| In this week's edition of the Covid Q&A, we tackle vacations. In hopes of making this very confusing time just a little less so, each week Bloomberg Prognosis picks one reader question and puts it to experts in the field. This week's question comes to us from Mollye in Baltimore. She asks:
My husband and I booked a cruise to the Bahamas with our two teenagers. We are excited to settle into a ship loaded with activities and not worry about whether people are vaccinated (you must be to board the ship). How should we prepare? What should we watch out for on board and when visiting ports? What would happen if someone got Covid while at sea?
Cruise ships acquired a special sort of notoriety during the pandemic. We all remember the early days of Covid when all those innocent vacationers were stranded at sea — unaware that an ultra-contagious virus was encircling the globe when they first set off on holiday. It highlighted something many passengers don't think (or want to think) about: Cruise ships are excellent breeding grounds for viruses.
The US Centers for Disease Control and Prevention warns that Covid spreads easily on ships because passengers are traveling in such close quarters.  Viruses can spread quickly among cruise ship passengers. Photographer: Hollie Adams/Bloomberg "This means to prepare for the cruise, all four of you should be fully vaccinated and boosted," says Jessica Justman, an infectious diseases specialist and epidemiologist at the Columbia University Irving Medical Center.
The CDC recommends a single booster for those ages 5 and up, and a second one for people over 50 (or, those over age 12 who are also immunocompromised — it's always best to check in with your doctor to figure out what's best for you.) "I suggest completing all booster doses a few weeks, and at least one week, before the trip starts," says Justman. She also suggests checking to see if your ship has opted into CDC's Covid-19 Program for Cruise Ships, which lets passengers check to see if their cruise meets certain vaccination standards.
"I would also be interested in how many inpatient beds and medical personnel are on the cruise and compare that to the number of passengers," says Justman. "One might confirm that the cruise follows guidelines such as the cruise ship health care guidelines from the American College of Emergency Physicians."
As for how to stay safe once you're off to sea, Justman suggests tactics such as trying to eat meals outdoors when possible. Because so many Covid cases are asymptomatic, it's not enough to simply avoid people who seem sick. "Breakfast and lunch are often available outdoors," she says. "When you do eat indoors, minimize the amount of time you have your mask off — in other words, as soon as you have finished your meal, it's a good idea to mask up again."
And if someone develops Covid on board, they need to isolate, or, if their case appears severe, be transferred to a nearby medical facility.
Thanks to all of you for writing in this week! Next Sunday, we'll be opening up the Q&A to non-Covid questions as well. So if you have any health-related inquiries, we want to hear from you. Write to us at AskPrognosis@bloomberg.net —Kristen V. Brown | 
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