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SS Future Re-Open Plan: Timing, Testing Needs??!!


TLCOhio
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On 4/2/2022 at 7:52 AM, TLCOhio said:

 

Appreciate the posting of this key NY Times story by RetiredandTravel on the 4th vaccine shot.  Agree with rkacruiser that "From what little I know, a 4th jab does not hurt and may help".  Very good comment and follow-up.  Agree!!

 

From that Times story, here was a key quote/item that I found of interest: "The most compelling data comes from an Israeli study that found that adults older than 60 who got a fourth dose were 78 percent less likely to die of Covid than those who got only three shots. The study was posted online last week and has not yet been reviewed for publication in a scientific journal." . . .

 

 

 

 

As noted the study has not been peer-reviewed yet.  But also note the NYT review of the Israel study showing boosters lowering mortality also reported pre-selection bias considerations: 

 

". . . .But that study, while it offers the only evidence, is deeply flawed. The participants all volunteered to get a fourth shot — and are likely to be people who are naturally careful about their health, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an adviser to the F.D.A.

“Who makes the choice to get a fourth dose? Someone who is attentive to their health, who’s more likely to exercise, is less likely to smoke, is more likely to wear a mask,” Dr. Offit said.

These other factors may make the booster shot look more effective than it actually is. In fact, other data from Israel suggest that a second booster has only marginal benefits in healthy young people. 

Given four months after the third dose, a fourth dose restored the level of antibodies to the same peak seen after the first booster, but no more than that. And this rise is likely to be fleeting, just as it was after the third dose.

“It’ll be short-lived, so I think the timing is going to be key here,” said Marion Pepper, an immunologist at the University of Washington. “If it’s not going to create a long-term, better quality immune response, then you question the value a little bit.” . . . 

 

 

 

https://www.nytimes.com/explain/2022/03/29/health/second-booster-shots-covid

 

Maybe they should have added *cruisers* to the list of people who are more likely to choose to get a fourth dose, even if not required, because although many are not worried about death as much as they are worried about getting quarantined  🙂

 

The NYT article also refers to the high degree of protection against actual death most people already have from the baseline vaccines (plus their old booster), regardless of the decline in antibody levels , and the absence of data that getting a 4th booster will help prevent transmission of Covid to others. 

 

Public health authorities have to make decisions and recommendations  for *population* health (including subpopulations), based on incomplete and/or biased information available so far, balanced against cost (not just side effects, which do occur in a significant minority, but also financial considerations) .  If a virus is neither very prevalent nor very contagious and most importantly  *not very deadly* in younger and/or healthier people, it is a judgment call, an educated guess, whether or not to create some risk from side effects, and to spend money, and distract medical personnel from other needs,  recommending mass vaccination of everyone right now.  NHS protocols, given current information, thus  do not seem unreasonable even though the U.S. is going further and is now blanket recommending all over 50 get the 4th shot.  We also have a higher risk population in the U.S. (e.g., more obesity, an independent risk factor, among other lifestyle issues), and greater willingness and capacity to 'print' money to fund this. 

 

However, every patient, including cruisers, should decide  individually *with his/her doctor*, (who at least in theory knows the entire health history, tolerance for risk, risk of exposure, community vaccine availability, etc. ) what should be recommended in a particular case, regardless of "guidelines."  Guidelines can be overridden, in special cases.

 

I am not ancient, but am no spring chicken, and am on immunosuppressant medication with other known risks.  So I received a 3rd Covid vaccine, with a doctor's prescription,  when it was not yet recommended by our public health departments. I now  easily fit  the 4th shot criteria both here and in Britain, even though  I had had unpleasant (but tolerable), side effects from the 3rd shot for several days. And I am cruising next month  in Europe (so will have more exposure than staying home in my Covid-free, isolated rural home). DH, younger and healthier, in contrast, not cruising next month, had moderately severe side effects for a much longer time after his 3rd shot (close to getting hospitalized), which he does not want to repeat.  So he will be holding off on a 4th shot at least until it is required for travel, and even then he might choose to avoid travel rather than go through what he went through before, likely every  6 months or so.  Hopefully by that time, there will be more data so he *and his doctor* can do a better *individualized* risk/benefit analysis to guide care.  

 

 

 

 

 

 

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1 hour ago, cruiseej said:

 

But there are questions about timing if you're aiming to travel later in the year. We have a land trip to Italy booked for October, and a Silversea cruise to Antarctica booked for December (hopefully this third time, after cancellations in 2020 and 2020, will be the charm!) So when should we get our fourth shots? If we get them now, and their effectiveness wanes over time like the previous shots, by October (7 months) and December (9 months) might mean we'd have pretty diminished protection. Will we be able to get a fifth shot (3rd booster) in another 5-6 months? Who knows? So as of now, we're thinking we should hold off on getting a 4th shot now, and wait a few months so our boost will come closer to our travels later in the year. Or are we increasing our risks now by not getting our second booster as soon as possible? Damned if you do; damned if you don't! 

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I absolutely agree with Catlover54's analysis of the unpredictability and possible unpleasantness of cruising right now. Here in the UK, as only the very elderly and immunosuppressed will get a 4th dose, probably until the autumn (so long as no extra variants arrive) we are just crossing our fingers and hoping for the best!

 

The regulations in Dubai  and the UK eased just before our holiday, and having just returned - so far so good. So we are crossing more fingers that Canada and the USA also ease restrictions before July!x

 

Am a little bit worried that our booked (moved and moved again) Tauck Christmas market river cruise in November no longer appears on their website to book?? Am emailing to them to see what is up!

 

The threat of international war and definite food shortages leads to maybe travel being a nice to have. Which for me is a great loss.

 

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Posted (edited)

What a kerfuffle!

 

The travel industry depending where you are going is becoming like a long drawn out race with hurdles for travellers thrown out at each turn. Based in the UK as fellow passengers mention unless you are of a certain age or have a certain medical condition you will not have had a 4th vaccine. I and my wife do not fall into the category so we have not been 4th vaccinated. Behind the scenes one of my friends who does have medical conditions and is over 75 has been called for a 5th dose - I have not even heard of that in the UK press.

 

Then we have the never ending changes of requirements for travel, we are going to be sailing with SS from Europe shortly. This now coincides with the airports having melt down queues for checking in with the airline, scrutinizing documentation that is required, long delay in security checks and finally will your flight get off on time or not be cancelled because of flight crew and airport staff shortages (that is if your baggage is loaded as we read over the weekend here). You finally arrive at the country of your destination and go through the same hoops of documentation. Almost there now, nope, you have an overnight hotel stay booked where in some countries they will take your temperature and check documentation again which I am all for.

 

The day comes for boarding, the PCR/Antigen test you took prior to travelling is no longer valid as the safest method is to take one at the quay at the point of embarkation - we will sit on the pier hoping that we are not testing positive.

 

To the ship, no lunch now as embarkation is after 2.00 pm and you get to meet your fellow travellers all in a similar position who have various stories to tell. exhausted and we have each port to navigate with their individual requirements.

 

I wonder how many people are sailing with us on this ship?

 

A wonderful cruise and then the return journey experiencing all the documentation, security and airline fun on the way back to blighty.

 

We are looking forward to our cruise after two cancelled cruises to Japan with SS in 2021 and 2022, but oh for the fun ahead of us.

 

Yes, what a kerfuffle and they say that it is easier to travel than ever now.

 

This is all written with tongue in cheek but I may have become rather cynical these days in relation to overseas travel.

 

Edited by Yosemitephil
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Though you should never believe anything you read in the press. The Israelis were the first to give a 4th shot. The original study was in Health care workers where the headline did say it reduced infections. but in the addenda the result was only statistically significant in those over 60.

So the Israelis did a larger study with 700000 patients and the results were better, But 600000 of the subjects were over 60. as one of my mentors told me when I dabbled in research. " Ron first pick the people you do the study on."

 

Bottom line is if you are over 60 or are immunocompromised or have co morbidities get your 4th shot. If young and healthy little upside.

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We will certainly get the 4th shot about a month before we leave for Europe.  I believe the initial clinical trials were for 6 months, I find it unsettling the lack of hard data on the 4th booster given the length of the trials.  The new variants obviously complicated the efficacy information but we still seem to be shooting in the dark.

 

We have pushed out cruising from 2023 to 2024, just too many uncertainties and the performance of these luxury cruise lines has left much to be desired.   If the Crystal event has given people pause on giving large down payments I'd direct you to the very important and informational SS finance thread by TLC aka "The Oracle of Ohio".  These cruise lines took on enormous amounts of debt during Covid, TLC & Co do a great job in the thread keeping us up to date on the cruise lines financial status.

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13 minutes ago, RetiredandTravel said:

We will certainly get the 4th shot about a month before we leave for Europe. We have pushed out cruising from 2023 to 2024, just too many uncertainties and the performance of these luxury cruise lines has left much to be desired.   If the Crystal event has given people pause on giving large down payments I'd direct you to the very important and informational SS finance thread by TLC aka "The Oracle of Ohio".  These cruise lines took on enormous amounts of debt during Covid, TLC & Co do a great job in the thread keeping us up to date on the cruise lines financial status.

 

Very much appreciate these varied and very good comments, insights and follow-ups from the recent posters about the second booster, etc.  Especially from RetiredandTravel, your labeling me of "The Oracle of Ohio" is very kind.  My wife and others call me lots of "names", but never do I achieve that high category as an "ORACLE".  I will share this info with her and then listen to her laugh.  Keep up the great sharing. 

 

From a Vancouver-area newspaper this morning, they had this headline: Cruise ship headed to Victoria had 'lots of COVID,' passenger says" with this sub-headline: " 'The whole 12th floor is an isolation ward,' said Ally Carol of Richmond, who boarded the ship in Fort Lauderdale, Florida, with her partner in late March for a 19-day cruise to Canada.

 

Here are some of their added reporting highlights: “They had planned to return home after the ship docked in Vancouver on April 7, but have now booked a flight from San Francisco after the cruise was cut short.  'There are active cases in cabins throughout the ship as well, and they [aren’t telling] anyone. They say it is a privacy issue and they can’t share with anyone, but medical teams in protective gear are seen going to rooms.'  The Caribbean Princess was supposed to be the first cruise ship to arrive in Canada after more than two years of pandemic restrictions when it arrived at Ogden Point on Wednesday.  But the Canadian leg of the journey was abruptly cancelled late Friday when Princess Cruises announced it was making the 'difficult decision to allow added time to prepare for dry dock' near Portland, Oregon.

 

Not good news for Princess cruises and/or Canada in doing their planned re-opening.  Learning to "live with it" sounds good and highly desirable, but this sailing sounds really bad and extremely challenged. The whole 12th floor on that ship as an "isolation ward" would scare the heck out of me. 

 

Full story at:

https://www.nsnews.com/bc-news/cruise-ship-headed-to-victoria-had-lots-of-covid-passenger-says-5228314


THANKS!  Enjoy!  Terry in Ohio

 

Lisbon, NW Spain, Bordeaux/Brittany: Live/blog, June 2017 from Portugal to France along scenic Atlantic Coast on the Silver Spirit.  Now at 32,250 views.  Many interesting pictures, details for history, food, culture, etc.:
www.boards.cruisecritic.com/showthread.php?t=2511358

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Technical issues in my previous post…what I meant to say was: the improvement in antibody levels is known to last only several months. Right now Covid prevalence in the US is low (always subject to change).  We are traveling again in September and so plan to get boosted in August. Hopefully by that time we will have a vaccine more effective against the current variants instead of a booster against the original virus. 

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On 4/4/2022 at 1:30 PM, TLCOhio said:

Not good news for Princess cruises and/or Canada in doing their planned re-opening.  Learning to "live with it" sounds good and highly desirable, but this sailing sounds really bad and extremely challenged. The whole 12th floor on that ship as an "isolation ward" would scare the heck out of me. 

 

Terry (Oracle), we totally agree with you.  We think there will be quite a few issues with the cruise season in Canada.  There are some quite stringent rules in place.  For anyone who may be interested, here is the link to the requirements as of April 1:  canada.ca/en/marine-transportation/marine-safety/ship-safety-bulletins/measures-support-safe-cruise-travel-canada-ssb-no-18-2021-modified-april-1-2022.  

 

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Greetings to The Oracle of Ohio!

 

On 4/3/2022 at 9:28 AM, TLCOhio said:

 Good luck Monday with your second booster.

 

All went well.  Absolutely no reaction to the shot.  

 

I really don't understand why there is dithering about what to do about this second booster.  If you have had three shots, it seems to me that you have made the decision that the Covid vaccine is something that you ought to have.  What harm is there in getting another booster shot?  And, what does it cost you?  

 

(As I see my tax bill for 2021 that I am going to have to pay as well as the amounts required for estimated 2022, these "shots" are the benefit that I am getting from our government that I didn't receive when money was being dispersed due to the pandemic.)  

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7 hours ago, rkacruiser said:

I really don't understand why there is dithering about what to do about this second booster.  If you have had three shots, it seems to me that you have made the decision that the Covid vaccine is something that you ought to have.  What harm is there in getting another booster shot? 

 

For me, it's not a question of if, but when. If I get a booster now, will I be able to get another one in 4 or 5 months? We have two trips scheduled for the last quarter of this year, so I want to have my immunity as high as possible then. With no certainty about whether we'll be able to keep getting boosters at 4-6 month intervals, we're leaning toward holding off on our second booster until later in the year. If I knew we could get a booster now and another late, I'd be all in. 😉

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Our vax giver told us there is no difference in the vaccine from 1-2-booster-booster.  Only difference from 1-2 is vol and vol is same for both booster.

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On 4/4/2022 at 10:19 PM, tosteve1 said:

what I meant to say was: the improvement in antibody levels is known to last only several months. Right now Covid prevalence in the US is low (always subject to change).  We are traveling again in September and so plan to get boosted in August. Hopefully by that time we will have a vaccine more effective against the current variants instead of a booster against the original virus. 

 

Appreciate these various comments and follow-ups from Mr. Banjo, tosteve1, netpj, cruiseej, rkacruiser and bohaiboy.  Yes, many questions regarding the boosters, best timing options, etc.  Glad things went well on the second booster for our SW Ohio neighbor. 

 

From the New York Times yesterday, they had this headline: “Israeli Study Says Second Booster Protects Against Omicron Infection But Wanes Fast with these highlights: “A second booster shot of the Pfizer-BioNTech Covid vaccine provides additional short-term protection against Omicron infections and severe illness among older adults, according to a large new study from Israel.  But the booster’s effectiveness against infection in particular wanes after just four weeks and almost disappears after eight weeks. Protection against severe illness did not ebb in the six weeks after the extra dose, but the follow-up period was too short to determine whether a second booster provided better long-term protection against severe disease than a single booster.   The study focused on adults ages 60 and older, and did not provide data on the effectiveness of a second booster in younger populations.  The findings, published on Tuesday in the New England Journal of Medicine, suggest that additional boosters are likely to provide fleeting protection against Omicron infections in older recipients, and are consistent with evidence that vaccine effectiveness against infection wanes faster than against severe disease.”

 

Here is more from their reporting: "The results come in the midst of a debate over whether and when Americans might need additional boosters. The Food and Drug Administration is convening a panel of outside advisers on Wednesday to discuss the broader U.S. booster strategy.  The rapid spread of the highly transmissible Omicron variant, which can evade some of the body’s immune defenses, has intensified the discussion of whether second boosters are broadly necessary."

 

Full story at:

https://www.nytimes.com/live/2022/04/05/world/covid-19-mandates-cases-vaccine

 

THANKS!  Enjoy!  Terry in Ohio

 

Panama Canal? Early 2017, Fort Lauderdale to San Francisco adventure through Panama Canal.  Our first stops in Colombia, Central America and Mexico, plus added time in the great Golden Gate City. Now at 31,144 views.
http://boards.cruisecritic.com/showthread.php?t=2465580

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Spacing between shots/boosters can make a difference. Many scientists believe the 3 week spacing between the two initial Pfizer doses was much too short. A better response is seen when the interval is longer and many countries did space them out. Probably true for boosters too.  And there are reasons to believe that frequent boosters may induce immune tolerance. I certainly don’t see a reason for Americans to rush to get boosted when Covid levels are so low here. If traveling in the next month that’s a different story. As with most Covid topics, the right answer is “we don’t know”!

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Great follow-up from our North Carolina neighbor about booster.  Very honest reality as to how we are still learning and trying to figure it all out, smartly??!!. 

 

The Silversea parent is building and moving forward.  From a trade publication this morning, they had this headline: New Royal Caribbean Group chief eyes new-builds and weighs acquisitions with these highlights: “The new president and chief executive officer of Royal Caribbean Group says he is already considering new-builds for all three of the company’s brands and orders would be placed 'as soon as business is back to normal pre-Covid levels, which is not far out'.  Speaking in France as he oversaw his first in-person ship delivery – Celebrity Cruises’ third Edge-class ship Celebrity Beyond – Jason Liberty said: 'It could be later this year, or next year, but we have ships still on order through to 2026, so we have a little time.'  Liberty added that no ships had been ordered for a couple of years.  'We do things with great intent – whether that’s building the best contemporary family brand with Royal Caribbean, modern luxury with Celebrity or ultra-luxury and expedition with Silversea.'  'All the data supports the demographics and the consumer trends – and we believe all three are going to grow, so we are going to need more ships.'  'The addressable market in these segments is huge. We take the learnings of each ship and roll them back into the fleet or into future designs. We are dreamers [and] innovators.'  Liberty said Royal Caribbean Group was currently in a 'very strong financial position' and had 'performed very well versus our competitors' as he confirmed the group could also consider acquiring ships.”

 

Here is more from their reporting: "Asked if he was eyeing any of the Crystal Cruises fleet, he said the demise of the line was a 'real shame' but he was comfortable with the group’s ultra-luxury offering, having just taken delivery of Silversea Cruises’ Silver Moon and Dawn and with the Silver Nova class to come.  However, he added: 'We haven’t ordered anything in expedition. They have one expedition ship. Expedition ships could be of interest.' ”

 

Excellent background as to how much Silversea has built and done recently.  Interesting focus and interest for expanding in the expedition area.  Reactions??

 

Full story at:

https://travelweekly.co.uk/news/cruise/new-royal-caribbean-group-chief-eyes-new-builds-and-weighs-acquisitions

 

THANKS!  Enjoy!  Terry in Ohio

 

From late 2018, see “Holy Lands, Egypt, Jordan, Oman, Dubai, Greece, etc.”, with many visuals, details and ideas for the historic and scenic Middle East. Now at 20,768 views.  Connect at:
www.boards.cruisecritic.com/topic/2607054-livenautica-greece-holy-lands-egypt-dubai-terrypix’s/

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1 hour ago, TLCOhio said:

 

 

Here is more from their reporting: "Asked if he was eyeing any of the Crystal Cruises fleet, he said the demise of the line was a 'real shame' but he was comfortable with the group’s ultra-luxury offering, having just taken delivery of Silversea Cruises’ Silver Moon and Dawn and with the Silver Nova class to come.  However, he added: 'We haven’t ordered anything in expedition. They have one expedition ship. Expedition ships could be of interest.' ”

 

Excellent background as to how much Silversea has built and done recently.  Interesting focus and interest for expanding in the expedition area.  Reactions??

 

 

Considering that SS is offloading the Silver Explorer next fall, notwithstanding the recent Silver Wind conversion, having it acquire another expedition ship would not be a major surprise.

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5 hours ago, tosteve1 said:

As with most Covid topics, the right answer is “we don’t know”!

 

I will give you an A+ for that answer.  

 

15 hours ago, cruiseej said:

With no certainty about whether we'll be able to keep getting boosters at 4-6 month intervals, we're leaning toward holding off on our second booster until later in the year. If I knew we could get a booster now and another late, I'd be all in.

 

A good, logical reason.  

 

5 hours ago, tosteve1 said:

And there are reasons to believe that frequent boosters may induce immune tolerance.

 

I wonder about this statement.  Are you able to supply a source for such thinking?

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Posted (edited)

My wife and I got our Booster-Booster today. So far a sore arm and that’s it. We’re cruising in about two weeks so that convinced us to get the shots. Plus we meet the age requirement! Couldn’t really see a reason not to. We might have waited if not traveling in the near future since we live in a low transmission area. Our first booster was five months ago. 

Edited by CruiserFromMaine
Clarifying last booster
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7 hours ago, taxatty said:

Considering that SS is offloading the Silver Explorer next fall, notwithstanding the recent Silver Wind conversion, having it acquire another expedition ship would not be a major surprise.

From listening to the company’s leadership, it seems there will be new ships built that are destination specific.  Now that the Muse class program is complete, I think once SS gets the first of the Evolution class ships launched (Nova) we’ll hear new news on the expedition front.

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On 4/5/2022 at 2:10 PM, rkacruiser said:

I really don't understand why there is dithering about what to do about this second booster.  If you have had three shots, it seems to me that you have made the decision that the Covid vaccine is something that you ought to have.  What harm is there in getting another booster shot?  And, what does it cost you?  

 

This assumes a lot about how individuals experience the vaccine. There's a significant cost to me: I feel like I've had COVID 4 times--first when I actually had it, and then with the 3 shots. . . so far. I'm eligible for #4 but am really torn about volunteering to experience those side effects again. The only impetus right now is the fact that I'm cruising at the end of May. 

 

Hey all you docs and scientists: do you think there will eventually be a titer test of some sort, so I can find out if I really need another booster?

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16 hours ago, rkacruiser said:

 

I will give you an A+ for that answer.  

 

 

A good, logical reason.  

 

 

I wonder about this statement.  Are you able to supply a source for such thinking?

I can’t give you a specific reference to the immune tolerance idea but it is touched upon in the Times summary from 3/29 as well as several legitimate medical podcasts I have listened to. Dr. Paul Offitt is an authority to listen to. He is a scientist first and not a politician. If the evidence clearly shows benefit to another booster he will support it. The Israeli data has not been reviewed yet. And corporate CEOs should not be the ones recommending more and more boosters!

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1 hour ago, tosteve1 said:

I can’t give you a specific reference to the immune tolerance idea but it is touched upon in the Times summary from 3/29 as well as several legitimate medical podcasts I have listened to. Dr. Paul Offitt is an authority to listen to. He is a scientist first and not a politician. If the evidence clearly shows benefit to another booster he will support it. The Israeli data has not been reviewed yet. And corporate CEOs should not be the ones recommending more and more boosters!

 

Very much appreciate these additional comments and follow-ups regarding booster shots, their effectiveness, etc.  

 

From the Wall Street Journal this morning, they had this headline: “Covid-19 Variant Strategy for Long Haul Is Needed, FDA Official Says" with this sub-headline: "Head of agency’s vaccines division says asking people to frequently get booster shots isn’t sustainable.”

 

Here are some of their story highlights: “A top U.S. health regulator said that asking people to frequently get Covid-19 boosters wasn’t sustainable because of vaccine fatigue and that authorities needed to develop a long-term strategy for protecting the public from the virus as it evolves.  Dr. Peter Marks, who heads the Food and Drug Administration’s vaccines division, said that last week’s authorization of a second booster dose for people 50 years and older and for people 12 and older with weakened immune systems was a stopgap.  'This is really trying to do the best we can with the knowledge we have at hand, which is something that we’ve had to do a fair amount of over the past two years as a public-health agency,' Dr. Marks on Wednesday told vaccine experts advising the agency.”

 

Here is more from this WSJ reporting about the comments by this top federal health official: "The FDA, Dr. Marks said, seeks a long-term strategy for Covid-19 vaccinations, including identifying new strains requiring an updated vaccine and the scientific data needed to support authorization.  Yet Dr. Marks and the experts said there are serious challenges to tweaking vaccines as needed, especially in time for the winter, when there could be another wave of infections.  Several of the experts also said a future Covid-19 vaccine should probably target more than one strain of the virus, which could protect against those currently circulating and potentially others that are yet to emerge."

 

These comments from this top FDA official does raise a number of key, strategic questions as to where we will be in six or twelve months, plus longer-term, etc., for safe, international travels, cruising, etc.  Interesting mention of "vaccine fatigue".  First time I have seen that phrase!!  Reactions and comments?

 

Full story at:

https://www.wsj.com/articles/fda-advisers-to-discuss-how-to-prepare-for-new-covid-19-variants-11649242800?mod=hp_lead_pos6

 

THANKS!  Enjoy!  Terry in Ohio 

 

Summer 2019 Calgary, Jasper/Banff National Parks, Western Canada Rocky Mountaineer rail adventure, Vancouver, sailing up to Alaska on Silver Muse, post-cruise excursion to Denali, etc.  Many visuals and details from our first in these scenic areas!  Live/blog:
https://boards.cruisecritic.com/topic/2682584-live-terryohio-silver-muse-alaska-canadarockies-pix’s/

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