key: cord-0884825-lr0k30tz authors: Li, Hua; Meng, Shuhan; Tong, Helong title: How to control cruise ship disease risk? Inspiration from the research literature date: 2021-07-05 journal: Mar Policy DOI: 10.1016/j.marpol.2021.104652 sha: fda27a4f36a23a00a5844ecb6dcfdd4f2c46cc89 doc_id: 884825 cord_uid: lr0k30tz The COVID-19 pandemic once brought the global cruise industry to a standstill. This has led to the realization that the development of viable disease risk management policies and measures will guarantee the sustainability of cruise tourism. The purpose of this study is to identify and develop a framework for risk management of cruise ship disease based on the research literature of cruise diseases in the Web of Science from 1996 to 2019. The study analyzed the characteristics of the literature researchers, the relationships between their research institutions organizations, the main cruise ship disease cases and measures. Based on the discussion of COVID-19 on cruise ships，risk management factors of cruise ship diseases were proposed，which include the port country's epidemic prevention capacity, the mode of disease transmission, the relevant regulations on international public health disposal, the design and construction of cruise ships, the medical and health conditions on cruise ships, and the characteristics of cruise tourism activities. A timeline and system framework for cruise ship disease risk management is proposed. A special "maritime mobile community prevention and control system" should be established, and a cooperation mechanism consisting of the government, non-governmental organizations, trade groups and industry experts should be established. The port should be capable of border isolation, detection and establishment of temporary shelter hospitals. At the same time, big data technologies such as disease tracking, investigation and health data are also important components of the risk management system. As the fastest growing sector of the global tourism industry, Cruise tourism has drawn extensive attention. Over the past 40 years, although the global economy has experienced many economic recessions and fluctuations triggered by various factors, the number of cruise passengers has maintained an average growth of about 7%. The cruise industry plays an important role in the global economy, creating 1177,000 jobs, sending out $50.024 billion in payroll and generating $150 billion in global revenue in 2018 [1] . Cruise ships, known as " marine mobile community," are characterized by large passenger capacity, high personnel density, long gathering time, narrow internal environment, relatively concentrated diet and many sailing places, etc. It is more likely to lead to collective outbreaks of infectious diseases than land communities [2] . As of 9:30 a.m. CET on 12 December 2020, 69,521,294 confirmed cases of COVID-19, including 1582,674 deaths, have been reported to WHO worldwide [3] . Although this is the third epidemic caused by coronavirus in the 21st century, the number of people infected now exceeds that of the first two combined [4, 5] . The negative impacts of COVID-19 are not limited to human casualties but also include shortand long-term social, economic and political impacts. The International Monetary Fund (IMF) predicts that the global economy could contract by − 3% in 2020, while the loss of GDP due to the epidemic situation could reach around $9 trillion [6] . The UNWTO estimates that the wide-spread of the novel coronavirus has resulted in the loss of about 1.1 billion international tourists, a drop in export earnings of between $91 billion and $1.1 trillion and the loss of between 100 million and 120 million jobs [7] . This is more serious than the global impact of the 2003 SARS epidemic and has severely affected the economic growth and prosperity of some countries [8, 9] . Accordingly, the threat to global public health posed by international tourism during the COVID-19 pandemic should also be fully recognized [10] . Farzanegan et al. (2020) found that there was a positive correlation between international tourism and the cumulative level of COVID-19 confirmed cases and deaths by April 30, 2020 [11] . Cruise tourism, which is highly dependent on global mobility, has exacerbated this situation. Major cruise companies such as Carnival, Royal Caribbean and Norwegian have witnessed a rapid increase in COVID-19 cases among passengers and crew members [11] . The market value of a number of cruise companies has shrunk dramatically. Among them, the stocks of Royal Caribbean Cruises, Carnival and Norway's three major cruise companies have fallen by an average of 84.2% in 62 days [12] , leaving the global cruise industry to a standstill. Since the worldwide suspension of cruises, the international cruise industry has carefully reflected on the lessons of the infection incidents of cruise tourists in Yokohama, Japan in the early stages of the epidemic [13] , and has actively studied safety and health measures and risk prevention mechanisms for the resumption of cruises. The Health Program of European Union has developed guidelines for the resumption of cruise ships called Healthy Gateways [14] . The Health Sail Panel has formulated 74 anti-epidemic recommendations for the resumption of cruise ships in North America, called "Recommendations from the Healthy Sail Panel" [15] . Some countries and regions around the world have resumed cruise ships [16] . However, among the cruise ships that have resumed sailing around the world, some cruise ships have been suspended due to the epidemic [16] . In the "Research Report on Restart of Chinese Cruise Industry", It is argued that the "cruise safety bubble" is a strategy for resuming sailings in other countries and regions of the world where the outbreak has not been controlled and is still in a high and medium risk environment [17] . "The strategy is to create a small, secure and enclosed environment that is decoupled from the general environment [17] . However, the research on epidemic risk management around the world still needs to be strengthened [18] . discussed the risk management measures of COVID-19 in Chinese universities [19] . McAleer (2020) concluded that prevention is better than cure for the C0VID-19 epidemic [18] . The critical importance of diagnostic tests in emergency situations is determined [20] . It seems sensible to conduct more tests and target more patients, and meanwhile it is also necessary to consider the cost issue [18] . There is mounting evidence that patients with mild symptoms or even no symptoms can transmit the disease [21, 22] . However, there are few papers on risk management from the perspective of cruise ships. Chinese scholars Liu and Zhang, taking COVID-19 as an example, propose short-term countermeasures and long-term epidemic prevention mechanisms for cruise ships [2] . At present, the research on risk management of cruise ship diseases is still worth discussing. Tracking and reviewing the evolution of knowledge and trends allows us to understand the past, analyze the present and anticipate the future [23, 24] . To that end, this study aims to comprehensively analyze the global references related to cruise diseases in the WOS database from 1996 to 2019. Specifically, this systematic review research intends to: 1) examine the trends of cruise diseases research; 2) analyze previous cruise diseases studies in terms of study contexts, organizations, authorship status, and keywords; 3) explore the themes of cruise diseases research over the last 24 decades; 4) present the factors of cruise diseases risk management, propose a framework of cruise diseases risk management and provide reference for in-depth research. The developments of information technology and bibliometrics have provided the basis for generating visual software [25, 26] . This paper chooses VOSviewer 1.6.10, ArcGIS 10.6, UCINET 6 as measurement and visualization software, and chooses STATA and Excel as auxiliary measurement tools [26] . This method enabled us to identify current profitable countries, authors, co-cited references, keywords and other information, so as to summarize the current status and results of previous research. The source of literature data is Web of Science Core Collection. The WOS Core Collection is a collection of authoritative and influential academic journals from around the world, covering a wide range of disciplines, and is characterized by high quality, large quantity and time span, and complete documentation [27] . The data retrieval is carried out by using the fields of "TI = cruise ship* Cruise Lines International Association: 2020 Cruise Industry Outlook Report An emergency responding mechanism for cruise epidemic prevention-taking COVID-19 as an example Coronavirus Disease (COVID-19) Dashboard Epidemiological characteristics and transmission model of Corona Virus Disease 2019 in China Airborne route and bad use of ventilation systems as non-negligible factors in SARS-CoV-2 transmission The Great Lockdown, INTERNATIONAL MONETARY FUND Impact of COVID-19 on Tourism Industry: A Review COVID-19: potential effects on Chinese citizens' lifestyle and travel Pandemics, transformations and tourism: be careful what you wish for International tourism and its global public health consequences International tourism and outbreak of coronavirus (COVID-19): a cross-country analysis Reconnecting tourism after COVID-19: the paradox of alterity in tourism areas Reconnecting tourism after COVID-19: the paradox of alterity in tourism areas COVID-19 reverse prediction and assessment on the diamond princess cruise ship INTERIM GUIDANCE FOR PREPAREDNESS AND RESPONSE OF CASES OF COVID-19 AT POINT OF ENTRY IN THE EUROPEAN UNION(EU)/EEA MEMBER STATES(MS) Recommendations from the Healthy Sail Panel Suspended for 9 months, the difficulties and controversies of international cruises Report on Restart of Chinese Cruise Industry Prevention is better than the cure: risk management of COVID-19 Risk management of COVID-19 by Universities in China Diagnostic Testing for the Novel Coronavirus Presumed asymptomatic carrier transmission of COVID-19 Transmission of 2019-NCOV infection from an asymptomatic contact in Germany The globalization of knowledge in history Hospitality marketing research: Recent trends and future directions The hotspots and trends of international literature research on MOOC from 2013-2015:a visualized analysis based on citespace The correlation between haze and economic growth: 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