Forty-eight people on board Royal Caribbean’s Symphony of the Seas ship that ended a seven-day sailing in Miami on Saturday tested positive for COVID-19 during the cruise, the cruise line said in an updated statement shared Monday morning.
Those 48 people who tested positive represented 0.78% of the 6,091 passengers and crew members on board Symphony of the Seas,  which left Miami on Dec. 11 and made stops in St. Maarten, St. Thomas, and Perfect Day at CocoCay (Royal Caribbean’s private island), the cruise line said in an updated statement provided Monday morning by spokesperson Lyan Sierra-Caro.
Initially, the cruise line reported 44 cases on board. “This number (48) includes four additional close contacts which were identified as COVID-19 positive at the end of the voyage,” Sierra-Caro said Monday. “The guests were quarantined on board and assisted upon the ship’s arrival on Dec. 18.”
All passengers 12 and older were required to be fully vaccinated and to test negative to board the Symphony of the Seas ship. The ship sailed with 95% of the onboard community fully vaccinated on the Dec. 11 to Dec. 18 cruise, with 98% of those people who tested positive being fully vaccinated, Royal Caribbean said.
On Saturday, the cruise line also notified passengers from that trip and from two others (a sailing that departed Dec. 4 and one that departed Dec. 18) that a passenger who sailed on that same ship earlier this month tested positive for the omicron variant of the coronavirus.
“We were notified by the (Centers for Disease Control and Prevention) that a guest on board our (December) 4th cruise tested positive and it was identified as omicron,” Sierra-Caro  said Saturday. “They asked us to notify guests on the sailing – the one that ended today – and the current one.”
►Odyssey of the Seas:Newest Royal Caribbean ship makes brief return to port due to COVID
►COVID on a cruise:How a breakthrough case sent one couple from an ocean view balcony to the ‘dungeon’
In the email to the passengers who sailed on the three cruises on Symphony of the Seas, Royal Caribbean outlined what happened.
“This guest did not report symptoms to our onboard medical teams as outlined in our health protocols,” the cruise line said in a copy of the email obtained by USA TODAY. “Their post cruise test results were subsequently confirmed as the omicron variant.”
The 48 cases on the recently disembarked cruise “were found as a result of immediately identifying close contacts after a guest tested positive,” Sierra-Caro said, noting each person was quarantined quickly.
Initially, Royal Caribbean said that everyone who tested positive was asymptomatic. In the statement Monday morning, it said that “everyone who tested positive were asymptomatic or had mild symptoms, and we continuously monitored their health.”
Six passengers disembarked earlier in the cruise and were transported home. The rest of the passengers were assisted Saturday at disembarkation in Miami, Sierra-Caro said.
In the email to passengers, Royal Caribbean said that the cases on the Dec. 11th sailing were “unrelated to the omicron case from the guest who sailed on Dec. 4th.”
It is not immediately clear why the cases were unrelated.
The cruise line advised that passengers visit a certified testing center three to five days after disembarkation, per CDC guidance.
On Saturday, the CDC said in a statement that the agency was aware of the situation on Symphony of the Seas and that it was working with the cruise line to gather more information.
On Monday, the CDC told USA TODAY in a statement provided by spokesperson David Daigle that the health agency continues to work with Royal Caribbean to gather information about the cases and potential exposures. The CDC added that “RCI collected specimens from the voyage that sailed from 12/11-12/18 for genetic sequencing.”
On the CDC’s cruise ship color status list, Symphony of the Seas is “Yellow,” indicating that the “CDC has investigated and the ship remains under observation,” according to the agency.
►Norwegian Cruise Line, Royal Caribbean:Update onboard mask requirement as omicron spreads
►’What a mess’:Travelers scrap plans to visit New York City as omicron shutters performances
Connor O’Dell, 29, from Orlando, Florida, was traveling with a party of 12 on the Symphony of the Seas sailing that wrapped up Saturday. Six of his traveling companions tested positive for COVID-19. Everyone in their group was fully vaccinated and most had had a booster shot, O’Dell said.
O’Dell and his fiance, James Johnson, 36, tested negative, he said. 
The first person who tested positive in their group was Johnson’s aunt, who is 66 and at high risk for COVID-19, O’Dell said. She was symptomatic and reported her symptoms to Royal Caribbean Thursday during the cruise.
“She was very symptomatic,” O’Dell said, noting she had a bad cough and sore throat, and that neither a doctor nor nurse gave her an in-depth physical exam or asked her about preexisting conditions. “We all knew the risks of going on the ship – the problem is that we were promised a set of protocols (or) adequate medical staffing and they were never adhered to.”
It took around four hours for a nurse to come to administer a coronavirus test and get a result. Johnson’s auntwas then quarantined for the rest of the trip.
Johnson said he contacted medical staff and, after several attempts, he reached a nurse who told him that they were understaffed. He asked if the ship’s medical team could check on his aunt. His aunt received a call the next day.
Out of their party, she was the only one who was checked in on by the cruise line at all, even after five others tested positive, Johnson said.
Johnson and O’Dell self-quarantined but later were told that they could leave their stateroom after the positive test came back on Johnson’s aunt, even though they had been spending time together as a group.
“We kept asking ‘are you sure we can leave?'” Johnson said. After half an hour, O’Dell said that they were asked by crew members to isolate again.
Johnson said that they received conflicting results, with his cousin being told she tested positive, then later told that it was actually her boyfriend who was positive. 
“They were so overwhelmed,” Johnson said. “They just kept saying something (and then) changing what they were saying. Everything was so confusing,” he said. 
When asked to comment on whether staff was overwhelmed and if the protocol wasn’t followed properly, Sierra-Caro said that wasn’t the case.
“Our staff was able to handle all the cases on board and we followed all of our protocols for testing and quarantine,” Sierra-Caro said.
Cruise Lines International Association, the leading trade organization for the cruise industry, told USA TODAY Monday in a statement that health and safety are the cruise industry’s “highest priority.”
“Together with our members, we are monitoring developments related to the Omicron variant and remain closely engaged with local and national authorities in the places where cruises sail,” the association said in a statement provided by Bari Golin-Blaugrund, vice president of strategic communications.
The cruise lines association continued that the protocols which include testing, masking, vaccination and other measures were “designed with variants in mind.” 

source