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Dr Pierfrancesco Lepore joined MSC Cruises in 2012 and as Vice President Medical Services he works closely with the medical teams of doctors and nurses on board all of the Company’s fleet of ships. The teams are complemented by a Health Protocol Compliance Officer, a role created last year to oversee all of the onboard measures under the cruise line’s industry-leading health and safety protocol.

It’s been nine months since MSC Grandiosa restarted sailing in the Mediterranean. What have been your key learnings from when you first introduced your health and safety protocol for guests and crew?

More than 60,000 guests have travelled safely with us since MSC Grandiosa set sail from Genoa in August last year when the protocol was first introduced and we have amassed a great deal of knowledge and data from each and every sailing. The protocol was designed from the outset to be recalibrated to the fluctuating evolution of the virus ashore and nobody knew when we resumed our operations whether that would have to happen and if so, when. Societies at large assumed that the health situation would improve but towards the latter part of 2020 we saw second and third waves in many countries with infection rates increasing and local restrictions put in place. The flexibility of our protocol meant that we could adapt immediately and this is an aspect of the precautionary measures that I’m especially proud.

So, what changes did you introduce?

We strengthened the protocol in November in line with the pandemic in mainland Europe with a series of enhanced rigorous measures. For example, we started additional on-board antigen testing for COVID-19 of all guests mid-way through their cruise which were on top of the original pre-boarding universal testing for all guests. The frequency of crew testing during their time on board increased from twice-a-month to weekly, which was in addition to pre-boarding testing for all crew that includes a 14-day quarantine period on board, plus other ongoing health monitoring measures. We also increased the frequency of on-board sanitation, in particular of public areas and high touch points.

Can you explain what the tests entail?

Let’s look firstly at the tests we have for guests. As part of the pre-embarkation health screening, in addition to checking temperatures and reviewing a detailed health questionnaire all guests are tested for COVID-19. There are two tests available; an antigen test for all guests and a secondary RT-PCR swab, if required. An antigen test detects specific proteins on the surface of the virus and RT-PCR tests detect the virus’s genetic material.

We have fully equipped testing equipment onboard our ships which are brought ashore to the terminal where we set up the swab stations for the tests to be conducted. Each station is composed of medical staff including registered and trained nurses together with one member of our Guest Services department to help the nurse identify the guest. In a port like Genoa, for example, with say 1,000 guests set to arrive at the terminal in their different pre-allocated time slots, up to 15 swab stations can easily be configured to process the tests.

The antigen test is a swab of the nose and throat that is conducted on all guests when they arrive at the cruise terminal before their holiday. The technique of taking samples isn’t invasive and the detection of the virus is very quick, with results known as the guests complete their check-in procedures. Our medical team collects the swabs which are then processed on board the ship to provide the results. In the meantime, guests go through the check-in process and the medical team find out the results, whether positive or negative.
If a guest tests positive, then they will be denied boarding and appropriate next steps as provided for by the protocol will be taken with the support of the local health authorities.
Understandably, the testing regime for all crew members is stricter given their time onboard is far longer than a guest’s week-long holiday at sea. All crew undergo at least two COVID-19 swab tests before boarding. The first one in their home country and then one at their port of embarkation. After the second COVID-19 test, the crew stay in strict isolation on board for 14 days and then once more they are be tested again for a final negative result. Then they are checked every week. On top of this, all crew have daily contactless temperature checks at totems located throughout their quarters of the ship. Of course, the crew always adhere to preventative health measures such as social distancing, wearing face masks and having access to hand sanitisers.

A number of European countries stipulated earlier this year that any of its residents returning from an overseas holiday would need to be tested for COVID-19 either 48 or 72 hours before they would be allowed back into their country of residence. How did you respond?

We offered our guests in February on board MSC Grandiosa that had to comply with these new measures introduced by their home countries in Europe either molecular RT-PCR or antigen COVID-19 tests – depending on what new domestic rules applied - before disembarkation at both Genoa and Civitavecchia ports in Italy.

For guests disembarking at Genoa, countries that require either 48- or 72-hours tests are arranged and the 72-hour option is available for guests leaving the ship at Civitavecchia. Tests are undertaken on board the ship with the RT-PCR data analysed at a shoreside laboratory while antigen results are known on the vessel.

The molecular RT-PCR test costs Euros €80 per guest and the antigen swab test is priced at Euro €25 per guest and the service, which we plan to introduce this summer on our other ships in the Mediterranean, is in addition to the complimentary COVID-19 tests that all guests receive at all embarkation ports as part of our industry-leading health and safety protocol.

There’s considerable talk among the cruise industry about sailings only for passengers who have been vaccinated and within the broader context of tourism there are various discussions about a health or so-called ‘green’ passport. Where does MSC Cruises stand on all of this?

 Vaccines are a gamechanger and we are very encouraged by the acceleration of the vaccine rollout in countries such as the US, the UK, Israel and the United Arab Emirates, for example. We are exploring a workable approach for how to incorporate the vaccine programmes alongside universal testing into our industry leading health and safety protocol, once they are more widely available.

Vaccines represent a light at the end of the tunnel, but we must acknowledge that their successful roll out globally will take some time. Therefore, health and safety protocols are absolutely critical to us for the wellbeing of our guests, crew and the communities that visit our ships. This reflects the guidance from the World Health Organization that described vaccines as a ‘gamechanger’ but added that ‘being vaccinated does not mean that we can throw caution to the wind and put ourselves and others at risk’ and urged that precautionary measures such as social distancing and wearing masks should continue ‘for the foreseeable future’.

All science-based protective measures need to be considered and evolve as the pandemic and the virus develop, and we believe that the most important thing is that a multi-layered approach is the right one to mitigate the risk.
We believe that vaccination should co-exist with testing systems and other health and safety protocols and should be seen as an advanced extension of responsible travel. Of course, the measures we implement will be continually evaluated over time as pandemic circumstances evolve, and we will always be guided by the evidence and advice of the scientific and medical community.

As vaccines are deployed more widely, we can also consider the appropriate use of health passports and other additional measures that can potentially provide further reassurance for holidaymakers and the destinations they visit. Finally, in the short to medium term we are prepared for the hybrid situation of safely transporting vaccinated and unvaccinated guests with the support of rigorous universal testing procedures.

For example, in the UK which has one of the world’s most progressive roll-out programmes of vaccines we will accept guests for our future cruises around the UK from May for British guests only who have either been vaccinated or who are waiting for their vaccine. All of these guests will still have to have antigen swab tests prior to embarkation and for those not yet vaccinated they will have to undertake a COVID-19 test 72 hours before they arrive at the cruise terminal.