We describe what we believe is the first instance of complete COVID-19 testing of all passengers and crew on an isolated cruise ship during the current COVID-19 pandemic. Of the 217 passengers and crew on board, 128 tested positive for COVID-19 on reverse transcription–PCR (59%). Of the COVID-19-positive patients, 19% (24) were symptomatic; 6.2% (8) required medical evacuation; 3.1% (4) were intubated and ventilated; and the mortality was 0.8% (1). The majority of COVID-19-positive patients were asymptomatic (81%, 104 patients). We conclude that the prevalence of COVID-19 on affected cruise ships is likely to be significantly underestimated, and strategies are needed to assess and monitor all passengers to prevent community transmission after disembarkation.
- viral infection
- clinical epidemiology
- respiratory infection
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Contributors AJI wrote the manuscript and collated the data. CC collated the data and reviewed the manuscript. JPG collated the data and reviewed the manuscript and was also the ship physician.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
Addendum Following online publication of the paper, a query was raised regarding the difference between the number of tests conducted (217) and the number of passengers and crew believed to be on board ship at the time (221). The authors wish to clarify that testing took place on Day 20. All passengers and crew received written confirmation of their tests by Day 24. The data from ATGen-Diagnostica and testing on the 2 evacuated passengers by Day 20 records a total of 217 individual test results. The authors feel this is an accurate portrayal of the denominator as the testing methodology was strict and are confident everyone on board at the time was tested.
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