The US Coast Guard’s Cruise Ship National Centre of Expertise (NCOE) has issued Industry Notice 21-01 to provide information to owners and operators within the cruise industry regarding new requirements established with the passage of the National Defense Authorization Act (NDAA). All cruise ships with 250 passenger or more on international and coastwise voyages must meet new requirements that include having a physician always present and available, compliance with health care guidelines, and safety briefings for all passengers on appropriate steps during a medical emergency. The USCG Office of Commercial Vessel Compliance also issued Policy Letter 21-02 “Foreign Passenger Vessel Examination COVID-19 Guidance” to provide guidance to the NCOE and Officers in Charge, Marine Inspection on Coast Guard examination requirements for all foreign cruise ships seeking to resume suspended operations within US ports due to the COVID- 19 pandemic. The Center for Disease Control and Prevention has also issued a lengthy COVID-19 Operations Manual for voyages under the Conditional Sailing Order.