cruise lines no longer requiring covid testing

Do You Need to Be Vaccinated to Cruise? It Depends on the Ship and Destination

While most cruise lines have scrapped covid vaccine and testing requirements, some companies and international cruise ports still have vaccination and testing rules in place..

• Copy Link copied

If you’re planning on sailing with Viking anytime soon, you’d better track down that COVID-19 vaccine certificate.

Courtesy of Viking

When cruising restarted in spring 2021, after a nearly 15-month pandemic-spurred shutdown imposed by the U.S. Centers for Disease Control and Prevention (CDC), cruisers faced a barrage of rules, including strict requirements for COVID-19 vaccinations and precruise COVID-19 testing. Later, the rules started to go by the wayside, and it was hard to keep track of who was requiring what. Not anymore.

Most cruise lines have now dropped or are soon dropping rules for both vaccinations and precruise testing, with at least one notable exception. Viking —on its river, ocean, and expedition ships—still requires everyone on board be fully vaccinated .

Another line that was still requiring COVID vaccinations, small-ship line Windstar Cruises, will be scrapping its vaccine mandate as of June 1, 2023. “We’ve invested in and improved our health and safety processes, including upgrading the HVAC systems on all of our ships, which has led to a cleaner and safer environment on board,” says Windstar president Christopher Prelog. “When combined with the widespread availability of vaccines and medical treatments, the risk factors are considerably lower now, giving us the confidence to lift the requirement.”

Are COVID vaccinations and testing still required for cruises?

Most cruise lines have dropped both their vaccine and testing requirements. Those that have lingered into 2023—mostly lines operating smaller ships—have been quietly scaling back their requirements.

The result: While there was a time after cruising restarted that you could be assured that your fellow passengers, at least those age 12 and up, were both fully vaccinated and tested for COVID-19 before getting on the ship, that is not the case anymore.

That said, specific countries have their own requirements, and several countries still require that cruise ship passengers are vaccinated and/or tested before arrival. If you are doing an itinerary outside of the Caribbean or Europe (where most vaccine and testing requirements have been dropped)—including to select countries in Central and South America or to Australia—you still have to read your cruise line’s precruise health and safety information carefully to make sure you comply with the latest requirements.

Contact your cruise line or check the U.S. State Department’s travel advisories for the latest.

What to know before you cruise

Vaccine and pretrip testing requirements can be confusing, especially if you are cruising internationally. Cruise lines have their own rules; countries have their own rules.

Before your trip, you will need to review your cruise line’s health and safety protocols. If a precruise test is required by a certain country, you will find that noted. In this case, you may be required to arrive at your ship with a negative COVID-19 test result in hand or not. (If testing is required, it can typically be either a PCR test or tele-health-monitored antigen test , paid for by the passenger. The cruise line may also require a test at the pier, paid for by the cruise line.)

If being fully vaccinated is required, that means having received the original series of vaccines at least 14 days prior to your cruise, or the original series plus a booster shot or shots.

As was the case even before the pandemic, you will be asked at embarkation to fill out a questionnaire inquiring about your current health status and whether you currently have any symptoms of illness.

You are free to pack and wear masks on your cruise. Most cruise lines suggest you do wear masks in crowded indoor situations—but it’s not enforced.

A quick cruise line guide to COVID requirements

Here’s a rundown of the basic rules for some leading cruise lines. Note: There may be additional requirements if you are traveling internationally. Be sure to review the latest requirements prior to boarding.

American Queen Voyages

On American Queen Voyages’ river, ocean, Great Lakes, and expedition ships, there are no longer any precruise testing or vaccinations required. Face coverings are optional, though masks may be required of any passengers showing symptoms.

Precruise testing is no longer required for vaccinated guests sailing with Azamara , except in ports where testing is required. No vaccination is necessary for cruises departing from or returning to the United States or Europe. In Australia, all guests 12 years and older must be fully vaccinated at least 14 days before sailing with all required COVID-19 vaccine doses (including a booster shot). Children under 12 years old are not required to be vaccinated.

Celebrity Cruises

No vaccination or testing is required on the majority of Celebrity Cruises sailings. Destinations with stricter requirements include: the Galápagos, Australia and New Zealand, transatlantic crossings, and select Central and South America itineraries. Unvaccinated guests need to be tested in Brazil, Chile, and Colombia.

As of April 23, 2023, on the Queen Mary 2 and Queen Victoria , and as of June 8, 2023, on the Queen Elizabeth , vaccinations and testing will no longer be required by Cunard (until then, testing and vaccination requirements apply).

Disney Cruise Line

For sailings embarking from the United States, which are the bulk of Disney Cruise Line’s sailings, no vaccination or testing is required. Disney recommends all guests be vaccinated before sailing and take a test for COVID-19 two days prior to their cruise. There are additional requirements on repositioning cruises and in Australia, so it is important to check the line’s website before your cruise.

Holland America Line

There are no precruise testing or vaccination requirements on most Holland America Line itineraries. There are requirements on select voyages (you can look up a specific voyage’s requirements on the line’s website).

Lindblad Expeditions

For voyages embarking on or after May 11, 2023, Lindblad Expeditions will no longer require guests to be fully vaccinated, although the line recommends guests be fully vaccinated (for cruises prior to that time, all passengers age five and up must be vaccinated). Lindblad recommends, but does not require, passengers take a predeparture COVID-19 test within five days of the start of their expedition.

Oceania Cruises

Vaccine requirements are purely dependent on the destinations being visited on each Oceania cruise. Passengers are advised to be up to date on the latest regulations for all destinations on their cruise itinerary.

Paul Gauguin Cruises

Effective April 2023, Paul Gauguin Cruises no longer requires that passengers are vaccinated or tested for COVID prior to embarkation, but it continues to encourage vaccination. “Paul Gauguin Cruises’ officers, staff and crew will remain fully vaccinated,” the line states. Travelers will need to present a health declaration form at embarkation.

Regent Seven Seas Cruises

Vaccines and precruise testing are generally not required to sail with Regent Seven Seas Cruises . There are some requirements in place based on local health regulations in a specific country a ship is visiting. Regent notifies guests approximately 30 days prior to sailing of any country-specific protocols.

Royal Caribbean

No vaccine or precruise testing is required on the majority of Royal Caribbean itineraries, with a few exceptions: Cruises from Australia, transpacific and transatlantic sailings, and cruises from Hawai‘i to Vancouver.

No vaccine or testing required except on certain Seabourn itineraries where a country may have specific requirements.

No vaccination is required for Silversea passengers except as designated by the destination. Precruise testing is not required except when specified by a destination.

Viking Cruises

All passengers and crew are required to be vaccinated on Viking’s river, ocean, and expedition ships—without exception. Viking strongly recommends passengers receive a booster dose before departing. Viking recommends but does not require a predeparture COVID-19 test (except if required by a destination).

Virgin Voyages

Virgin Voyages has no precruise testing or vaccination requirements. Masks may be required at select times.

Windstar Cruises

Beginning June 1, 2023, Windstar will no longer require guests to be vaccinated. Crew will continue to be vaccinated. Masks are optional, with the line highly recommending guests wear masks in indoor public spaces. All guests fill out a health questionnaire on embarkation. A precruise COVID-19 test is not required unless you show symptoms.

This article was originally published in May 2022; it was most recently updated on April 19, 2023, with current information.

• Search Please fill out this field.
• Manage Your Subscription
• Give a Gift Subscription
• Newsletters
• Sweepstakes

Every Cruise Line's Requirements for COVID Vaccines, Testing

A guide to every major cruise line's health requirements for safe sailing.

Cruise lines have shifted their requirements for passengers, making cruising accessible to practically everyone. Many popular cruise lines have eliminated the vaccine and pre-embarkation test as the industry is beginning to shift away from mandatory vaccines and testing.

The changes began shortly after the CDC ended a pandemic-era policy of publicly displaying COVID-19 cases onboard, different cruise lines to the public in July 2022. For those looking to check current COVID-19 trends onboard the CDC urges direct contact with the cruise line, and the organization will continue to monitor and offer guidelines to ships.

Below, we break down each line's list of regulations to sail as well as what travelers need to know to plan.

Avalon Waterways

Where they sail: These small-ship river cruises sail throughout Europe, Asia, South America, and down the Nile River in Egypt.

Who needs the vaccine: All international travelers from the U.S. must be fully vaccinated before boarding. Beginning March 2023 the vaccine is no longer required (but strongly encouraged).

What other safety measures are in place: All guests will undergo a health screening upon arrival and luggage will be disinfected. Avalon will provide COVID-19 testing for travelers who need to show proof of a negative test to return home at no extra cost. Depending on the location of the cruise a pre-departure COVID-19 test may or may not be required.

Find out more: Avalon Waterways

Where they sail : Azamara sails mid-size ships all over the world, to all seven continents.

Who needs the vaccine : All guests and crew 12 and older will be required to be fully vaccinated at least two weeks before boarding a ship. Beginning Dec. 1, 2022, the company plans to drop the vaccine requirement for departures from the U.S. and Europe.

What other safety measures are in place : Depending on the port of embarkation guests may or may not to pre-test to travel. For a full list of ports and whether they require a test guests can check online.

Azamara's ships have been upgraded with new HVAC filtration systems, and EPA-certified disinfectants are used to clean the ship.

Find out more : Azamara

Carnival Cruises

Where they sail: Carnival sails large ships around the world, including popular trips to the Caribbean. The company sailed its maiden voyage on the Mardi Gras out of Florida in July.

Who needs the vaccine: All guests are encouraged to be vaccinated but unvaccinated travelers, or vaccinated guests without proof of vaccination, will have to present the negative results of a PCR or antigen test taken no earlier than 3 days before sailing.

What other safety measures are in place: For cruises five days or less, there will no longer be pre-cruise testing for vaccinated passengers unless a specific port requires it. Itineraries including Bahamas, Bermuda, or Grand Cayman will still be required to test. All guests will also be required to fill out a health screening 72 hours before embarkation and undergo health screenings prior to boarding. Unvaccinated travelers on a cruise to Bermuda will be required to purchase travel insurance (children under 12 are exempt as long as they are traveling with vaccinated parents).

Both vaccinated and unvaccinated guests who have recovered from COVID-19 within three months of their sailing date, do not need the required pre-cruise COVID test before embarkation, only if they are at least 10 days past their COVID-19 infection, have no symptoms and present documentation of recovery from COVID-19 from their healthcare provider.

Find out more: Carnival Cruise Line

Celebrity Cruises

Where they sail: Celebrity Cruises sails all over the world.

Who needs the vaccine: The vaccine is no longer required to sail on cruises from the U.S. and Europe. A vaccine is required for sailings visiting Canada.

What other safety measures are in place: A pre-embarkation test is no longer required for vaccinated guests on sailings nine days or less. Unvaccinated passengers will still be required to test three days prior to sailing. Self-tests are acceptable from European and U.S. ports that don't stop in Bermuda or Canada.

Find out more : Celebrity Cruises

Where they sail: Cunard, which sails all over the world, is known for its transatlantic journeys aboard the Queen Mary 2.

Who needs the vaccine: All guests 18 and older must be fully vaccinated. Unvaccinated passengers under 18 will be required to undergo a PCR test within 72 hours of their departure.

What other safety measures are in place: Cunard has "enhanced" their onboard ventilation systems and implemented mandatory mask-wearing policies indoors. All guests aged 4 and older are required to have a negative COVID-19 test before boarding. Crew will be tested regularly while on board. Guests who have certain pre-existing medical conditions, including those who are on supplementary oxygen, will not be allowed to board.

Disney Cruise Line

Where they sail: Disney sails family-friendly journeys including to the Caribbean, Europe, and Alaska.

Who needs the vaccine: Vaccination is no longer required by highly suggested.

What other safety measures are in place: Unvaccinated guests must provide results of a COVID-19 test taken 1 to 2 days before sail date, at home tests are not accepted, this requirement will end Nov. 14. The Cruise line also has a full list of enhanced cleaning protocols.

Find out more: Disney Cruise Line

Grand Circle Cruise Line

Where they sail: Grand Circle Cruise Line sails small ships and river cruises all over the world, including an extensive list of European itineraries. The company plans to start sailing again in August, including to Greece, Turkey, and Italy.

Who needs the vaccine: All guests and crew are required to be fully vaccinated with the booster shot.

What other safety measures are in place: All ships have been equipped with High Efficiency Particular Air (HEPA) filters and buffets have been eliminated. The cruise line states some itineraries will require proof of a negative COVID-19 test prior to travel, and that instructors will be sent out 30 days prior to travel.

Find out mor e: Grand Circle Cruise Line

Holland America

Where they sail: Holland America sails large ships all over the world, including to the Mediterranean, Caribbean, Europe, and more.

Who needs the vaccine: Unvaccinated guests are welcome but will be required to self-test three days before cruising.

What other safety measures are in place: Vaccinated passengers traveling on ships for less than 16 days excluding itineraries with the Panama Canal, trans-ocean, and other selected itineraries will no longer be required to test.

Lindblad Expeditions

Where they sail: Lindblad Expeditions is known for its adventurous trips to hard-to-reach destinations like Antarctica and the Russian Far East, partnering with National Geographic to add to the experience.

Who needs the vaccine: All guests 12 and older need to be vaccinated before boarding. Boosters are recommended but not required.

What other safety measures are in place: Pre-departure testing will not be required unless for a specific destination.

Margaritaville at Sea

Where they sail: Margaritaville at Sea offers 3-day cruises to Grand Bahama Island departing from the port of Palm Beach. The cruise line also offers the opportunity to take the ship one way to the Bahamas to allow guests to stay at the Margaritaville resort, and then take the ship back to the Bahamas at a later date.

Who needs the vaccine: All guests are welcome regardless of vaccination status, according to the cruise line.

What other safety measures are in place: All crew members must be vaccinated for COVID-19 and the cruise line states there are vaccination requirements on board (but does not specify).

Find out more: Margaritaville at Sea

MSC Cruises

Where they sail: MSC Cruises sails large ocean cruises around the world, including throughout Europe, South America, the Persian Gulf, and the Caribbean. In August, the company started sailing to the Bahamas with a stop at its private island, Ocean Cay.

Who needs the vaccine: Vaccinations are recommended but no longer required.

What other safety measures are in place: Fully-vaccinated passengers are no longer required to show proof of a negative test unless it is required of the destination. Unvaccinated children must show proof of a negative PCR test.

Norwegian Cruise Line

Where they sail: Norwegian sails big ocean cruises all around the world, including popular itineraries all throughout the Caribbean and Greece.

Who needs the vaccine: All passengers may sail regardless of vaccination status.

What other safety measures are in place: Testing is no longer required for any passenger regardless of vaccination status with the exception of local government mandates.

Find out more : Norwegian Cruise Line

Oceania Cruises

Where they sail: Oceania Cruises sails all over the world, including offering several World Cruise itineraries.

Who needs the vaccine: All passengers regardless of vaccination status are allowed to sail.

What other safety measures are in place: Only unvaccinated guests will be required to show proof of a negative PCR or antigen test taken 72 hours prior to boarding. Unvaccinated children aged 12 years and younger are exempt.

P&O Cruises

Where they sail: The UK-based cruise line sails around Europe, including to the Canary Islands, as well as to the Caribbean from Southampton in the UK.

Who needs the vaccine: Although P&O Cruises' policy states that passengers over the age of 15 are required to be vaccinated, the latest update on its website says guests will be contacted directly in regards to vaccination protocol.

What other safety measures are in place: All guests are required to undergo a COVID-19 test at the terminal. Masks will be required on board indoors, and all shore excursions will be with vetted operators.

Princess Cruises

Where they sail: The global cruise line sails large ocean ships all around the world, from Australia to Alaska.

Who needs the vaccine: All guests are welcome on board, but unvaccinated passengers will be required to test and may need an additional medical exemption at some ports.

Regent Seven Seas Cruises

Where they sail: Regent Seven Seas offers all-inclusive luxury cruises around the globe, which include perks like free airfare, free excursions, and complimentary unlimited drinks on board.

Who needs the vaccine: All guests are now welcome. Unvaccinated passengers will be required to test 3-days before embarkation.

What other safety measures are in place: Pre-departure testing may not be necessary depending on the port. Currently cruises leaving from Bermuda, Canada, and Greece will require a test.

Royal Caribbean International

Where they sail: Royal Caribbean sails large ocean ships all over the world, including many popular itineraries throughout the Caribbean and Asia.

Who needs the vaccine: Everyone is welcome regardless of vaccination status, passengers traveling to Bermuda or Canada are required to be vaccinated.

W hat other safety measures are in place: On Royal Caribbean, unvaccinated travelers 12 and older leaving from a U.S. or Caribbean port still have to get tested within three days of embarkation,  according to the cruise line , vaccinated guests are exempt.

Royal Caribbean will accept a variety of tests as proof to board, including simply taking a photo of a self-administered home test.

Find out more : Royal Caribbean International

Where they sail: The British cruise line, exclusively for guests 50 and older, sails both ocean and river cruises around the globe.

Who needs the vaccine: All guests must be fully vaccinated, including a booster shot at least 14 days before boarding a ship. Saga was the first major cruise line to implement this vaccination policy.

What other safety measures are in place: Ocean Cruise guests will be required to get tested for COVID-19 in the terminal. Masks are required on bus transfers, in hotels, and on excursions.

Find out more : Saga

Where they sail: Seabourn's mid-size luxury cruises head all around the world, from Alaska to the Caribbean.

Who needs the vaccine: Vaccinations are not required on most cruise itineraries, unvaccinated guests will be required to present a negative test taken within three days of embarkation.

What other safety measures are in place: Masks are recommended onboard in most indoor venues and the casinos are frequently sanitized.

Where they sail: Silversea brings guests all around the world in luxury and style, including to the Galapagos and Antarctica.

Who needs the vaccine: All guests are welcome, however, unvaccinated guests may not be welcome on all sailings depending on local regulations.

What other safety measures are in place: Vaccinated guests do not need a pre-departure test unless local regulations such as cruises leaving from Australia, Bermuda, Canada, or Greece require it. Unvaccinated travelers will need a negative COVID-19 test within 72 hours of embarkation.

UnCruise Adventures

Where they sail: This small-ship company is known for its Alaska journeys as well as adventures in places like the Galapagos and island hopping in Hawaii.

Who needs the vaccine: As of April 7, all guests are welcome on board regardless of vaccination status.

What other safety measures are in place: Guests will no longer be required to present proof of vaccination or a COVID-19 test prior to, or during any point of sailing and the cruise line will no longer be running at limited capacity. These measures go into effect on April 7, until then guests 12 and older must provide proof of vaccination, and itineraries may sail at less then full capacity.

Masks are required in public spaces, according to the company "bandana" and "buff" face masks will not be accepted.

Victory Cruise Lines

Where they sail: Victory Cruise Lines is known for its Great Lakes cruises, providing all-inclusive sailings to see breathtaking sights from Niagara Falls to the iconic architecture of Chicago from Lake Michigan. Beyond the U.S., Victory Cruise Lines sails to Mexico's Yucatán Peninsula.

Who needs the vaccine: All guests and crew will be required to be vaccinated before boarding, and will be required to show physical proof prior to boarding.

What other safety measures are in place: Testing is no longer required on any river cruise.

Luggage is then disinfected before being brought onto the ship and staterooms cleaned with electrostatic fogging. Masks will be required during the embarkation process and while riding a shore excursion bus, but will not be required on board.

Viking Cruises

Where they sail: Viking sails ocean and river cruises all over the world, including throughout Europe. This summer, Viking will sail several voyages, including around England for UK residents, to Bermuda, and to Iceland in June.

Who needs the vaccine: All guests must be fully vaccinated to board a ship. Guests who are eligible must have a booster.

What other safety measures are in place: In addition to vaccines, all guests may be required to undergo a saliva PCR test at embarkation as well as "frequent" testing throughout the journey. All staterooms are equipped with independent air handling units.

Virgin Voyages

Where they sail: The brand-new cruise line is launching mini sailings from England for UK residents, and has cruises throughout the Caribbean, and transatlantic options.

Who needs the vaccine: All are welcome regardless of vaccination status, the cruise line removed all vaccine and testing requirements for all its ships in late October, according to the company.

What other safety measures are in place: Virgin Voyages was the first cruise line to eliminate pre-departure testing for vaccinated guests. The cruise line will continue to work with an advisory board to help ensure health and safety on board at all times, including the use of air filtration systems and sanitization of high touch surface areas.

Find out more : Virgin Voyages

Windstar Cruises

Where they sail: Windstar operates small-ship cruises and several sailing vessels all around the globe, including to places like Central America .

Who needs the vaccine: All guests will be required to be fully vaccinated at least 14 days before boarding one of Windstar's yachts. Boosters are highly encouraged and are recommended to be administered at least one week prior to travel.

What other safety measures are in place: Guests no longer need a pre-embarkation test unless a specific destination requires it.

Alison Fox is a contributing writer for Travel + Leisure. When she's not in New York City, she likes to spend her time at the beach or exploring new destinations and hopes to visit every country in the world. Follow her adventures on Instagram .

Related Articles

Latest News

Why Stellenbosch and Franschhoek are South Africa’s premier wine destinations

How common are car accident brain injuries

Steps to take after a travel-related injury

How dangerous are pedestrian accidents

Five kid-friendly places to enjoy fall in Nashville

TIS2024 advocates technological innovation as a driver for more sustainable and personalized tourism

G20 Ministers show strong recognition for ICAO’s aviation decarbonization initiatives 

Alfred Sanzari Enterprises completes multi-million-dollar Glenpointe Marriott capital improvement project

The Paradox of Standards: How mastery elevates personalization in hospitality

Millennium Hotels and Resorts relaunches global guest loyalty programme, MyMillennium

Princess Cruises lifts Covid-19 protocols for most voyages

Majestic Princess in Singapore, June 2017.

The change applies to all itineraries sailing from US and European homeports except destinations where government regulations, such as Australia and New Zealand, may still have their own requirements.

Beginning October 21, Princess Cruises is lifting its Covid-19 protocols, meaning there are no longer vaccination or testing requirements on most voyages. Guests sailing with Princess Cruises will no longer have to provide a negative test result, regardless of their vaccination status.

The cruise line already changed its protocols on September 6, when it removed the need for test results for vaccinated guests. This has now been updated to include unvaccinated guests. Children under five do not require pre-travel testing. The minimum age to sail is 6 months or 12 months based on the cruise itinerary.

A small number of sailings that the cruise line calls “enhanced guidelines voyages” also continue to have their own vaccination and testing requirements. Guests are advised to continue to check the requirements for their cruise before booking and again before it’s time to sail.

Canada On September 26, Transport Canada announced that it was removing its COVID-19 requirements for cruise guests to enter the country effective for cruises October 1 and beyond. Visitors are also no longer required to upload their information into the ArriveCAN app. Thus, protocols for cruises including Canada are now the same as the standard in the United States, United Kingdom & Europe (this excludes any Enhanced Guidelines Voyages).

Australia & New Zealand If cruise departs, arrives or visits Australia guests 12 to 17 years old must be fully vaccinated (no booster). Guests ages 18 or older must have received primary series of COVID-19 vaccines including one booster dose if eligible, received any time before embarkation.

Guests aged 18 years or older who are not up to date require a vaccination exemption to sail. Guests 12 and older not fully vaccinated on cruises departing, arriving or visiting Australia require a medical exemption and have different testing requirements. Under local protocols, prior infection with COVID-19 is not grounds for a medical exemption. Medical exemptions need to be submitted to Princess for validation before a booking can be guaranteed.

Vicky Karantzavelou

Vicky  is the co-founder of TravelDailyNews Media Network where she is the  Editor-in Chief . She is also responsible for the daily operation and the financial policy. She holds a Bachelor's degree in Tourism Business Administration from the Technical University of Athens and a Master in Business Administration (MBA) from the University of Wales.

She has many years of both academic and industrial experience within the travel industry. She has written/edited numerous articles in various tourism magazines.

Aristocrat Gaming partners with Princess Cruises to elevate onboard gaming

Related posts.

Princess Cruises sails to all regions of the Caribbean for the first time ever in Summer 2026

Princess Cruises takes delivery of new Sun Princess from Fincantieri

Princess Cruises announces The Love Boat themed cruise with iconic original cast

Previous post, safely secures $12m. to extend short-term home rental insurance leadership, zambezi grande in zambia opens on the banks of the zambezi river.

VAI Resort announces partnership with José Andrés Group

Affordable coastal living: Finding your dream property in the Southern Hemisphere

Fairmont introduces CEO “Chill Experience Officer” in Vancouver

Palladium Hotel Group elevates guest experiences with world-class entertainment across its properties

ATM signs partnership with ICCA as international business events sector expected to reach US$1.5tn this year

Grenada Tourism Authority reveals Carriacou’s first underwater sculpture park: A World Adrift

onefinestay and Lovevery launch exclusive guest stay partnership in London homes

Top five luxurious hotel spas in Ontario to unwind and recharge

Asi Ginio is Joyned’s new Chairman

Where to find artisanal products in Florence

AHLA and World Wildlife Fund revamp Hotel Kitchen platform

HSMAI announces 2024 Sales Career Achievement and Professional of the Year honorees

Over 42,000 passengers to take to the skies from Shannon Airport over Halloween

Central Holidays unveils groundbreaking technology system to revolutionize travel booking experience

Ethiopian Airlines resumes its flight to Monrovia, Liberia

VisitEngland announces 2023-2024 Visitor Attraction Accolades winners

GIATA partners with Boutique Setters

Bvlgari Hotel London appoints Duncan Palmer as Managing Director

From Frankfurt Airport to 243 destinations in 93 countries

World Travel, Inc. selects Sabre as its primary GDS partner

TourismAcademy.org becomes Learn Tourism

H&H Development expands its “Eden House” brand

Canada hotels record first occupancy decline in nine months

St. Regis Hotels & Resorts unveils The St. Regis Longboat Key

Hilton reports Third Quarter results: Net income was $344 million

SAS starts flying to Nuuk in Greenland

The Points Guy releases holiday travel survey results

Amadeus further supports NDC adoption with enhanced United Airlines partnership

Dignity of Work Pledge secures $7.4m. in commitments from hospitality companies

Travelex launches home delivery pilot in The Netherlands

Star Alliance Management team firmly focused on seamless customer experience

TravelAI “proof of concept” phase over as it turns AI into profits

BCD Travel survey identifies challenges, influences and satisfaction related to air travel

Ten tips to beat jet lag: How to enjoy your travels from the moment you land

IGTM in Lisbon’s success sets the stage for Cannes 2025

Forbes Travel Guide unveils inaugural Verified Air Travel Awards

Thompson Hotels presents “A Taste of Thompson Chef Series” – An innovative culinary experience

BirchStreet appoints Phil Beck as General Manager, BirchStreet Pay

Tender for designer of Central Passenger Terminal at Katowice Airport

UFI counts down to 91st Global Congress in Cologne

2024 Big Book of Airline Data reveals $918bn. in revenue for 2023, up more than 32% from 2022

Mirai now available on Oracle Cloud Marketplace

Take2Eton Group appoints James Parkhouse as CEO

Understanding settlements: Tips from an Austin car accident attorney

Hugo Lecanda appointed to oversee Puerto Vallarta and Punta Mita markets in dual role

How a personal injury lawyer provides essential compensation guidance

Seven features that make the Chrysler Pacifica the ultimate travel vehicle

Munich Airport new Winter flight plan: Airlines offer flights to 180 destinations

Behavioural science research reveals key spending drivers for airline passengers in 2025

Groupe GM partners with esteemed French skincare brand Typology to create its first hotel line

Eve Air Mobility presents Eve TechCare at MRO Europe

The Data Appeal Company partners with Visa to enhance tourism through AI-driven spending insights

Arival unveils largest-ever study on the state of the global experiences industry

The TUI Palma Marathon Mallorca 2024 shines as a global sporting event

Yacht charter season in Monaco: When and where to rent for the perfect holiday

Langham Hospitality Group appoints Angela Zhou as SVP of Finance

SITA appoints Nathalie Altwegg to spearhead growth for the company’s airports business

Britain competes for Chinese visitors, and encourages them to explore more of the country

Global cruise travel booms as Trip.com anticipates record demand for Disney Adventure

A new report identifies 40 actions that can bring more equitable benefits to destinations

Up Hotel Agency launches dynamic AI-driven website tool for independent hotels

Flexjet offers $100,000 prize for Project LXi – Design the ultimate private jet interior contest

Cheval Collection appoints General Manager for second Dubai property

Jackknife accidents: Everything you need to know

Qatar Airways launches the world’s first Boeing 777 Starlink-equipped flight

Saving money on your US trip

Rosewood Hotels & Resorts strengthens global leadership team with strategic appointments

Five great reasons to use a flight case

High-risk truck accident zones in Texas and tips for staying safe

Weekend escapes: Quick getaways to Gatlinburg, TN

How to spend a fun day with kids on your pigeon forge trip

Six strategies for making your corporate travel trip as seamless as possible

Seven packing tips for international travel

How do you prove liability in a car accident with no witnesses

What do you need to know about Airbnb cleaning management?

What to wear to dinner on a cruise

World Travel Protection welcomes two senior leaders in North America

Air Canada awarded Gold Level Certification for Mental Health at Work from Excellence Canada

BWH Hotels partners with Mews as it grows its global footprint

Marriott International and MGM Resorts International sign agreement to launch W Las Vegas

Tinaba with Banca Profilo becomes Europe’s first fintech to integrate Alipay+ Mini Programs

TUI Care Foundation launches new TUI Futureshapers Global initiative

How to sell your house fast: The secret strategies real estate agents won’t tell you

Radisson Hotel Group in Italy: 5 signings and introduction of new brands to the region

HX joins TheUnited States Tour Operators Association (USTOA)

Etihad Airways to offer daily flights to Dusseldorf and Copenhagen from October 2025

Nevada welcomes new Aer Lingus service

Gulf Air celebrates 50 years of operations to Egypt

The Hospitality Show announces highlights and key sponsorships for 2024

Wego reveals top destinations preferred by travellers from Kuwait in 2024

World of Hyatt and Peloton reward members for prioritizing wellbeing 

Barbadian hotelier receives Doctorate from The University of the West Indies

NBA and Sport 24 announce multiyear extension to air live NBA games in-flight and at sea

More than 4 in 5 holiday travelers are changing their plans due to inflation

Gulf Air to expand Bahrain – Singapore service to daily flights

InterLnkd and FlightHub launch Canada’s first intelligent travel shopping mall

Ryanair flights are now available to Etraveli Group’s customers

Finnair adds flights to the United States and Asia for next summer

More travel and tourism leaders join list of CMEx 2024 Laureates

IHG Hotels & Resorts accelerates Garner expansion with four additional signings across Europe

The GDS-Movement and BeCause partner to accelerate sustainable tourism 

Quito Airport Sustainability Conference: A high-level meeting to discuss today’s challenges and their future impact

Accelya’s FLX Platform to deliver retail and distribution transformation for Air Transat

ISON Travel chooses Sabre to power global expansion and enhance pperations

Ajman Tourism Development Department explores prospects for tourism cooperation in China

Patch Marketing launches Octoplus channel management solution for venues

Marriott International announces global launch of Connect Responsibly with Marriott Bonvoy Events

Minut rolls out AI-powered marijuana detection to ensure high standards in rental properties

Six Senses introduces Six Senses Lake Como and Six Senses Milan

Six benefits of using private luxury transportation for your travels

airBaltic reveals November 2024 destination trends from Riga

Why visit Sicily in autumn

Honeymoon bliss in the Galápagos islands, the perfect mix of nature, luxury, and adventure

Regent Santa Monica Beach now open, marking the brand’s return to The Americas

Five essential travel services and resources for planning your ideal vacation

Digital nomad life – How to have fun on the go

Scotland top choice for international visitors

Mallorca hosts 2024 Global INSTO Meeting and III Sustainable Destinations Summit

Rental car customer loyalty hinges on trust, J.D. Power finds

The Conscious Travel Foundation launches online auction to support the work of its Community Impact Fund

TIS2024 will offer innovative strategies for improving tourism competitiveness through technology

Embraer reached a new US$ 22.7 billion backlog record

Premier Resorts & Management opens Renaissance Hotel on Daytona Beach oceanfront

CTO announces theme and Social Media showcase for Caribbean Tourism Month 2024

Africa’s travel and tourism innovators celebrate at World Travel Awards VIP reception

Belfast International Airport achieves Level 3 Optimisation, strengthening its commitment to sustainable operations

Davidson Hospitality Group partners with Alliance for Hospitality Equity & Diversity

Railbookers announces return of “Around the World By Luxury Train” in 2025

Destination DC announces expanded Washington, DC Special Agent Academy

BMA House hosted 7th Global Good Awards, celebrating sustainable leadership

ASM Global appoints Middle East Venue expert for KAFD Conference Center, Saudi Arabia

ICAO: International air travel liability limits set to increase, enhancing customer compensation

Alexander Hotel announces prestigious luxury affiliations

First phase of modernized check-in area at Miami International Airport unveiled

Emirates consolidates commercial portfolios to prime for global growth

Austria, Slovenia, and Croatia jointly focus on slow travel appeal in the US market

Hill Robinson Spain launches new office

Japanese Hoshino Resorts brings Onsen Ryokan to U.S., selects Sharon Springs, NY

142 direct winter destinations from Brussels Airport during the winter season

Malta to host Europe’s first urban long distance mountain biking event

Azamara Cruises returns to Alaska in Summer 2026

Unique approaches to travel industry sustainability forthcoming at “A World for Travel” event

The Ritz-Carlton, Boston appoints Joe Mauro as new Director of Sales & Marketing

Travel Compositor expands leadership team with new CCO and Brazilian Sales Manager

Cycling jerseys with UV protection: how to stay safe from the sun

Making the most of your family time in Sevierville

Make a big impact: Eye-catching banner printing

Global travel advisor Gennady Podolsky highlights ten memorable New Year’s Eve experiences

Visit Nebraska opens grant cycle and promotes marketing opportunities

Rwanda: Twenty years of gorilla conservation efforts

How can i remove vocals from a song

AURA AERO Inc. selects Volusia County for 500,000 sq.f. manufacturing and assembly plant in Florida

Atlanta multifamily property The Upton announces nationwide call for artists in residency

The world’s most glamorous casino destinations

Best diabetic supplies online: Border free health offers a lifeline for diabetes management

Hilton and Universal Pictures debut one-of-a-kind suite inspired by “Wicked” characters

How autoflower seeds can fit into your travel lifestyle

CAA Board of Directors selects next Executive Director

How to prove liability in a slip and fall personal injury claim

HomeToGo releases 2025 Travel Forecast, revealing five vacation trends

Coach passengers spend £8.3 billion a year in Britain’s tourist hotspots

WEILL client hotels awarded 20 Michelin Keys

Club Med appoints new VP of Marketing and VP of Sales for North America

ASM Global appoints events expert to grow Middle East venues 

Wendy Wu Tours partners with TProfile to revolutionise specialist touring content for travel agents

Brussels Airport achieves Level 4+ in ACI Europe’s Airport Carbon Accreditation programme

Kaelis partners with LOT Polish Airlines to inspire infants and young travellers’ imaginations

Explore Worldwide launches new small group tours

Etihad Airways is now available on the APG Platform, APG’s NDC portal

Maui’s Grand Wailea announced partnership with Nobu, restaurant launching Summer 2025

RoomRaccoon partners with Pxier to enhance hospitality offering

Renowned Antuguan resort, Hermitage Bay re-opens after extensive renovation

Rio de Janeiro’s room rates jumped to eight-year high thanks to Rock in Rio

PriceTravel Holding appoints Mikael Hellstrom as Head of Sales for USA & Canada

limehome accelerates UK expansion

Paris 2024 Olympics and the latest innovations in AI, cybersecurity and sustainability to be featured at TIS2024

Wyndham Grand Clearwater Beach announces new culinary leadership

GDS-Movement reveals the winners of the 2024 GDS-Awards

UFI releases latest edition of Euro Fair Statistics

New study shows airports and air connectivity power 5% of European GDP

Emirates cabin crew to step into the virtual world for safety training

Vibe and Mize: new dynamic partnership transforming online booking with AI-driven fintech solutions

GUEXT commences today in Madrid, hosting over 130 companies

SAS and Scandic enter strategic partnership to enhance customer experience and loyalty benefits

Avoya Travel announces technology and commission enhancements at 2024 conference

Brands Logos

• Carnival Cruises
• P&O Australia
• P&O Cruises
• Princess Cruises
• Holland America

Investor Relations

• Annual Reporting
• Quarterly & Semiannual Reporting
• Supplemental Schedules
• SEC Filings
• Webcasts / Presentations
• Archived Financial Information
• Stock Quote / Chart
• Investment Calculator
• Historical Lookup
• News Releases
• Events Calendar
• Email Alerts
• Analyst Coverage
• Earnings Estimates
• Shareholder Benefit
• Dividend/Split History
• Investor FAQs
• Online Investor Kit
• Information Request

News Release

Carnival cruise line removes pre-cruise testing for vaccinated guests and welcomes all unvaccinated to sail.

MIAMI , Aug. 12, 2022 /PRNewswire/ -- Carnival Cruise Line today announced protocol updates that meet public health goals but recognize the evolving nature of COVID-19. With these changes, America's Cruise Line is making it easier for more guests to sail with simplified vaccination and testing guidelines, including no testing for vaccinated guests on sailings less than 16 nights, and eliminating the exemption request process for unvaccinated guests, who will only need to show a negative test result at embarkation. All new guidelines are effective for cruises departing on Tuesday, Sept. 6, 2022 or later, and include:

• Vaccinated guests must continue to provide evidence of their vaccination status prior to embarkation. Pre-cruise testing is no longer required, except for cruises to Canada , Bermuda , Greece and Australia (per local guidelines), and on voyages 16 nights or longer.
• Unvaccinated guests are welcome to sail and are no longer required to apply for a vaccine exemption, except for cruises in Australia or on voyages 16 nights and longer.
• Unvaccinated guests or those who do not provide proof of vaccination must present the results of a negative PCR or antigen test taken within three days of embarkation.
• All policies are subject to local destination regulations.

Note: Guests under the age of five years are exempt from vaccination and testing requirements from the United States and under the age of 12 from Australia .

Voyages 16 nights and longer will continue to have vaccination and testing requirements that are specific to the itinerary. Requirements for long voyages and destination-specific protocols are available on Carnival's Have Fun. Be Safe. page on Carnival.com .

For guests who have a pending vaccine exemption application and are awaiting confirmation for cruises departing Sept. 6 or later, the booking is confirmed unless booked on a sailing that calls on Canada , Bermuda , Australia or if the voyage is 16 nights or longer. 

Christine Duffy , president of Carnival Cruise Line . "We've got lots happening, with Carnival Luminosa and Carnival Celebration joining our fleet this November and more to come in 2023. Whatever the ship, homeport or itinerary that works for you, our great onboard team is ready to deliver a fun vacation – something we all look forward to even more nowadays!"

Duffy added that Carnival is in the process of updating its website, communications, and processes, and sharing more details with guests and travel advisor partners to reflect these new, simplified policies. "We appreciate the patience of our guests and travel advisor partners as we update all materials, but the end result is a very positive one for all who are looking forward to cruising with us," she said.

For additional information on Carnival Cruise Line and to book a cruise vacation, call 1-800-CARNIVAL, visit www.carnival.com , or contact your favorite travel advisor or online travel site.

ABOUT CARNIVAL CRUISE LINE Carnival Cruise Line , part of Carnival Corporation & plc (NYSE/LSE: CCL; NYSE: CUK), is proud to be known as America's Cruise Line .  Since its founding in 1972, Carnival has continually revolutionized the cruise sector, making a cruise vacation an affordable and popular option for millions of guests. Carnival operates from 14 U.S. homeports and employs more than 40,000 team members representing 120 nationalities. Carnival's newest ship, Mardi Gras , featuring the first roller coaster at sea, is the first cruise ship in the Americas powered by eco-friendly Liquefied Natural Gas (LNG).  Carnival returns to Australia in October 2022 and will welcome four additional ships over the next two years, including Carnival Celebration, which arrives to Miami in November to close out Carnival's 50th birthday festivities.

SOURCE Carnival Cruise Line

[email protected]

AIDA Cruises is the market leader in the German-speaking cruise market. Home of the smile, AIDA Cruises is the epitome of a premium-quality, relaxing cruise and operates one of the world’s most state-of-the-art fleets. Visit: www.aida.de

Carnival Cruise Line, also known as America’s Cruise Line, is a leader in contemporary cruising and operates a fleet of ships designed to provide fun and memorable vacation experiences at a great value. Visit: www.carnival.com

Costa Cruises delivers Italy’s finest at sea, bringing modern Italian lifestyle to its ships to provide guests with a true European experience that embodies a unique passion for life through warm hospitality, entertainment and gastronomy. Visit: www.costacruise.com

Cunard is the epitome of British refinement for travelers who relish the line’s impeccable White Star Service, gourmet dining, world-class entertainment, and the legacy of historic voyages and transatlantic travel. Visit: www.cunard.com

Holland America Line's premium fleet of spacious, elegant mid-sized ships feature sophisticated five-star dining, extensive entertainment and activities, innovative culinary enrichment programs and compelling worldwide itineraries. Visit: www.hollandamerica.com

P&O Cruises (UK) is Britain’s favorite cruise line with a fleet of ships combining genuine service and a sense of occasion and attention to detail, ensuring passengers have the holiday of a lifetime, every time. Visit: www.pocruises.co.uk

P&O Cruises (Australia) provides a quintessential holiday experience for Australians and New Zealanders, taking them to some of the world's most idyllic and hard-to-reach places across Asia and the South Pacific. Visit: www.pocruises.co.au

Princess is the world’s leading international cruise line and tour company operating a fleet of modern cruise ships, renowned for the innovative design and wide array of choices in dining, entertainment and amenities. Visit: www.princess.com

Seabourn provides ultraluxury cruising vacations in a unique, small-ship style that focuses on genuine, intuitive service, all-suite accommodations, superb cuisine and unique experiences in destinations worldwide. Visit: www.seabourn.com

There's COVID-19 on nearly every cruise ship right now: Here's what cruisers need to know

Things are getting iffy again for cruisers -- at least for those with near-term bookings.

The ongoing surge in COVID-19 cases around the world is causing a growing number of disruptions to itineraries and even some last-minute cancellations of entire voyages.

The number of passengers being quarantined on ships (after testing positive for COVID-19) also is on the rise. And passengers who aren't COVID-19 positive are getting caught up in short-term quarantines for being "close contacts" of shipmates who are.

Meanwhile, just getting to ships is becoming increasingly stressful, as getting the pre-cruise COVID-19 test that's often required before cruising is getting more difficult . Plus, a "perfect storm" of soaring COVID-19 cases and rough winter weather has wreaked havoc with airline operations for weeks.

Still, the situation isn't anywhere near as dramatic or disruptive as what we saw at the start of the COVID-19 pandemic two years ago, when whole ships were being quarantined due to outbreaks of the illness and, eventually, the entire industry shut down.

As I saw myself during a cruise to Antarctica in recent weeks, many sailings are operating relatively normally, even when there are COVID-19 cases on board.

Here's a look at everything you need to know if you've got a cruise booked in the coming weeks -- or further out.

COVID-19 cases on ships are up a lot

While cruise ships have recorded relatively few cases of COVID-19 over the past year, in part due to unusually strict health protocols , the number of passengers and crew testing positive on ships has been rising sharply in recent weeks along with the greater surge on land.

At the end of December, the U.S. Centers for Disease Control and Prevention reported that 5,013 COVID-19 cases had been reported on cruise vessels operating in U.S. waters during the last two weeks of the month, up from just 162 cases during the first two weeks of the month.

That's a 3,094% increase.

Anecdotal reports are that the number of cases on ships is up even more in the first 10 days of the new year.

Notably, all 92 cruise vessels currently operating in U.S. waters have recorded at least a handful of COVID-19 cases in recent weeks, according to CDC data.

Still, it's important to note that most of these "cases" of COVID-19 are asymptomatic or mild, only discovered during routine testing. While some ships only are testing passengers who report feeling ill for COVID-19 (and close contacts of those who subsequently test positive), other ships are testing every single passenger at least once per voyage, sometimes more. One line, Viking , is testing every single passenger for COVID-19 every day.

Cruise lines also are testing all crew members regularly.

The result is the detection of many asymptomatic cases that otherwise would have gone undetected. This is a level of surveillance that is much greater than what is the norm for other travel venues such as land-based resorts or theme parks, and it can give the false impression that the positivity rate for COVID-19 on ships is unusually high as compared to other places.

If anything, the positivity rate is far lower on ships than on land, thanks to much stricter health protocols (more on that in a moment).

It's also important to note that the detection of COVID-19-positive passengers or crew on board your ship won't necessarily impact your sailing (unless you are among those testing positive).

Health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19. The current protocol on most ships is to isolate COVID-19-positive passengers and crew but otherwise continue on with voyages as planned.

Your itinerary could change

While health authorities no longer are quarantining whole ships when a few passengers or crew test positive for COVID-19, the presence of the illness on board a vessel still could result in notable disruptions to your itinerary.

Cruise lines in recent weeks have faced a growing number of ports that are balking at allowing ships with COVID-19-positive passengers or crew to dock.

Several ships recently had to skip port calls in Mexico , for instance, after passengers and crew on board the vessels tested positive for COVID-19. The ports have since reopened after Mexico's Health Department overruled the decisions of local port officials.

Cruise ships also have had to cancel stops recently at the islands of Aruba, Bonaire and Curaçao, and at San Juan, Puerto Rico, due to local worries about COVID-19-positive passengers and crew on board and/or tighter COVID-19-related entry requirements.

Lines also are dealing with a small but growing number of destinations -- India and Hong Kong, for example -- that are at least temporarily closing to cruising completely, even for ships where no one has tested positive for COVID-19.

Viking on Sunday was forced to announce a major revision of its soon-to-begin, 120-day world cruise after India notified the line it was closing to cruise ships. Viking's 930-passenger Viking Star will begin its world cruise this week by heading south from Los Angeles to Central America and South America instead of sailing westward toward Asia, where it was scheduled to spend a significant amount of time in India.

Your cruise could be canceled on short notice

A growing number of cruise lines are canceling sailings on short notice, citing the disruptions caused by COVID-19. The world's largest cruise operator Royal Caribbean on Friday canceled soon-to-depart sailings on four of its 25 ships, including the next three departures of the world's largest ship, Symphony of the Seas .

Norwegian Cruise Line on Wednesday canceled soon-to-depart voyages on eight of its 17 ships.

Other lines canceling one or more sailings in recent days include Holland America , Silversea , Atlas Ocean Voyages, Regent Seven Seas Cruises, MSC Cruises , Costa Cruises and Oceania Cruises .

The cancellations come as lines struggle to maintain adequate staffing levels on some ships due to crew members testing positive. When crew test positive, they and their close contacts must stop working and isolate, even if asymptomatic, leaving shipboard venues short-staffed.

You probably won't be quarantined, stranded or stuck

As noted above, health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19.

The current protocol on most ships is to quickly isolate COVID-19-positive passengers and their close contacts. But only the COVID-19-positive passengers are being isolated long term.

As my colleague Ashley Kosciolek experienced first-hand on a cruise in 2021, close contacts only are being isolated for a short period while they are tested for COVID-19. If they test negative, they typically are allowed out of their rooms to rejoin the rest of their fellow cruisers on board.

This means that many sailings are going ahead as planned, with little disruption, even when some passengers and crew on the trips test positive for COVID-19. I experienced this myself in late December when on a Silversea vessel where four passengers tested positive for COVID-19. Some passengers who were deemed close contacts of the passengers who tested positive were isolated for a short period while being tested for COVID-19. But the positive cases had little impact on most of the passengers on board the vessel, and the voyage went ahead as planned.

Such a protocol comes at the recommendation of the CDC, which has set guidelines for how cruise lines should respond to COVID-19-positive cases on board ships, and it has worked well for the past year .

Of course, if you do test positive for COVID-19 on a ship, you will, unfortunately, face what could be several days of isolation in a cabin on a ship or on land. If you are an American cruising overseas, you also won't be able to return to the U.S. until you have tested negative for COVID-19 (or until you recover from the illness and are cleared in writing to travel by a licensed healthcare provider or a public health official).

This is one of the biggest risks of taking a cruise right now, and one reason you may consider canceling a sailing scheduled in the short term (see the section on more-flexible cancellation policies below).

Most COVID-19 cases on ships aren't serious

Cruise lines are reporting that the vast majority of passengers testing positive for COVID-19 in recent weeks are asymptomatic or have mild symptoms.

All major cruise lines currently are requiring all or nearly all passengers to be fully vaccinated for COVID-19, with some also starting to require booster shots , to boot. This creates an onboard population that is far less likely to experience serious symptoms of COVID-19 than a cross-section of people on land, according to CDC data.

For all adults ages 18 years and older, the cumulative COVID-19-associated hospitalization rate is about eight times higher in unvaccinated persons than in vaccinated persons, according to the latest CDC data.

You'll face lots of new health protocols

If you haven't cruised since before the pandemic, you might be surprised by how many new health- and safety-related policies cruise lines have implemented to keep COVID-19 off ships.

For starters, there are the vaccine mandates noted above. No other segment of the travel industry has been as uniform in requiring almost every customer to be fully vaccinated against COVID-19.

Related: Will I need a COVID-19 vaccine to cruise? A line-by-line guide

As noted above, cruise lines also are requiring passengers to undergo COVID-19 tests before boarding ships -- a screening process that is keeping many COVID-19 positive people from ever stepping on board a vessel.

When COVID-19 is detected on a ship, cruise lines sometimes then test passengers multiple times to ensure it isn't spreading. On my recent trip to Antarctica, I underwent six COVID-19 tests in just eight days -- three in advance of stepping on board the vessel (including a PCR test required by Chile, where my trip began) and three while on board.

In addition, most cruise lines now are requiring passengers to wear masks at all times while in interior spaces of vessels, and they have stepped up cleaning regimens, improved air filtration systems on ships and made other onboard changes.

The CDC says to avoid cruising for now

On Dec. 30, the CDC added cruise ships to its list of "Level 4" destinations you should avoid visiting for now due to high levels of COVID-19.

For what it's worth, more than 80 countries around the world -- including a good chunk of all the places you might want to travel -- are on this list. So, the CDC is basically telling you that now isn't a good time to travel. Fair enough. But the warning shouldn't be seen as a call-out on any elevated risk to cruising as opposed to visiting other places, per se.

Places on the Level 4 list currently include Canada, much of Europe and nearly every country in the Caribbean.

The cruise industry has been highly critical of the designation, arguing that cruise ships are far safer places to be right now than almost anywhere else, given their strict health protocols.

"The decision by the CDC to raise the travel level for cruise is particularly perplexing considering that cases identified on cruise ships consistently make up a very slim minority of the total population onboard — far fewer than on land — and the majority of those cases are asymptomatic or mild in nature, posing little to no burden on medical resources onboard or onshore," the main trade group for the industry, the Cruise Lines International Association, said in a statement to TPG.

You can cancel if you're worried (in many cases)

If you're booked on a cruise in the coming weeks, and you're having second thoughts, there's a good chance you can get out of your trip. Many lines continue to be far more flexible than normal about cancellations.

Take cruise giant Carnival Cruise Line . Its current flexible cancellation policy allows passengers to cancel as long as a public health emergency remains in effect and receive 100% of the cruise fare paid in the form of a future cruise credit. Passengers are also able to cancel if they test positive for COVID-19. (Proof of a positive test result is required.)

Another large line, Norwegian, just last week extended its pandemic-era Peace of Mind policy to allow passengers to cancel any sailing taking place between now and May 31. For now, the cancellation needs to be done by Jan. 31, and the refund would come in the form of a future cruise credit to be used on any sailing that embarks through Dec. 31.

That means you could call the line right now to back out of a cruise that is just days away. In normal times, you'd lose all your money if you backed out of a seven-night Norwegian cruise with fewer than 31 days' notice.

Planning a cruise? Start with these stories:

• A beginners guide to picking a cruise line
• The 5 most desirable cabin locations on any cruise ship
• The 8 worst cabin locations on any cruise ship
• A quick guide to the most popular cruise lines
• 21 tips and tricks that will make your cruise go smoothly
• 15 ways cruisers waste money
• What to pack for your first cruise

• Today's news
• Reviews and deals
• Climate change
• 2024 election
• Newsletters
• Fall allergies
• Health news
• Mental health
• Sexual health
• Family health
• So mini ways
• Unapologetically
• Buying guides

Entertainment

• How to Watch
• My watchlist
• Stock market
• Biden economy
• Personal finance
• Stocks: most active
• Stocks: gainers
• Stocks: losers
• Trending tickers
• World indices
• US Treasury bonds
• Top mutual funds
• Highest open interest
• Highest implied volatility
• Currency converter
• Basic materials
• Communication services
• Consumer cyclical
• Consumer defensive
• Financial services
• Industrials
• Real estate
• Mutual funds
• Credit cards
• Balance transfer cards
• Cash back cards
• Rewards cards
• Travel cards
• Online checking
• High-yield savings
• Money market
• Home equity loan
• Personal loans
• Student loans
• Options pit
• Fantasy football
• Pro Pick 'Em
• College Pick 'Em
• Fantasy baseball
• Fantasy hockey
• Fantasy basketball
• Download the app
• Daily fantasy
• Scores and schedules
• GameChannel
• World Baseball Classic
• Premier League
• CONCACAF League
• Champions League
• Motorsports
• Horse racing

New on Yahoo

• Privacy Dashboard

Top Stories

• Oldest living US person dies
• Battleground state sweep
• Latest stats on economy
• Menendez case
• Zelenskyy's new t-shirt
• Tucker Carlson
• Nicole Shanahan
• Vast deposit of 'white gold'
• Pizza, side of cocaine
• Atlantic current may collapse

When are cruise lines still requiring COVID testing? Here's what passengers should know.

After the Centers for Disease Control and Prevention ended its COVID-19 cruise ship program last month, many cruise lines changed their health and safety protocols and dropped some testing requirements .

Major brands like Royal Caribbean International and Carnival Cruise Line rolled back their COVID-19 rules and removed testing for vaccinated passengers on some voyages, while other lines scrapped them for all sailings.

Tests are still required in a number of cases, though. Policies may vary depending on local requirements at various destinations. Here's what passengers need to know about cruise protocols, from testing to face masks and social distancing.

Cruise lines change COVID-19 rules: Carnival, Royal Caribbean and more drop pre-cruise testing after end of CDC program

Is the cruise industry coming back?: After more than 2 years under a COVID cloud, the answer is yes.

When do cruise lines still require COVID-19 testing?

► Carnival Cruise Line will require vaccinated passengers to test only on trips 16 or more nights or where required by local rules, including on voyages to Canada and Bermuda, beginning Sept. 6, according to a press release.

Unvaccinated travelers or those who do not show proof of vaccination will be required to "present the results of a negative PCR or antigen test taken within three days of embarkation." In the U.S., guests under 5 are exempt from vaccine and testing rules.

►Royal Caribbean will require vaccinated guests 5 and older to test on U.S. cruises 10 nights or longer beginning Sept. 5, according to its website . They must test within three days of boarding. Unvaccinated guests age 5 and up need to take a test within three days of sailing on all trips. The changes are subject to local regulations.

►Celebrity Cruises will require vaccinated passengers to test only on voyages that are 10 or more nights where local rules permit starting Sept 5., according to its website . They must do so within three days of sailing. Unvaccinated guests 5 and up must take a test within three days prior to their trip for U.S. sailings.

►Norwegian Cruise Line Holdings Ltd. will drop all pre-cruise requirements for vaccinated passengers age 12 and over as of Sept. 3, according to a news release .

Guests age 12 and older who are unvaccinated or do not show proof of vaccination will still need to test within 72 hours before boarding. The company said it "continues to strongly recommend all guests be up to date on vaccination protocols and test at their convenience prior to travel." Changes are also subject to local requirements.

► MSC Cruises will no longer require fully vaccinated U.S. residents to take a test before boarding on sailings from U.S. ports to the Bahamas and the Caribbean as of Sept. 1. Unvaccinated passengers age 2 and older still need to show proof of a proof of a "lab-administered negative COVID-19 viral test negative test" taken within three days of their cruise, according to its website .

Passengers 2 and older who are not U.S. residents must "show proof of a negative antigen or RT-PCR lab administered test" taken within three days of their sailing, regardless of vaccination status, according to its website . The line's policies vary by destination.

►Princess Cruises will require travelers on voyages 16 nights or longer to "take a supervised test within three days of embarkation (guests 5 and older)," as of Sept. 6, according to a news release. That rule also applies to guests on full Panama Canal transits and certain other voyages.

Passengers who are unvaccinated need to show a negative result from a self-test taken within three days of embarkation on sailings 15 nights or less. Unvaccinated children under 5 are exempt. The changes are subject to local regulations.

►Holland America Line will not require testing for vaccinated guests on sailings 15 nights or shorter starting Sept. 6, according to a news release. Unvaccinated passengers age 5 and up must show a negative result from a medically supervised test or self-test taken within three days of embarkation.

Those changes are subject to local restrictions, and exclude full Panama Canal transits and certain other sailings.

All guests 5 and up must provide "a medically supervised COVID-19 test with written negative result" on cruises 16 nights or more. Travelers need to test within three days of embarkation, and unvaccinated travelers must still request an exemption.

►Disney Cruise Line will no longer require fully vaccinated guests traveling on the Disney Dream, Disney Fantasy, Disney Wonder and Disney Wish to take a test before their cruise beginning Sept. 23, according to its website . For sailings on the Disney Magic, the change will take effect Nov. 7.

Travelers who are not fully vaccinated must continue to show proof of a negative test test taken one to three days before their trip, though they will no longer need to take an additional test at the terminal on embarkation day.

What kind of COVID-19 tests do cruise lines require?

Cruise lines still set criteria for the tests they accept. Carnival said it will accept self-administered tests as well as lab-administered tests from unvaccinated guests on voyages that are 15 nights or less beginning Sept. 6, according to a news release.

Royal Caribbean will also allow passengers on U.S. cruises to take a home test or one "professionally administered by a health professional" starting Sept. 5 according to its website . Celebrity will accept self-tests beginning on the same date, as well.

Those changes are subject to local requirements.

Norwegian Cruise Line, meanwhile, will require "proof of a medically supervised negative PCR or Antigen test" for unvaccinated passengers 12 and up, according to its website . Travelers should check with their cruise line for their specific rules.

'More than I hoped for': This is what it's like cruising with a disability right now

First-time cruisers: 3 things to know before stepping foot on the ship

What kind of on-board testing requirements do cruise lines have?

Cruise lines still have on-board protocols in place, as well. For its part, Carnival requires passengers who are exposed to or in close contact with anyone who tests positive for COVID or displays symptoms to be tested, along with their close contacts, according to its website . Those passengers may have to quarantine in their rooms until medical staff clears them.

Other cruise lines have similar protocols in place, like Norwegian, which advises passengers who have COVID symptoms while sailing to contact the ship's medical center, which is equipped to test on board, per its website . Royal Caribbean Group's namesake brand, Royal Caribbean International, also offers testing to travelers who feel sick, and its medical lab "allows for rapid, accurate onsite PCR testing with results in under an hour, alongside a multitude of other evaluative tests," its website reads.

What other protocols do cruise lines have in place?

► Masks: Carnival highly recommends guests wear masks in public indoor areas except when eating or drinking, and "when in large congregate events outdoors where physical distancing cannot be maintained," per its website . The cruise line also recommends masking during embarkation and debarkation and requires masks in the medical center. Crew members also wear masks indoors at all times.

On Royal Caribbean International, masks are optional for passengers who are vaccinated. They are recommended for unvaccinated kids. MSC has a similar policy . On Princess sailings, masks are recommended but not mandatory in most areas of the ship, though the cruise line notes on its website that "you may need to wear them in select venues or certain situations." Masks are optional on all Norwegian voyages.

►Cleaning: Many cruise lines continue to emphasize heightened cleaning on board. Norwegian, for example, has "enhanced cleaning and sanitation protocols" in place with EPA-approved disinfectants, and is making use of medical-grade air filters, according to its website . Royal Caribbean similarly boosted its cleaning regimen, including cleaning frequently used places like elevators and stairways every two hours. Crew must also take continual training classes and "refreshers," per its website .

MSC is also utilizing "hospital-grade disinfectants, electrostatic sprayers, increased cleaning frequency and a focus on high-traffic, frequently-touched areas," according to its website .

►Physical distancing: Cruise lines may recommend social distancing during parts of trips. Royal Caribbean International recommends distancing in select parts of the ship indicated by signage.

Cruise lines may also change their policies as needed.

"Our member lines continuously monitor health conditions onboard and employ health and safety protocols commensurate with those conditions," Anne Madison, a spokesperson for Cruise Lines International Association, told USA TODAY in an email. "This may result in cruise lines adjusting protocols when appropriate in consultation with medical and other health experts in order to continue to make science-driven and medically informed decisions."

Passengers can find more information on ship protocols on their cruise line's website.

This article originally appeared on USA TODAY: When cruise lines are still requiring testing

Recommended Stories

College football playoff picture: here's what the 12-team bracket looks like after week 8.

Oregon is now the No. 1 team in the country after Georgia's win over Texas.

NFL reportedly investigating tackle that injured Chris Godwin for elements of banned hip-drop

Ravens LB Roquan Smith may owe some money to the NFL if it's determined he used a banned hip-drop tackle on Chris Godwin.

Deion Sanders is living up to the hype at Colorado — 'We have earned where we are'

Midway through his second year, Deion Sanders has transformed Colorado from a 1-11 joke into a team in contention for the College Football Playoff.

'This kid just won’t give up': Student who practiced alone for 2-plus years ready to answer Arizona State's call for a kicker

For more than two years Nolan Krinsky practiced on his own, hoping for an opportunity to make the Arizona State football team. Wednesday, he finally gets his shot.

Midseason grades: A+ for Boise State, F for Oklahoma State & more | College Football Power Hour

Caroline Fenton, Jason Fitz & Adam Breneman give several teams their midseason report cards, share the scariest performances from Week 8 and preview the biggest games of Week 9.

NCAA mulling in-season action after Oregon's controversial late-game situational move helped Ducks beat Ohio State

The NCAA Football Playing Rules Committee is actively “engaged” in examining Oregon's controversial play for possible action.

Pistons called for playing 6 men on the court during 4th-quarter collapse in season opener

The Pistons might still be the Pistons.

Shohei Ohtani 50-50 home run ball auctions at record-shattering $4.4 million after last-minute flurry of bids

The Ohtani ball auction was two minutes from ending. Then 11 bids came in.

Apple, Goldman Sachs fined $89 million for misleading Apple Card customers

The Consumer Financial Protection Bureau (CFPB) issued $89 million in fines against Apple and Goldman Sachs.

'I’m no longer the best coach to lead this program in this current environment': Tony Bennett says tearful goodbye to Virginia

In a tearful news conference, Tony Bennett said the changing landscape of college basketball played a part in his sudden retirement.

NASCAR awards Bobby Allison an 85th victory 53 years after he took the checkered flag at Bowman Gray Stadium

Allison's win in the 1971 race had never been officially recognized by NASCAR until Wednesday.

NBA Predictions! Here are 36 bold takes for 2024-25, including one for every team

Here are 36 predictions about this upcoming NBA season, including at least one involving every single team:

Officials reverse controversial Texas pass interference call during delay for fans throwing objects onto the field

Have you ever seen a pass interference call take nearly five minutes to get figured out?

Feds clear way for EVTOL startups to bring flying vehicles to U.S. airspace

Federal regulators have cleared the path for electric vertical takeoff and landing aircraft to share U.S. airspace with planes and helicopters -- a win for the burgeoning industry and a timely decision for startups like Joby Aviation and Archer Aviation that are expected to launch air taxi networks commercially in 2025. The Federal Aviation Administration published Tuesday its much-anticipated final ruling on the integration of “powered-lift” vehicles, a category the FAA revived two years ago to accommodate eVTOLs and one that describes aircraft that can take off and land like helicopters but then transition to forward flight like airplanes. “Powered-lift aircraft are the first new category of aircraft in nearly 80 years and this historic rule will pave the way for accommodating wide-scale Advanced Air Mobility (AAM) operations in the future,” FAA Administrator Mike Whitaker said in a statement.

'The Voice' recap: Snoop Dogg presses the Coach Replay button, one contestant wows all four judges

Blind Auditions continued in Week 2 of the reality singing competition as one coach hits the show's powerful new button.

'We didn't want to play against a male player': Transgender issue pits female volleyball players against their own university

Nevada women’s volleyball players take a stand against the university in the name of "fair competition and safety for everyone."

Yahoo Top 10: After a tumultuous Week 8 in the SEC, who belongs at No. 1?

Alabama fans are dealing with a whole new reality this season. Texas fans are coping after the Longhorns' first loss of the season. Week 8 brought with it a new outlook for many teams after a surprising Saturday of action.

Texas’ potential QB controversy & big time SEC fines for field storming | College Football Enquirer

On today's episode of The College Football Enquirer, Dan Wetzel, Ross Dellenger and SI's Pat Forde unpack Texas' complicated quarterback situation with Quinn Ewers and Arch Manning. They also look ahead to the biggest matchups of the weekend, including Texas vs. Vanderbilt, LSU vs. Texas A&M and Boise State vs. UNLV.

McIlroy/Scheffler vs. Koepka/DeChambeau match has a name, a date and a site

'The Showdown' will pit some of the finest PGA Tour and LIV Golf players against one another.

Chiefs complete trade for Titans receiver DeAndre Hopkins

The Kansas City Chiefs are sending a conditional draft pick to the Tennessee Titans for wide receiver DeAndre Hopkins.

Here Are the Updated COVID-19 Testing Requirements for Each Major Cruise Line

For many, testing and vaccination requirements have made cruising more confusing than ever, by sophia pargas • published august 8, 2022 • updated on august 15, 2022 at 10:07 am.

Ever since the start of the pandemic, new COVID-19 protocols have complicated many travelers' ideal summer getaway: cruising.

To many, the newfound hassle of determining cruise line regulations , gathering documents and finding a testing center has turned many away from sailing. In recent months, however, many cruise lines have altered requirements to become more lenient on pre-boarding testing regulations.

Philadelphia news 24/7: Watch NBC10 free wherever you are

Before taking to the seas on your next adventure, read this guide to review the updated testing mandates on all of your favorite cruise lines.

(All information is based on sailings out of the United States.)

Get top local stories in Philly delivered to you every morning. Sign up for NBC Philadelphia's News Headlines newsletter.

Carnival Cruise Lines

Testing Requirements for Vaccinated Passengers:

• Vaccinated guests must continue to provide evidence of their vaccination status, either through VeriFLY or at embarkation.
• Canada: a PCR test can be taken 3 days before sailing or an antigen test can be taken 2 days before sailing
• Bermuda: a PCR test can be taken 4 days before sailing or an antigen test can be taken 2 days before sailing
• Greece: a PCR or antigen test can be taken 2 days before sailing
• Australia: a PCR test 3 days before sailing or a self-administered antigen test 1 day before sailing

Testing Requirements for Unvaccinated Passengers:

• Unvaccinated guests are welcome to sail and are no longer required to apply for a vaccine exemption, except for cruises in Australia or on voyages 16 nights and longer. 
• Bermuda: a PCR test can be taken 4 days before sailing (antigen tests are not accepted)

For more information, please see here .

Celebrity Cruise Line

• Cruises 5 days or less: With the exception of sailings to Bermuda and Canada, no fully vaccinated passengers will be required to test before sailing.
• Cruises 6 days or more: All guests are required to take an official COVID-19 test before boarding. They can take a PCR test 72 hours prior to sailing, or an antigen test two days prior to sailing.

All unvaccinated guests ages 2 and older are required to receive a lab-administered PCR or antigen test up to 3 days before sailing.

Cunard Luxury Cruise Line

Testing Requirements:

All guests 5 and older are required to take an official negative COVID-19 test before embarking.

Disney Cruise Line

All vaccinated guests are required to show proof of a negative antigen, NAAT or PCR test within two days of sailing.

Unvaccinated guests (those 4 and under) must provide proof of a negative NAAT or PCR test within three days of sailing. Rapid antigen tests are not accepted.

Holland America Cruise Line

Regardless of vaccination status, all guests ages 2 and up are required to show proof of a negative antigen or NAAT COVID test.

MSC Cruises

• Cruises 5 days or less: Beginning August 29, no fully vaccinated passengers will be required to test before sailing.
• Cruises 6 days or more: All guests are required to take an official COVID-19 test before boarding.

Norwegian Cruise Line

Beginning September 4, no fully vaccinated passengers will be required to test before sailing.

Beginning September 4, all children under 11 years old will not be required to test before sailing. Children 12 and older who are unvaccinated must receive a PCR or antigen test up to 72 hours before sailing.

Princess Cruise Line

Testing Requirements: All guests 2 and older are required to submit a negative test regardless of vaccination status.

Royal Caribbean Cruises

Viking Ocean Cruises

Viking does not require a pre-departure COVID-19 test unless it is required by a sailing's destination.

• Economy & Markets
• Digital Life

These 7 Cruise Lines Have Dropped Their COVID Testing Requirements

Several cruise lines have eliminated their requirement for a negative COVID test before boarding for some passengers in the wake of the Centers for Disease Control and Prevention halting its COVID-19 Program for Cruise Ships.

The CDC’s COVID-19 Program for Cruise Ships was dropped in mid-July as the agency said, “cruise travelers have access to recommendations that allow them to make informed decisions about cruise ship travel.”

The COVID-19 Program for Cruise Ships was a voluntary program that provided recommendations for cruise lines on COVID protocols such as vaccinations and testing.

Following the announcement by the CDC , seven cruise lines have rolled back their COVID testing policy for vaccinated passengers embarking on their ships.

One of the first to announce that it would no longer have a COVID testing requirement for all passengers was Virgin Voyages. The company said on its website that it was removing the requirement for a COVID-19 test to boarding on its Valiant Lady and Scarlet Lady ships at the end of July.

The cruise line also opened up 10% of its sailing to unvaccinated passengers but said its crew members would continue to be fully vaccinated.

Also updating its COVID policies was cruise line Azamara , which said on its website as of July 25, it would stop requiring COVID-19 tests for its passengers. However, the company said testing would still be required in ports that have the requirement in accordance with country regulations.

Margaritaville at Sea also dropped its COVID testing requirement for vaccinated passengers on July 22. The cruise line said that vaccinated passengers need to provide proof of inoculation, while nonvaccinated passengers would need a negative Antigen test verified by a testing agency taken no more than one day prior to sailing.

More recently, Carnival Cruise Line , Royal Caribbean, and MSC Cruises announced that they also were not requiring vaccinated passengers to have a negative COVID test for pre-embarkation on shorter voyages.

Carnival on Thursday will drop COVID testing for fully vaccinated passengers on “certain cruises with itineraries 5 days or less” unless a destination has a different requirement, it said on its COVID-19 guest protocols webpage . These destinations include the Bahamas, Bermuda, and Grand Cayman, where COVID testing prior to boarding is required regardless of the length of the sailing.

Cruises that are six days or longer will still require a negative COVID test for boarding a Carnival cruise for passengers aged 2 and older unless a destination has a different requirement. Those on a back-to-back cruise 16 days or longer will also be tested mid-voyage, Carnival said.

MSC’s COVID testing policy will change on Aug. 8, according to its website, which said only unvaccinated passengers will be required to provide a negative COVID test for pre-embarkation of the company’s ships on all sailings. Vaccinated passengers will also need to submit a negative COVID test on voyages that are six nights or longer.

Also on Aug. 8, Royal Caribbean passengers who are vaccinated and on sailings that are five nights or less will no longer need COVID testing, the cruise line said in a statement on its website . But if a vaccinated passenger is on a sailing that is six nights or longer, the cruise lines are still requiring a negative COVID test for boarding.

Lastly, Norwegian Cruise Line updated its COVID testing policy, eliminating testing for vaccinated passengers, according to its website . The cruise line requires passengers 12 and older to be fully vaccinated.

© Copyright IBTimes 2024. All rights reserved.

Chair Of Global Plastics Talks Pledges Deal Next Month

Global Business Web Behind Malaysia's 'Houses Of Horror' Youth Homes

East DR Congo Grapples With Chinese Gold Mining Firms

Climate Change Worsened Deadly Africa Floods, Scientists Say

IMF Predicts Slightly Slower Global Growth In 2024 And 2025

UN Eyes Modest 2024 Maritime Trade Growth, But Future Uncertain

How Much Aid Is Getting Into Gaza?

Disney To Name Bob Iger's Replacement In Early 2026

Arizona: The Rising Swing State Leaning Trump So Far On Polymarket

Amnesty Says Migrant Workers Exploited At Carrefour Saudi Stores

Have Fun. Be Safe.

Cruising with Carnival is easy! Vaccines and testing are not required for most U.S. and European departures.*

Guests sailing to and from Australia must visit the Australia Have Fun. Be Safe. page for protocols specific to those cruises.

VACCINATION & TESTING

Although vaccines are not required, we encourage all guests, 5 years of age and older, to be up to date with their COVID-19 vaccines, when eligible, and carry proof of vaccination. Testing is not required for either vaccinated or unvaccinated guests. However, we encourage all guests, 5 years and older, to take a pre-cruise COVID-19 test within three days of their cruise.

*Carnival Luminosa - 9/14/2023: This Carnival Journeys Transpacific voyage will be calling on certain destinations (including Australia) which are still observing COVID-19 protocols. Below are more details regarding vaccination and testing requirements for this voyage:

• Guests, aged 12 years and older, must be fully vaccinated to sail. Additionally, we strongly recommend that guests get a booster, if eligible.
• All guests, aged two years and above, regardless of vaccination status, are required to take a self-administered Rapid-Antigen Test (RAT) within 24 hours of boarding or a PCR test within 48 hours prior to boarding. Evidence of a negative result is required to cruise.
• Vaccine exemptions are required for guests, aged 12 years and older, with medical conditions preventing vaccination. If you, or a member of your party, meet the criteria for a vaccine exemption, you may apply here .
• Full details regarding vaccination and testing requirements and FAQs are available on the Australia Have Fun. Be Safe. page .

DESTINATION REQUIREMENTS

We will continue to monitor the protocols and requirements of the destinations we visit and will update our guests directly and this page of any changes.

Have questions? Check out our Have Fun. Be Safe. FAQs for all sailings, except Carnival Luminosa’s 09/14/2023 voyage.

• Favorites & Watchlist Find a Cruise Cruise Deals Cruise Ships Destinations Manage My Cruise​ FAQ Perfect Day at CocoCay Weekend Cruises Crown & Anchor Society Cruising Guides Gift Cards Contact Us Royal Caribbean Group
• Back to Main Menu
• Search Cruises " id="rciHeaderSideNavSubmenu-2-1" class="headerSidenav__link" href="/cruises" target="_self"> Search Cruises
• Cruise Deals
• Weekend Cruises
• Last Minute Cruises
• Family Cruises​
• 2024-2025 Cruises
• All Cruise Ships " id="rciHeaderSideNavSubmenu-4-1" class="headerSidenav__link" href="/cruise-ships" target="_self"> All Cruise Ships
• Cruise Dining
• Onboard Activities
• Cruise Rooms
• The Cruise Experience
• All Cruise Destinations " id="rciHeaderSideNavSubmenu-5-1" class="headerSidenav__link" href="/cruise-destinations" target="_self"> All Cruise Destinations
• Cruise Ports
• Shore Excursions
• Perfect Day at CocoCay
• Caribbean Cruises
• Bahamas Cruises​
• Alaska Cruises
• European Cruises​
• Mediterranean Cruises​
• Royal Destinations
• Cruise Planner
• Make a Payment
• Check-In for My Cruise
• Beverage Packages​
• Shore Excursions​
• Book a Flight
• Dining Packages​
• Royal Gifts
• Required Travel Documents
• Transportation
• Book a Hotel
• Redeem Cruise Credit
• All FAQs " id="rciHeaderSideNavSubmenu-7-1" class="headerSidenav__link" href="/faq" target="_self"> All FAQs
• Boarding Requirements
• Future Cruise Credit​
• Travel Documents​
• Check-in​ & Boarding Pass
• Transportation​
• Perfect Day at CocoCay​
• Post-Cruise Inquiries
• Royal Caribbean
• Celebrity Cruises

What are the pre-cruise testing requirements for my cruise?

Pre-cruise testing is no longer required to sail on any of our sailings.

Still need help? Contact Us

Get support by phone or email.

Email Your Questions

Locate a Travel Agent

Previewing: Promo Dashboard Campaigns

My Personas

Code: ∅.

A .gov website belongs to an official government organization in the United States.

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• About COVID-19
• People with Certain Medical Conditions and COVID-19
• COVID-19 Vaccines
• How to Protect Yourself and Others
• Tools and Resources
• Clinical Care Quick Reference
• Infection Control Guidance
• Containing COVID-19 in Non-U.S. Healthcare Settings
• Surveillance and Data Analytics
• Safety Precautions: Cleaning and Disinfecting for COVID-19
• Interim Guidelines for Biosafety and COVID-19
• CDC Science behind Long COVID
• Health Equity in COVID-19
• Variants and Genomic Surveillance for SARS-CoV-2
• SARS-CoV-2 Interagency Group
• View All Home

Infection Control Guidance: SARS-CoV-2

• This guidance applies to all U.S. settings where healthcare is delivered, including nursing homes and home health. The recommendations in this guidance continue to apply after the expiration of the federal COVID-19 Public Health Emergency.

Summary of recent changes

For awareness.

Updates: Recommendations included in this guidance (e.g., duration of isolation, recommended personal protective equipment) are being reviewed as part of updates to the 2007 Guideline for Isolation Precautions. Once a draft is finalized by the Healthcare Infection Control Practices Advisory Committee (HICPAC), it will be posted in the federal register for a public comment period before being returned to HICPAC for additional review. Further information about HICPAC, the guideline development and public comment process, and future meetings is available at: Healthcare Infection Control Practices Advisory Committee (HICPAC).

Updates as of May 8, 2023

• Updated recommendations for universal source control and admission testing in nursing homes
• Added Appendix to assist facilities with how and when to implement broader use of source control, including examples of potential metrics

Introduction

Reminder‎.

For healthcare personnel, see Isolation and work restriction guidance . For strategies to mitigate healthcare personnel staffing shortages, see Contingency and crisis management .

For healthcare professionals advising people in non-healthcare settings about isolation for laboratory-confirmed COVID-19, see Preventing Spread of Respiratory Viruses When You're Sick .

This interim guidance has been updated based on currently available information about COVID-19 and the current situation in the United States. Updates were made to reflect the high levels of vaccine-and infection-induced immunity and the availability of effective treatments and prevention tools . This guidance provides a framework for facilities to implement select infection prevention and control practices (e.g., universal source control) based on their individual circumstances (e.g., levels of respiratory virus transmission in the community).

This guidance is applicable to all U.S. settings where healthcare is delivered (including nursing homes and home health). This guidance is not intended for non-healthcare settings (e.g., restaurants) and not for persons outside of healthcare settings. CDC's main landing page for COVID-19 content will help readers navigate to information regarding modes of transmission, clinical management, laboratory settings, COVID-19 vaccines and CDC guidance on other COVID-19-related topics.

Employers should be aware that other local, territorial, tribal, state, and federal requirements may apply, including those promulgated by the Occupational Safety and Health Administration (OSHA).

Implications for the Community Transmission Metric with the End of the Public Health Emergency‎

With the end of the federal COVID-19 Public Health Emergency (PHE) on May 11, 2023, CDC will no longer receive data needed to publish Community Transmission levels for SARS-CoV-2. This metric informed CDC's recommendations for broader use of source control in healthcare facilities to allow for earlier intervention, to avoid strain on a healthcare system, and to better protect individuals seeking care in these settings.

As described in CDC's Core IPC Practices , source control remains an important intervention during periods of higher respiratory virus transmission. Without the Community Transmission metric, healthcare facilities should identify local metrics that could reflect increasing community respiratory viral activity to determine when broader use of source control in the facility might be warranted (See Appendix).

1. Recommended routine infection prevention and control (IPC) practices during the COVID-19 pandemic

Encourage everyone to remain up to date with all recommended COVID-19 vaccine doses.

• HCP, patients, and visitors should be offered resources and counseling about the importance of receiving the COVID-19 vaccine.

Establish a Process to Identify and Manage Individuals with Suspected or Confirmed SARS-CoV-2 Infection

• Post visual alerts (e.g., signs, posters) at the entrance and in strategic places (e.g., waiting areas, elevators, cafeterias). These alerts should include instructions about current IPC recommendations (e.g., when to use source control and perform hand hygiene). Dating these alerts can help ensure people know that they reflect current recommendations.
• A positive viral test for SARS-CoV-2
• Symptoms of COVID-19 , or
• Close contact with someone with SARS-CoV-2 infection (for patients and visitors) or a higher-risk exposure (for healthcare personnel (HCP) .
• For example:
• The definition of higher-risk exposure and recommendations for evaluation and work restriction of these HCP are in the Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 .
• Patients should be managed as described in Section 2.
• Visitors with confirmed SARS-CoV-2 infection or compatible symptoms should defer non-urgent in-person visitation until they have met the healthcare criteria to end isolation (see Section 2); this time period is longer than what is recommended in the community. For visitors who have had close contact with someone with SARS-CoV-2 infection or were in another situation that put them at higher risk for transmission, it is safest to defer non-urgent in-person visitation until 10 days after their close contact if they meet any of the criteria described in Section 2 (e.g., cannot wear source control).

Additional information about visitation from the Centers for Medicare & Medicaid Services (CMS) is available at Policy & Memos to States and Regions | CMS .

Implement Source Control Measures

Source control refers to use of respirators or well-fitting facemasks or cloth masks to cover a person's mouth and nose to prevent spread of respiratory secretions when they are breathing, talking, sneezing, or coughing. Masks and respirators also offer varying levels of protection to the wearer. Further information about types of masks and respirators, including those that meet standards and the degree of protection offered to the wearer, is available at: Masks and Respirators . People, particularly those at high risk for severe illness, should wear the most protective mask or respirator they can that fits well and that they will wear consistently.

Even when a facility does not require masking for source control, it should allow individuals to use a mask or respirator based on personal preference, informed by their perceived level of risk for infection based on their recent activities (e.g., attending crowded indoor gatherings with poor ventilation) and their potential for developing severe disease if they are exposed.

Source control options for HCP include:

• A NIOSH Approved ® particulate respirator with N95 ® filters or higher;
• A respirator approved under standards used in other countries that are similar to NIOSH Approved N95 filtering facepiece respirators (Note: These should not be used instead of a NIOSH Approved respirator when respiratory protection is indicated);
• A barrier face covering that meets ASTM F3502-21 requirements including Workplace Performance and Workplace Performance Plus masks ; OR
• A well-fitting facemask.

When used solely for source control, any of the options listed above could be used for an entire shift unless they become soiled, damaged, or hard to breathe through. If they are used during the care of patient for which a NIOSH Approved respirator or facemask is indicated for personal protective equipment (PPE) (e.g., NIOSH Approved particulate respirators with N95 filters or higher during the care of a patient with SARS-CoV-2 infection, facemask during a surgical procedure or during care of a patient on Droplet Precautions), they should be removed and discarded after the patient care encounter and a new one should be donned.

Source control is recommended for individuals in healthcare settings who:

• Have suspected or confirmed SARS-CoV-2 infection or other respiratory infection (e.g., those with runny nose, cough, sneeze); or
• Had close contact (patients and visitors) or a higher-risk exposure (HCP) with someone with SARS-CoV-2 infection, for 10 days after their exposure

Source control is recommended more broadly as described in CDC's Core IPC Practices in the following circumstances:

• By those residing or working on a unit or area of the facility experiencing a SARS-CoV-2 or other outbreak of respiratory infection; universal use of source control could be discontinued as a mitigation measure once the outbreak is over (e.g., no new cases of SARS-CoV-2 infection have been identified for 14 days); or
• Facility-wide or, based on a facility risk assessment, targeted toward higher risk areas (e.g., emergency departments, urgent care) or patient populations (e.g., when caring for patients with moderate to severe immunocompromise) during periods of higher levels of community SARS-CoV-2 or other respiratory virus transmission (See Appendix)
• Have otherwise had source control recommended by public health authorities (e.g., in guidance for the community when COVID-19 hospital admission levels are high)

Implement Universal Use of Personal Protective Equipment for HCP

If SARS-CoV-2 infection is not suspected in a patient presenting for care (based on symptom and exposure history), HCP should follow Standard Precautions (and Transmission-Based Precautions if required based on the suspected diagnosis).

As SARS-CoV-2 transmission in the community increases, the potential for encountering asymptomatic or pre-symptomatic patients with SARS-CoV-2 infection also likely increases. In these circumstances, healthcare facilities should consider implementing broader use of respirators and eye protection by HCP during patient care encounters as described below.

NIOSH Approved particulate respirators with N95 filters or higher used for:

• All surgical procedures that might pose higher risk for transmission if the patient has SARS-CoV-2 infection (e.g., that generate potentially infectious aerosols or involving anatomic regions where viral loads might be higher, such as the nose and throat, oropharynx, respiratory tract).
• NIOSH Approved particulate respirators with N95 filters or higher can also be used by HCP working in other situations where additional risk factors for transmission are present, such as when the patient is unable to use source control and the area is poorly ventilated. They may also be considered if healthcare-associated SARS-CoV-2 transmission is identified and universal respirator use by HCP working in affected areas is not already in place.
• To simplify implementation, facilities in counties with higher levels of SARS-CoV-2 transmission may consider implementing universal use of NIOSH Approved particulate respirators with N95 filters or higher for HCP during all patient care encounters or in specific units or areas of the facility at higher risk for SARS-CoV-2 transmission.
• Eye protection (i.e., goggles or a face shield that covers the front and sides of the face) worn during all patient care encounters.

Optimize the Use of Engineering Controls and Indoor Air Quality

• Optimize the use of engineering controls to reduce or eliminate exposures by shielding HCP and other patients from infected individuals (e.g., physical barriers at reception / triage locations and dedicated pathways to guide symptomatic patients through waiting rooms and triage areas).
• Take measures to limit crowding in communal spaces, such as scheduling appointments to limit the number of patients in waiting rooms or treatment areas.
• Guidelines for Environmental Infection Control in Health-Care Facilities
• American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) resources for healthcare facilities , which also provides COVID-19 technical resources for healthcare facilities
• Ventilation in Buildings, which includes options for non-clinical spaces in healthcare facilities

Perform SARS-CoV-2 Viral Testing

• Anyone with even mild symptoms of COVID-19, regardless of vaccination status , should receive a viral test for SARS-CoV-2 as soon as possible.
• Due to challenges in interpreting the result, testing is generally not recommended for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 30 days. Testing should be considered for those who have recovered in the prior 31–90 days; however, an antigen test instead of a nucleic acid amplification test (NAAT) is recommended. This is because some people may remain NAAT positive but not be infectious during this period.
• Guidance for work restrictions, including recommended testing for HCP with higher-risk exposures, are in the Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 .
• Guidance for use of empiric Transmission-Based Precautions for patients with close contact with someone with SARS-CoV-2 infection are described in Section 2.
• Testing considerations for healthcare facilities with an outbreak of SARS-CoV-2 are described below .
• In general, performance of pre-procedure or pre-admission testing is at the discretion of the facility.
• Performance of expanded screening testing of asymptomatic HCP without known exposures is at the discretion of the facility.

Create a Process to Respond to SARS-CoV-2 Exposures Among HCP and Others

Healthcare facilities should have a plan for how SARS-CoV-2 exposures in a healthcare facility will be investigated and managed and how contact tracing will be performed.

If healthcare-associated transmission is suspected or identified, facilities might consider expanded testing of HCP and patients as determined by the distribution and number of cases throughout the facility and ability to identify close contacts. For example, in an outpatient dialysis facility with an open treatment area, testing should ideally include all patients and HCP. Depending on testing resources available or the likelihood of healthcare-associated transmission, facilities may elect to initially expand testing only to HCP and patients on the affected units or departments, or a particular treatment schedule or shift, as opposed to the entire facility. If an expanded testing approach is taken and testing identifies additional infections, testing should be expanded more broadly. If possible, testing should be repeated every 3–7 days until no new cases are identified for at least 14 days.

Guidance for outbreak response in nursing homes is described in setting-specific considerations below.

Healthcare facilities responding to SARS-CoV-2 transmission within the facility should always notify and follow the recommendations of public health authorities.

2. Recommended infection prevention and control (IPC) practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection

The IPC recommendations described below (e.g., patient placement, recommended PPE) also apply to patients with symptoms of COVID-19 (even before results of diagnostic testing) and asymptomatic patients who have met the criteria for empiric Transmission-Based Precautions based on close contact with someone with SARS-CoV-2 infection. However, these patients should NOT be cohorted with patients with confirmed SARS-CoV-2 infection unless they are confirmed to have SARS-CoV-2 infection through testing.

Duration of Empiric Transmission-Based Precautions for Symptomatic Patients being Evaluated for SARS-CoV-2 infection

The decision to discontinue empiric Transmission-Based Precautions by excluding the diagnosis of current SARS-CoV-2 infection for a patient with symptoms of COVID-19 can be made based upon having negative results from at least one viral test.

• If using NAAT (molecular), a single negative test is sufficient in most circumstances. If a higher level of clinical suspicion for SARS-CoV-2 infection exists, consider maintaining Transmission-Based Precautions and confirming with a second negative NAAT.
• If using an antigen test, a negative result should be confirmed by either a negative NAAT (molecular) or second negative antigen test taken 48 hours after the first negative test.

If a patient suspected of having SARS-CoV-2 infection is never tested, the decision to discontinue Transmission-Based Precautions can be made based on time from symptom onset as described in the Isolation section below. Ultimately, clinical judgment and suspicion of SARS-CoV-2 infection determine whether to continue or discontinue empiric Transmission-Based Precautions.

Duration of Empiric Transmission-Based Precautions for Asymptomatic Patients following Close Contact with Someone with SARS-CoV-2 Infection

In general, asymptomatic patients do not require empiric use of Transmission-Based Precautions while being evaluated for SARS-CoV-2 following close contact with someone with SARS-CoV-2 infection. These patients should still wear source control and those who have not recovered from SARS-CoV-2 infection in the prior 30 days should be tested as described in the testing section.

Examples of when empiric Transmission-Based Precautions following close contact may be considered include:

• Patient is unable to be tested or wear source control as recommended for the 10 days following their exposure
• Patient is moderately to severely immunocompromised
• Patient is residing on a unit with others who are moderately to severely immunocompromised
• Patient is residing on a unit experiencing ongoing SARS-CoV-2 transmission that is not controlled with initial interventions

Patients placed in empiric Transmission-Based Precautions based on close contact with someone with SARS-CoV-2 infection should be maintained in Transmission-Based Precautions for the following time periods.

• Patients can be removed from Transmission-Based Precautions after day 7 following the exposure (count the day of exposure as day 0) if they do not develop symptoms and all viral testing as described for asymptomatic individuals following close contact is negative.
• If viral testing is not performed, patients can be removed from Transmission-Based Precautions after day 10 following the exposure (count the day of exposure as day 0) if they do not develop symptoms.

Patient Placement

• If cohorting, only patients with the same respiratory pathogen should be housed in the same room. MDRO colonization status and/or presence of other communicable disease should also be taken into consideration during the cohorting process.
• Facilities could consider designating entire units within the facility, with dedicated HCP, to care for patients with SARS-CoV-2 infection when the number of patients with SARS-CoV-2 infection is high. Dedicated means that HCP are assigned to care only for these patients during their shifts. Dedicated units and/or HCP might not be feasible due to staffing crises or a small number of patients with SARS-CoV-2 infection.
• Limit transport and movement of the patient outside of the room to medically essential purposes.
• Communicate information about patients with suspected or confirmed SARS-CoV-2 infection to appropriate personnel before transferring them to other departments in the facility (e.g., radiology) and to other healthcare facilities.

Personal Protective Equipment

• HCP who enter the room of a patient with suspected or confirmed SARS-CoV-2 infection should adhere to Standard Precautions and use a NIOSH Approved particulate respirator with N95 filters or higher, gown, gloves, and eye protection (i.e., goggles or a face shield that covers the front and sides of the face).
• Respirators should be used in the context of a comprehensive respiratory protection program, which includes medical evaluations, fit testing and training in accordance with the Occupational Safety and Health Administration's (OSHA) Respiratory Protection standard ( 29 CFR 1910.134 )
• Additional information about using PPE is available in Protecting Healthcare Personnel

Aerosol-Generating Procedures (AGPs)

• Procedures that could generate infectious aerosols should be performed cautiously and avoided if appropriate alternatives exist.
• AGPs should take place in an airborne infection isolation room (AIIR), if possible.
• The number of HCP present during the procedure should be limited to only those essential for patient care and procedure support. Visitors should not be present for the procedure.
• Counsel patients and their visitor(s) about the risks of an in-person visit.
• Encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets, when appropriate.
• Facilities should provide instruction, before visitors enter the patient's room, on hand hygiene, limiting surfaces touched, and use of PPE according to current facility policy.
• Visitors should be instructed to only visit the patient room. They should minimize their time spent in other locations in the facility.

Duration of Transmission-Based Precautions for Patients with SARS-CoV-2 Infection

The following are criteria to determine when Transmission-Based Precautions could be discontinued for patients with SARS-CoV-2 infection and are influenced by severity of symptoms and presence of immunocompromising conditions. Patients should self-monitor and seek re-evaluation if symptoms recur or worsen. If symptoms recur (e.g., rebound), these patients should be placed back into isolation until they again meet the healthcare criteria below to discontinue Transmission-Based Precautions for SARS-CoV-2 infection unless an alternative diagnosis is identified.

In general, patients who are hospitalized for SARS-CoV-2 infection should be maintained in Transmission-Based Precautions for the time period described for patients with severe to critical illness.

In general, patients should continue to wear source control until symptoms resolve or, for those who never developed symptoms, until they meet the criteria to end isolation below. Then they should revert to usual facility source control policies for patients.

Patients with mild to moderate illness who are not moderately to severely immunocompromised :

• At least 10 days have passed since symptoms first appeared and
• At least 24 hours have passed since last fever without the use of fever-reducing medications and
• Symptoms (e.g., cough, shortness of breath) have improved

Patients who were asymptomatic throughout their infection and are not moderately to severely immunocompromised :

• At least 10 days have passed since the date of their first positive viral test.

Patients with severe to critical illness and who are not moderately to severely immunocompromised :

• At least 10 days and up to 20 days have passed since symptoms first appeared and
• The test-based strategy as described for moderately to severely immunocompromised patients below can be used to inform the duration of isolation.

The exact criteria that determine which patients will shed replication-competent virus for longer periods are not known. Disease severity factors and the presence of immunocompromising conditions should be considered when determining the appropriate duration for specific patients. For a summary of the literature, refer to Preventing Spread of Respiratory Viruses When You're Sick

Patients who are moderately to severely immunocompromised may produce replication-competent virus beyond 20 days after symptom onset or, for those who were asymptomatic throughout their infection, the date of their first positive viral test.

• Use of a test-based strategy and (if available) consultation with an infectious disease specialist is recommended to determine when Transmission-Based Precautions could be discontinued for these patients.

The criteria for the test-based strategy are:

Patients who are symptomatic:

• Resolution of fever without the use of fever-reducing medications and
• Symptoms (e.g., cough, shortness of breath) have improved, and
• Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAAT

Patients who are not symptomatic:

Environmental Infection Control

• All non-dedicated, non-disposable medical equipment used for that patient should be cleaned and disinfected according to manufacturer's instructions and facility policies before use on another patient.
• Refer to List N on the EPA website for EPA-registered disinfectants that kill SARS-CoV-2; the disinfectant selected should also be appropriate for other pathogens of concern at the facility (e.g., a difficile sporicidal agent is recommended to disinfect the rooms of patients with C. difficile infection).
• Management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures.
• Once the patient has been discharged or transferred, HCP, including environmental services personnel, should refrain from entering the vacated room without all recommended PPE until sufficient time has elapsed for enough air changes to remove potentially infectious particles [more information (to include important footnotes on its application) on clearance rates under differing ventilation conditions is available]. After this time has elapsed, the room should undergo appropriate cleaning and surface disinfection before it is returned to routine use.

3. Setting-specific considerations

In addition to the recommendations described in the guidance above , here are additional considerations for the settings listed below.

Dialysis Facilities

Considerations for Patient Placement

• Hepatitis B isolation rooms can be used if: 1) the patient is hepatitis B surface antigen-positive or 2) the facility has no patients on the census with hepatitis B infection who would require treatment in the isolation room.
• In the context of an outbreak or an increase in the number of confirmed SARS-CoV-2 infections at the facility, if a separate shift or unit is not initially available, efforts should be made to create specific shifts or units for patients with confirmed SARS-CoV-2 infection to separate them from patients without SARS-CoV-2 infection.

Additional Guidance for Use of Isolation Gowns

• When caring for patients with suspected or confirmed SARS-CoV-2 infection, gowns should be worn over or instead of the cover gown (e.g., laboratory coat, gown, or apron with incorporate sleeves) that is normally worn by hemodialysis personnel.

Cleaning and Disinfecting Dialysis Stations

• Current procedures for routine cleaning and disinfection of dialysis stations are appropriate for patients with SARS-CoV-2 infection.
• Internal disinfection of dialysis machines is not required immediately after use unless otherwise indicated (e.g., post-blood leak). It should be done according to the dialysis machine manufacturer's instructions (e.g., at the end of the day).

Emergency Medical Services

Considerations for vehicle configuration when transporting a patient with suspected or confirmed SARS-CoV-2 infection

• Isolate the ambulance driver from the patient compartment and keep pass-through doors and windows tightly shut.
• Before entering the isolated driver's compartment, the driver (if they were involved in direct patient care) should remove and dispose of PPE and perform hand hygiene to avoid soiling the compartment.
• Close the door/window between these compartments before bringing the patient on board.
• During transport, vehicle ventilation in both compartments should be on non-recirculated mode to maximize air changes that reduce potentially infectious particles in the vehicle.
• If the vehicle has a rear exhaust fan, use it to draw air away from the cab, toward the patient-care area, and out the back end of the vehicle.
• Some vehicles are equipped with a supplemental recirculating ventilation unit that passes air through high-efficiency particulate air (HEPA) filters before returning it to the vehicle. Such a unit can be used to increase the number of air changes per hour (ACH) Health Hazard Evaluation Report 95–0031–2601 pdf .
• After patient unloading, allowing a few minutes with ambulance module doors open will rapidly dilute airborne viral particles.
• Before entering the driver's compartment, the driver (if they were involved in direct patient care) should remove their gown, gloves and eye protection and perform hand hygiene to avoid soiling the compartment. They should continue to wear their NIOSH Approved particulate respirator with N95 filters or higher.

Additional considerations when performing AGPs on patients with suspected or confirmed SARS-CoV-2 infection:

• If possible, consult with medical control before performing AGPs for specific guidance.
• Bag valve masks (BVMs) and other ventilatory equipment should be equipped with HEPA filtration to filter expired air.
• EMS systems should consult their ventilator equipment manufacturer to confirm appropriate filtration capability and the effect of filtration on positive-pressure ventilation.
• If possible, the rear doors of the stationary transport vehicle should be opened and the HVAC system should be activated during AGPs. This should be done away from pedestrian traffic.
• If possible, discontinue AGPs prior to entering the destination facility or communicate with receiving personnel that AGPs are being implemented.

Dental Facilities

• Dental healthcare personnel (DHCP) should regularly consult their state dental boards and state or local health departments for current information and recommendations and requirements specific to their jurisdictions.
• Dental care for these patients should only be provided if medically necessary. Follow all recommendations for care and placement for patients with suspected or confirmed SARS-CoV-2 infection. Extra attention may be required to ensure HVAC ventilation to the dental treatment area does not reduce or deactivate during occupancy based on temperature demands.
• If a patient has a fever strongly associated with a dental diagnosis (e.g., pulpal and periapical dental pain and intraoral swelling are present) but no other symptoms consistent with COVID-19 are present, dental care can be provided following the practices recommended for routine health care during the pandemic.
• Commonly used dental equipment known to create aerosols and airborne contamination include ultrasonic scaler, high-speed dental handpiece, air/water syringe, air polishing, and air abrasion.
• Dental treatment should be provided in individual patient rooms whenever possible with the HVAC in constant ventilation mode.
• At least 6 feet of space between patient chairs.
• Adjunct use of portable HEPA air filtration systems to enhance air cleaning
• Physical barriers between patient chairs. Easy-to-clean floor-to-ceiling barriers will enhance effectiveness of portable HEPA air filtration systems (check to make sure that extending barriers to the ceiling will not interfere with fire sprinkler systems).
• Operatories oriented parallel to the direction of airflow when possible.
• Where feasible, consider patient orientation carefully, placing the patient's head near the return air vents, away from pedestrian corridors, and toward the rear wall when using vestibule-type office layouts.
• Ensure to account for the time required to clean and disinfect operatories between patients when calculating your daily patient volume.

Nursing Homes

• This should be a full-time role for at least one person in facilities that have more than 100 residents or that provide on-site ventilator or hemodialysis services. Smaller facilities should consider staffing the IPC program based on the resident population and facility service needs identified in the IPC risk assessment .
• Stay connected with the healthcare-associated infection program in your state health department , as well as your local health department, and their notification requirements. Report SARS-CoV-2 infection data to National Healthcare Safety Network (NHSN) Long-term Care Facility (LTCF) COVID-19 Module. See Centers for Medicare & Medicaid Services (CMS) COVID-19 reporting requirements .
• Admission testing is at the discretion of the facility. Pros and cons of screening testing are described in Section 1 .
• Residents who leave the facility for 24 hours or longer should generally be managed as an admission.
• Empiric use of Transmission-Based Precautions is generally not necessary for admissions or for residents who leave the facility for less than 24 hours (e.g., for medical appointments, community outings) and do not meet criteria described in Section 2.
• Ideally, residents should be placed in a single-person room as described in Section 2.
• If limited single rooms are available, or if numerous residents are simultaneously identified to have known SARS-CoV-2 exposures or symptoms concerning for COVID-19, residents should remain in their current location.
• When performing an outbreak response to a known case, facilities should always defer to the recommendations of the jurisdiction's public health authority.
• A single new case of SARS-CoV-2 infection in any HCP or resident should be evaluated to determine if others in the facility could have been exposed.
• The approach to an outbreak investigation could involve either contact tracing or a broad-based approach; however, a broad-based (e.g., unit, floor, or other specific area(s) of the facility) approach is preferred if all potential contacts cannot be identified or managed with contact tracing or if contact tracing fails to halt transmission.
• Testing is recommended immediately (but not earlier than 24 hours after the exposure) and, if negative, again 48 hours after the first negative test and, if negative, again 48 hours after the second negative test. This will typically be at day 1 (where day of exposure is day 0), day 3, and day 5.
• Due to challenges in interpreting the result, testing is generally not recommended for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 30 days. Testing should be considered for those who have recovered in the prior 31-90 days; however, an antigen test instead of a nucleic acid amplification test (NAAT) is recommended. This is because some people may remain NAAT positive but not be infectious during this period.
• In the event of ongoing transmission within a facility that is not controlled with initial interventions, strong consideration should be given to use of Empiric use of Transmission-Based Precautions for residents and work restriction of HCP with higher-risk exposures. In addition, there might be other circumstances for which the jurisdiction's public authority recommends these and additional precautions.
• If no additional cases are identified during contact tracing or the broad-based testing, no further testing is indicated. Empiric use of Transmission-Based Precautions for residents and work restriction for HCP who met criteria can be discontinued as described in Section 2 and the Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 , respectively.
• If antigen testing is used, more frequent testing (every 3 days), should be considered.
• Facilities should follow guidance from CMS about visitation.
• Visitors should be counseled about their potential to be exposed to SARS-CoV-2 in the facility.
• If indoor visitation is occurring in areas of the facility experiencing transmission, it should ideally occur in the resident's room. The resident and their visitors should wear well-fitting source control (if tolerated) and physically distance (if possible) during the visit.

Assisted Living, Group Homes and Other Residential Care Settings (excluding nursing homes)

In general, long-term care settings (excluding nursing homes) whose staff provide non-skilled personal care* similar to that provided by family members in the home (e.g., many assisted livings, group homes), should follow community prevention strategies based on COVID-19 hospital admission levels , similar to independent living, retirement communities or other non-healthcare congregate settings. Residents should also be counseled about strategies to protect themselves and others , including recommendations for source control if they are immunocompromised or at high risk for severe disease. CDC has information and resources for older adults and for people with disabilities .

Visiting or shared healthcare personnel who enter the setting to provide healthcare to one or more residents (e.g., physical therapy, wound care, intravenous injections, or catheter care provided by home health agency nurses) should follow the healthcare IPC recommendations in this guidance. In addition, if staff in a residential care setting are providing in-person services for a resident with SARS-CoV-2 infection, they should be familiar with recommended IPC practices to protect themselves and others from potential exposures including the hand hygiene, personal protective equipment and cleaning and disinfection practices outlined in this guidance.

*Non-skilled personal care consists of any non-medical care that can reasonably and safely be provided by non-licensed caregivers, such as help with daily activities like bathing and dressing; it may also include the kind of health-related care that most people do themselves, like taking oral medications. In some cases where care is received at home or a residential setting, care can also include help with household duties such as cooking and laundry.

Considerations for Implementing Broader Use of Masking in Healthcare Settings

Introduction :

Use of well-fitting masks in healthcare settings are an important strategy to prevent the spread of respiratory viruses. Well-fitting masks can help block virus particles from reaching the nose and mouth of the wearer (wearer protection) and, if someone is ill, help block virus particles coming out of their nose and mouth from reaching others (source control). Masking by healthcare personnel as part of Standard and Transmission-Based Precautions and by ill individuals as part of respiratory hygiene and cough etiquette (i.e., for people with symptoms) are already well-described. This appendix describes considerations for implementing broader use of masking in healthcare settings. However, even when masking is not required by the facility, individuals should continue using a mask or respirator based on personal preference, informed by their perceived level of risk for infection based on their recent activities (e.g., attending crowded indoor gatherings with poor ventilation) and their potential for developing severe disease if they are exposed.

When to Implement Broader Use of Masking

The overall benefit of broader masking is likely to be the greatest for patients at higher risk for severe outcomes from respiratory virus infection and during periods of high respiratory virus transmission in the community.

Facilities should consider several factors when determining how and when to implement broader mask use:

• Facilities might tier their interventions based on the population they serve. For example, facilities might consider a lower threshold for action in areas of the facility primarily caring for patients at highest risk for severe outcomes (e.g., cancer clinics, transplant units) or in areas more likely to provide care for patients with a respiratory infection (e.g., urgent care, emergency department). Except when experiencing an outbreak within the facility, facilities with residents or patients that generally do not leave the facility might consider implementing masking only for staff and visitors
• Reviewing plans with stakeholders including patient and family groups and healthcare personnel can help a facility determine practices that will be more broadly supported.
• Some jurisdictions might consider a coordinated approach for all facilities in the jurisdiction.
• Facilities and jurisdictions might have access to more granular data for their jurisdiction to help guide efforts locally

Metrics for Community Respiratory Virus Transmission

CDC is in the early stages of developing metrics that could be used to guide when to implement select infection prevention and control practices for multiple respiratory viruses. However, at this time there are some general metrics that could be used to help facilities make decisions about community respiratory virus incidence. Data on the exact metric thresholds that correspond with a higher risk for transmission are lacking. In addition, data from these systems are generally not available for all jurisdictions.

Some facilities might consider recommending masking during the typical respiratory virus season (approximately October–April).

Facilities could also follow national data on trends of several respiratory viruses.

• SARS-CoV-2 Specific Metrics During the COVID-19 pandemic one of the strongest indicators of increasing cases in nursing homes was increasing community incidence. If a jurisdiction still has access to SARS-CoV-2- community incidence, using these data to guide local recommendations at the levels previously described (community incidence > or = to 100/100,000) could be considered.CDC will also continue to collect and report SARS-CoV-2 hospital admissions data on the CDC COVID Data Tracker . These data continue to be available at the county level and are used by CDC to help the public decide when masking in the community should be considered. Based on CDC analyses from data from late 2022 and early 2023, these levels might be less useful to inform masking recommendations in healthcare facilities.Using the current cutoff for masking in the community (>20 new COVID-19 admissions per 100,000 population over the last 7 days), the ability of these levels to indicate ongoing SARS-CoV-2 transmission at nursing homes (at 1 new infection per 100 resident-weeks, or higher) was low (sensitivity < 20%), although the specificity was high. Using a lower cutoff of 10 new COVID-19 admissions per 100,000 population (7-day total) increased sensitivity to about 40% but reduces specificity. CDC continues to recommend that healthcare facilities institute facility-wide masking when masks are recommended in the community.
• Metrics Encompassing Other Respiratory Viruses The RESP-NET interactive dashboard or data from the National Emergency Department Visits for COVID-19, Influenza, and Respiratory Syncytial Virus can be used to inform when respiratory virus season is beginning or ending, as described above. For more granular information, outpatient respiratory illness visits determined by data reported to ILINet , are aggregated to provide state level estimates. Cutoffs for action are not well-defined and data are reported as 13 activity levels which correspond to the number of standard deviations below, at, or above the mean for the current week compared with the mean during non-influenza weeks. Choosing a lower level will likely increase sensitivity for true increases in ILI.

Definitions:

Healthcare Personnel (HCP): Are paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air. HCP include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, home healthcare personnel, physicians, technicians, therapists, phlebotomists, pharmacists, dental healthcare personnel, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel).

Healthcare settings: Are places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute-care facilities, nursing homes, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, dental offices, and others.

Source control: The Use of respirators, well-fitting facemasks, or well-fitting cloth masks to cover a person's mouth and nose to prevent spread of respiratory secretions when they are breathing, talking, sneezing, or coughing. Source control devices should not be placed on children under age 2, anyone who cannot wear one safely, such as someone who has a disability or an underlying medical condition that precludes wearing one safely, or anyone who is unconscious, incapacitated, or otherwise unable to remove their source control device without assistance. Face shields alone are not recommended for source control. At a minimum, source control devices should be changed if they become visibly soiled, damaged, or hard to breathe through. Further information about source control options is available at: Masks and Respirators (cdc.gov)

Cloth masks: Textile (cloth) covers that are intended primarily for source control in the community. They are not personal protective equipment (PPE) appropriate for use by healthcare personnel. Guidance on design, use, and maintenance of cloth masks is available.

Facemask: OSHA defines facemasks as "a surgical, medical procedure, dental, or isolation mask that is FDA-cleared, authorized by an FDA EUA, or offered or distributed as described in an FDA enforcement policy. Facemasks may also be referred to as 'medical procedure masks'." Facemasks should be used according to product labeling and local, state, and federal requirements. FDA-cleared surgical masks are designed to protect against splashes and sprays and are prioritized for use when such exposures are anticipated, including surgical procedures. Other facemasks, such as some procedure masks, which are typically used for isolation purposes, may not provide protection against splashes and sprays.

Respirator: A respirator is a personal protective device that is worn on the face, covers at least the nose and mouth, and is used to reduce the wearer's risk of inhaling hazardous airborne particles (including dust particles and infectious agents), gases, or vapors. Respirators are approved by CDC/NIOSH, including those intended for use in healthcare.

Airborne Infection Isolation Rooms (AIIRs):

• AIIRs are single-patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 12 ACH (6 ACH are allowed for AIIRs last renovated or constructed prior to 1997).
• Air from these rooms should be exhausted directly to the outside or be filtered through a HEPA filter directly before recirculation.
• Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized.
• Facilities should monitor and document the proper negative-pressure function of these rooms.

Immunocompromised: For the purposes of this guidance, moderate to severely immunocompromising conditions include, but might not be limited to, those defined in the Interim Clinical Considerations for Use of COVID-19 Vaccines .

• Other factors, such as end-stage renal disease, may pose a lower degree of immunocompromise. However, people in this category should still consider continuing to use of source control while in a healthcare facility.
• Ultimately, the degree of immunocompromise for the patient is determined by the treating provider, and preventive actions are tailored to each individual and situation.

Close contact: Being within 6 feet for a cumulative total of 15 minutes or more over a 24-hour period with someone with SARS-CoV-2 infection.

SARS-CoV-2 Illness Severity Criteria (adapted from the NIH COVID-19 Treatment Guidelines)

The studies used to inform this guidance did not clearly define "severe" or "critical" illness. This guidance has taken a conservative approach to define these categories. Although not developed to inform decisions about duration of Transmission-Based Precautions, the definitions in the National Institutes of Health (NIH) COVID-19 Treatment Guideline s are one option for defining severity of illness categories. The highest level of illness severity experienced by the patient at any point in their clinical course should be used when determining the duration of Transmission-Based Precautions. Clinical judgment regarding the contribution of SARS-CoV-2 to clinical severity might also be necessary when applying these criteria to inform infection control decisions.

Mild Illness : Individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise, headache, muscle pain) without shortness of breath, dyspnea, or abnormal chest imaging.

Moderate Illness : Individuals who have evidence of lower respiratory disease by clinical assessment or imaging, and a saturation of oxygen (SpO2) ≥94% on room air at sea level.

Severe Illness : Individuals who have respiratory frequency >30 breaths per minute, SpO2 <94% on room air at sea level (or, for patients with chronic hypoxemia, a decrease from baseline of >3%), ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mmHg, or lung infiltrates >50%.

Critical Illness : Individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction.

In pediatric patients, radiographic abnormalities are common and, for the most part, should not be used as the sole criteria to define COVID-19 illness category. Normal values for respiratory rate also vary with age in children, thus hypoxia should be the primary criterion to define severe illness, especially in younger children.

Frequently asked questions

Can employees choose to wear respirators when not required by the employer.

In situations where the use of a respirator is not required either by the employer or by an Occupational Safety and Health Administration (OSHA) standard, the employer may still offer filtering facepiece respirators or permit employees to use their own respirators as long as the employer determines that such respirator use will not in itself create a hazard. This is considered voluntary use under the Respiratory Protection Standard . CDC encourages employers to permit workers to voluntarily use filtering facepiece respirators like N95s. If an employer allows voluntary use of filtering facepiece respirators, the employer must provide users with 29 CFR 1910.134 Appendix D – Information for Employees Using Respirators When Not Required Under the Standard. See 29 CFR 1910.134(c)(2) for additional requirements applicable to voluntary respirator use.

Healthcare personnel, both paid and unpaid, should be allowed to bring their own highly protective masks (such as N95 respirators) as long as the mask does not violate the facility’s safety and health requirements. They should not be asked to remove their more protective source control device (a well-fitting N95 respirator, for example) for a less protective device (such as a procedure mask) unless the mask or respirator is visibly soiled, damaged, or hard to breathe through. However, devices brought from home may not be appropriate for protecting healthcare personnel from all job hazards, and they should change to recommended personal protective equipment when indicated (for instance, before entering the room of a patient managed with Transmission-Based Precautions). Learn more about the types of masks and respirators and infection control recommendations for healthcare personnel.

What should visitors use for source control (masks or respirators) when visiting healthcare facilities?

CDC recommends that people visiting healthcare facilities use the most protective form of source control (masks or respirators) that fits well and will be worn consistently. Healthcare facilities may choose to offer well-fitting facemasks as a source control option for visitors but should allow the use of a clean mask or respirator with higher level protection by people who chose that option based on their individual preference. Masks and respirators used for source control should be changed if they become visibly soiled, damaged, or hard to breathe through. Learn more about the types of masks and respirators .

Why does CDC continue to recommend respiratory protection with a NIOSH-approved particulate respirator with N95 filters or higher for care of patients with known or suspected COVID-19?

CDC’s guidance to use NIOSH-approved particulate respirators with N95 filters or higher when providing care for patients with suspected or confirmed SARS-CoV-2 infection is based on the current understanding of SARS-CoV-2 and related respiratory viruses.

Facemasks commonly used during surgical procedures will provide barrier protection against droplet sprays contacting mucous membranes of the nose and mouth, but they are not designed to protect wearers from inhaling small particles. NIOSH-approved particulate respirators with N95 filters or higher, such as other disposable filtering facepiece respirators, powered air-purifying respirators (PAPRs), and elastomeric respirators, provide both barrier and respiratory protection because of their fit and filtration characteristics.

Respirators should be used as part of a respiratory protection program that provides staff with medical evaluations, training, and fit testing.

Although facemasks are routinely used for the care of patients with common viral respiratory infections, NIOSH-approved particulate respirators with N95 filters or higher are routinely recommended for emerging pathogens like SARS CoV-2, which have the potential for transmission via small particles, the ability to cause severe infections, and limited or no treatment options. While the situation is evolving for SARS-CoV-2, CDC continues to recommend respiratory protection while the impact of new variants is being assessed.

What personal protective equipment (PPE) should be worn by individuals transporting patients with suspected or confirmed SARS-CoV-2 infection within a healthcare facility? For example, what PPE should be worn when transporting the patient to radiology for imaging that cannot be performed in the patient room?

In general, transport and movement of a patient with suspected or confirmed SARS-CoV-2 infection outside of their room should be limited to medically essential purposes. If being transported outside of the room, such as to radiology, healthcare personnel (HCP) in the receiving area should be notified in advance of transporting the patient. For transport, the patient should wear a well-fitting source control (if tolerated) to contain secretions and their body should be covered with a clean sheet.

If transport personnel must prepare the patient for transport (e.g., transfer them to the wheelchair or gurney), transport personnel should wear all recommended PPE (gloves, a gown, a NIOSH-approved particulate respirator with N95 filters or higher, and eye protection [i.e., goggles or disposable face shield that covers the front and sides of the face]). This is recommended because these interactions typically involve close, often face-to-face, contact with the patient in an enclosed space (e.g., patient room). Once the patient has been transferred to the wheelchair or gurney (and prior to exiting the room), transporters should remove their gown and gloves and perform hand hygiene.

The transporter should continue to wear their respirator. The transporter should also continue to use eye protection if there is potential that the patient might not be able to tolerate their well-fitting source control device for the duration of transport. Additional PPE should not be required unless there is an anticipated need to provide medical assistance during transport (e.g., helping the patient replace a dislodged facemask).

After arrival at their destination, receiving personnel (e.g., in radiology) and the transporter (if assisting with transfer) should perform hand hygiene and wear all recommended PPE. If still wearing their original respirator and eye protection, the transporter should take care to avoid self-contamination when donning the remainder of the recommended PPE. This cautious approach will be refined and updated as more information becomes available and as response needs change in the United States.

EMS personnel should wear all recommended PPE because they are providing direct medical care and are in close contact with the patient for longer periods of time.

What personal protective equipment (PPE) should be worn by environmental services (EVS) personnel who clean and disinfect rooms of hospitalized patients who have SARS-CoV-2 infection?

In general, minimize the number of personnel entering the room of patients who have SARS-CoV-2 infection. Healthcare facilities should consider assigning daily cleaning and disinfection of high-touch surfaces to nursing personnel who will already be in the room providing care to the patient. If this responsibility is assigned to EVS personnel, they should wear all recommended PPE when in the room. PPE should be removed upon leaving the room, immediately followed by performance of hand hygiene.

After discharge, terminal cleaning can be performed by EVS personnel. If not wearing all recommended PPE, they should delay entry into the room until time has elapsed for enough air changes to remove potentially infectious particles. After this time has elapsed, EVS personnel can enter the room and should wear a gown and gloves when performing terminal cleaning; well-fitting source control might also be recommended. Eye protection and a facemask (if not already worn for source control) should be added if splashes or sprays during cleaning and disinfection activities are anticipated or otherwise required based on the selected cleaning products. Shoe covers are not recommended at this time for SARS-CoV-2.

Which procedures are considered aerosol generating procedures in healthcare setting?

Some procedures performed on patients are more likely to generate higher concentrations of infectious respiratory aerosols than coughing, sneezing, talking, or breathing. These aerosol-generating procedures (AGPs) potentially put healthcare personnel and others at an increased risk for pathogen exposure and infection.

Development of a comprehensive list of AGPs for healthcare settings has not been possible, due to limitations in available data on which procedures may generate potentially infectious aerosols and the challenges in determining if reported transmissions during AGPs are due to aerosols or other exposures.

There is neither expert consensus, nor sufficient supporting data, to create a definitive and comprehensive list of AGPs for healthcare settings.

Commonly performed medical procedures that are often considered AGPs, or that might create uncontrolled respiratory secretions, include:

• Open suctioning of airways
• Sputum induction
• Cardiopulmonary resuscitation
• Endotracheal intubation and extubation
• Non-invasive ventilation (e.g., BiPAP, CPAP)
• Bronchoscopy
• Manual ventilation

Based on limited available data, it is uncertain whether aerosols generated from some procedures may be infectious, such as:

• Nebulizer administration*
• High flow O2 delivery

*Aerosols generated by nebulizers are derived from medication in the nebulizer. It is uncertain whether potential associations between performing this common procedure and increased risk of infection might be due to aerosols generated by the procedure or due to increased contact between those administering the nebulized medication and infected patients.

References related to aerosol generating procedures:

T ran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J (2012) Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review. PLoS ONE 7(4);

How long does an examination room need to remain vacant after being occupied by a patient with confirmed or suspected COVID-19?

The amount of time that the air inside an examination room remains potentially infectious depends on a number of factors including the size of the room, the number of air changes per hour, how long the patient was in the room, if the patient was coughing or sneezing, and if an aerosol-generating procedure was performed.

In general, it is recommended to restrict HCP and patients without PPE from entering the room until sufficient time has elapsed for enough air changes to remove potentially infectious particles.

General guidance is available on clearance rates under differing ventilation conditions .

In addition to ensuring sufficient time for enough air changes to remove potentially infectious particles, HCP should clean and disinfect environmental surfaces and shared equipment before the room is used for another patient.

Does CDC recommend the use of oral antimicrobial rinses before dental appointments to prevent the transmission of SARS-CoV-2?

Preprocedural mouth rinses (PPMR) with an antimicrobial product (e.g. chlorhexidine gluconate, povidone-iodine) have been shown to reduce the level of oral microorganisms in aerosols and spatter generated during dental procedures. Evidence from recent studies suggest that some PPMR solutions are efficacious and may temporarily decrease the viral load of SARS-CoV-2 in the oral cavity. Targeted clinical studies are currently underway to learn more about the potential role of PPMR and the prevention of SARS-CoV-2 transmission.

Because more research is needed to demonstrate the effectiveness of PPMR in preventing transmission of SARS-CoV-2 in the dental setting, CDC does not provide a recommendation for or against the use of PPMR before dental procedures. However, if PPMR are used before dental procedures, they should be used as an adjunct to other infection prevention and control measures recommended to decrease the spread of infectious diseases in dental settings. Such measures include delaying elective dental procedures for patients with suspected or confirmed SARS-CoV-2 infection until they are no longer infectious or for patients who meet criteria for quarantine until they complete quarantine.

Previous Updates

Updates as of September 23, 2022

• Updated to note that vaccination status is no longer used to inform source control, screening testing, or post-exposure recommendations.
• Updated circumstances when use of source control is recommended.
• Updated circumstances when universal use of personal protective equipment should be considered.
• Updated recommendations for testing frequency to detect potential for variants with shorter incubation periods and to address the risk for false negative antigen tests in people without symptoms.
• Clarified that screening testing of asymptomatic healthcare personnel, including those in nursing homes, is at the discretion of the healthcare facility.
• Updated to note that, in general, asymptomatic patients no longer require empiric use of Transmission-Based Precautions following close contact with someone with SARS-CoV-2 infection.
• Updated screening testing recommendations for nursing home admissions.
• Clarified the types of long-term care settings for whom the healthcare infection prevention and control recommendations apply

Updates as of February 2, 2022

Due to concerns about increased transmissibility of the SARS-CoV-2 Omicron variant, this guidance is being updated to enhance protection for healthcare personnel, patients, and visitors and to address concerns about potential impacts on the healthcare system given a surge in SARS-CoV-2 infections. These updates will be refined as additional information becomes available to inform recommended actions.

• In general, quarantine is not needed for asymptomatic patients who are up to date with all recommended COVID-19 vaccine doses or who have recovered from SARS-CoV-2 infection in the prior 90 days; potential exceptions are described in the guidance. However, some of these patients should still be tested as described in the testing section of the guidance.
• A test-based strategy and (if available) consultation with infectious disease experts is now recommended for determining the duration of Transmission-Based Precautions for patients with SARS-CoV-2 infection who are moderately to severely immunocompromised.
• Included additional examples when universal respirator use could be considered.
• Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2.
• Strategies to Mitigate Healthcare Personnel Staffing Shortages.
• Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes.

Updates as of September 10, 2021

• Updated source control recommendations to address limited situations for healthcare facilities in counties with low to moderate community transmission where select fully vaccinated individuals could choose not to wear source control. However, in general, the safest practice is for everyone in a healthcare setting to wear source control.
• Updated quarantine recommendations for fully vaccinated patients who have had close contact with someone with SARS-CoV-2 infection to more closely align with recommendations for the community.
• Clarified the recommended intervals for testing asymptomatic HCP with a higher-risk exposure and patients with close contact with someone with SARS-CoV-2 infection.
• Recommendations for fully vaccinated HCP, patients, and visitors.
• SARS-CoV-2 testing.
• Duration of Transmission-Based Precautions for patients with SARS-CoV-2 infection.
• Specialized healthcare settings (e.g., dental, dialysis, EMS)

As of February 10, 2021

• Updated the Implement Universal Use of Personal Protective Equipment section to expand options for source control and patient care activities in areas of moderate to substantial transmission and describe strategies for improving fit of facemasks. Definitions of source control are included at the end of this document.
• Included a reference to Optimizing Personal Protective Equipment (PPE) Supplies that include a hierarchy of strategies to implement when PPE are in short supply or unavailable.

As of December 14, 2020

• Added links to Frequently Asked Questions addressing Environmental Cleaning and Disinfection and assessing risks to patients and others exposed to healthcare personnel who worked while infected with SARS-CoV-2.
• Described recommended IPC practices when caring for patients who have met criteria for a 14-day quarantine based on prolonged close contact with someone with SARS-CoV-2 infection.
• Double gloving is not recommended when providing care to patients with suspected or confirmed SARS-CoV-2 infection.
• In general, HCP caring for patients with suspected or confirmed SARS-CoV-2 infection should not wear more than one isolation gown at a time.

As of November 4, 2020

• Provided different options for screening individuals (healthcare personnel, patients, visitors) prior to their entry into a healthcare facility.
• Provided information on factors that could impact thermometer readings.
• Provided resources for evaluating and managing ventilation systems in healthcare facilities.
• Added link to Frequently Asked Questions about use of Personal Protective Equipment.

N95 and NIOSH Approved are certification marks of the U.S. Department of Health and Human Services (HHS) registered in the United States and several international jurisdictions.

COVID-19 (coronavirus disease 2019) is a disease caused by a virus named SARS-CoV-2. It can be very contagious and spreads quickly.

For Everyone

Health care providers, public health.