Idled Cruise Line’s Offer: Use Our Ships as Hospitals. Is That a Good Idea?

WASHINGTON — The idea was floated between friends.

At White House news conferences on Thursday and Friday, President Trump told reporters that Micky Arison, a former business associate and the chairman of Carnival Corporation, the world’s largest cruise operator, had offered to make its ships available as floating hospitals during the coronavirus pandemic. They would be used for patients battling illnesses unrelated to the coronavirus, to relieve strain on the health care system.

“You could increase places to stay. Let’s say places to stay, if it works. I mean, you know, I don’t know. Maybe people won’t want them, but he made the offer. It was a very generous offer,” Mr. Trump said on Thursday, adding that the cruise ships would present “lots of rooms” and could be docked in New York, Los Angeles and San Francisco.

“We’re discussing where it can be most useful,” he added on Friday when asked about the idea. “If we needed something, they would be willing to. So far, we haven’t needed to.”

The idea, which the White House declined to explain, was Mr. Trump’s latest in a string of seeming improvisations, as he has come under pressure from states facing the prospect of swarms of new patients in hospitals running out of room to care for them. Like a new but limited Google-related testing website and an experimental antiviral treatment he has praised in the past week, they are free-form relief ideas, independent of his administration’s official policymaking.

Roger Frizzell, a spokesman for Carnival Corporation, said that the ships-for-hire idea had been discussed for days, and escalated quickly after Mr. Arison spoke to the president on Thursday. Carnival, which made close to $19 billion as recently as 2018, would not profit from the plan, Mr. Frizzell said, and would only charge for “essential costs” like food and drink. But an abrupt transfer of hospital patients would likely mean that outside medical staff would need to contribute to the efforts. If a city or hospital needs to transform the facility, Mr. Frizzell said, they would have to cover the costs.

An American city and a foreign country have been in touch with Carnival in the past 24 hours about the offer, Mr. Frizzell said, declining to identify them.

The potential public-private partnership with Carnival has also prompted concerns about how Mr. Trump might be leveraging past business relationships in a public health crisis.

Carnival has been at the center of the coronavirus storm, since the Diamond Princess cruise ship, operated by its Princess division, was first quarantined in Yokohama, Japan, on Feb. 3, with an outbreak onboard. More than 700 people fell ill, and the company’s response has been criticized as slow and inadequate.

Another Princess ship, the Grand Princess, was quarantined in Oakland, Calif., this month after passengers fell ill with coronavirus. They have since been evacuated from the ship. More recently, the Costa Luminosa, part of another Carnival division, sailed for a week after a suspected coronavirus case was discovered without instituting protective protocols. Numerous passengers have now tested positive.

The president has talked to Mr. Arison a handful of times in recent months as the cruise industry has fallen on hard times; they spoke in particular about yet another Carnival ship, the Westerdam, which was turned away from several ports in Asia over coronavirus fears in mid-February. The ship ended up docking in Cambodia. Mr. Trump spoke to Mr. Arison twice before the docking, according to people familiar with the calls, and at least once before their conversation this week. One passenger tested positive for the coronavirus, but that was later said to be in error.

Mr. Trump and Mr. Arison have been associates for over a decade, and their businesses have at times overlapped. There was a 2005 “Apprentice Legend Cruise” from New York to the Caribbean that included cast members from the show. And Carnival sponsored “The New Celebrity Apprentice” reality series, which was broadcast in 2017.

If Carnival supplies cruise ships to the public, it would not be the first time it has responded to health emergencies in the United States. The federal government has used the company’s vessels several times after crippling hurricanes, including in 2005, when the Federal Emergency Management Agency spent $236 million in a hastily signed agreement with Carnival for three ships on the Mississippi River and in Mobile Bay, and tens of millions more for another ship that housed relief workers on the island of St. Croix after Hurricane Maria.

The difference this time, public health experts warned, is the rapid transformation of the ships, which are designed like hotels, into hospital-like space for an unknown variety of ailments. Carnival said that up to 1,000 rooms could be outfitted with remote monitoring devices, and that up to seven intensive care units with ventilators could handle another batch of patients.

Inspectors for the Centers for Disease Control and Prevention last year gave the Carnival ship Fantasy one of its worst ratings ever, noting that it had “brown water discharged from two shower hoses in the medical center.” And epidemiologists have said that the layout of cruises makes them especially vulnerable to disease spread; ships have often had to deal with outbreaks of norovirus.

In recent years, Carnival has had to pay tens of millions of dollars in fines for illegally dumping oil-contaminated waste into the sea, discharging plastic into waters in the Bahamas, falsifying records and interfering with court supervision of ships by sending in teams ahead of inspections to pre-empt environmental violations.

Mr. Trump on Friday said that the Carnival ships are “very clean.”

For health emergencies, cruise ships are a “worst case scenario,” said Tara C. Smith, a professor of epidemiology at Kent State University who has written about the health challenges of cruise travel.

“All of the rooms are very tiny. They’re difficult to get in and out of,” she said. “Even if you’re not thinking about Covid-19, you still need to think about infection control.”

Ms. Smith said that transmission of normal infectious agents like MRSA, which is common in hospitals, could introduce other kinds of outbreaks on ships that might not have trained janitorial workers familiar with hospital procedures.

Carnival is among the cruise companies that suspended operations to and from American ports earlier this month, and the industry globally is at an almost total halt. After lively debates between officials on the Trump administration’s coronavirus task force, the State Department this month advised Americans against traveling on cruises, warning that they presented a higher risk of coronavirus infection and made people vulnerable to possible international travel restrictions.

Demand for cruises, which form a $45 billion global industry, had already plummeted in recent months after the high-profile outbreaks on ships. Cruise companies have had to pull new lines of credit as their stocks have dropped dramatically amid cancellations. Industry experts have estimated that it can cost a large company millions of dollars to cancel even a four-day cruise.

Mr. Trump has said the cruise industry is a “prime candidate” for a bailout in the coming months.

Carnival defended its push to provide ships to areas with severe outbreaks of the coronavirus, saying that it was a way to use its vessels that otherwise would be docked or anchored but without passengers.

“We just want to help and try to make a difference, since we find ourselves in this very unusual position where our ships are paused right now,” said Mr. Frizzell, the Carnival Corporation spokesman.

Critics said that Mr. Trump’s idea could be a way for the company to carve out new revenue, camouflaged as a sunny public relations maneuver, with costs that could include staffing and maintenance.

“It’s a way of generating income, so they can generate a million or two million in income. They’re not idiots,” said Ross Klein, a sociologist at Memorial University of Newfoundland who studies the cruise industry.

Mr. Klein said that it was suspicious that the Trump administration would not look to other cruise companies around the world that might make a contract competitive. Carnival, he said, could dock off the American coasts as the beneficiary of friendly loopholes in the tax code, which have allowed the company to pay virtually no corporate taxes.

“Why not put out a bid?” Mr. Klein said. “Maybe there’s a foreign vessel that would come over here and do it cheaper.”

To help alleviate the pressure on hospitals, Mr. Trump on Wednesday promised that two Navy hospital ships would be deployed to the east and west coasts and “launched over the next week or so,” a claim that Mark T. Esper, the defense secretary, had to quickly walk back, saying it would take at least several weeks.

Unlike the Carnival ships, the U.S.N.S. Comfort, which is being prepared in Norfolk, Va., is outfitted with a hospital-like layout and geared for trauma care, with as many as 1,200 doctors, nurses and other medical specialists, who can use the ship’s dozen operating rooms and radiological and laboratory resources. Gov. Andrew M. Cuomo of New York called the U.S.N.S. Comfort “literally a floating hospital.”

“The Navy hospital ships were purposefully altered to be floating hospitals,” said Bryan McGrath, a national security consultant and managing director of the FerryBridge Group. “Carnival cruise ships are built for a very different purpose, and I suspect a bit of a gimmick here in using them for this purpose in order to justify provision of economic relief to the cruise ship industry.”

Noah Weiland reported from Washington, and Maggie Haberman from New York. Tariro Mzezewa contributed reporting.

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