Keeping thousands of passengers safe in floating cities

When SARS-CoV-2 was first detected in Wuhan, the danger felt very distant to Luca Sabatini, operator of medical services for Costa Crociere, a subsidiary of the Carnival Corporation. Sabatini always felt his work on the cruise ships combined his passion for medical sciences and travel. “Can you imagine that you have one place where you can carry out your job, and at the same time have the chance to be to travel the world?”

But the pandemic soon hit close to home when there was a COVID-19 outbreak on a cruise ship in Japan. With the cruise industry’s global network of ports and passengers, “everyone knew our industry was at risk.”

Each Costa ship is a city of its own, so naturally, they already had a small clinic, with X-ray and ultrasound equipment, lab facilities, and professional staff. Sabatini’s department handles all aspects of on-board medical care: logistics, maintenance, equipment and devices, doctors, IT, and labs. And these clinics now needed an upgrade to account for COVID-19.

A new way to cruise

Marco Diodà is Vice President of procurement and supply chain and oversees the complex logistics of moving a cruise fleet around the world from Costa´s headquarters in Genoa, Italy’s busiest port. While sitting in front of a huge scale model of the Costa Smeralda, he describes his role as “providing the vessels everything they need, when they need it. And our priority number one is to take care of the safety of the guests and the crew.”

After a year of developing safety protocols in coordination with Italian health authorities that include the ability to quickly and accurately test both passengers and crews for COVID-19 and other infections, the ships are slowly making their way to sea. Costa introduced new arrangements for the ships’ buffet, entertainment, and spa areas, and to their walkways.

The fragile point, however, is the check-in, Sabatini notes.
“Before departure, we only have a few hours to test thousands of passengers. In that time, we have to make sure that we separate people in a limited space so that they don't infect each other, whilst being fast enough with our tests to ensure all passengers have both a safe test result and are checked in by the time the ship departs in the afternoon.”

On-board testing with QIAstat-Dx

“There is a massive screening upon embarkation and there are devices on board that are able to quickly identify specific viruses [if passenger shows signs of symptoms of an illness] to allow the guest to be more comfortable, living in a safe environment,” explains Diodà. Before entry, passengers are given thermal temperature checks, divided into groups of 24, and assigned a location in the waiting area that was spaced away from other groups.

The same thought process applies to passengers already on board. What if someone starts showing symptoms then? Miles away from a port? “We had to make sure we could identify infected passengers as early as possible and restyled the ship accordingly,” says Sabatini.

QIAstat-Dx Analyzers are now available in many ships of the fleet.

“The device is exactly what we need,” Sabatini says. “It is so easy to use, that after a short training, laboratory professionals in the medical team can easily operate it. The results  are available extremely quickly, they’re reliable and, above all, they are not only SARS-CoV-2 specific but also offer indications of more than 20 other targets straightaway. “So here we have the system "QIAstat-Dx system" as a backup to immediately realize if it's real positive or not.”

A valued member of the lab

“We already have proven systems with regards to outbreaks of infections, for example, from norovirus,” he says. “Even with thousands of passengers, we're still a very well-organized microcosm. That makes spacing and contact tracing very easy, especially because we can operate with no outside interference.”

Sabatini says that as more routes reopen, the QIAstat-Dx system will remain in each ship’s medical lab. "Our testing strategy points in the right direction even beyond the coronavirus crisis. That´s why we will adapt our existing protocols to include the occurrence of respiratory infections on board and test our passengers for these pathogens in the future. For this, QIAstat-Dx offers just the right panels."

“I believe it will be a bridge between the current situation and the future situation,” Diodà says.

He also believes that these best practices will remain in place. “Changes are inevitable after big crisis,” he says. “Numerous security measures not there before have since become standard.” The industry has learned “that we could only adapt by reacted quickly. Such agility is something we will need to keep for the future.”

Sabatini is simply ready to be aboard. “I'm personally looking forward to having a night at sea again, enjoying spectacular sunsets from the balcony.”

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