(CNN) Stuck at sea, with home and family far away, the cruise ship crew members who have yet to be repatriated in the wake of the Covid-19 pandemic are struggling with being stranded — and it's taking a heavy toll.
In recent weeks, there have been reports of onboard deaths and protests, confirmed by cruise lines.
The United Nations and the World Health Organization said on Thursday that the ongoing pandemic is fueling a "high prevalence" of mental distress worldwide, and cruise ship crew who remain in isolation on ocean waters are no exception.
One crew member of the Regal Princess cruise ship died on May 9 after going overboard in Rotterdam, in the Netherlands. Princess Cruises confirmed the death of the 39-year-old Ukrainian woman and said the cruise line had cooperated with and facilitated an investigation led by police in Rotterdam. Rotterdam police confirmed to CNN that the death was ruled a suicide.
A crew member on board Royal Caribbean's Jewel of the Seas also died by going overboard, confirmed Royal Caribbean. The cruise line said it was assisting the authorities with the investigation and did not confirm the date of death.
On Carnival Corporation's Carnival Breeze, which is currently sailing back to Europe to repatriate crew members, a Carnival employee also passed away on May 9, according to a Carnival spokesperson. The cruise line did not confirm the cause of death.
"His death is not related to Covid-19, but out of respect for his family, we will not be providing additional details," the Carnival spokesperson told CNN.
Last week, a group of crew members who are Romanian citizens confined on board a Royal Caribbean ship started a hunger strike, with the aim of drawing attention to their plight, reported the Miami Herald. Royal Caribbean told CNN that the situation had since been resolved.
Royal Caribbean also confirmed reports of protests on board another ship, the Majesty of the Seas, after photos surfaced on social media showed protesting crew, and a sign hanging on the pool deck reading "How many more suicides you need?" Royal Caribbean did not confirm that the deaths were suicides.
The situation on Majesty was resolved after a meeting with the captain and executive team, said Royal Caribbean spokesperson Jonathon Fishman.
Cruise lines said repatriation efforts for stranded seafarers are ongoing, but many employees are frustrated and disheartened. Adding to this stress is the pressure of days spent trapped inside a tiny — often windowless — cabin. Bad Wi-Fi, inconsistent communication and financial worries add to the burden.
Cruise ships disembarking crew in the US must comply with strict regulations imposed by the Centers for Disease Control and Prevention, the US health protection agency.
The cruise lines have to sign attestations adhering to requirements before staff are allowed to leave the ship. Crew are instructed to travel via cruise line-organized charter flights, and repatriation of crew via commercial transport is only allowed on a case-by-case basis with prior CDC approval.
Repatriation efforts across the world are also complicated by closed borders, ports barring cruise ships and travel lockdowns. Plus, the cruise ships always intended to keep a number of crew members board during the interim period.
"Our situation is getting worse," said Caio Saldanha, a DJ from Brazil who works for Celebrity Cruises, owned by Royal Caribbean. Saldanha spoke to CNN last week from a windowless cabin on the Celebrity Equinox ship in the Bahamas.
Saldanha said he reads news of on the on-board deaths of other crew members online, and believed they were suicides.
"We are being treated as cargo," he told CNN. "We need help."
Much of the conversation about cruise ships at the beginning of the Covid-19 pandemic focused on getting passengers home, and the plight of cruise ship employees was largely sidelined. Now, most passengers have disembarked, but thousands of crew still remain in limbo.
For Saldanha, hearing about possible crew suicides exacerbated his already high levels of anxiety.
"I constantly feel huge sadness and a huge urge to get out of here," he said. "It's a nightmare."
Saldanha was originally on board the Celebrity Infinity ship. He boarded in March, alongside his fiancée Jessica Furlan, who also works for Celebrity Cruises.
After almost two months on board Celebrity Infinity, Saldanha and Furlan were moved to Celebrity Reflection and then to Celebrity Equinox, as part of the repatriation efforts.
Equinox was at full capacity with crew awaiting repatriation, said Saldanha, so there were too many people on board for all crew be placed in guest cabins. Saldanha and Furlan were placed in one of the windowless crew cabins.
While cabins on Celebrity Equinox were full, according to Saldanha, the public areas of the ship as a "ghost ship", as seen in his video below.
His fiancée, Saldanha said, felt the burden. He says Furlan has been experiencing skin rashes, nightmares and anxiety attacks.
Last Friday, Saldanha and Furlan were transhipped again. They're currently on Celebrity Reflection, which has fewer crew members on board, so they have been allocated a guest cabin.
They're more comfortable on Reflection, said Saldahna, but still desperate to get home: "We [are] still being held by the company against our will, but we feel better on this ship," he said on Monday.
Earlier this month, Royal Caribbean, owner of Celebrity, said the cruise line had reached an agreement with the US Centers for Disease Control and Prevention (CDC) to disembark crew in compliance with the CDC's strict guidelines.
Brazilian crew, including Saldanha and Furlan, are due to travel home via a flight out of the Bahamas on May 27, according to a Royal Caribbean weekly update document issued on May 12 and seen by CNN. The departure airport was not specified, and the information was listed as subject to change.
The document also told crew that there are a "combination of factors that affect repatriation plans" including restrictions based on the location of the ship, restrictions in nations where flights connect and restrictions in the final "gateway nation."
"Some countries have temporarily closed their borders to everyone, including their own nationals," reads the document. "We are currently working through all possible options."
Saldanha voiced frustration at the mixed messages he said he's received from the cruise line, as well as the general difficulties of being on board.
He said he empathizes with the Romanians who reportedly staged the hunger strike: "I feel they are right to take this action," he said.
Royal Caribbean did not respond to CNN's inquiry about whether some Royal Caribbean crew members are in crew cabins, rather than guest cabins.
"The goal of getting all of our crew home safely remains our top priority," the cruise line said in a statement provided to CNN.
"So far we have successfully repatriated over 16,000 crew members, and we are working with governments and health authorities around the world on our plans, and we very much appreciate our crews' patience, understanding and good spirit."
Royal Caribbean also confirmed the death of a crew member on board the Mariner of the Seas, apparently of natural causes.
The cruise line said the "majority" of its crew would be repatriated by the end of May.
American Brian Bailey felt like he'd reached a career high when he started working as the expedition activities manager for Silversea Cruises, on board the small Silver Cloud ship, which accommodates 254 guests and a couple hundred crew members. Silversea Cruises is owned by Royal Caribbean.
Bailey fulfilled his love of theater by coordinating the onboard performances — plus, he got to see the incredible sights and wildlife of Antarctica as the cruise ship made its way around the South Pole.
"It was the perfect mix of entertainment and science, being on an expedition vessel," Bailey told CNN.
But in the wake of Covid-19, Bailey, like Saldanha, was one of many crew members left stranded.
"I had my own internal struggles," Bailey said of his period in flux at sea. But he explained that his emotional turmoil was mitigated by having a role to fill on his ship — he went from entertaining guests to entertaining the crew.
Now, Bailey's back home: after over a month at sea, he disembarked at Tenerife in the Canary Islands in April. But leaving the ship was bittersweet, as not everyone disembarked. As Bailey breathed a sigh of relief back on land, he shouted strained goodbyes to his still-marooned colleagues. He then made the long journey back to the US via air.
Since then, Bailey said he's been in constant communication with his former shipmates. He's also been campaigning to raise awareness of the situation, speaking to his US Senate representatives, media outlets and contacting the United Nations via Twitter.
"We value our crew as our greatest asset and we are proud of them for their leadership. Our shoreside staff is working tirelessly to assure the fastest possible repatriation of our non-essential crew," said a Silversea Cruises spokesperson.
"Due to the very limited flight availability and other local restrictions that are out of our control, this has taken much longer than usual, but it is in progress."
Krista Thomas, who lives in Vancouver, Canada, is also actively campaigning to get stranded crew home. Thomas worked on board cruise ships for six years and has many friends in the industry.
She started a Facebook page to offer information and support for stranded crew. At first, Thomas said crew who reached out to her were optimistic. But as time has gone on, messages "are becoming more despondent and hopeless," she told CNN.
Thomas gave an example of crew who've missed the birth of a child, and others who've lost a family member while they've been stranded hundreds of miles away.
"I have recently added a licensed psychologist to our group page, as a volunteer, so that there is an option for me to give to crew who do not want to use the crew helpline," she said.
Thomas pointed out that the strict guidelines for quarantine and isolation mean many crew members are almost entirely isolated.
She believes even healthy people could "slide into depression in these circumstances."
Many crew have had their contracts ended, so they are no longer allowed to work. Thomas said that some crew have reached out to her, worried about the financial implications for themselves and their families.
Plus, as Bailey noted, not being able to work removes a sense of purpose or distraction.
"So then, you have days of not doing anything: not having a purpose, not getting paid — no answers to when you're going to be able to go home. It just becomes this state of limbo," Bailey said.
All ships have doctors on board, but former ship doctor Eilif Dahl told CNN that cruise lines should ensure counseling services are also available, all the time, but particularly during a crisis such as this.
"Ships' doctors are not psychiatrists, and in this situation they will be overworked," said Dahl, now Professor Emeritus at the Department of Occupational Medicine at the Norwegian Centre for Maritime and Diving Medicine at Haukeland University Hospital in Bergen, Norway.
Dahl advised that cruise lines should provide external expert assistance to aid employees' mental well-being.
Many cruise lines provide free therapy for crew.
A Princess Cruises spokesperson told CNN that each ship offers telephone access to trained counselors.
In-cabin exercise opportunities and fitness programming are also available, the cruise line added, plus movies on demand and satellite stations.
"Additionally, ship-created content hosted by onboard staff airs daily including fitness classes, games and trivia," the Princess Cruises spokesperson said. "Ships are offering various free and low-cost internet packages for personal email, internet browsing and other social media platforms. All crew are provided three meals a day and snacks for Western and various Asian preferences."
The cruise line reiterated its commitment to reuniting ship crew with their families and said progress is being made. Princess Cruises added it's a "complex process" due to the international travel restrictions, which vary from country to country and include countries with closed borders.
Royal Caribbean told CNN there is an employee assistance program available for crew members, which is confidential and available 24 hours a day.
A spokesperson for Carnival Cruise Line told CNN that all employees are given access to an employee assistance program which includes credentialed counselors.
"In addition, our onboard medical team is trained to identify guests and crew who might need additional resources and support," the cruise line said.
"Regarding our repatriation efforts, we are doing everything we can [to] get all of our crew members home, and we are working with government officials on a debarkation plan across our fleet," the Carnival spokesperson added.
"We continue to take care of our crew members on board, including providing Wi-Fi for them to keep in touch with their loved ones back home. We are working diligently to resolve issues and keep our crew members informed."
Carnival, Princess Cruises and Royal Caribbean told CNN they were supporting the families of those crew members who had died.
There are also independent helplines available. The International Seafarers' Welfare and Assistance Network runs a 24-hour-a-day helpline for seafarers and their families.
Roger Harris, the network's executive director, told CNN that the organization has had triple the number of calls than usual over the past couple of months.
The question of connectivity on board can be a contentious one, as often employees must pay extra for Wi-Fi, which can be glitchy out in the ocean. But many cruise companies are currently offering their stranded employees free or discounted connection, something Harris advocates.
"Making life as easy as possible, allowing them to use guest cabins, ensuring that they are safe in terms of catching the virus and protected as far as possible," was Harris' top advice for cruise lines to ensure employee mental health.
Facebook campaigner Thomas also cited the importance of good Wi-Fi and technology, plus socially distanced interaction, healthy food options and access to medicine and psychological services. But Thomas said the only real solution is to repatriate crew.
"The only way to manage this humanitarian crisis is to get the crew home. It is too late for anything else," Thomas said.
Harris also reiterated the importance of keeping workers in the loop about repatriation efforts, to ensure no one feels abandoned.
Pre-pandemic, working for a cruise line was often glamorized as a perma-vacation. The long hours and unpredictability were glossed over.
But now, many more people are aware of this "hidden workforce," as Harris called cruise staffers.
Harris said he hopes that cruise lines will provide increased support for those working at sea going forward. Medical expert Dahl is more cynical.
"Cruise lines will be mostly concerned about getting back to business, which will be extremely difficult," he said.
Crew member Bailey said he felt the blame lies with the countries that closed their ports, rather than with the cruise line. As soon as it's safe, he would love to return to his role at Silversea.
That said, he feels there were many aspects of the cruise industry that need to be reimagined for the future, to ensure the desperation of current events is never repeated.
"There just needs to be a pandemic response protocol, so that when this happens, they bring the ships in and get [passengers and crew] off the ships immediately and into quarantine," Bailey said.
"There needs to be some sort of agreement that we're not going to just abandon people."