Cruise lines are taking serious action to prevent a coronavirus outbreak on their ships.
Royal Caribbean issued an order on Sunday that would deny boarding to any passenger who has traveled to — or been within 6 feet of someone who has traveled to — areas with major ongoing outbreaks of the illness known as COVID-19, including mainland China, Hong Kong, Macau, Iran, South Korea, and the Italian regions of Emilia-Romagna, Lombardy and Veneto within the past 15 days, according to their website.
They will also deny boarding to anyone exhibiting flu-like symptoms or feeling unwell.
Additionally, the brand will require mandatory health screenings for passengers who have been to regions that have seen less severe outbreaks. That includes Japan, Singapore, Thailand, and all other parts of Italy besides those mentioned above.
Anyone who is unsure if they’ve been in contact with someone who has traveled to the worst-hit areas will also require a health screening before boarding.
The screenings will look for symptoms including fever or low blood oximetry. Anyone denied boarding because of these restrictions will receive a full refund.
Passengers who are allowed to board but begin to feel unwell during their trip will be quarantined, the statement says.
Princess Cruises, which experienced the worst outbreak at sea that has reportedly left six passengers dead, has set similar parameters for passengers who have traveled to affected countries “currently subject to lockdown by government health authorities” within 14 days, though they don’t call out Italy, Iran, or the less seriously affected regions mentioned by Royal Caribbean.
In addition to restrictions on passengers, the company has also blocked crew from China or South Korea from boarding their ships.
Princess also suggests passengers “pack 14 days of extra medication” when embarking on a cruise. Two weeks is the incubation period for coronavirus and the amount of time those suspected of being infected have been quarantined so far.
Those who have booked a Princess cruise, can keep an eye on the status of their sailing here.
Both companies have also promised increased environmental sanitation and readily available medical care on board their ships.
A representative for Carnival tells PEOPLE, the brand has “implemented enhanced screening, prevention and control measures for our ships, guests and crew” in response to the spread of coronavirus. Adding, “Since the travel restrictions have gone into place, all of Carnival Cruise Line’s ships have been cleared to sail multiple times and there have been no operational cancellations.”
MSC Cruises issued a similar statement to PEOPLE, noting bans on passengers from the same affected countries and portions of Italy, and noting, “Everyone – guests and crew alike – are health screened before they start their cruise and thermal screening is conducted on anyone who steps on or off any of our ships at any port, as well as during a cruise.” Their fleet has also “been given an elevated deep-sanitization cleaning and every ship has increased disinfection in all public areas.” No MSC cruises have had confirmed cases of coronavirus to date.
PEOPLE’s requests for comment from Disney and Norwegian cruise lines were not returned.
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Several cruises have been affected by the outbreak so far — with at least one resulting in confirmed cases on board.
A Diamond Princess cruise ship was quarantined off the coast of Japan in early February after the illness was reported, with 621 people eventually testing positive. According to Forbes, six passengers have died. Everyone has now disembarked after being stuck on the ship for several weeks.
In a statement to PEOPLE, Princess Cruises said, “Our hearts go out to the families, friends and all who are impacted by these losses. All of us at Princess Cruises, as well as the crew of the Diamond Princess, offer our sincere condolences.”
On February 28, a Braemar cruise was turned away from docking in the Dominican Republic, after it reported eight passengers, including two Americans with potential coronavirus symptoms on board.
Fred. Olsen Cruise Lines, the parent company of the ship, shared in a statement that there were “a small number of influenza-like cases on board,” however, the “medical team has now advised that they are all feeling better.” The company called the ship’s refusal of entry to be an “overreaction by the Dominican Republic.”
As of Friday, the ship — which was carrying 1,128 passengers and 384 crew members — was “awaiting advice on the next steps” and “liaising with a number of airlines to secure onward travel for guests,” the New York Times reported.
In addition, an MSC cruise carrying 6,000 passengers was recently denied entry at two Caribbean ports — Jamaica and the Cayman Islands — after a crew member was taken ill. It was eventually allowed to dock in Cozumel, Mexico, last Wednesday and the ship has since returned to Miami, according to NBC 6 South Florida. The crew member’s illness turned out to be a typical seasonal flu.
Cruises with passengers on board exhibiting flu-like symptoms have also recently faced issues when attempting to dock in Europe, including Italy, where the outbreak has been most severe.
Coronavirus is a blanket term for several respiratory illnesses, ranging from the common cold to more severe viruses such as Severe Acute Respiratory Syndrome (SARS). Symptoms typically include fever, cough, trouble breathing, headache and sore throat.
For people who have severe cases, it can turn into pneumonia, SARS, kidney failure and death, according to the World Health Organization.
On Tuesday, the Centers for Disease Control urged Americans to start preparing for the virus to spread in the U.S. with the “expectation that this will be bad.”
“It’s not so much of a question of if this will happen in this country anymore but a question of when this will happen,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC, said in a press briefing on Tuesday.
The CDC also says that the best prevention methods are basic forms of hygiene — careful handwashing, avoiding touching the face, moving away from people who are coughing or sneezing and staying home at signs of illness.