Current track

Title

Artist

Current show

Rick Dees

6:00 pm 11:00 pm

Current show

Rick Dees

6:00 pm 11:00 pm


ABC News

Page: 4

CDC is aware of recent reports of suspected cases of SARS-CoV-2 reinfection among persons who were previously diagnosed with COVID-19 [1–3]. There is currently no widely accepted definition of what constitutes SARS-CoV-2 reinfection and the reports use different testing methods, making reinfection diagnoses difficult. To develop a common understanding of what constitutes SARS-CoV-2 reinfection, CDC proposes using both
1) investigative criteria for identifying cases with a higher index of suspicion for reinfection and2) genomic testing of paired specimens.
CDC examined appropriate time periods following initial SARS-CoV-2 infection or illness to investigate reinfection. Since August 2020, CDC has recommended against the need for retesting persons with asymptomatic infection within 90 days of first SARS-CoV-2 infection or illness because evidence to date suggests that reinfection does not occur within this time window (CDC Guidance on Duration of Isolation and Precautions for Adults with COVID-19).
At this time, we propose two time windows for investigation as listed below:
For persons with or without COVID-19–like symptoms ≥90 days after initial infection/illness; and
For persons with COVID-19–like symptoms 45–89 days after initial infection/illness.
For persons with detection of SARS-CoV-2 RNA from a respiratory specimen ≥90 days after their first laboratory-confirmed SARS-CoV-2 infection/illness, we apply a standard set of criteria detailed below. Investigating highly suspicious COVID-19–like cases in the 45–89-day window is also important. However, we propose stricter criteria to select cases in this earlier timeframe using a higher index of suspicion for reinfection. If evidence of reinfection during this time window is identified, it will further inform future prevention efforts and guideline development.
CDC notes that SARS-CoV-2 reinfection is a rapidly evolving area of research. This initial set of proposed criteria might not capture all instances of reinfection; we offer these initial investigative criteria in an effort to better understand the potential for reinfection. This initial set of proposed criteria will be refined if new evidence suggests other avenues of investigation, with the goal of creating a standardized case definition of SARS-CoV-2 reinfection.
Investigate cases that meet criterion A or B

For persons with detection of SARS-CoV-2 RNA ≥90 days since first SARS-CoV-2 infectionPersons with detection of SARS-CoV-2 RNA* ≥90 days after the first detection of SARS-CoV-2 RNA, whether or not symptoms were presentANDPaired respiratory specimens (one from each infection episode) are available*If detected by RT-PCR, only include if Ct value 30 with 99% of the genome covered
1000x average genome coverage recommended for analysis of minor variation
Removal of amplicon primer contamination from assembly
In addition:
Use of high-fidelity sequencing platforms (Q score per read >30) preferred for consensus generation
If low fidelity sequencing platforms (Q score per read 2 nucleotide differences per month* in consensus between sequences that meet quality metrics above, ideally coupled with other evidence of actual infection (e.g., high viral titers in each sample, positive for sgmRNA, or culture)
Poor evidence but possible
≤2 nucleotide differences per month* in consensus between sequences that meet quality metrics above or >2 nucleotide differences per month* in consensus between sequences that do not meet quality metrics above, ideally coupled with other evidence of actual infection (e.g., high viral titers in each sample, positive for sgmRNA, or culture)
* The mutation rate of SARS-CoV-2 is estimated at 2 nucleotide differences per month; thus if suspected reinfection occurs 90 days after initial infection, moderate evidence would require >6 nucleotide differences.

At this time, only paired specimens are being tested to determine reinfection, as protocols for determining reinfection from a single specimen do not yet exist.
Other information can provide supporting but not definitive evidence for reinfection, such as culture or sub-genomic mRNA analysis (to detect the presence of replication-competent virus) or serology, which could be useful to document a serologic response to SARS-CoV-2. Aside from laboratory evidence, other supporting evidence for reinfection could include clinical course (COVID-19–like symptoms) and epidemiologic links to a confirmed case.

Links with this icon indicate that you are leaving the CDC website.The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website’s privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

For more information on CDC’s web notification policies, see Website Disclaimers.

Disruption in treatment for patients who use drugs or with substance use disorder can be very stressful. These disruptions can include loss of in-person treatment options for substance use disorder (e.g., clinic appointments for getting medication for opioid use disorder and access to other support services), which can lead to increased use or return to drug use for people not currently using.
Consider offering virtual face-to-face interaction via technologies to provide more personalized support. Disruptions can also occur in patients who use syringe services programs, which may limit access to clean syringes, safe disposal of used syringes, testing for infectious diseases, access to naloxone, and referral to care for treatment of substance use disorder and infectious diseases.
Patients may also experience a disruption in access to their typical illicit drug supply which can lead to withdrawal and emotional distress. If they get contaminated drug products, they may be at increased risk of overdose or other adverse reactions.
If patients present with acute withdrawal, overdose, or other adverse reactions from drug use, take time to have a nonjudgmental conversation with them about their use, work with them to find alternative treatment strategies, and offer harm reduction strategies that align with their current needs. For example, your patient may not be ready to stop their drug use but may benefit from information about syringe service programs and prescription for naloxone.
If you have not done so already, healthcare providers with an active Drug Enforcement Agency (DEA) license are eligible to complete an approved trainingexternal icon and submit an application to SAMHSA for outpatient prescribing of buprenorphine for the treatment of opioid use disorder.
More information and resources can be found at:

Links with this icon indicate that you are leaving the CDC website.The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website’s privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

For more information on CDC’s web notification policies, see Website Disclaimers.

Evaluate your workplace to identify scenarios where workers cannot maintain social distancing of at least 6 feet from each other and/or customers. Use appropriate combinations of controls following the hierarchy of controls to address these situations to limit the spread of the virus that causes COVID-19. A committee of both workers and management may be most effective at recognizing all scenarios.
While protecting workers, it is important to note that control recommendations or interventions to reduce risk to COVID-19 must be compatible with any safety programs and personal protective equipment (PPE) normally required for the job task. Approaches to consider may include the following:
Create a COVID-19 Workplace Health and Safety Plan.
Review the CDC Interim Guidance for Businesses and Employers and the Resuming Business Toolkit for guidelines and recommendations that all employers can use to protect their employees.
Continue to follow any state and local regulations for utility workers in addition to the recommendations here.
Identify an on-site workplace coordinator who will be responsible for COVID-19 assessment and control.
When developing plans, include all employees in the workplace, for example: staff, utility employees, relief employees, janitorial staff, maintenance, and supervisory staff.
If customers and contractors enter the workspace, develop plans to communicate with them regarding modification to work or service processes.
Notify all workers that any COVID-19 concerns should be directed to the individual appointed as the COVID-19 workplace coordinator.

Implement flexible sick leave and supportive policies and practices.
Develop policies that encourage sick employees to stay at home without fear of reprisals, and ensure employees are aware of these policies.
If contractors are employed in the workplace, develop plans to communicate with the contracting company regarding modifications to work processes.

Consider conducting daily in-person or virtual health checks (e.g., symptom and/or temperature screening) of employees on scheduled workdays.
Screening options could include having employees self-screen before arriving at work or having on-site screening by taking employees’ temperatures and assessing potential symptoms prior to beginning work. (see CDC Interim Guidance for Businesses and Employers)
Make sure employees can maintain at least 6 feet of distance while waiting for screening.
Make employee health screenings as private as possible and maintain the confidentiality of everyone’s medical status and history.

Take action if an employee is suspected or confirmed to have COVID-19.
Immediately separate employees who report with or develop symptoms at work from other employees and arrange for private transport home. These employees should self-isolate and contact their health care provider immediately.
Perform enhanced cleaning and disinfection after anyone suspected or confirmed to have COVID-19 has been in the workplace. Cleaning staff should clean and disinfect offices, bathrooms, common areas, and shared equipment used by the sick person, focusing especially on frequently touched surfaces or objects. If other workers do not have access to these areas or items, wait 24 hours (or as long as possible) before cleaning and disinfecting.
Employees who test positive for COVID-19 should immediately notify their employer of their results.
Sick employees should follow CDC recommended steps to self-isolate or seek care. Employees should consult with healthcare providers and should not return to work until the criteria to discontinue home isolation are met.
While maintaining confidentiality of everyone’s medical status, employers should inform employees about possible exposure to COVID-19 in the workplace and instruct potentially exposed employees to follow quarantine.

Develop hazard controls using the hierarchy of controls to prevent infection among workers. You may be able to include a combination of controls noted below.
Engineering Controls (Isolate people from the hazards)Alter the workspace using engineering controls to prevent exposure to the virus that causes COVID-19.
Modify the alignment of workstations where feasible. For example, redesign workstations so workers are not facing each other.
Establish, where possible, physical barriers between workers, and between workers and customers.
Use strip curtains, plastic barriers, or similar materials to create impermeable dividers or partitions.

Close or limit access to common areas where employees are likely to congregate and interact, such as break rooms, parking lots, and in entrance/exit areas.
Consider making foot-traffic single direction in narrow or confined areas, such as aisles and stairwells, to encourage single-file movement at a 6-foot distance.
Use visual cues such as floor decals, colored tape, and signs to remind workers to maintain distance of 6 feet from others, including at their workstation and in break areas.
Place handwashing stations or hand sanitizers with at least 60% alcohol in multiple locations throughout the workplace for workers and customers.
Use touch-free stations where possible.
Make sure restrooms are well stocked with soap and paper towels.

Make sure the workspace is well ventilatedexternal icon.
Work with facilities management to adjust the ventilation so that the maximum amount of fresh air is delivered to occupied spaces while maintaining the humidity at 40-60%.
Portable high efficiency particulate air (HEPA) filtration units may be considered to remove contaminants in the air of poorly ventilated areas.
Additional considerations for improving the building ventilation system can be found in the CDC Interim Guidance for Businesses and Employers.

Administrative Controls (Change the way people work)Provide training and other administrative policies to prevent the spread of COVID-19.
All workers should have a basic understanding of COVID-19, how the virus that causes the disease is thought to spread, what the symptoms of the disease are, and what measures can be taken to prevent or minimize the transmission of the virus that causes COVID-19.
Trainings should include the importance of social distancing (maintaining a distance of 6 feet or more when possible), wearing cloth face coverings or masks appropriately, covering coughs and sneezes, washing hands, cleaning and disinfecting high-touch surfaces, not sharing personal items or tools/equipment unless absolutely necessary, and not touching their face, mouth, nose, or eyes.
Train utility field service workers how to conduct an additional on-site COVID-19 specific hazard assessmentexternal icon before entering a building to determine if anything has changed since the assessment was conducted by the scheduler.
Remind workers that if their assessment deems the job unsafe, they can exercise Stop Work Authority (SWA) and consult with management for next steps.

Workers should be encouraged to go home or stay home if they feel sick. Ensure that sick leave policies are flexible and consistent with public health guidance, and that employees are aware of and understand these policies.
Consider maintaining small groups of workers in teams (cohorting) to reduce the number of coworkers each person is exposed to.
Provide additional vehicles for transport to the worksite to limit the number of people riding together.

Conduct a COVID-19 specific phone assessment before scheduling work assignments within a customer’s home or business.
Determine if the task is urgent and should be scheduled or if it can be delayed.
Train schedulers to conduct a situational phone assessment before conducting work at a building to determine the risk of exposure to the virus that causes COVID-19. Questions to assess risk of COVID-19 illness include:
Has anyone in the building been diagnosed with COVID-19?
Has anyone in the building had recent contact with someone who has been diagnosed with COVID-19?
Is anyone in the building currently experiencing symptoms?
If anyone in the building has symptoms, have they remained isolated away from the task area?

Develop guidance for workers’ entry into occupied dwellings, businesses, and service facilities based on task, occupancy, and information gathered from the phone assessment. Additional infection control guidance will be necessary if there might be a risk of a worker being exposed to SARS-CoV-2, the virus that causes COVID-19.
Ask for a small number of utility field service workers to voluntarily train on the proper use of PPE if they must enter a worksite where someone is ill or has been confirmed to have COVID-19 and they cannot be physically separated from the work area. See Infection Control Guidance for Healthcare Professional about Coronavirus for more information.
As part of your organization’s COVID-19 workplace health and safety plan, train and equip workers to comply with any regulations and infection control protocols in place at the facilities where work is occurring, if they are at least as protective as your organization’s established protocols.
Clean and disinfect frequently touched surfaces.

Provide cleaning and disinfecting materials and conduct targeted and more frequent cleaning of frequently touched surfaces (shared vehicles, tools, equipment, break rooms, rest areas, countertops, doorknobs, toilets, tables, light switches, phones, faucets, sinks, keyboards, etc.).
Clean and disinfect all work surfaces and tools between customers or at the end of a shift.
Do not share materials such as clip boards, pens, or touchscreens if possible.
Provide employees adequate time and access to soap, clean water, and a way to dry hands for handwashing.
Remind employees to wash their hands often with soap and water for at least 20 seconds. If soap and water are not available, they should use hand sanitizer with at least 60% alcohol.
Provide hand sanitizer, tissues, and no touch waste baskets at the cash registers and in the restrooms.

Maintain social distancing at the worksite.
Limit the number of people at the worksite at one time. (Consult state and local guidance if available.)
Remind employees that people may be able to spread the virus that causes COVID-19 even if they do not show symptoms. Consider all close interactions (within 6 feet) with employees, customers, and others as a potential source of exposure.
Post signs and reminders at entrances, in work vehicles, and in strategic places providing instruction on social distancing, hand hygiene, use of cloth face coverings or masks, and cough and sneeze etiquette. Signs should be accessible for people with disabilities (e.g., large print), easy to understand, and may include signs for non-English speakers, as needed.
Communication and training should be easy to understand, in preferred language(s) spoken or read by the employees and include accurate and timely information.
Emphasize use of images (infographics) that account for language differences.
Reinforce training with signs (preferably infographics), placed in strategic locations. CDC has free, simple posters available to download and print, some of which are translated into different languages.
Use cloth face coverings or masks as appropriate.
Cloth face coverings or masks are intended to protect other people—not the wearer. They are not considered to be personal protective equipment.
Emphasize that care must be taken when putting on and taking off cloth face coverings or masks to ensure that the worker or the cloth face covering or mask does not become contaminated.

Cloth face coverings or masks should be routinely laundered.
Cloth face coverings or masks should not be worn if their use creates a new risk (e.g., interferes with driving or vision, or contributes to heat-related illness) that exceeds their COVID-19 related benefits of slowing the spread of the virus. Cloth face coverings or masks should also not be worn by anyone who has trouble breathing or is unable to remove it without assistance. CDC provides information on adaptations and alternatives that should be considered when cloth face coverings or masks may not be feasible (e.g., people who are deaf or hard of hearing, have intellectual or developmental disabilities, or sensory sensitivities).
Consider requiring that visitors to the workplace (service personnel, customers) to also wear cloth face coverings or masks.
If the company provides employees with work clothing, provide enough to allow workers to wear fresh clothing daily. If laundry service is not provided, encourage employees to wash their work clothing daily at the highest recommended temperature setting.
Personal Protective Equipment (PPE)PPE is the last step in the hierarchy of controls because it is more difficult to use effectively than  other measures. To be protective and not introduce an additional hazard, the use of PPE requires characterization of the environment, knowledge of the hazard, training, and consistent  correct use. This is why special emphasis is given to administrative and engineering controls  when addressing occupational hazards, including when applying guidance to slow the spread of SARS-CoV-2.In the current COVID-19 pandemic, use of PPE such as surgical masks or N95 respirators is being prioritized for healthcare workers and other medical first responders, as recommended by  current CDC guidance. If a utility field service worker is entering a worksite that may have a suspected or confirmed person with COVID-19, see the Infection Control Guidance for Healthcare Professionals about Coronavirus for more information on PPE.

Revisions were made on October 27, 2020, to reflect the following:
Updated content to Reinfection
Revisions were made on September 10, 2020, to reflect the following:
Updated content to Reinfection
Revisions were made on June 20, 2020, to reflect the following:
Revisions were made on May 29, 2020, to reflect the following:
Revisions were made on May 25, 2020, to reflect the following:
Revisions were made on May 20, 2020, to reflect the following:
Revisions were made on May 12, 2020, to reflect the following:
New information about COVID-19-Associated Hypercoagulability
Updated content and resources to include new NIH Treatment Guidelines
Minor revisions for clarity

This interim guidance is for clinicians caring for patients with confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). CDC will update this interim guidance as more information becomes available.
Clinical Presentation
Incubation period
The incubation period for COVID-19 is thought to extend to 14 days, with a median time of 4-5 days from exposure to symptoms onset.1-3 One study reported that 97.5% of persons with COVID-19 who develop symptoms will do so within 11.5 days of SARS-CoV-2 infection.3
Presentation

The signs and symptoms of COVID-19 present at illness onset vary, but over the course of the disease, most persons with COVID-19 will experience the following1,4-9:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

Symptoms differ with severity of disease.  For example, fever, cough, and shortness of breath are more commonly reported among people who are hospitalized with COVID-19 than among those with milder disease (non-hospitalized patients). Atypical presentations occur often, and older adults and persons with medical comorbidities may have delayed presentation of fever and respiratory symptoms.10,14 In one study of 1,099 hospitalized patients, fever was present in only 44% at hospital admission but eventually developed in 89% during hospitalization.1 Fatigue, headache, and muscle aches (myalgia) are among the most commonly reported symptoms in people who are not hospitalized, and sore throat and nasal congestion or runny nose (rhinorrhea) also may be prominent symptoms.  Many people with COVID-19  experience gastrointestinal symptoms such as nausea, vomiting or diarrhea, sometimes prior to developing fever and lower respiratory tract signs and symptoms.9 Loss of smell (anosmia) or taste (ageusia) preceding the onset of respiratory symptoms has been commonly reported in COVID-19 especially among women and young or middle-aged patients who do not require hospitalization.11,12 While many of the symptoms of COVID-19 are common to other respiratory or viral illnesses, anosmia appears to be more specific to COVID-19.12
Several studies have reported that the signs Signs and symptoms of COVID-19 in children are similar to adults vary by age of the child,  and are usually milder compared to adults.15-19 For more information on the clinical presentation and course among children, see Information for Pediatric Healthcare Providers.
Asymptomatic and Pre-Symptomatic Infection
Several studies have documented SARS-CoV-2 infection in patients who never develop symptoms (asymptomatic) and in patients not yet symptomatic (pre-symptomatic).16,18,20-30 Since asymptomatic persons are not routinely tested, the prevalence of asymptomatic infection and detection of pre-symptomatic infection is not yet well understood. One study found that as many as 13% of reverse transcription-polymerase chain reaction (RT-PCR)-confirmed cases of SARS-CoV-2 infection in children were asymptomatic.16 Another study of skilled nursing facility residents who were infected with SARS-CoV-2 after contact with a healthcare worker with COVID-19 demonstrated that half of the residents were asymptomatic or pre-symptomatic at the time of contact tracing, evaluation, and testing.27 Patients may have abnormalities on chest imaging before the onset of symptoms.21,22.
Asymptomatic and Pre-Symptomatic Transmission
Increasing numbers of epidemiologic studies have documented SARS-CoV-2 transmission during the pre-symptomatic incubation period,21,31-33. Virologic studies using RT-PCR detection have reported tests with  low cycle thresholds, indicating larger quantities of viral RNA and viable virus has been cultured from persons with asymptomatic and pre-symptomatic SARS-CoV-2 infection.25,27,30,34 The relationship between SARS-CoV-2 viral RNA shedding and  transmission risk is not yet clear. The proportion of SARS-CoV-2 transmission due to asymptomatic or pre-symptomatic infection compared to symptomatic infection is unclear.35
Clinical Course
Illness Severity
The largest cohort reported of >44,000 persons with COVID-19 from China showed that illness severity can range from mild to critical:36
Mild to moderate (mild symptoms up to mild pneumonia): 81%
Severe (dyspnea, hypoxia, or >50% lung involvement on imaging): 14%
Critical (respiratory failure, shock, or multiorgan system dysfunction): 5%
In this study, all deaths occurred among patients with critical illness, and the overall case fatality rate was 2.3%.36 The case fatality rate among patients with critical disease was 49%.36 Among children in China, illness severity was lower with 94% having asymptomatic, mild, or moderate disease; 5% having severe disease; and 44,000 confirmed cases of COVID-19 in China, the case fatality rate was highest among older persons: ≥80 years, 14.8%; 70–79 years, 8.0%; 60–69 years, 3.6%; 50–59 years, 1.3%; 40–49 years, 0.4%;

In general, reinfection means a person was infected (got sick) once, recovered, and then later became infected again. Based on what we know from similar viruses, some reinfections are expected. We are still learning more about the virus that causes COVID-19. Ongoing COVID-19 studies will help us understand:
How likely is reinfection
How often reinfection occurs
How soon after the first infection can reinfection take place
How severe are cases of reinfection
Who might be at higher risk for reinfection
What reinfection means for a person’s immunity
If a person is able to spread COVID-19 to other people when reinfected
What CDC is doing
CDC is actively working to learn more about reinfection to inform public health action. CDC developed recommendations for public health professionals to help decide when and how to test someone for suspected reinfection. CDC has also provided information for state and local health departments to help investigate suspected cases of reinfection. We will update this guidance as we learn more about reinfection.
Prevention
At this time, whether you have had COVID-19 or not, the best way to prevent infection is to take steps to protect yourself:
Wear a mask in public places
Stay at least 6 feet away from other people
Wash your hands
Avoid crowds and confined spaces

Links with this icon indicate that you are leaving the CDC website.The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website’s privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

For more information on CDC’s web notification policies, see Website Disclaimers.

Procedures/Methods
DESIGN
Statement of purpose: This toolkit is designed to provide state and local health departments with the tools needed to investigate suspected cases of SARS-CoV-2 reinfection.
How investigational design meets objectives: This toolkit can be used in conjunction with surveillance (passive or active) for suspected cases of SARS-CoV-2 reinfection. Once the study population is identified, chart abstraction and reviews of existing surveillance reporting will be used to characterize suspected cases. Additionally, paired specimens might undergo confirmatory RT-PCR, viral culture, sgmRNA, and genomic sequencing to provide evidence of reinfection.
Description of risks: This research involves little to no risk to participants. Adherence to the HIPAA Privacy Rule and deidentification of collected data will ensure participant anonymity. If additional nasal wash specimens are collected, adverse effects are expected to be mild but could include nosebleeds and nasal irritation. If additional serum is collected, adverse effects are expected to be mild but could include hematoma or bruising. There is also minimal risk to the medical professionals. For sub-studies pursuing additional specimen collection we recommend following universal precautions and COVID-19 guidance on specimen collection and transport (Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for COVID-19).
Description of anticipated benefits to the research participant: We anticipate that research participants will benefit from the improved COVID-19 prevention guidelines that will result from this research.
Description of the potential risks to anticipated benefit ratio: The potential risks posed by specimen collection are outweighed by the societal and individual benefit of enhanced surveillance and improved prevention guidelines that could reduce transmission of SARS-CoV-2 within communities.
STUDY POPULATION
Description and source of study population: The study population can include all individuals with a suspected or confirmed case of COVID-19 within the surveillance catchment area or the health department’s jurisdiction.
Investigative criteria:
Prioritize persons with detected SARS-CoV-2 RNA ≥90 days since first SARS-CoV-2 infection:
Persons with detected SARS-CoV-2 RNA* ≥90 days after the first detection of SARS-CoV-2 RNA, whether or not symptoms were present
AND
Paired respiratory specimens (one from each infection episode) are available
*If detected by RT-PCR, only include if Ct value

Cruise lines that have ships operating or planning to operate in U.S. waters during the period of the No Sail Order extension
Parent Company
Cruise Line
No Sail Order Response Plan Status
Ship Name
Ship Status
Commercial Travel Allowed¥
Bahamas Paradise Cruise Line
Bahamas Paradise Cruise Line
Complete and accurate with signed acknowledgement
Grand Celebration
Green
Yes
Grand Classica
Green
Yes
Walt Disney Company
Disney Cruise Line
Complete and accurate with signed acknowledgement
Disney Wonder
Green
Yes
MSC Cruise Management (UK) Limited
MSC Cruises
Complete and accurate with signed acknowledgement
MSC Armonia
Green
Yes
MSC Meraviglia
Green
Yes
MSC Preziosa
Green
Yes
MSC Seaside
Green
Yes
Norwegian
Cruise Line Holdings

NorwegianCruise Line
Complete and accurate with signed acknowledgement
Norwegian Gem
Provisionally Green*
No
Norwegian Jewel
Green
Yes
Pride of America
Green
Yes
Oceania Cruises
Complete and accurate with signed acknowledgement
Oceania Regatta
Green
Yes
Royal Caribbean Group
Celebrity Cruises
Complete and accurate with signed acknowledgement
Celebrity Apex
Green
Yes
Celebrity Eclipse
Green
Yes
Celebrity Edge
Green
Yes
Celebrity Equinox
Green
Yes
Celebrity Millennium
Green
Yes
Celebrity Reflection
Green
Yes
Celebrity Silhouette
Green
Yes
Celebrity Summit
Green
Yes
Royal Caribbean International
Complete and accurate with signed acknowledgement
Adventure of the Seas
Green
Yes
Brilliance of the Seas
Green
Yes
Enchantment of the Seas
Green
Yes
Freedom of the Seas
Green
Yes
Grandeur of the Seas
Red
No
Harmony of the Seas
Green
Yes
Independence of the Seas
Green
Yes
Liberty of the Seas
Green
Yes
Mariner of the Seas
Green
Yes
Navigator of the Seas
Green
Yes
Oasis of the Seas
Green
Yes
Rhapsody of the Seas
Green
Yes
Serenade of the Seas
Green
Yes
Symphony of the Seas
Green
Yes
Vision of the Seas
Green
Yes

*Provisionally Green: Ship meets the surveillance criteria for “Green” status, but the following have not been completed:
Review and revision of the cruise line’s No Sail Order response plan, or
Cruise line’s signed acknowledgement of a complete and accurate plan, or
Ship’s submission of a signed attestation to CDC for crew to travel commercially.
ⱽProvisionally Yellow: Ship meets the surveillance criteria for “Yellow” status, but the following have not been completed:
Review and revision of the cruise line’s No Sail Order response plan, or
Cruise line’s signed acknowledgement of a complete and accurate plan, or
Ship’s submission of a signed attestation to CDC for crew to travel commercially.
^Provisionally Red: Ship meets the surveillance criteria for “Red” status, but the following have not been completed:
Review and revision of the cruise line’s No Sail Order response plan, or
Cruise line’s signed acknowledgement of a complete and accurate plan.
¥Commercial Travel Allowed: Allowed for ships that are “Green” and have submitted a signed attestation to CDC for crew to travel commercially.
Note: The above list includes cruise ships operating in U.S. waters or seeking to operate in U.S. waters during the period of the No Sail Order extension.
Frequently Asked Questions
What does it mean for a cruise ship operator to have a plan that is complete and accurate?
A complete and accurate plan adequately addresses every element of the No Sail Order. A cruise ship operator must be in compliance with the No Sail Order, the operator’s No Sail Order response plan, and CDC’s Interim Guidance for Mitigation of COVID-19 Among Cruise Ship Crew During the Period of the No Sail Order. CDC assesses compliance through implementation checks on a sample of ships covered under a cruise ship operator’s plan. There must be no evidence of noncompliance.
What steps is CDC taking to make sure ships stay in compliance with the criteria for commercial transport of crew?
CDC will review weekly surveillance data provided by ships, and only those ships that continue to report no cases of COVID-19 or COVID-like illness will maintain this status.
What other changes can cruise ships make if they meet these criteria?
CDC is committed to helping cruise lines provide for the safety and well-being of their crew members onboard. As cruise ships are able to show they have no cases of confirmed COVID-19 or COVID-like illnesses on board, crew members will be able to resume some of their daily interactions with fellow crew members.
Some examples of decreased restrictions on cruise ships if they meet these criteria include resuming in-person meetings, events, and social gatherings; reopening bars, gyms, or other group settings onboard for crew member use; and removing requirements to wear face coverings.
What is the difference between the two attestations CDC requires under the No Sail Order?
Under the No Sail Order, cruise lines are required to develop and implement comprehensive plans to prevent, detect, respond to, and contain COVID-19 among crew members onboard. While these response plans have been under review, CDC has allowed cruise lines to disembark crew members if they submit a signed attestation stating they have complied with the requirements to safely disembark crew members. This attestation included a requirement that crew members only use noncommercial travel to disembark and reach their final destinations and do not interact with the public during travel.
Cruise lines that have a complete and accurate No Sail Order response plan may disembark crew members without a signed attestation if they use noncommercial travel and follow CDC requirements. Cruise company officials must sign an acknowledgment of the completeness and accuracy of their response plan. Cruise ships that want to use commercial travel for crew members must meet additional requirements, which include demonstrating there are no confirmed cases of COVID-19 or COVID-like illness on board and submitting a signed attestation for commercial travel.
What does it mean if a cruise line is not listed on the table above?
If a cruise line is not listed, it means the cruise line is not operating and does not plan to operate any of its ships in U.S. waters during the period of the No Sail Order.
What does it mean if a cruise ship is not listed on the table above?
If a cruise ship is not listed, it means the ship is not operating in U.S. waters and does not plan to operate in U.S. waters during the period of the No Sail Order.