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(CNN Español) - The gigantic Royal Caribbean Oasis of the Seas has four outdoor pools and a 25-meter slide, and caused a stir shortly after its renovation in 2014, when it added the first Tiffany & boutique Co in the sea.
But in January 2019, the cruise ship, which defines itself as one of the largest in the world, made the headlines for less happy news: hundreds of passengers became ill from norovirus, a highly contagious gastrointestinal condition.
The Centers for Disease Control and Prevention of the United States (CDC) reported that 561 passengers and 31 crew members were treated on a cruise ship outside of Port Canaveral, Florida. More than the total number of passengers who became ill from norovirus on each cruise that sailed in 2018, the CDC said.
- The longest cruise ship in the world sets sail for London: 245 days, 51 countries, 111 ports
It could be worst. As miserable as norovirus is, passengers sometimes face more serious crises at sea. In fact, most cruises have morgues on board, and medical centers. Last year, 189 cruise deaths were reported, according to CDC data provided to Kaiser Health News.
With a record 30 million people traveling on cruise ships this year, it is vital to understand the care available.
Before paying a deposit for any cruise, take the time to read beyond the company's marketing material, to study the quality of medical facilities, said Ken Carver, president of International Cruise Victims, a nonprofit organization which supports passengers who suffer injuries or illnesses at sea. Most cruise lines are not prepared enough to handle serious illnesses or accidents, he said.
Oasis of the Seas cruise, where hundreds of passengers became ill from norovirus, a highly contagious gastrointestinal condition, in January 2019.
"Your health is at risk if you get sick on a cruise," Carver said.
Cruise industry officials strongly disagree.
"The safety and comfort of our guests and our crew is of paramount importance to the cruise industry, which includes medical and personal facilities," said Megan King, spokeswoman for the Cruise Lines International Association.
There are clear rules and regulations for medical care on cruise ships. At least one qualified medical professional must be available at all times on each trip.
In addition, all ships that carry at least 250 passengers, have overnight accommodation and embark or disembark in the United States must have an office, an intensive care room and equipment to process laboratory work, control vital signs and administer medications
But medical care for passengers who suffer serious injuries or illnesses may be compromised by the limitations of being at sea without the benefit of expensive medical equipment and specialized doctors, Carver said. The problems can be further expanded because:
- Doctors on cruises are not usually specialists. Cruises usually hire doctors to treat health problems like a norovirus. "Many cruise doctors are not even qualified for an emergency room," said Philip Gerson, a lawyer who has sued cruise lines for 49 years for everything from personal injuries to death due to malpractice. Most cases are incidents of slips and falls that result in orthopedic injuries, he said.
- Medical center hours are limited. For example, when Carnival cruises are at sea, the clinic's hours of operation are from 9 am to 12p.m. and from 3 pm to 6 pm On the days that the ship is anchored at the port, the schedule is from 8 am to 10 am and from 4p.m. at 6 pm, according to the company's website.
- Some doctors on board do not speak English fluently. Foreign doctors can be excellent and cruise lines require them to be certified under US standards. But few passengers realize that some doctors on board may not speak English well, which may be important in critical situations, Gerson said.
- Few passengers know how their health insurance works at sea. Before buying a package for a cruise, it is essential to check with your insurer to see if you are covered and how you are covered by medical problems at sea, recommended Brett Rivkind, a Miami-based maritime lawyer who has handled thousands of cruise ship demands during 35 years. The question you should ask yourself is: if I get sick or get injured on the cruise, how am I covered?
- Most passengers do not buy travel insurance. Travel insurance may seem like a waste of money, which may explain why most do not buy it, but insurance can save very sick passengers hundreds of thousands of dollars, Rivkind said. He said he had a client jailed for an air ambulance bill of $ 500,000. The Carnival Cruise Vacation Protection Plan reimburses up to $ 10,000 for certain medical costs and up to $ 30,000 for emergency medical evacuation, the company says on its site. Carnival policies range from $ 49 per person for less expensive cruises to $ 189 per person for more expensive trips. But Rivkind said that it is generally better to buy insurance from an independent company than directly from the cruise line.
- Injured passengers must act as their own investigators. If you slip, fall and break an arm or leg on a cruise, it is essential to act quickly for your own interests, Gerson suggested. Take photos of where you fell (or ask another person to do so if you can't). Get a video of the scene, if possible. And, if you receive medical care on board, be sure to request a copy of your medical records. All this should be sent by email to your lawyer, he said.
Some cruise companies try to collect passenger information for legal reasons. If a cruise line has a passenger injury form that specifically asks what the passenger could have done to avoid the accident, "leave that part of the form blank," Gerson said. This is the way the company tries to blame you for the accident or injury.
Getting transferred out of the boat for medical attention is not always a good thing. When a passenger has a serious medical problem, the cruise often leaves the patient at the next port for help, Gerson said. If the next port is New Jersey, that might be fine, but if it's a place abroad, maybe not, he said. You might consider refusing to get off the ship if you distrust medical care at a port, he suggested.
Seeing a doctor, particularly after hours, can be difficult. "Sometimes you have to have a very persistent family member," Rivkind said. "You must be prepared to be very persistent and do what you have to do to get someone's attention."
After the situation with norovirus infection on the Oasis of the Seas cruise ship, in January, Royal Caribbean offered full refunds to more than 5,400 passengers, although less than 9% became ill. But refunds will not pay unexpectedly huge medical bills at sea.
"Cruise lines protect cruise lines," Carver said. "If something bad happens at sea, you have to protect yourself."
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