FORT LAUDERDALE, Fla. — After earning a reputation in the early days of the pandemic as floating disease carriers, cruise ships are back in favor with American travelers.

With COVID in the general population easing, so, too, are cases aboard ships.

The number of COVID-19 cases reported on cruise ships leaving U.S. ports has declined each month since last summer, according to data from the Centers for Disease Control and Prevention obtained by the South Florida Sun Sentinel.

Fewer than 4,400 cases were reported on ships leaving from U.S. ports during January, compared with 13,238 in July 2022. Nationally, people stepped onto cruise ships to sail 13 million times in January, versus last summer when cruise ships were sailing at limited capacity.

So is it safe to go on a cruise now?

“The risk is less, but there is not zero risk,” says Dr. Preeti Malani, an infectious disease specialist with University of Michigan.

Gauge risk, take precautions

Three years ago, on March 10, 2020, the World Health Organization declared the novel coronavirus outbreak a global pandemic. After several COVID waves that took hundreds of thousands of lives and created severe illness, the worst appears to be over. The Biden administration is planning to let the coronavirus public health emergency in the United States expire in May.

Major cruise lines have eliminated their precautions and no longer require vaccination or pre-boarding testing. As the COVID rate continues to drop, sailing mostly has returned to normal with some crew members and the occasional passenger wearing a mask,

However, some changes remain: Most cruise lines have improved air filtration and placed more hand sanitizer stations on deck.

It’s now up to individual passengers to gauge their risk tolerance and take precautions. The CDC still recommends getting vaccinated and taking a COVID-19 test before boarding a cruise ship.

Ellen Dill, a 70-year-old retiree living in The Villages in Central Florida, calls her experience “a cautionary tale for cruisers.”

Dill says she is immunocompromised and has had five doses of the COVID vaccine. She said she had been excited for an eight-day cruise of the Western Caribbean and tested herself before boarding.

But her third day on the ship out of Cape Canaveral, severe cold symptoms triggered a visit to the infirmary. She tested positive for COVID.

Dill says she had been so careful throughout the pandemic and it was her first time having COVID. She saw hand-sanitizing stations, but noticed passengers rarely using them.

“I took a risk. I know that,” she said. “I had a mask and I should have worn it more, but people stare at you.”

Dill spent the rest of the cruise quarantined in her cabin, joined eventually by her husband who tested positive three days later.

Carnival delivered her meals to her cabin, provided free internet, and gave her a credit for a portion of the trip, she said. “We will go on a cruise again.”

Cruise lines report symptomatic and asymptomatic cases to the CDC for all passengers in a cabin when one has symptoms that trigger a visit to the ship’s medic. Some international ports also still require testing to disembark. However social media is abundant with passengers posting about getting COVID while cruising and choosing not to report it to avoid “being stuck in a cabin.”

Dill said she does not agree with that route. “Trying to hide that you have COVID just puts everyone around you at risk.”

Carnival Cruise Line did not respond directly to questions on its reimbursement policy, additional sanitation on ships with COVID cases or whether ships are stocked with Paxlovid or other antivirals to treat coronavirus.

A Carnival spokesman offered this written statement: “Our commitment to the health and well-being of our guests, crew, and communities we visit has enabled us to safely welcome back millions of guests since resuming sailing in 2021.”

Nearly every cruise line that reports to the CDC had cases on their ships over the last nine months. However, the top nine ships by case count were all owned by Royal Caribbean Cruise Line and Princess Cruises.

The Caribbean Princess, owned by Princess Cruises, had the most cases — 3,542 — since May 2022, more than double the number on the ship with the next highest amount reported, CDC data shows. The Caribbean Princess caters to a 60-plus crowd, leaves out of Fort Lauderdale, and sails for 10 days to ports in the Caribbean and South America.

Princess Cruises did not respond by Friday evening to the Sun Sentinel’s requests for comment, nor did Royal Caribbean.

Princess has struggled with coronavirus cases on its ships since the start of the pandemic. Its Ruby Princess drew international attention as an incubator for coronavirus in early 2020 when at least 28 people died and 700 cases were linked to the ship. It also had an incident as recently as November 2022 when the Majestic Princess carrying 800 COVID-positive passengers docked in Sydney after being hit with a major outbreak. The ship had returned from New Zealand and had more than 4,000 people aboard.

The cruise lines have had a difficult few years during the pandemic. In March 2020, after reports of ships loaded with COVID-positive passengers being turned away from ports, the CDC issued a No Sail Order that grounded all ships. After eight months, the CDC transitioned to a conditional sail order and cruise lines figured out how to sail safely and limit capacity. All restrictions now are lifted and travel agents say almost all ships are back to sailing at full capacity.

In Fort Lauderdale, for example the 40 ships based at Port Everglades are at an average 83% occupancy rate, said spokesperson Joy Oglesby. “We’re on course for a full recovery.”

In 2023, Americans want to get back on ships

Cruise line passenger counts are rising, and more Americans are planning to vacation on ships in 2023

A survey from AAA Auto Club found 52% of U.S. adults are as likely or more likely to take a cruise this year than before the pandemic. That’s up from 45% last year.

“The cruise lines are offering good rates to keep momentum going,” said Clara Lopez Boyden, a travel agent with Boyden Travel in Orlando. She said some international ports still want passengers to be vaccinated for COVID. “I do a lot of research and educate my clients about what’s needed at the time of booking. It can change.”

Even when vaccinated, Boyden advises clients to buy travel protection. She hasn’t had a clients’ tickets refund because of COVID, but a few have been offered discounts on a future cruise. “I think that slowly but surely any consideration of giving cruise credit back for COVID might be going away,” she said.

Malani, the infectious disease doctor, said for anyone considering a cruise, it’s possible to manage your risk.

“If you spend time in a packed space that’s not well-ventilated, you could have exposure,” she said. “But there are a lot of outdoor spaces and decks, and you could spend more of your time there.”

Get boosted and avoid crowds in the days before departure, she advises.

For someone at higher risk of complications because of age or health issues, it is important to have a plan in place before the cruise, she said. “It may be harder to get healthcare once you are out to sea, so that’s a consideration.”

Malani emphasized COVID is less virulent than in 2020 and most people have some immunity, making it likely if someone did get infected at sea, their symptoms would be mild.

“I think most people will be okay,” she said. “I think this will be an almost normal summer.”

‘Industry is doing well’

In Florida and nationwide, there has been a continued decline in newly reported cases and COVID hospitalizations.

Most Americans are comfortable traveling again, according to a new AARP survey conducted in November and December of 2022. Just one in four say COVID-19 is a barrier to travel, compared to about half who felt that way a year earlier.

Miami cruise critic Stewart Chiron said higher bookings in 2023 signify travelers feel confident again about the wane of the pandemic and safety of cruising.

“The industry is doing well,” he said. “Assuring cruising is as safe as possible for passengers and crews has been a herculean effort. Now that requirements are lifted, you are not hearing about large outbreaks or people dying or medical centers on board filling up.”

“People want to get back to their lives,” Chiron said. “They are rethinking their vacations, and cruising continues to be a good option.”