Cruise Ship Travel and the Spread of COVID-۱۹ – Australia as a Case Study

Introduction: Cruise ship linked COVID-۱۹ outbreaks have been identified as a potential source of community transmission of COVID-۱۹ in Australia and worldwide. The risk factors and potential mitigation around COVID-۱۹ infections on cruise ships and communities is a research gap. Methods: A correlation and regression analyses for risk factors for COVID-۱۹ attack rates oncruise ships worldwide with reported COVID-۱۹ from January ۱, ۲۰۲۰ to May ۱۱, ۲۰۲۰ were performed, with a more detailed analysis done for Australia. Geospatial emerging hot spot analysis during key time periods was used to assess temporal trends in spatial clustering of COVID-۱۹ cases related to two cruise ship events in NSW, Australia. Results: For ۳۶ cruise ships with global COVID-۱۹ cases, available cabins had a moderate inverse correlation with the attack rate (-۰.۴۱۵۴; ۹۵% CI [-۰.۰۰۰۲, -۰.۰۰۰۰۳], P < ۰.۰۱۱۸). The number of cabins, the number of decks with cabins, and passenger-to-space ratio were significantly associated with attack rate, however, the duration at sea was not. By May ۲۰۲۰, cruise ship passengers made up ۱۴.۹% of COVID-۱۹ cases in Australia and ۲۷% of the COVID-۱۹ related deaths. Emerging hot spots of community transmission in Sydney occurred during ۱-۲ incubation periods of two cruise ship events. Conclusion: Mitigation of risk on cruise ships should focus on spatial design and reducing crowding, including rapid surveillance and on-board testing. To mitigate this risk during the era of COVID-۱۹, all passengers disembarking an infected ship should be quarantined for at least the ۱۴-day window period and tested for COVID-۱۹, regardless of symptoms. Vaccination should be a pre-requisite for travel of any kind once available.

کلیدواژه ها:

COVID-۱۹ ، Travel ، Contact Tracing ، public health ، spatial analysis ، Infection Control