What happens if you're quarantined on a cruise ship?

Here at The Points Guy, I routinely hear from readers that the main reason they're hesitant to cruise right now isn't fear of COVID-19; it's what a quarantine or isolation situation on board would mean for their vacation and their ability to return home afterward.

What happens if you test positive for COVID-19 on your voyage or you're exposed to someone who's positive? Here, I'm pulling back the curtain, based on my own experience in cruise ship quarantine and a play-by-play from Steven Episcopo, a TPG reader who had to isolate after testing positive for COVID-19 on a recent voyage.

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What is the difference between isolation and quarantine?

Before we dive too deeply into the particulars, it's important to establish what these two terms mean. They aren't interchangeable. The U.S. Centers for Disease Control and Prevention lays out the differences between them on its website.

Isolation: Isolation separates sick people with a contagious disease from people who are not sick.

Quarantine: Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

In Episcopo's case, he tested positive but his girlfriend did not. Episcopo was moved to isolation, while his girlfriend was quarantined in their cabin for 24 hours.

What happens in cruise ship quarantine?

In the event that cases of COVID-19 are detected on board, cruise ships have a complex contact tracing system that allows them to track who might have been exposed.

In June 2021, on my first cruise back after the 2020 shutdown, I was exposed during a shore excursion to two asymptomatic passengers who later tested positive as part of a routine onboard screening.

If you are identified as a close contact — if you've been in the same space as an infected person for 15 minutes or more — you will be asked to return to your cabin and stay there. Someone from the ship's medical center will be sent to test you. You will need to remain in quarantine in your room at least until your results come back negative but possibly longer, depending on your circumstances and the ship's policies.

During your quarantine, crew will do all they can to make sure you're comfortable and entertained. This could include offering you free Wi-Fi, in-cabin movie rentals and complimentary room service, since you won't be able to leave for meals. During my confinement, which lasted 13 hours, I was also sent a bottle of sparkling wine and some chocolate-covered strawberries as a nod to the inconvenience.

When your results come back, you will be permitted to leave your stateroom if your results are negative. If they are positive, you might be given another test to rule out false positive results.

In some cases, you might be asked to remain in quarantine until all close contacts have been tested. Why? Should one of those contacts test positive, it would be necessary to start contact tracing all over again. In that case, it's best for the cruise operator to keep all initial contacts away from the general ship population until they are all cleared as negative.

Where do cruise ships isolate passengers?

Following changes to the CDC's regulations for cruise ships, passengers who test positive are now allowed to remain in the cabins they booked if they are disembarking within 36 hours from returning a positive result and if they're the only person staying in the stateroom.

However, in most cases, if you test positive for COVID-19, you will be relocated from your booked room to a cabin in an area known on some ships as the "Red Zone," near the vessel's medical facilities. Most of those cabins fall into the ocean view category, so although they don't offer fresh air, they do provide natural light. These rooms employ a negative-pressure airflow system to keep particulates from escaping in the air when the doors to those rooms are opened.

In cases that require relocation, you cannot stay in your own cabin if you test positive, no matter how nice, expensive or big a cabin you booked. On the cruise when I ended up in quarantine, I booked a balcony cabin figuring that I'd at least have fresh air if I became ill. I didn't realize that, if I had tested positive (which, thankfully, I didn't), I would have been moved to a different cabin.

Cruise ship crew members take all necessary precautions when moving a COVID-19-positive passenger from their room to an isolation cabin.

"The transfer to the Red Zone was like something out of a movie," Episcopo said. "Two crew members in full PPE escorted me, while the one behind me used some sort of airborne sanitizer.... There were crew members at every possible turn, making sure that no other guests on the ship could see this happening. (Stairs were blocked off and the elevator waiting for me was one without windows.)

"They took me down to the fourth deck and escorted me through a closed hallway fire door. On the other side was a plastic divider they had to remove... They dropped me off at my room, which was a standard ocean view stateroom."

The cabin change was disappointing for Episcopo, who had originally booked an inside cabin on a canceled voyage, opted for 120% future cruise credit and ended up with an Owner's Suite (for just $640 total, for two people) after placing an upgrade bid on the sailing where he was moved to an isolation cabin.

What happens in cruise ship isolation?

Passengers in cruise ship isolation have little, if any, contact with other people in an effort to curtail the spread of COVID-19. The only people you're likely to see are the ship's doctors and nurses, who can check on you if warranted. However, most of the time, they will simply call your cabin each day to see if you're feeling OK and to make sure you have everything you need as you recover. They only show up in person when necessary.

You're not likely to see housekeeping or room service staff, either. "Inside my new room, there were some cleaning supplies like what the housekeeping crew uses because they weren't allowed to come clean my room," Episcopo said. "There were red 'biohazardous waste' bags that I had to put all of my garbage in to leave outside my door."

Regular room service meals also will be deposited outside your door. "There was a piece of paper with QR codes for each day on it," Episcopo said. "This is how I ordered my food. I just scanned the next day's QR code, filled out the form before 9 p.m., and the food came at almost the exact time I entered for each meal. (There were half-hour windows to choose from.)"

The cruise lines understand that life in isolation is likely to be boring and frustrating. They tend to offer extras like Wi-Fi and movies to passengers in isolation to help pass the time.

"[The cruise ship] provided me [with] access to Wi-Fi and the on-demand movie catalog for free," Episcopo said. "Over the next 2.5 days, I read an entire book, watched several movies [and] watched hopelessly out the window as people explored the ports of call."

In addition to testing capabilities, ship medical facilities are now equipped with ventilators and oxygen, which allow for a higher level of care for COVID-19 passengers than what was possible prior to the 2020 shutdown. Should your health situation become more serious after you test positive during your sailing, lines have agreements in place with ports on their itineraries to allow for shoreside care if necessary.

What happens after quarantine or isolation on a cruise ship?

Depending on the length of your sailing, you will either serve out your quarantine or isolation and return to your cabin and regular ship activities, or you will stay in confinement until the voyage ends.

At that time, if your isolation is complete, you can return home as normal. If it's not, you will be sent by private transportation to finish your isolation either in a hotel or at home. The only exception is if you live nearby and drove to the port. In that case, you will be permitted to use your own car to get back home.

Check with your cruise line to see whether they will cover the cost of any necessary hotel stays or charter flights home. Most will, but some require passengers to carry travel insurance that covers them in the event medical evacuation is needed.

Things to bring on your cruise with you, just in case

If you're someone who likes to plan ahead, it might be a good idea to pack a few things that will help you pass the time if you do end up quarantined or isolated. Here are a few quick recommendations:

• A tablet preloaded with shows you've been meaning to binge, movies you've been wanting to watch and books you'd like to read.
• Coloring books with plenty of colored pencils or crayons for both kids and adults.
• A deck of cards or other small, portable games.
• Small craft projects like knitting or crocheting.
• Resistance bands so you can stretch and work out while in a small space.
• Packaged snacks for eating between meals, since you might not be able to order food on a whim.
• Extra clothing, just in case you're required to isolate for a few days after your sailing ends.
• Your work laptop (if you're able to work remotely), which will come in handy if your return home is delayed.
• Extra prescription medicine in case your isolation extends the length of your trip.

Featured graphic by filo/Getty Images.