this ship, so with folks in such tight proximity, there needed to have a procedure in place,” said Ferguson. “It was a joint decision, but it was something we actively asked the federal government to do.”
In Florida, the CDC held two ships off shore on March 8 and March 10 because those ships had crew members on board who had transferred from the Grand Princess. All crew tested negative for COVID-19, and both ships were able to dock in Fort Lauderdale.
But in the case of the MSC Meraviglia, the governor’s office said it was never notified that a former cruise passenger had tested positive after leaving a ship that was set to dock in Miami on March 15. DeSantis seemed to know few details about the situation at Monday’s press briefing.
“You’ll have to ask the port on that,” he said. “I mean, I think that CDC is screening the folks or involved. If there’s health issues on the cruise...we at the state would be alerted, but we were not alerted.”
The protocols in California and Florida are so disparate because of a shift in U.S strategy, from containment to mitigation, said Florida International University infectious disease epidemiologist Dr. Mary Jo Trepka.
“Originally the idea was to aggressively follow up every case and prevent anybody who is positive from getting into the country,” she said. “Now that we have so many cases within the country, the only thing to do is to try to keep people apart with social distancing.”
She said people who have returned from a cruise that had a case of COVID-19 should be tested, even though testing has its limitations; people who have the disease, but are not yet showing symptoms may test negative.
“Nothing is perfect, but those people should. It makes sense at this point that they be tested and quarantined at home.”
More than 300 people in Florida have tested positive for COVID-19, the disease caused by the new coronavirus, and seven have died.
MSC Meraviglia timeline
Meraviglia’s status came into question after a Canadian passenger who disembarked from an eight-day Caribbean cruise in Miami on March 8 later tested positive for COVID-19. A spokesperson for MSC Cruises said he did not report any symptoms to the medical staff on board the ship during the cruise.
That day, 103 passengers from that cruise remained on board along with the crew, and thousands of new passengers joined for another eight-day cruise. A spokesperson for MSC Cruises did not confirm how many crew members are on board; the ship can hold more than 1,500 crew. The company took the temperatures of passengers and crew each day during the cruise, the spokesperson said.
Four days into the new cruise, on March 12, the Public Health Agency of Canada notified MSC Cruises that a former passenger had tested positive, and confirmed the passenger’s identity to the company that evening.
That night, crew members received a notice from the staff captain ordering several workers to move out of the Deck 2 forward cabins with all of their luggage, citing an emergency situation, according to one of the workers who requested anonymity for fear of retaliation from the company. A spokesperson for MSC Cruises said the company isolated seven crew members who had been in close contact with the passenger who tested positive
The next day, on March 13, MSC Cruises notified the CDC that a former passenger had tested positive for COVID-19. The company announced new screening protocols for boarding on its website, reassuring passengers saying, “we can confirm there have been no cases of coronavirus on board any of our ships.” The spokesperson for the company said although the ships don’t have testing kits, there have not been any cases of respiratory illness and fever or other COVID-19 symptoms on any of the company’s 18 ships.
The company said it notified the CDC quarantine station at Miami International Airport and the U.S. Coast Guard about the positive test result.
CDC said it reviewed the medical information for passengers and crew on the March 8-15 cruise and sent a notification to state health departments and the World Health Organization alerting them about the risk.
PortMiami and the Florida Department of Health say they were never notified.
MSC Cruises said the CDC notified the company via email that the ship was cleared to dock.
The ship docked in Miami on Sunday, March 15, and 3,877 passengers disembarked without any medical screening.
Level 3 travel warning
The MSC Meraviglia remains moored at PortMiami as the company makes arrangements to send crew members home. MSC Cruises canceled all U.S. cruises through April 30; other cruise companies are on hiatus, too. Muniz-Amador, spokesperson for the Miami-Dade agency that runs the seaport, said the ship is scheduled to depart Miami on Wednesday.
A crew member who asked to remain anonymous said that he still hasn’t been notified about the former passenger testing positive. He said the company had been taking his temperature every day, but stopped on Sunday. He hopes to be able to go home to Manila, Philippines soon. None of the agencies involved nor the cruise line responded to questions about whether departing crew would be screened or tested for COVID-19 before flying home.
A spokesperson for MSC Cruises said the company is checking on the seven isolated crew members and their former roommates twice a day and none are experiencing elevated temperatures.
Passengers who disembarked from the MSC Meraviglia in Miami on Sunday say they have not been contacted by MSC Cruises or their local health departments about what to do. A small county in Michigan, Lenawee County, is directing anyone who cruised on the MSC Meraviglia or five other ships with positive passenger tests contact the health department.
One MSC Meraviglia passenger who returned to South Carolina said he got tested for COVID-19 there on Monday. He said he has an elevated temperature and is staying inside. He has sent two emails and called MSC Cruises four times to try tell them about his symptoms, he said, hoping it can help others stay safe. His emails haven’t been returned, he said, and the person answering calls hasn’t taken his information.
On Tuesday the CDC elevated its cruise travel warning to Level 3, the highest possible, citing the increased risk of contracting COVID-19 on ships. The CDC advises anyone who has been on a cruise ship in the last two weeks to stay at home for 14 days after they disembark, monitor their health and practice social distancing.
Sacramento Bee reporter Sophia Bollag contributed to this report.
This story was originally published March 18, 2020 at 11:54 AM.
