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CDC, No Sail Order and Suspension of Further Embarkation, 85 FR 16628 (Mar. 24, 2020)

Summary

This Federal Register notice of March 24, 2020 (85 FR 16628, Vol. 85, No. 57) publishes the CDC's No Sail Order and Suspension of Further Embarkation, issued on March 14, 2020 under sections 361 and 365 of the Public Health Service Act and 42 CFR Parts 70 and 71. The order applies to cruise ships with the capacity to carry 250 or more individuals, passengers and crew, on an itinerary with an overnight or 24-hour stay onboard, except ships that voluntarily suspend operations. The notice says the CDC Director has reason to believe cruise ship travel may continue to introduce, transmit or spread COVID-19, and cites transmission aboard six Nile River cruise ships each carrying approximately 100 passengers. It asks crew members from areas of high infection to self-quarantine for 14 days. The order does not apply to vessels operated by a U.S. federal or state government.

Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used

Full text

                                             16628                         Federal Register / Vol. 85, No. 57 / Tuesday, March 24, 2020 / Notices

                                             to Congress. By the form, broadcast                       Dated: March 18, 2020.                              DEPARTMENT OF HEALTH AND
                                             licensees and permittees identify                       Sarah L. Stewart,                                     HUMAN SERVICES
                                             employees by gender and race/ethnicity                  Deputy General Counsel, Federal Mine Safety
                                             in ten specified major job categories in                and Health Review Commission.                         Centers for Disease Control and
                                             the form.                                               [FR Doc. 2020–06113 Filed 3–23–20; 8:45 am]
                                                                                                                                                           Prevention
                                             Federal Communications Commission.                      BILLING CODE 6735–01–P                                No Sail Order and Suspension of
                                             Cecilia Sigmund,                                                                                              Further Embarkation
                                             Federal Register Liaison Officer, Office of the
                                             Secretary.                                                                                                    AGENCY: Centers for Disease Control and
                                             [FR Doc. 2020–06154 Filed 3–23–20; 8:45 am]             FEDERAL RESERVE SYSTEM                                Prevention (CDC), Department of Health
                                             BILLING CODE 6712–01–P
                                                                                                                                                           and Human Services (HHS).
                                                                                                     Formations of, Acquisitions by, and                   ACTION: Notice.
                                                                                                     Mergers of Bank Holding Companies
                                                                                                                                                           SUMMARY: The Centers for Disease
                                             FEDERAL MINE SAFETY AND HEALTH                                                                                Control and Prevention (CDC), a
                                             REVIEW COMMISSION                                         The companies listed in this notice
                                                                                                                                                           component of the Department of Health
                                                                                                     have applied to the Board for approval,
                                                                                                                                                           and Human Services (HHS), announces
                                             Temporary Suspension of In-Person                       pursuant to the Bank Holding Company
                                                                                                                                                           the issuance of a No Sail Order and
                                             Hearings                                                Act of 1956 (12 U.S.C. 1841 et seq.)                  Suspension of Further Embarkation on
                                             AGENCY: Federal Mine Safety and Health
                                                                                                     (BHC Act), Regulation Y (12 CFR part                  March 14, 2020 for all cruise ships that
                                             Review Commission.                                      225), and all other applicable statutes               are not voluntarily suspending
                                             ACTION: Notice.
                                                                                                     and regulations to become a bank                      operation.
                                                                                                     holding company and/or to acquire the
                                                                                                                                                           DATES: This action was effective March
                                             SUMMARY: The Federal Mine Safety and                    assets or the ownership of, control of, or
                                                                                                                                                           14, 2020.
                                             Health Review Commission (the                           the power to vote shares of a bank or
                                             ‘‘Commission’’) is temporarily                                                                                FOR FURTHER INFORMATION CONTACT:
                                                                                                     bank holding company and all of the
                                             suspending all in-person hearings, and                                                                        Jennifer Buigut, Division of Global
                                                                                                     banks and nonbanking companies
                                             settlement judge conferences and                                                                              Migration and Quarantine, Centers for
                                                                                                     owned by the bank holding company,                    Disease Control and Prevention, 1600
                                             mediations.                                             including the companies listed below.                 Clifton Road NE, MS V18–2, Atlanta,
                                             DATES: Applicable: March 18, 2019.                        The applications listed below, as well              GA 30329. Phone: 404–498–1600.
                                             FOR FURTHER INFORMATION CONTACT:                        as other related filings required by the              Email: dgmqpolicy@cdc.gov.
                                             Sarah Stewart, Deputy General Counsel,                  Board, if any, are available for                      SUPPLEMENTARY INFORMATION: On March
                                             Office of the General Counsel, Federal                  immediate inspection at the Federal                   14, 2020, the Director of the Centers for
                                             Mine Safety and Health Review                           Reserve Bank indicated. The                           Disease Control and Prevention issued
                                             Commission, at (202) 434–9935.                          applications will also be available for               the following No Sail Order and Other
                                             SUPPLEMENTARY INFORMATION: Pursuant                     inspection at the offices of the Board of             Measures Related to Operations. A copy
                                             to guidance issued by the Office of                     Governors. Interested persons may                     of the order is provided below and a
                                             Management and Budget (M–20–16) and                     express their views in writing on the                 copy of the signed order can be found
                                             in view of the risks presented by the                   standards enumerated in the BHC Act                   at https://www.cdc.gov/quarantine/
                                             novel coronavirus COVID–19, the                         (12 U.S.C. 1842(c)).                                  cruise/index.html.
                                             Commission’s Office of the Chief
                                                                                                       Comments regarding each of these                    U.S. Department of Health and Human
                                             Administrative Law Judges (‘‘OCALJ’’)
                                                                                                     applications must be received at the                  Services Centers for Disease Control
                                             is, effective March 18, 2019, suspending
                                                                                                     Reserve Bank indicated or the offices of              and Prevention (CDC) Order Under
                                             all in-person hearings, and settlement
                                                                                                     the Board of Governors, Ann E.                        Sections 361 & 365 of the Public Health
                                             judge conferences and mediations until
                                                                                                     Misback, Secretary of the Board, 20th                 Service Act (42 U.S.C. 264, 268) and 42
                                             Friday, April 30, 2020.
                                                With the consent of the parties and in               Street and Constitution Avenue NW,                    Code of Federal Regulations Part 70
                                             coordination with the presiding                                                                               (Interstate) and Part 71 (Foreign): No
                                                                                                     Washington, DC 20551–0001, not later
                                             administrative law judge, hearings may                                                                        Sail Order and Other Measures Related
                                                                                                     than April 22, 2020.
                                             continue by telephone or other means.                                                                         to Operations
                                                                                                       A. Federal Reserve Bank of Richmond
                                             Similarly, settlement judge conferences                 (Adam M. Drimer, Assistant Vice                       Applicability
                                             and mediations may be held by                                                                                   This Notice of No Sail Order and
                                                                                                     President) 701 East Byrd Street,
                                             telephone or by other means. If the                                                                           Other Measures Related to Operations
                                                                                                     Richmond, Virginia 23219. Comments
                                             parties agree that an in-person                                                                               shall apply only to the subset of
                                                                                                     can also be sent electronically to or
                                             evidentiary hearing is not needed, cases                                                                      carriers 1 described below and
                                             may also be presented for a decision on                 Comments.applications@rich.frb.org:
                                                                                                                                                           hereinafter referred to as ‘‘cruise ships,’’
                                             the record.                                               1. CSBH, LLC, Baltimore, Maryland; to               except this Order shall not apply to any
                                                The parties will be notified if the                  become a bank holding company                         cruise ship that voluntarily suspends
                                             hearing needs to be rescheduled. OCALJ                  through the acquisition of New Horizon                operations for the period of this Order:
                                             will reassess the risks presented by in-                Bank, National Association, Powhatan,                   All commercial, non-cargo,2
                                             person hearings prior to April 30, 2020,                Virginia.                                             passenger-carrying vessels operating in
                                             and issue a subsequent order informing




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                                                                                                       Board of Governors of the Federal Reserve
                                             the public as to whether the suspension                                                                          1 Carrier is defined by 42 CFR 71.1 to mean ‘‘a
                                                                                                     System, March 18, 2020.
                                             of in-person hearings will continue.                                                                          ship, aircraft, train, road vehicle, or other means of
                                                The presiding administrative law                     Yao-Chin Chao,                                        transport, including military.’’
                                             judge may be contacted with questions                   Assistant Secretary of the Board.                        2 Given the substantial risk of person-to-person

                                             regarding this notice.                                                                                        transmission of COVID–19, as opposed to
                                                                                                     [FR Doc. 2020–06094 Filed 3–23–20; 8:45 am]
                                                                                                                                                           transmission via indirect contact, this Order is
                                                Authority: 30 U.S.C. 823.                            BILLING CODE P                                        currently limited to passenger, non-cargo vessels.



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                                                                            Federal Register / Vol. 85, No. 57 / Tuesday, March 24, 2020 / Notices                                           16629

                                             international, interstate, or intrastate                 International Health Regulations. The                borders with ease. For example, the
                                             waterways and subject to the                             following day, the Secretary of the                  Islamic Republic of Iran has seeded at
                                             jurisdiction of the United States with                   Department of Health and Human                       least 97 COVID–19 cases in 11 other
                                             the capacity to carry 250 3 or more                      Services (HHS) declared that COVID–19                countries, as reported by the WHO, and
                                             individuals (passengers and crew) with                   constitutes a public health emergency                as of March 9, 2020, the Schengen Area
                                             an itinerary anticipating an overnight                   under the Public Health Service Act. To              of Europe has exported 201 COVID–19
                                             stay onboard or a twenty-four (24) hour                  date, CDC has issued Level 3 Travel                  cases to 53 countries.
                                             stay onboard for either passengers or                    Health Notices recommending that                        In the United States, community
                                             crew.4                                                   travelers avoid all nonessential travel to           transmission has occurred in
                                                                                                      China, Iran, South Korea, and most of                Washington State, California, and New
                                             General Background                                                                                            York. CDC is closely monitoring
                                                                                                      Europe; the U.S. Department of State
                                                COVID–19 is a communicable disease                    has issued a global Level 3 Health                   COVID–19 transmission and is
                                             caused by a novel (new) coronavirus,                     Advisory directing U.S. citizens to                  supporting state and local health
                                             SARS–CoV–2, that was first identified                    reconsider all travel abroad due to the              departments in conducting contact
                                             as the cause of an outbreak of                           global impact of COVID–19 and Level 4                tracing investigations of confirmed
                                             respiratory illness that began in Wuhan,                 Travel Advisories (Do Not Travel) for                COVID–19 cases identified in the
                                             China. The virus is thought to spread                    China, Iran, and certain parts of Italy. In          United States. These investigations are
                                             primarily by person-to-person contact                    addition, CDC has recommended that                   complex and resource intensive;
                                             through respiratory droplets produced                    travelers, particularly those with                   persons identified as infected or at-risk
                                             when an infected person coughs or                        underlying health conditions, avoid all              can require observation, movement
                                             sneezes; it may also spread through                      cruise ship travel worldwide; the U.S.               restriction (such as isolation or
                                             contact with contaminated surfaces or                    Department of State has similarly issued             quarantine), clinical evaluation, and
                                             objects. Manifestations of severe disease                guidance that U.S. citizens should not               care. Public health authorities in the
                                             have included severe pneumonia, acute                    travel by cruise ship at this time. As of            United States are working concurrently
                                             respiratory distress syndrome (ARDS),                    March 11, 2020, the President of the                 to contain the spread of the disease and
                                             septic shock, and multi-organ failure.                   United States has suspended entry to                 mitigate its impact.
                                             According to the World Health                            the U.S. by most foreign nationals who               Risk of Transmission on Cruise Ships
                                             Organization (WHO), approximately                        have recently visited China, Iran, and
                                             3.6% of reported COVID–19 cases have                                                                             Cruise ships often involve the
                                                                                                      most of Europe due to COVID–19. On
                                             resulted in death globally. This                                                                              movement of a number of people in
                                                                                                      March 11, 2020, the WHO declared the
                                             mortality rate is higher among the                                                                            closed and semi-closed settings. Cruises
                                                                                                      COVID–19 outbreak a pandemic. As of                  vary in size, with larger cruises
                                             elderly or those with compromised                        March 13, 2020, there have been over
                                             immune systems. Older adults and                                                                              involving populations of more than
                                                                                                      132,000 cases of COVID–19 globally in                4,000 passengers and crew. Like other
                                             people who have severe chronic                           over 122 locations resulting in over
                                             medical conditions like heart, lung, or                                                                       close-contact environments, cruise ships
                                                                                                      4,950 deaths; more than 1,620 cases                  facilitate transmission of COVID–19.
                                             kidney disease are also at higher risk for               have been identified in the United                      There are several features of cruise
                                             more serious COVID–19 illness. Early                     States, with new cases being reported                ships that increase the risk of COVID–
                                             data suggest older people are twice as                   daily and over 41 deaths due to the                  19 transmission. A hallmark of cruise
                                             likely to have serious COVID–19 illness.                 disease. A Presidential Declaration of               travel is the number and variety of
                                                On January 30, 2020, the Director                     National Emergency concerning                        person-to-person contacts an individual
                                             General of the WHO declared that the                     COVID–19 was issued on March 13,                     passenger may have daily. The
                                             outbreak of COVID–19 constitutes a                       2020.                                                dynamics of passenger-to-passenger,
                                             Public Health Emergency of                                  Global efforts to slow transmission               passenger-to-crew, crew-to-passenger,
                                             International Concern under the                          have included drastic control measures               and crew-to-crew intermingling in a
                                                3 Based on substantial epidemiological evidence
                                                                                                      with substantial societal and economic               semi-closed setting are particularly
                                             related to congregate settings and mass gatherings,      impact. Countries such as Russia,                    conducive to SARS–CoV–2 spread,
                                             this Order suspends operation of vessels with the        Australia, the Philippines, Japan, Israel,           resulting in high transmission rates.
                                             capacity to carry 250 individuals or more. Evidence      and the United States have imposed                   Cruises include frequent events that
                                             shows that settings as small as nursing homes or         stringent restrictions on travelers who
                                             movie theaters can proliferate the spread of a
                                                                                                                                                           bring passengers and crew close
                                             communicable disease. As the numbers of                  have recently been in China. Similar                 together, including group and buffet
                                             passengers and crew onboard a ship increases,            travel restrictions have since been                  dining, entertainment events, and
                                             certain recommended mitigation efforts such as           imposed on individuals from countries                excursions. Cruise ship cabins are small,
                                             social distancing become more difficult to               experiencing substantial outbreaks,
                                             implement. In light of the demonstrated rapid
                                                                                                                                                           increasing the risk of transmission
                                             spread of this communicable disease in current           including Iran, South Korea, and                     between cabinmates. Close quartering is
                                             cruise ship settings, application of this Order to       Europe. In many countries, including                 a particular concern for crew, who
                                             vessels carrying 250 or more individuals is a            the United States, citizens, permanent               typically eat and sleep in small,
                                             prudent and warranted public health measure.             residents, and their close relatives
                                             Moreover, the management of current coronavirus
                                                                                                                                                           crowded spaces. Infection among crew
                                             cases in addition to existing seasonal care needs        returning from areas known to have                   members may lead to transmission on
                                             (e.g., influenza) has placed an extreme burden on        high rates of infection are being                    sequential cruises on the same vessel
                                             the public health and healthcare systems and this        requested to self-quarantine for 14 days             because crew members may continue
                                             Order will help avoid further stressing those            (a period estimated to encompass the
                                             systems.
                                                                                                                                                           working and living onboard the ship
                                                                                                      incubation period for the virus)




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                                                4 This order shall not apply to vessels operated by                                                        from one cruise to the next. Crew from
                                             a U.S. Federal or State government agency. Nor           following return from countries with                 one ship may in turn serve onboard
                                             shall it apply to vessels being operated solely for      sustained community transmission.                    multiple different ships for subsequent
                                             purposes of the provision of essential services, such    Despite these unprecedented global                   voyages, which also has the potential to
                                             as the provision of medical care, emergency
                                             response, activities related to public health and
                                                                                                      efforts at containment, cases of COVID–              amplify transmission.
                                             welfare, or government services, such as food,           19 have been shown to rapidly                           Transmission of COVID–19 on cruise
                                             water, and electricity.                                  propagate, crossing international                    ships may also be amplified by


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                                             16630                         Federal Register / Vol. 85, No. 57 / Tuesday, March 24, 2020 / Notices

                                             difficulty decontaminating numerous                     returned home before any notifications                evaluation and additional confirmed
                                             surfaces in common areas.                               about COVID–19 were provided,                         cases in multiple states/countries are
                                             Contamination of frequently touched                     potentially spreading the disease to                  anticipated.
                                             surfaces, such as door handles and                      their home communities. Evidence of
                                                                                                                                                           The Director Has Reason To Believe
                                             faucets in public toilet rooms, elevator                COVID–19 transmission onboard six
                                                                                                                                                           That Cruise Ship Travel May Continue
                                             buttons, handrails in stairs and                        similar Nile River cruise ships, each
                                                                                                                                                           To Introduce, Transmit, or Spread
                                             passageways, and utensils/dispensing                    carrying approximately 100 passengers,
                                                                                                                                                           COVID–19
                                             mechanisms (for beverages) in self-                     illustrates that even ships with
                                             service buffets, etc., is also likely to be             moderate numbers of passengers and                       Cruise ship travel markedly increases
                                             a significant factor in transmission. Less              crew onboard carry a substantial risk of              the risk and impact of the COVID–19
                                             obvious examples of frequently touched                  disease transmission and outbreak.                    disease outbreak within the United
                                             surfaces, include playing cards, slot                      The initial stages of the COVID–19                 States. Disembarkation of passengers at
                                             machine levers, and chips in the casino;                epidemic were marked by the outsized                  sequential ports may lead to disease
                                             computer keyboards in the internet café;               role of a single cruise ship, the Diamond             transmission in those ports. Return of
                                             books, puzzles, and games in the library;               Princess in Yokohama, Japan, which for                disembarked infected passengers to
                                             gym equipment; counters and surfaces                    a period of 18 days was the setting for               their communities could lead to
                                             in gift shops; and the cruise card used                 the largest number of cases outside the               widespread disease transmission. Cases
                                             by passengers to pay/register for                       original epicenter in China. The                      that have been confirmed to date may
                                             everything on board and exit/enter the                  outbreak of COVID–19 onboard the                      have led to secondary transmission,
                                             ship in port. The high volume of people                 Diamond Princess demonstrates the                     including in a healthcare worker.
                                             on board a cruise ship and wealth of                    speed and extent of disease                              Furthermore, the passenger
                                             high-touch surfaces make successful                     transmission that can occur onboard                   population of cruises often includes a
                                             control of this method of transmission                  cruise ships. Despite quarantine and                  substantial number of older adults,
                                             very difficult.                                         isolation efforts, more than 700 cases of             meaning there is higher risk for COVID–
                                                Moreover, the nature of cruise travel                infection with the virus that causes                  19 morbidity and mortality. Industry
                                             presents additional opportunities for                   COVID–19 were identified among                        trade publications report that 51% of
                                             spread of the disease to ports of calls                 Diamond Princess passengers and crew                  cruise ship passengers are over the age
                                             and passengers’ home communities.                       during the three weeks following the                  of 50. The median age of passengers
                                             During a cruise, disembarkation of                      identification of one case of COVID–19                onboard the Grand Princess Sailing B,
                                             passengers at sequential ports of call                  in a person who was symptomatic                       for example, was 66 and 1,200
                                             under uncontrolled conditions may lead                  before leaving the ship. There are                    passengers on the ship were over age 70.
                                             to disease transmission in those ports.                 several cases of severe disease                       Given these demographics, many cruise
                                             Once a cruise concludes, passengers                     associated with the Diamond Princess,                 passengers are at high risk for severe
                                             residing in different countries or                      including at least six deaths.                        disease if they become infected.
                                             throughout the United States may                        Additionally, approximately half of the                  Beyond the risk to these individuals,
                                             require air transportation or other types               infected passengers did not report                    the intensive care requirements for
                                             of common carriers to return home.                      symptoms at the time their infections                 cruise ship passengers with severe
                                             Return of disembarked infected                          were diagnosed.                                       disease stresses a healthcare system
                                             passengers to their communities could                      On March 4, 2020, Placer County,                   already overburdened and facing a
                                             lead to widespread, interstate disease                  California officials reported the death of            shortage of beds needed for influenza
                                             transmission.                                           a passenger who had been onboard the                  and other seasonal and critical
                                                Quarantine and isolation measures are                Grand Princess cruise ship during a                   healthcare conditions. The addition of
                                             difficult to implement effectively                      voyage from February 11–21, 2020                      further cruise ship cases place
                                             onboard a cruise ship and only occur                    (Sailing A) and was a confirmed                       healthcare workers at substantial
                                             after an infection has already been                     COVID–19 case. As of March 7, 2020,                   increased risk. Specifically, these cases
                                             identified onboard a cruise. If ships are               there were 22 presumptive positive                    divert medical resources away from
                                             at capacity, it may not be feasible to                  cases of COVID–19 among persons who                   persons with other medical problems
                                             fully separate ill and well persons                     were onboard Sailing A. The Grand                     and other COVID–19 cases, consuming
                                             onboard the ship, particularly among                    Princess left San Francisco for a second              precious diagnostics, therapeutics, and
                                             the crew. Because crew are required to                  sailing on February 21 (Sailing B). Sixty-            protective equipment. Ongoing concerns
                                             continue working to keep a ship safely                  eight passengers and most of the crew                 with cruise ship transmission also draw
                                             operating, effective quarantine for crew                from Sailing A were also on Sailing B.                valuable resources away from the
                                             is particularly challenging.                            While testing of those who were                       immense Federal, state, and local effort
                                                                                                     onboard Sailing B continues, to date, 22              to contain and mitigate the spread of
                                             Already Observed Impact of Cruise Ship                  crew and 8 passengers have tested                     COVID–19. Safely evacuating, triaging,
                                             Travel in General and in the U.S.                       positive for COVID–19. As a result of                 quarantining, and repatriating cruise
                                                Cruise ship travel has already been                  the outbreak onboard the Grand                        ship passengers involves complex
                                             associated with a number of COVID–19                    Princess, the Federal government                      logistics, incurs financial costs at all
                                             clusters and outbreaks, including on the                engaged in a massive effort to disembark              levels of government, and diverts
                                             Diamond Princess (Asia) and the Grand                   and quarantine American passengers                    resources away from larger efforts to
                                             Princess (California to Mexico,                         from the ship on four military bases to               suppress or mitigate the virus.
                                             California to Hawaii). The threat of                    help prevent further transmission to the
                                             spread is not limited to larger cruise                                                                        Coordination Efforts With the Cruise




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                                                                                                     passengers’ home communities.
                                             ships. An outbreak onboard a Nile River                 Passengers from Sailing A were from                   Ship Industry
                                             cruise with 171 passengers and crew (29                 more than 30 U.S. states and 25                         To address the continued and
                                             of which were American citizens)                        countries; Sailing B included passengers              significant risks and burdens posed by
                                             resulted in 45 confirmed COVID–19                       from over 50 countries. More than 70                  ongoing cruise ship operations, CDC
                                             cases (3 of which are American                          persons from this voyage have reported                and other Federal agencies have
                                             citizens). Many of these passengers                     symptoms and require assessment and                   engaged with representatives from


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                                                                           Federal Register / Vol. 85, No. 57 / Tuesday, March 24, 2020 / Notices                                                  16631

                                             Cruise Lines International Association                  of COVID–19. The scope of this                          7. This order does not prevent the
                                             (‘‘CLIA’’), the leading industry trade                  pandemic is inherently and necessarily                periodic reboarding of the ship by HHS/
                                             group. To that end, CLIA members and                    a problem that is international and                   CDC personnel and/or USCG and/or
                                             certain individual cruise lines have                    interstate in nature, and cannot be                   other Federal, state, or local agencies or
                                             voluntarily taken steps to try to mitigate              controlled sufficiently by the cruise ship            the taking on of ships’ stores and
                                             the impact of the spread of COVID–19.                   industry or individual state or local                 provisions under the supervision of
                                             On March 13, 2020, CLIA and their                       health authorities. Accordingly, under                HHS/CDC personnel and/or USCG.
                                             associated members announced that all                   42 CFR 70.2, the Director determines                    8. This order does not prevent the
                                             member cruise lines would voluntarily                   that measures taken or likely to be taken             ship from taking actions necessary to
                                             suspend cruise ship operations from                     by state and local health authorities                 maintain the seaworthiness or safety of
                                             U.S. ports of call for 30 days as public                regarding COVID–19 onboard cruise                     the ship, or the safety of harbor
                                             health officials and the Federal                        ships are inadequate to prevent the                   conditions, such as movement to
                                             government continue to address                          further interstate spread of the disease.             establish safe anchorage, or as otherwise
                                             COVID–19. The Federal government                           The Director further determines that               directed by USCG personnel.
                                             recognizes the enormity and importance                  this Order provides public health                       CDC may modify this order by an
                                             of this action taken by CLIA and the                    authorities, in concert with the cruise               updated publication in the Federal
                                             commitment it demonstrates to                           ship industry, the necessary pause in                 Register or by posting an advisory to
                                             protecting the health of both cruise ship               operations to develop and implement an                follow at www.cdc.gov.
                                             passengers and the public at large.                     appropriate and robust plan to prevent
                                                                                                     and mitigate the spread of COVID–19,                  Authority
                                             Following the example set by CLIA
                                             members, additional cruise lines have                   and acts to prevent the spread of the                   The authority for these orders is
                                             also voluntarily suspended operations                   disease and ensure cruise ship                        Sections 361 and 365 of the Public
                                             from U.S. ports of call. Although the                   passenger and crew health.                            Health Service Act (42 U.S.C. 264, 268)
                                             CLIA members and the additional cruise                     Therefore, in accordance with                      and 42 CFR 70.2, 71.32(b).
                                             lines implementing a voluntary                          Sections 361 and 365 of the Public                      Dated: March 19, 2020.
                                             suspension of operations represent a                    Health Service Act (42 U.S.C. 264, 268)               Robert R. Redfield,
                                             large majority of the cruise industry, not              and 42 CFR 70.2, 71.32(b), for all cruise
                                                                                                                                                           Director, Centers for Disease Control and
                                             all cruise lines or ships have announced                ships not voluntarily suspending                      Prevention.
                                             a voluntary suspension of operations or                 operations for the period described
                                                                                                                                                           [FR Doc. 2020–06166 Filed 3–23–20; 8:45 am]
                                             that they will follow the important                     below, it is ordered:
                                                                                                                                                           BILLING CODE 4163–18–P
                                             example set by CLIA members. This                          1. Cruise ship operators shall be
                                             Order is intended to cover and                          allowed to disembark passengers and
                                             specifically apply to those cruise lines                crew members at ports or stations only
                                                                                                                                                           DEPARTMENT OF HEALTH AND
                                             or ships that do not undertake a                        as directed by the United States Coast
                                                                                                                                                           HUMAN SERVICES
                                             voluntary suspension of operations. As                  Guard (USCG), in consultation with
                                             a result, this Order specifically excludes              HHS/CDC personnel and, as                             Centers for Medicare & Medicaid
                                             from applicability any cruise line or                   appropriate, as coordinated with                      Services
                                             ship that voluntarily suspends                          Federal, state, and local authorities.
                                             operations for the period of this Order,                   2. Cruise ship operators shall not                 [Document Identifier: CMS–10468, CMS–
                                                                                                     reembark any crew member, except as                   10418, CMS–10488, CMS–R–290 and CMS–
                                             as CLIA members have done.
                                                                                                                                                           10525]
                                                                                                     approved by USCG, in consultation with
                                             Findings and Immediate Action                           HHS/CDC personnel, until further                      Agency Information Collection
                                                Accordingly, and consistent with 42                  notice.                                               Activities: Proposed Collection;
                                             CFR 71.32(b), the Director of CDC                          3. Cruise ship operators shall not
                                                                                                                                                           Comment Request
                                             (‘‘Director’’) finds evidence to support a              embark any new passengers or crew,
                                             reasonable belief that cruise ships are or              except as approved by USCG, or other                  AGENCY: Centers for Medicare &
                                             may become infected or contaminated                     Federal authorities as appropriate, in                Medicaid Services, HHS.
                                             with a quarantinable communicable                       consultation with HHS/CDC personnel.                  ACTION: Notice.
                                             disease.5 This reasonable belief is based                  4. Cruise ship operators shall not
                                             on information from epidemiologic and                   commence or continue operations (e.g.,                SUMMARY: The Centers for Medicare &
                                             other data regarding the nature and                     shifting berths, moving to anchor, or                 Medicaid Services (CMS) is announcing
                                             transmission of COVID–19 on cruise                      discharging waste), except as approved                an opportunity for the public to
                                             ships from the recent outbreaks onboard                 by USCG, in consultation with HHS/                    comment on CMS’ intention to collect
                                             the Diamond Princess, Grand Princess,                   CDC personnel, until further notice.                  information from the public. Under the
                                             and other cruise ships. As a result,                       5. While in port, the cruise ship                  Paperwork Reduction Act of 1995 (the
                                             cruise ship passengers may be infected                  operator shall observe health                         PRA), federal agencies are required to
                                             with or exposed to COVID–19 by virtue                   precautions as directed by HHS/CDC                    publish notice in the Federal Register
                                             of having been onboard a cruise ship at                 personnel.                                            concerning each proposed collection of
                                             a time when cases of COVID–19 are                          6. The cruise ship operator shall                  information (including each proposed
                                             being reported in significant numbers                   comply with all HHS/CDC, USCG, and                    extension or reinstatement of an existing
                                             globally and specifically on cruise                     other Federal agency instructions to                  collection of information) and to allow
                                             ships, when testing is available. The                   follow CDC recommendations and                        60 days for public comment on the
                                             Director also finds that cruise ship                    guidance for any public health actions                proposed action. Interested persons are




lotter on DSKBCFDHB2PROD with NOTICES
                                             travel may exacerbate the global spread                 relating to passengers, crew, ship, or any            invited to send comments regarding our
                                                                                                     article or thing on board the ship, as                burden estimates or any other aspect of
                                               5 COVID–19 is a communicable disease for which
                                                                                                     needed, including by making ship’s                    this collection of information, including
                                             quarantine is authorized under Section 361 of the       manifests and logs available and                      the necessity and utility of the proposed
                                             Public Health Service Act (42 U.S.C. 264) and 42
                                             CFR 70.1, 71.1, as listed in Executive Order 13295,     collecting any specimens for COVID–19                 information collection for the proper
                                             as amended by Executive Orders 13375 and 13674.         testing.                                              performance of the agency’s functions,


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