tag:theconversation.com,2011:/africa/topics/cruise-ship-25385/articlesCruise ship – The Conversation2022-10-28T01:41:02Ztag:theconversation.com,2011:article/1933842022-10-28T01:41:02Z2022-10-28T01:41:02ZCruise ships are back and carrying COVID. No, it’s not 2020. But here’s what needs to happen next<p>Cruise ships carrying passengers with COVID are back in the news. The Coral Princess, with an unconfirmed number of people testing positive on board, is <a href="https://www.canberratimes.com.au/story/7959796/virus-infected-cruise-ship-to-dock-in-wa/">set to dock</a> at Fremantle, Western Australia. The Quantum of The Seas, with passengers reportedly testing positive, <a href="https://twitter.com/9NewsQueensland/status/1585194230825246721">is heading for</a> Brisbane. There have been similar situations at other ports in <a href="https://www.rnz.co.nz/news/national/477429/cruise-ship-with-covid-19-cases-failed-to-follow-current-isolation-guidelines">New Zealand</a> and <a href="https://www.cruiselawnews.com/2022/10/articles/disease/covid-cruise-ships-return-down-under-with-hundreds-of-infected-guests/">the Pacific</a>.</p>
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<p>But this isn’t 2020. The cruise ship industry and health authorities have learned much from large outbreaks linked to the Ruby Princess and Diamond Princess cruise ships early in the pandemic.</p>
<p>Yet, there’s even more we can do to limit the impact of SARS-CoV-2 (the virus that causes COVID) spreading from cruise ships to communities on land.</p>
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Read more:
<a href="https://theconversation.com/fleas-to-flu-to-coronavirus-how-death-ships-spread-disease-through-the-ages-137061">Fleas to flu to coronavirus: how 'death ships' spread disease through the ages</a>
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<h2>Why are we worried about cruise ships?</h2>
<p>Cruise ships can have epidemics of a variety of infectious diseases, <a href="https://theconversation.com/cruise-ships-can-be-floating-petri-dishes-of-gastro-bugs-6-ways-to-stay-healthy-at-sea-this-summer-126351">not just COVID</a>, facilitated by large numbers of people in close proximity, especially during indoor social activities.</p>
<p>We know SARS-CoV-2 is spread mainly by <a href="https://theconversation.com/the-pressure-is-on-for-australia-to-accept-the-coronavirus-really-can-spread-in-the-air-we-breathe-160641">inhaling contaminated air</a>, so indoor activities may pose a risk if ventilation is poor.</p>
<p>Cruises typically last at least a week, which covers the incubation period for infections such as influenza and COVID. So all it takes is for one infected person to be on the ship to set off an epidemic.</p>
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<p>Staff stay on ships much longer than passengers, and can continue to infect new passengers, perpetuating a cycle of outbreaks. </p>
<p>But <a href="https://www.nature.com/articles/s41591-020-0869-5#Fig1">almost half</a> of infections are transmitted asymptomatically. So, without testing everyone on board (before they board and during outbreaks), infectious people can board a ship without being aware they are infected and cause an epidemic. Infected staff can also infect new passengers, and passengers can infect communities they visit on land.</p>
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Read more:
<a href="https://theconversation.com/cruise-ships-are-coming-back-to-nz-waters-should-we-really-be-welcoming-them-188974">Cruise ships are coming back to NZ waters – should we really be welcoming them?</a>
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<h2>What happened with cruise ships and COVID in 2020?</h2>
<p>Early in the pandemic, large outbreaks on ships, such as the <a href="https://theconversation.com/yes-australians-on-board-the-diamond-princess-need-to-go-into-quarantine-again-its-time-to-reset-the-clock-131906">Diamond Princess</a> made the headlines. Some 634 of 3,711 (17%) people on board <a href="https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180">tested positive</a> for COVID. The ship was quarantined for two weeks. </p>
<p>An <a href="https://elifesciences.org/articles/58699?utm_source=content_alert&utm_medium=email&utm_content=fulltext&utm_campaign=26-August-20-elife-alert">estimated 69%</a> of transmissions on board were transmitted asymptomatically.</p>
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Read more:
<a href="https://theconversation.com/yes-australians-on-board-the-diamond-princess-need-to-go-into-quarantine-again-its-time-to-reset-the-clock-131906">Yes, Australians on board the Diamond Princess need to go into quarantine again. It's time to reset the clock</a>
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<p>The Ruby Princess had a COVID outbreak in March 2020 with <a href="https://www.abc.net.au/news/2022-10-12/nsw-ruby-princess-class-action-trial-covid-19-testing-sydney/101527156">around 700 cases</a>. Yet health authorities allowed passengers to disembark in Sydney without testing, who then dispersed around the country at a time we had no vaccines. </p>
<p>Our research <a href="http://www.ijtmgh.com/article_119534_550421b9e1139603f85c3fc9af97d25a.pdf">showed</a> this resulted in growing community clusters for weeks afterwards.</p>
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Read more:
<a href="https://theconversation.com/ruby-princess-inquiry-blames-nsw-health-officials-for-debacle-144512">Ruby Princess inquiry blames NSW health officials for debacle</a>
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<h2>But it’s not 2020</h2>
<p>We now have vaccines. But vaccination rates vary globally (and cruise passengers are often from many countries). Some vaccines are <a href="https://pmj.bmj.com/content/postgradmedj/98/1159/389.full.pdf">less effective than others</a>, not everyone is up-to-date with their <a href="https://theconversation.com/millions-of-australians-still-havent-had-their-covid-boosters-what-message-could-convince-them-now-190482">booster shots</a>, <a href="https://www.bmj.com/content/377/bmj-2022-071113">vaccine immunity wanes</a> (even after having a booster), and current vaccines are generally <a href="https://theconversation.com/whats-the-difference-in-protection-against-omicron-between-2-doses-and-3-doses-of-vaccine-176447">less-effective</a> against currently circulating Omicron subvariants.</p>
<p>This means people can be infected and infectious despite being vaccinated.</p>
<p>Many of us have also had COVID, especially in 2022. But our immunity following infection (whether or not we’re also up to date with our vaccines) wanes too. People who were infected with older variants may also have a <a href="https://www.science.org/doi/10.1126/science.abq1841">dampened immune response to Omicron</a>, which means limited protection.</p>
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<p>Cruise ships and health authorities have also tightened up their COVID protocols. </p>
<p>The New South Wales government, for instance, publishes on its website <a href="https://www.nsw.gov.au/covid-19/travel/cruising-rules">the COVID risk</a> of in-coming vessels. It places ships in one of three categories according to a number of factors, including the number of COVID cases on board.</p>
<p>Cruise ships also have <a href="https://cruisepassenger.com.au/news/coral-princess-covid-outbreak/">strict protocols</a> for controlling and managing outbreaks. This includes masks for close contacts, mandatory isolation for infected passengers for five days, and testing of anyone with symptoms.</p>
<p>The problem is that transmission can continue because of asymptomatic infections. The ship may need medical evacuations or assistance for severely ill people. There is also the problem of infection being transmitted to communities on shore after people without symptoms disembark.</p>
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Read more:
<a href="https://theconversation.com/what-the-let-it-rip-covid-strategy-has-meant-for-indigenous-and-other-immune-compromised-communities-176664">What the 'let it rip' COVID strategy has meant for Indigenous and other immune-compromised communities</a>
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<h2>We can do more</h2>
<p>People disembarking and unknowingly spreading the virus is especially a problem for small towns.</p>
<p>The itinerary of the Coral Princess, which has since been modified, included the Western Australian towns of Broome and Geraldton, both of which have large Aboriginal communities, and other towns, such as Albany and Busselton. </p>
<p>Small towns may not have a hospital, may have limited access to health care, and would not have capacity to deal with many severely ill patients. Capacity for medical evacuations are also limited.</p>
<p>In the map below, we can see how hospitals are distributed in rural areas around Broome. Most hospitals are near Perth and the southwest coast. Broome has one hospital with about 40 beds. Large hospitals in Perth and Darwin are about 2,000 kilometres away, which would be the destinations for medical evacuations of severely ill patients.</p>
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<a href="https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Map showing distribution of hospitals in Western Australia" src="https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=849&fit=crop&dpr=1 600w, https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=849&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=849&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1067&fit=crop&dpr=1 754w, https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1067&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/492085/original/file-20221027-36452-5tqk25.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1067&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Most major hospitals are near Perth, which is about 2,000 kilometres from Broome.</span>
<span class="attribution"><span class="source">Samsung Lim, author provided</span></span>
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<p>So it’s important to monitor for outbreaks in Broome after the Coral Princess docked there this week, and ensure availability of testing to enable early intervention (such as antiviral drugs) to control outbreaks.</p>
<p>Cruises with outbreaks on board should ideally <a href="https://ozsage.org/working_group/regional-rural-and-remote/">avoid</a> small towns or remote locations with limited health services or vulnerable populations, as the impacts on these communities may be much greater than in a large city. </p>
<p>Visiting small towns during an on-board epidemic <a href="https://ozsage.org/media_releases/ozsage-position-statement-cruise-ship-epidemic-and-risk-to-small-towns-in-western-australia/">would be safer</a> if everyone who disembarks is tested first, is negative, and wears a mask on shore.</p>
<h2>What else could we do?</h2>
<p>The cruising industry has acknowledged the reality of COVID being a continuing threat. This could be improved by recognising the role of asymptomatic transmission in testing policies.</p>
<p>For instance, all passengers and crew should have a negative rapid antigen test at the start of the cruise, and during an outbreak. All close contacts and all disembarking passengers should be tested for COVID, regardless of symptoms. The cost of testing would be much less than the lost costs of large epidemics.</p>
<p>During a cruise epidemic, companies also need to consider the locations being visited, how much COVID is already present there (some remote towns have very little COVID) and available health-care systems for locals.</p>
<p>Rapid use of antivirals may also help to control epidemics on board as these allow passengers testing positive to <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00644-2/fulltext">clear the virus faster</a>.</p>
<p>The aviation industry <a href="https://www.ashrae.org/file%20library/technical%20resources/covid-19/12-19_walkinshaw.pdf">does well</a> in providing safe air in-flight. The cruise industry has also started <a href="https://www.cruisecritic.com.au/articles.cfm?ID=5474">changing ventilation</a> to add fresh air instead of recirculated air indoors.</p>
<p>But there is still some way to go before we can say the threat of COVID is over, on-board or on land.</p><img src="https://counter.theconversation.com/content/193384/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>C Raina MacIntyre currently receives funding from NHMRC, MRFF and Sanofi for nvestigator driven research.</span></em></p><p class="fine-print"><em><span>Samsung Lim receives funding from Medical Research Future Fund, Department of Health.</span></em></p><p class="fine-print"><em><span>Ashley Quigley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We’ve learned much from large COVID outbreaks linked to the Ruby Princess and Diamond Princess cruise ships early in the pandemic. But there’s still some way to go.C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW SydneyAshley Quigley, Research Assistant, UNSW SydneySamsung Lim, Associate Professor, Biosecurity Program, The Kirby Institute, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1319062020-02-20T05:46:45Z2020-02-20T05:46:45ZYes, Australians on board the Diamond Princess need to go into quarantine again. It’s time to reset the clock<p>Today’s evacuation of about 180 passengers from the cruise ship Diamond Princess to serve another period of quarantine back in Australia has raised questions about the best way to control spread of the coronavirus.</p>
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<p>The passengers had already spent 14 days quarantined on board the ship, which had been docked in Japan, and now face another 14 days at the Howard Springs quarantine facility close to Darwin.</p>
<p>Di Stephens, Northern Territory’s acting chief health officer, <a href="https://www.abc.net.au/news/2020-02-20/cruise-ship-australians-arrive-darwin-for-coronavirus-quarantine/11981394">told the ABC</a> today:</p>
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<p>These people need to go into quarantine because we are not entirely convinced that the quarantine procedures on that ship were 100% effective.</p>
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<p>By contrast, Japan’s health ministry is allowing <a href="https://www.nytimes.com/2020/02/19/world/asia/japan-cruise-ship-coronavirus.html">hundreds of people</a> to leave the ship without being subject to further quarantine.</p>
<p>So what’s behind Australia’s announcement to impose a second quarantine period? And what were conditions like on board to prompt this decision?</p>
<h2>What’s quarantine?</h2>
<p>Quarantines have been put in place around the world as part of the global public health response to COVID-19 – the disease caused by a new coronavirus, now named SARS-CoV-2. </p>
<p>The idea is to limit the spread of the virus within and between countries.</p>
<p>Formal measures designed to limit contact between infected (or potentially infected) people are called “social distancing”. And they have been used to control communicable diseases for <a href="https://www.bible.com/bible/116/LEV.13.NLT">at least 2,500 years</a>.</p>
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Read more:
<a href="https://theconversation.com/remote-village-to-metropolis-how-globalisation-spreads-infectious-diseases-92216">Remote village to metropolis: how globalisation spreads infectious diseases</a>
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<p>Today, the term <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5229a2.htm">quarantine refers to</a> the separation or restriction of movement of people who are not ill but are believed to have been exposed to an infectious disease. </p>
<p>This differs to isolation, which is the term used for the separation or restriction of movement of people who are ill, thereby minimising onward transmission.</p>
<h2>How long should quarantine last?</h2>
<p>Quarantine periods are determined by certain characteristics of the infectious agent, most notably the incubation period. This is the period between being exposed to it and symptoms appearing.</p>
<p>For COVID-19, the <a href="https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.5.2000062">average incubation period</a> is thought to be around six days, and can range from two to 11 days.</p>
<p>While a <a href="https://www.medrxiv.org/content/10.1101/2020.02.06.20020974v1.full.pdf">preliminary report</a> has suggested a longer incubation period of up to 24 days, this is <a href="https://doi.org/10.1002/jmv.25708">considered unlikely</a>.</p>
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Read more:
<a href="https://theconversation.com/how-contagious-is-the-wuhan-coronavirus-and-can-you-spread-it-before-symptoms-start-130686">How contagious is the Wuhan coronavirus and can you spread it before symptoms start?</a>
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<p>People who have been in close contact with someone confirmed to have COVID-19 are considered to have been potentially exposed to the virus. As a precaution, these people are placed in quarantine, essentially to “sit out” their potential incubation period.</p>
<p>The quarantine period of 14 days currently being used in Australia and elsewhere for COVID-19 takes into account the maximum known incubation period for this disease, plus a few extra days as a reasonable precaution.</p>
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<p>In quarantine, people will either develop the disease and have symptoms or they will remain well. In theory, if a person remains well after their period of quarantine, they are deemed uninfected and restrictions are lifted.</p>
<p>Another factor that influences how long someone needs to be quarantined is the infectious period. That’s the period during which the infection can be transmitted from one person to another.</p>
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Read more:
<a href="https://theconversation.com/theres-no-evidence-the-new-coronavirus-spreads-through-the-air-but-its-still-possible-131653">There's no evidence the new coronavirus spreads through the air – but it's still possible</a>
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<p>If the infectious period starts before the symptoms (from asymptomatic or minimally symptomatic individuals), the virus can be transmitted silently. This can substantially complicate disease prevention and control. </p>
<p>When a new virus emerges – as with SARS-CoV-2 – the infectious period is largely unknown. While the proportion of asymptomatic or minimally symptomatic COVID-19 cases is not clear, it is increasingly apparent people can be infected <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2001899?query=RP">without having any symptoms</a>. However, further evidence is needed to see if these people can infect others.</p>
<h2>When is it best to extend the quarantine period?</h2>
<p>Crucial to quarantine is ensuring that best possible infection control practices are put in place to prevent ongoing transmission. </p>
<p>It is also essential to assess real-time data about newly diagnosed cases, which tells us how effective quarantine measures have been.</p>
<p>In some circumstances, it may be necessary to extend a person’s period of quarantine, as in the case of the Australian citizens on board the cruise ship Diamond Princess.</p>
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Read more:
<a href="https://theconversation.com/cruise-ships-can-be-floating-petri-dishes-of-gastro-bugs-6-ways-to-stay-healthy-at-sea-this-summer-126351">Cruise ships can be floating petri dishes of gastro bugs. 6 ways to stay healthy at sea this summer</a>
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<h2>So, what happened on board the Diamond Princess?</h2>
<p><a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports">Data from the World Health Organisation</a> (WHO) give us clues to what’s behind Australia’s decision to impose a second period of quarantine.</p>
<p>The graph below shows there may have been up to four possible waves of infections on board, including an initial undetected wave before quarantine measures were imposed.</p>
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<img alt="" src="https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=698&fit=crop&dpr=1 600w, https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=698&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=698&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=877&fit=crop&dpr=1 754w, https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=877&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/316386/original/file-20200220-92530-g31xi.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=877&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>These data demonstrate ongoing SARS-CoV-2 transmission between people on board during the quarantine period. It also indicates breaches in infection control on board may have contributed to ongoing waves of infections, which an expert highlights in the video below.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/t-J1OSg2hw8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">An expert raises concerns about infection control measures on the Diamond Princess cruise ship.</span></figcaption>
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<p>Evidence of ongoing transmission during the quarantine period supports the decision by several countries to evacuate their citizens from the Diamond Princess, including Australia, to “reset the clock” and to impose a further 14-day quarantine period.</p>
<p>This additional measure – while causing considerable and understandable frustration to those affected – is designed to limit transmission of COVID-19 within Australia.</p>
<h2>The rights of individuals versus public good</h2>
<p>Implementing public health measures, such as isolation and quarantine, requires decision-making that <a href="https://www.who.int/healthsystems/topics/health-law/chapter10.pdf">balances the rights</a> of individuals and public good.</p>
<p>When appropriately designed and implemented, quarantine and isolation work. Even when quarantine is not absolutely adhered to, it can still be effective at reducing the likelihood of large-scale outbreaks. </p>
<p>With <a href="https://www.ncbi.nlm.nih.gov/books/NBK92450/">SARS</a> (severe acute respiratory syndrome), these strategies were thought to have been an important part in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1691853/">controlling the epidemic</a>, though they were <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5229a2.htm">resource and labour intensive</a>.</p>
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Read more:
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<img src="https://counter.theconversation.com/content/131906/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Quarantine measures on the Diamond Princess cruise ship weren’t effective, suggests new data. So Australian passengers without symptoms are going into quarantine again.Stacey L Rowe, PhD candidate, Monash UniversityBenjamin Cowie, Director, WHO Collaborating Centre for Viral Hepatitis, The Peter Doherty Institute for Infection and ImmunityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/663502016-10-03T15:38:35Z2016-10-03T15:38:35ZCruise lines promise big payouts, but the tourist money stays at sea<figure><img src="https://images.theconversation.com/files/140132/original/image-20161003-20217-1pebwka.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><span class="source">Wolfgang Moroder</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>The cruise industry tends to provoke strong responses, some for and – as seen by <a href="https://www.theguardian.com/world/shortcuts/2016/sep/27/dont-look-now-venice-tourists-locals-sick-of-you-cruise-liners">recent protests in Venice, Italy</a> – some very much against.</p>
<p>On the one hand cruise devotees can describe the cruises they’ve taken, preferred destinations, cruise lines, ships – even their favourite captains. Nothing will dissuade these ardent fans from their annual trip, some of whom embark on 20 or more a year. In 2014, the Cruise Lines International Association reported <a href="http://www.cruising.org/docs/default-source/research/uk_ireland_marketreport_2014.pdf?sfvrsn=2">two thirds of passengers were repeat guests</a>. On the other hand, many people and organisations remain fiercely opposed to the industry, its employment policies, its record on environmental management, the opacity of its taxation arrangements, and the impact its super-sized ships have on destinations. </p>
<p>The recent protest in Venice saw residents take to the water to protest against huge cruise ships entering the city via the Grand Canal. This encapsulates many of the criticisms against the industry, especially those lines with ships capable of carrying 6,000 or more passengers and crew. </p>
<p>In a city such as Venice, which is slowly sinking beneath the waves, such huge vessels can cause further environmental damage, adding to the <a href="http://www.dailymail.co.uk/news/article-2583621/Venice-ban-giant-cruise-ships-lifted-absence-practical-alternative-navigation-routes.html">erosion of the canals and impact on the fragile ecosystem</a>. These huge ships dwarf the city’s beautiful architecture, and disgorge thousands of passengers that choke the narrow canals and streets. Venice’s governing officials have consistently refused to acknowledge calls to limit the size and number of ships as they believe they bring greater number of tourists and economic benefits to the city.</p>
<h2>A ship that undermines</h2>
<p>Venice versus the cruise ships is just one example of growing unease about the scale of mass-market tourism. Cities and towns worldwide have started to protest this more vigorously, with <a href="https://www.theguardian.com/commentisfree/2014/sep/02/mass-tourism-kill-city-barcelona">Barcelona being another recent case</a>. At the heart of these protests, especially with regards to cruise tourism, are concerns that it is economically, socially and environmentally unsustainable. </p>
<p>Tourists’ holiday expenditure in Europe is split roughly equally between accommodation, transport and other expenses. But for those on cruises their accommodation travels with them, removing a third of the destination’s potential income. Another third is affected because cruise passengers often return to the ship for lunch and dinner, <a href="http://www.cleveland.com/business/index.ssf/2012/10/caribbean_cruises_leave_wave_o.html">included as part of their cruise package</a>. In fact a significant number of passengers <a href="https://skift.com/2014/03/01/cruise-ships-compete-with-ports-for-passenger-dollars/">never get off the ship in port</a>, preferring to make use the ships’ amenities, which are then at their least busy.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140134/original/image-20161003-20223-fcki7y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Towering over the competition.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/infomatique/26877087374">infomatique</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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</figure>
<h2>A ship that divides</h2>
<p>The social impact of cruise tourism depends on the size of the destination, the extent to which the destination relies on cruise tourism for revenue, and the size of visiting cruise ships.</p>
<p>One feature of the cruise industry is their preference for offering “private islands” to their passengers. While some are indeed islands, mostly in the Caribbean, others are actually coastal peninsulas and so neither islands nor really private. They are leased by national governments to cruise lines who operate them as exclusive enclaves. This brings little economic benefit to local residents, as all food and refreshments are carried from the ship to the islands and beaches. </p>
<p>One such enclave, <a href="http://articles.sun-sentinel.com/keyword/labadee">Labadee on the north-west coast of Haiti</a>, permits a small number of local people to sell souvenirs twice a week during cruise season. Up to 50 more are employed as beach hands, tour guides, live exhibits, and toilet attendants. This type of “off the shelf” development appeals to governments looking for short term income, but while this approach offers cruise operators significant benefits, it has little to offer the local community.</p>
<h2>A ship that pollutes</h2>
<p>Criticism of cruise lines from an environmental perspective is growing around concerns about pollution and marine fuel’s role in climate change. While cruise ships account for only 8% of global shipping and recently-built mega-ships are able to fully process sewage and food waste on board, an increase in the <a href="http://www.pocruises.com/exotic-fly-cruises/">fly-cruise</a> market means that air miles should be included when calculating the true cost of cruise tourism pollution. </p>
<p>The cruise industry is reluctant to engage with any criticism. And while perhaps it’s unfair to suggest this is different to any other similarly-sized commercial entities, it is irrefutable that cruise lines are able to generate huge profits because they are incorporated in tax havens such as Bermuda, Liberia and Panama. These open shipping registries, commonly known as <a href="https://www.hg.org/article.asp?id=31395">flags of convenience</a>, means minimal regulation to comply with in terms of labour costs, environmental regulations and safety standards. </p>
<p>While legal and applicable to all shipping, cruise lines rely heavily on their workforce to satisfy their passengers’ high service expectations. That these same companies take any opportunity to avoid any legislation that would offer these workers wage protection and job security is just one of a long line of criticisms the industry is seemingly reluctant to acknowledge, let alone address. In a world that since the <a href="https://panamapapers.icij.org/">Panama Papers</a> is increasingly aware of such issues, the industry cannot afford to ignore it much longer.</p><img src="https://counter.theconversation.com/content/66350/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Weeden does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Cruise ship destinations like Venice have realised that the benefits the industry promises don’t add up.Clare Weeden, Principal Lecturer in Tourism and Marketing, University of BrightonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/657592016-09-23T10:12:41Z2016-09-23T10:12:41ZWhy cruise liners could be a crucial part of the response to national disasters<figure><img src="https://images.theconversation.com/files/138512/original/image-20160920-12448-1blxcwj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Canapes not required. </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-106416110/stock-photo-luxury-cruise-ship-sailing-at-sunset.html?src=pWXOKp5E33RvvZ5f9g2qXQ-2-93">EpicStockMedia</a></span></figcaption></figure><p>In January and February 2014, two major earthquakes <a href="https://www.theguardian.com/world/2014/feb/03/greek-island-kefalonia-earthquake">hit the</a> Greek island of Kefalonia. No one was killed and only one person injured, thanks to strict construction rules in an area of regular seismic activity, yet the earthquakes were a human disaster nonetheless: they damaged the homes of about 5,000 of the 36,000 island inhabitants, leaving them all homeless. </p>
<p>Large scale homelessness and damaged infrastructure are common after earthquakes like these. After this Kefalonian disaster, however, something unique happened: luxury cruise ships provided victims with temporary accommodation and other necessities in the days and weeks that followed. </p>
<p>This has the potential to be tremendously important to how we handle disasters in future. It could provide a blueprint that has major implications both for victims and economic recovery. </p>
<p>To avoid the worst when crises like earthquakes strike, governments and NGOs continuously prepare disaster relief plans. There include three internationally recognised phases. There’s a preparation phase, which is about logistics: sourcing everything from emergency services to food to tents. These resources are then deployed during phase two, immediate response, ahead of a third phase for reconstruction. </p>
<p>In Kefalonia, the island’s authorities did not have the resources to handle these phases in-house. Amid heavy rain and cold weather in the hours after the first earthquake struck, they requested assistance from NGOs like the Red Cross and Lions Clubs and, unusually, the private sector – in this case Greek shipowners. These organisations all began collaborating instantly. </p>
<p>Some victims received standard-issue army tents and camped in a local sports stadium for a night, which is the sort of thing that traditionally happens in these situations. But temperatures were very cold and there was no heating, so they were taken along with everyone else to two cruise ships. These had been provided by the shipowners either free or at minimum cost within 24 hours of the first earthquake. </p>
<h2>Making a difference</h2>
<p>Victims and other local people that participated in <a href="https://pureapps2.hw.ac.uk/portal/en/publications/getting-the-right-thing-done-in-kefallonia--ethics-cruise-industry-and-disaster-management(9b5ec4cb-d07d-4a79-b949-c7ceff26762c)/export.html">our research</a> into how the disaster was handled said that using these vessels brought only positive outcomes. The crew’s training in handling demanding customers during regular cruises was extremely useful, since many victims were severely traumatised. </p>
<p>The ships gave these people high-quality accommodation, catering and sanitary facilities, which enabled them to think about how to restructure their lives in a safe and relaxed environment. Our respondents all agreed it was a much better solution than camping. Many victims remained onboard for two months. </p>
<p>The other benefit of moving the victims offshore was that it cleared the vicinity of the earthquake. This made it easier for the local government to focus on quickly repairing damaged infrastructure such as roads, water supply systems and ports. It enabled it to skip much of the first two phases in dealing with a natural disaster and move straight to reconstruction. </p>
<p>It is worth pointing out that the shipowners did not get involved for any potential future economic benefit. They sought no publicity and were ready to break ongoing contracts if necessary to assist the victims. Like the crew and everyone else involved in the humanitarian response, they were motivated purely out of a sense of doing the right thing. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=366&fit=crop&dpr=1 600w, https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=366&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=366&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=460&fit=crop&dpr=1 754w, https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=460&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/138623/original/image-20160921-21701-11l4rh2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=460&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ferries to the rescue.</span>
<span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/a/a7/Superfast.JPG">Wikimedia</a></span>
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<h2>Shipping them in</h2>
<p>According to the <a href="http://www.unep.org/urban_environment/issues/coastal_zones.asp">UN Environment Programme</a>, half of the world’s population lives within 60km of the sea, and three-quarters of all large cities are located on the coast. What happened in Kefalonia should therefore be seen as a template for disaster relief for a large proportion of the world’s population. </p>
<p>Cruise ships can provide an immediate high-quality response that is not affected by weather conditions. While they would have been less helpful after the recent earthquake in <a href="http://www.wtvq.com/2016/08/28/the-latest-italy-lowers-quake-death-toll-back-to-290/">Accumoli</a> in Italy, which was further inland, Kefalonia demonstrates how such ships can free up resources for restoration. </p>
<p>Neither is there any need to ask shipowners for favours in the event of disaster. Country governments in high-risk zones ought to be assessing to what extent their shipping sector might be able to help, and open negotiations in advance. Countries without shipping industries ought to be looking at reaching agreements with shipowners from other countries, while NGOs should consider their potential to help with such arrangements, too. </p>
<p>In Greece two years ago, necessity was the mother of an extremely innovative invention. Not only could it benefit other countries after natural disasters, there is no reason why it couldn’t be used to handle other situations of human distress such as refugee crises as well.</p><img src="https://counter.theconversation.com/content/65759/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stavros Karamperidis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Tents and food parcels are one thing, ready-built accommodation is another.Stavros Karamperidis, Assistant Professor in Shipping and International Logistics, Heriot-Watt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/552452016-03-01T13:25:00Z2016-03-01T13:25:00ZTime to rock the boat? Cruise ships can destroy the very destinations they sell to us<figure><img src="https://images.theconversation.com/files/112974/original/image-20160225-15156-fmhw5e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">atm2003 / shutterstock</span></span></figcaption></figure><p>Italy plans to cut back on the number of visitors allowed into Cinque Terre, a particularly picturesque section of its north-western coast. Around 2.5m tourists visited the area in 2015; this year, numbers will be <a href="http://www.theguardian.com/world/2016/feb/17/italy-to-impose-limits-on-visitors-to-cinque-terre-with-tourist-ticket-system">limited to 1.5m</a>. Such a drastic move raises questions about the impacts and benefits of mass tourism – and particularly cruise ships.</p>
<p>This region of the Italian Riviera, characterised by its charming seaside villages set against rugged terrain, was once difficult to access and off the beaten path of mass tourism. Cruises helped change all that. </p>
<p>These ships began docking in the nearby port of La Spezia just a couple of decades ago, and several now arrive every week. This brought immediate economic benefits to the region. However, as the numbers of tourists have grown each year, the strain on local infrastructures has become too much to bear. Last year, <a href="http://www.telegraph.co.uk/news/worldnews/europe/italy/11899585/Italys-stunning-Cinque-Terre-coastal-villages-complain-of-being-smothered-by-tourism.html">nearly 650,000</a> of those Cinque Terre tourists came from cruise ships.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/113376/original/image-20160301-31050-ua7122.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ahoy, Cinque Terre! Room for 650,000 more?</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/basykes/3701634853/">Bev Sykes</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>These are small villages in precarious locations and therefore lack the necessary water, sewerage, electrical, and transportation services to accommodate such a rise in demand. While there are a few public toilets in Cinque Terre, these are not enough – and residents now report tourists using footpaths and even private gardens to <a href="http://www.telegraph.co.uk/news/worldnews/europe/italy/11899585/Italys-stunning-Cinque-Terre-coastal-villages-complain-of-being-smothered-by-tourism.html">relieve themselves</a>.</p>
<h2>Everyday life among tourists</h2>
<p>None of this is new. Venice should already have provided a warning of the damage wrought by too many cruise ships. More than half of the historic city’s population has left since 1980, when its popularity as tourist destination skyrocketed, and fewer than <a href="http://www.citymetric.com/transport/can-smart-mobility-planning-prevent-disneyfication-venice-1456">58,000 people</a> live in the city today. Their numbers are dwarfed by the 100,000 or more tourists per day during the peak summer season, up to <a href="http://www.ibtimes.com/venice-massive-tourism-now-huge-cruise-ships-ruining-citys-priceless-charms-780741">30,000 of whom</a> are on a cruise.</p>
<p>Most major ocean liners hold 3,000 or more passengers. These large ships allow the number of visitors to the city to exceed its physical capacity, as determined by hotel rooms. This makes everyday life cumbersome. Strolling tourists clutter the footpaths, pausing to take photographs. There are lengthy queues for water taxis, the rates of which have risen because of demand. This is reflective of prices throughout the city.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/113284/original/image-20160229-4074-1ass7py.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Modern cruise ships tower over traditional Venice.</span>
<span class="attribution"><span class="source">meunierd / shutterstock</span></span>
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<p>Within the city, tourism is prioritised because of the money it brings in. Property prices continue to rise and residents find it difficult to afford housing in the city. Market stands are steadily closing down as they cannot compete for space in the <em>campi</em> with cafés and pubs, let alone the souvenir shops bursting with Venetian masks. Basic services for <a href="https://vimeo.com/24874188">life in the city</a> are diminishing.</p>
<h2>Ocean life also pays the price</h2>
<p>Each year cruise ships dump about <a href="http://libcloud.s3.amazonaws.com/93/ac/7/4988/Cruise_Ship_Report_Card_2014.pdf">1 billion gallons</a> of waste into the sea. They’re supposed to eject it into the deep ocean, however sometimes they dump closer to shore, presenting <a href="http://www.sciencedirect.com/science/article/pii/S0025326X11003754">serious health risks</a>.</p>
<p>When the Costa Concordia struck ground off of Italy’s coast in January 2012, the disaster once again shed light on the ecological damage cruise ships can cause. After human-rescue efforts were exhausted, marine biologists, fearing toxins (such as petrolchemicals and human waste) would enter the water, worked quickly to move coral and sponge species to safer areas nearby. In particular, about 200 giant <a href="http://www.reuters.com/video/2012/11/01/giant-mussels-rescued-from-around-shipwr?videoId=238824032">fan mussels</a> were manually relocated.</p>
<p>The waters and fragile coral reefs around Caribbean islands can be particularly affected by big cruise ships. Coral reefs are a crucial tourism attraction, and an essential part of their marine ecosystem, but two-thirds of the region’s coral is <a href="http://www.wri.org/publication/reefs-risk-caribbean">threatened by human activity</a>.</p>
<p>In one incident last December, the Zenith, a 12-deck vessel carrying more than 1,800 passengers <a href="http://www.dailymail.co.uk/travel/travel_news/article-3354133/Zenith-cruise-ship-anchor-damages-coral-reef-Cayman-Islands.html">dropped anchor near the Grand Cayman’s coral reef</a> and destroyed large chunks of it as the anchor and its chain dragged across the ocean floor. While there are regulations against damaging the Cayman’s coral reef, the ship was inside the anchorage area. Thus, there remains no compensation for the damage, just a public statement of grievance about the incident.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/U3l31sXJJ0c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Local scuba instructor Scott Prodahl documented the damage to the reef.</span></figcaption>
</figure>
<p>Some places have even deliberately demolished their coral reefs. Falmouth, on Jamaica’s north coast, has dredged its port to clear the way for the very largest ships, such as Royal Caribbean’s 6,000-passenger Allure of the Seas and the Oasis of the Seas. While trade journal Port Technology assures that <a href="https://www.porttechnology.org/technical_papers/jamaican_cruise_ship_terminal_respects_environment/">care was taken</a> and modules installed to help rebuild coral elsewhere, environmentalists say the project destroyed <a href="http://archive.onearth.org/article/dreamboat?page=3">35m cubic feet of coral reef</a> and two square miles of mangroves.</p>
<h2>Sustainable cruise shipping?</h2>
<p>Cruise ships aren’t all bad, of course. They are a part of the mass tourism trend that has democratised travel and opened up activities which were once reserved for the wealthy. Cruises provide a way for millions of people to go abroad and experience different cultures. This is not without merit. </p>
<p>But the industry’s tremendous growth is rapidly degrading its destinations – the very products it promises. Its continued financial success is based on the sustainability of these destinations. If the cruise industry does not see this as enough reason to impose regulations, then the international community has a responsibility to step in, both for the people who live in destinations that depend on tourism and for ourselves as tourists who want there to be a world to see well into the future.</p><img src="https://counter.theconversation.com/content/55245/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jillian Rickly does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Large ocean liners with several thousand passengers can overwhelm small towns and vulnerable coastlines.Jillian Rickly, Assistant Professor in Tourism Management and Marketing, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.