Cruise Line Industry being treat as the Proverbial Step Child??

[caribill]

17 hours ago, skynight said:

Ships will not return to normal until there is a working vaccine.

To properly know that a vaccine is both safe and effective will take at least a couple of years. The 108+ vaccines currently being developed can be rushed to market, but it will take time to verify that they are safe. Any vaccine available later this year certainly, for example, will not have been proven safe for someone who is pregnant as well as the baby. A number of potential vaccines in the past for other diseases were only found to be unsafe after long term testing.

 

On airlines a passenger probably has the possibility of one or just a few exposures during a flight. With proper protection and spaced seating (airlines are not crowded) one can reduce the probability of becoming infected. On a cruise ship you have hundreds of possible exposures each day.

Not selling a middle seat on a plane still puts you only a couple of feet away from someone in the same row, in front of you, and in back of you. As church choir rehearsals, funerals and other small gatherings have shown, it does not take long for an infected person to infect the others around him/her.

 

Ports, not just CDC U.S. ports, are just not allowing cruise ships to dock.

That is currently which is why all cruising is currently on hold. But is it not just the possible transmission of the virus from a passenger to someone in the port that needs to be a concern. A passenger can pick up the virus on shore from a resident of the port being visited and bring it back to the ship.

 

 

see above in red

[caribill]

1 hour ago, cruzsnooze said:

I would like to see the ship have a quarantine block of rooms with a NEGATIVE air flow to prevent cross contamination.  If the screening tests are readily available and fast I personally would be happy to take it along with all embarking passengers 

 

None of the tests can detect a person who has become recently infected and has not had enough of the virus grow in the body to be detected. It takes four or five days minimum after exposure to get to that point.

 

Also, some of the quick result tests have been shown to have up to a 15% false negative result. For a ship with 2000 passengers that test negative, up to 300 of them could actually be positive.

[logan25]

5 hours ago, caribill said:

 

Also, some of the quick result tests have been shown to have up to a 15% false negative result. For a ship with 2000 passengers that test negative, up to 300 of them could actually be positive.

The term false negative is based on actually positive.  For your hypothetical, you are assuming 2000 positives are tested and 15% receive false negative.  Not likely, not even a little bit.

 

In our state (yours and mine), tests are administered to individuals with reason to believe they have been exposed or available upon request.  Of that pool, a little over 6% have to date been recorded positive.  Based on that, I would never assume 2000 are positives.
 

Edited May 25, 2020 by logan25

[Daniel A]

6 hours ago, caribill said:

 

None of the tests can detect a person who has become recently infected and has not had enough of the virus grow in the body to be detected. It takes four or five days minimum after exposure to get to that point.

It looks like you are saying that we can't have a vaccine that is 100% proven for 100% of the population for at least a "couple of years."  You are also saying that there are no tests that are 100% reliable therefore they're useless.

 

Is the only thing we can do is stay locked down for the rest of our lives?  (I say rest of our lives because there will be a lot of deaths from lockdowns during that time period.)  I'm not sure what your point is.

[spyro1952]

On 5/23/2020 at 7:11 PM, chipmaster said:

 

You could argue there is indeed a double standard, but for airlines there isn't many international and quarantines are required.

 

When you put a few thousand people mingling for a few days to weeks the petri dish will almost certainly insure that if anyone has a disease getting on they will  give it to a few more.       You can argue the same for bar, airlines, etc. except duration, size and proximity are far less.   Cruise is really special intimate environment that last for days to weeks unlike most others that are hours at most.   

 

When sports venues allow spectators is when cruises likely should be able to sail, about the same in terms of risk, IMHO   

 

 

From a fact that people haven't acted rationally across the board no different with this one, LOL

Most of EU countries are under some type of quarantine for international visitors.  I am waiting to get to friends in Dublin.  I can fly there but have to register with Irish government and quarantine for 2 weeks - not allowed outside anywhere.  They also make unannounced visits and fines violators.  Other countries have similar restrictions.  
I seriously doubt cruising resumes anytime soon.  I also foresee CDC extending ban as Trump’s punishment for not paying US taxes and costing so much $$ and chaos.

[caribill]

5 hours ago, logan25 said:

The term false negative is based on actually positive.  For your hypothetical, you are assuming 2000 positives are tested and 15% receive false negative.  Not likely, not even a little bit.

 

 

Thanks for correcting my interpretation of what that means.

[caribill]

3 hours ago, Daniel A said:

It looks like you are saying that we can't have a vaccine that is 100% proven for 100% of the population for at least a "couple of years."  You are also saying that there are no tests that are 100% reliable therefore they're useless.

 

 

No, they are certainly not useless. But just like noro can come aboard a ship that had none when a new passenger embarks who has not developed symptoms, so can a newly infected person with Covid-19.

[npcl]

5 hours ago, logan25 said:

The term false negative is based on actually positive.  For your hypothetical, you are assuming 2000 positives are tested and 15% receive false negative.  Not likely, not even a little bit.

 

In our state (yours and mine), tests are administered to individuals with reason to believe they have been exposed or available upon request.  Of that pool, a little over 6% have to date been recorded positive.  Based on that, I would never assume 2000 are positives.
 

Just to be clear a false negative test is when someone that has the illness, takes a test and it yields a negative result.

In other words the test results say negative when they are really infected.

 

There are well documented cases of people showing serious symptoms getting tested multiple times, each time get a negative result, then a few days later finally getting a positive test.  In one case an MD, he tested negative 4 times with symptoms, then finally they did a deep lung test, which finally tested positive.

 

The accuracy rate on the tests are rather poor.  One study that looked into  the 5 minute Abbott test  came back with a 44% false negative rate (false negative as in the test result yielding a negative indication when some actually had the illness).

 

To quote a study done on PCR

 

 "Researchers still don’t know what the real-world false positive rate is, but clinical sensitivity of RT-PCR tests ranges from 66% to 80%. That means nearly one in three infected people who are tested will receive false negative results."

 

 

Most experts believe that problems with sample collection are the main culprit behind inaccurate testing. False negative results are likely occurring because health care providers aren’t collecting samples with enough of the virus for the tests to detect.

This can happen because someone doesn’t insert a swab deep enough in the nose or doesn’t collect enough of the sample. False negatives could occur if a person is tested too early or too late during their infection and there isn’t a lot of virus in their cells. And finally, errors can happen if a sample sits too long before being tested, which allows the viral RNA to break down.

 

So actually your 15% estimates of false negatives is really far to low.

 

If someone has symptoms they should assume that they have the illness, until it is proven otherwise and not just 1 negative test.  If someone has been close to someone else that has been found to be infected, they should self isolate for 14 days, symptoms or not.

 

For comparison the rapid tests for the flu also have about 50% false negative rate and they have been around for years.

Edited May 25, 2020 by npcl

[npcl]

4 hours ago, Daniel A said:

It looks like you are saying that we can't have a vaccine that is 100% proven for 100% of the population for at least a "couple of years."  You are also saying that there are no tests that are 100% reliable therefore they're useless.

 

Is the only thing we can do is stay locked down for the rest of our lives?  (I say rest of our lives because there will be a lot of deaths from lockdowns during that time period.)  I'm not sure what your point is.

Tests are not useless, but they are also not a panacea.  To be used effectively one needs to understand their limitations.  They can confirm the disease in someone showing mild symptoms or are asymptomatic.  They can find previously unknown cases.

 

But unfortunately, due to a number of limitations, they cannot prove that someone is not infected. They can only show that at the time the test was taken, the sample did not get sufficient virus to register a positive test.

 

Or to use logic terms  a necessary but not sufficient condition.

 

TO put it in terms of us prior to a flight or cruise, they could find some cases and reduce the number of infected by testing prior to a flight or cruise, but cannot provide assurance that no one is infected.

Edited May 25, 2020 by npcl

[npcl]

While more accurate the tests for antibodies also have some limits in accuracy that impacts how one looks at the data and the tendency to generate higher numbers when dealing with small numbers of the population having been infected

 

Recently, researchers from the University of California (UC) compared 10 serological tests. The sensitivity of the tests was mostly above 90%, but specificity is more important when checking for evidence of past infection. Although this hasn’t been proven for SARS-CoV-2, antibodies, in theory, would suggest immunity to the coronavirus. False positives then would tell a person they are safe when they aren’t.

 

The study has not been peer-reviewed yet; however, the authors report that most of the kits were 95%-99% specific, meaning there would be less than a 5% false positive rate. While this seems like very good news, if SARS-CoV-2 infections are rare in a population, a false positive rate of 5% could limit a test’s usefulness. If only 5% of a population have had the coronavirus, a test with 95% specificity would result in a 50% chance of a false positive.

 

Several of the tests had clinical specificities over 98%, and one of the authors of the UC paper called those tests “critical for reopening society.” But some experts have criticized the optimistic tone of the study. If only 5% of the population have antibodies, a test with 99% specificity still produces 16% false positive results.

[logan25]

22 minutes ago, npcl said:

 

So actually your 15% estimates of false negatives is really far to low.

 

 

You are directing part of your comment to the wrong poster.  I was replying to a prior poster using “15%”.

Edited May 25, 2020 by logan25

[chipmaster]

6 hours ago, logan25 said:

The term false negative is based on actually positive.  For your hypothetical, you are assuming 2000 positives are tested and 15% receive false negative.  Not likely, not even a little bit.

 

In our state (yours and mine), tests are administered to individuals with reason to believe they have been exposed or available upon request.  Of that pool, a little over 6% have to date been recorded positive.  Based on that, I would never assume 2000 are positives.
 

 

You don't know you are a false negative that is really positive till you test positive.   But.. what if you don't test again for a few weeks or more, was that first test really a negative?  

 

For example NYC has 15-25% that were exposed than you can do the math from there, LOL

 

Edited May 25, 2020 by chipmaster

[logan25]

4 minutes ago, chipmaster said:

 

You don't know you are a false negative that is really positive till you test positive.   But.. what if you don't test again for a few weeks or more, was that first test really a negative?

 

I have read the term “pre-symptomatic”.  
 

Still statistically flawed to hypothesize all 2000 passengers are positive or pre-symptomatic.

Edited May 25, 2020 by logan25

[npcl]

20 minutes ago, chipmaster said:

 

You don't know you are a false negative that is really positive till you test positive.   But.. what if you don't test again for a few weeks or more, was that first test really a negative?  

 

For example NYC has 15-25% that were exposed than you can do the math from there, LOL

 

The studies I referenced were based upon analysis of clinical results.  Which involved multiple tests, specific time frames, symptom onset dates, etc.

 

As far as your question probably not, but then that situation would not have been incorporated into the study results.  It would not have been criteria for a valid study.

[npcl]

16 minutes ago, Roberto256 said:

 

I guess everyone can form their own opinion on how soon they should get a vaccine.

 

Personally, I'm not interested in something that is rushed out, just in time for an election.

 

I have however re-thought my position on drinking bleach and other disinfectants.

 

It took me a while, but now I see the simple elegance in this strategy.

 

Dead people contract very few viruses.

 

So, drinking bleach should be very, very effective against covid-19.

 

 

 

Before it gets to market I suspect that, rushed or not, most of the immediate safety questions will be addressed.

 

The questions I would like to see answered that will take the longest time are:

 

1. Duration of protection

2. Impact of infection after the period of immunity ends.

 

While this is a statistically low probability.

 

There are some illnesses, such as Dengue Fever,  where the second infection is worse than the first.  The antibodies generated from the first infection do immunity, but once the level drops and the immunity is no longer there a second infection if often far worse. Sanofi Pasteur ran into problems with their Dengue fever vaccine when they found that the vaccine acted like a first infection, resulting in worse results for those vaccinated, once the immunity dropped.  Now it is only recommended for those that have already had Dengue once.

[npcl]

1 hour ago, logan25 said:

 

You are directing part of your comment to the wrong poster.  I was replying to a prior poster using “15%”.

Yes, I did not see the earlier post.

 

The way I look at it is that the US has over 1.1 million active cases. From some of the better studies looking at over all infection rates (such as the recent one in Spain or the one in Sweden) the total of those infected may run up to 10 times the reported cases.  Using the lower currently active cases (we are still relatively early and most are still active) compared to the total cases with the 10x multiplier would yield around 11 million potentially currently infected. Since the US has a population of 330 million that would put the potential infected at around 3.3%  So if you had a cruise of 1500 and the infected numbers are totally random then the number of potentially infected would be approximately 50.  Of which with a test with a 33% false negative rate would mean that 16 potentially infected would get past a single test at time of boarding.

 

Now one could argue that the number is less than the currently active X 10. However offsetting that is the factor that those likely to get on such a cruise are those that are less likely to be concerned about the risk, and more likely to be out and about in an environment where they have a higher than just random change of encountering the virus.

 

It does make an interesting boundary condition and if you dropped the 10 X from the equation and assumed that the active cases are all that exist (not likely with an illness where 50% are asymptomatic).  then in a cruise of 1500 you would still get 5 passengers infected from a random scenario with one or two making it past the test.

 

Using the two scenarios as boundary conditions you would get between 1-2 lower bound and 16 upper bound making it onto a 1500 passenger cruise even with quick tests.

 

Applying the same numbers to a 150 person airline flight would yield  the range from 0-1 person after testing.  With more flights having the zero than having the 1.

 

Edited May 25, 2020 by npcl

[jakeT]

Before this the cruise industry did not do a good job in protecting the health of its passengers. Virus ran though out the ship.  They know it came from the buffed type food service.  
All you need is one person who has there rights to be a jerk to infect half a ship.  Still today cruise lines are selling tickets for cruises but are not saying anything on what going to happen?

Are they going out with a full ship, 50% of  the ship.  How Restaurant Are going to work, elevators a major problem. Ect

[chipmaster]

22 minutes ago, npcl said:

Yes, I did not see the earlier post.

 

The way I look at it is that the US has over 1.1 million active cases. From some of the better studies looking at over all infection rates (such as the recent one in Spain or the one in Sweden) the total of those infected may run up to 10 times the reported cases.  Using the lower currently active cases (we are still relatively early and most are still active) compared to the total cases with the 10x multiplier would yield around 11 million potentially currently infected. Since the US has a population of 330 million that would put the potential infected at around 3.3%  So if you had a cruise of 1500 and the infected numbers are totally random then the number of potentially infected would be approximately 50.  Of which with a test with a 33% false negative rate would mean that 16 potentially infected would get past a single test at time of boarding.

 

Now one could argue that the number is less than the currently active X 10. However offsetting that is the factor that those likely to get on such a cruise are those that are less likely to be concerned about the risk, and more likely to be out and about in an environment where they have a higher than just random change of encountering the virus.

 

It does make an interesting boundary condition and if you dropped the 10 X from the equation and assumed that the active cases are all that exist (not likely with an illness where 50% are asymptomatic).  then in a cruise of 1500 you would still get 5 passengers infected from a random scenario with one or two making it past the test.

 

Using the two scenarios as boundary conditions you would get between 1-2 lower bound and 16 upper bound making it onto a 1500 passenger cruise even with quick tests.

 

Applying the same numbers to a 150 person airline flight would yield  the range from 0-1 person after testing.  With more flights having the zero than having the 1.

 

 

So fly is a reasonably low risk as if let's just round up 1-2 on an airplane, and you are likely to have lower probability sitting near the person or interacting, then should be pretty safe to fly.

 

On a ship where those 2-16 will be using the elevator, going to the theater, bar, use the same pool, buffet and dining room day over day and likely get a few other people infected and then so on and so forth.  I see a repeat of the Diamond, no?

 

The planes take the infected all over the world to spread their mahem, the cruise ship incubates it to the pandemic. 

 

 

[npcl]

17 minutes ago, chipmaster said:

 

So fly is a reasonably low risk as if let's just round up 1-2 on an airplane, and you are likely to have lower probability sitting near the person or interacting, then should be pretty safe to fly.

 

On a ship where those 2-16 will be using the elevator, going to the theater, bar, use the same pool, buffet and dining room day over day and likely get a few other people infected and then so on and so forth.  I see a repeat of the Diamond, no?

 

The planes take the infected all over the world to spread their mahem, the cruise ship incubates it to the pandemic. 

 

 

On one flight for any particular passenger yes the odds are pretty low..  But still on 1000 flights  you get 200-400 with a likely infected passenger on board and the chance of transmission.

 

The big difference is keep the cruise short, less than 5 day median incubation time, and even though you might have transmission it will not be noticeable on the cruise and the odds of a local public health departments tracking it back to the cruise and getting the CDC involved to quarantine the ships next cruise is probably also low.  Basically it might be like a subway system, transmission occurring, but not rising to the level where the ships get shutdown again because the visibility is low.  It would depend upon someone coming off the ship, testing positive and their local public health department raising the potential ship source to the CDC.  It would probably take multiple reports tied to a ship before any action would be taken, because with short cruises the issue of point of infection would be difficult, unless you had multiple reports tied to a particular ship, because of how wide spread the illness is now. Transmission lost in the noise so to speak.

Edited May 25, 2020 by npcl

[chipmaster]

12 minutes ago, npcl said:

On one flight for any particular passenger yes the odds are pretty low..  But still on 1000 flights  you get 200-400 with a likely infected passenger on board and the chance of transmission.

 

The big difference is keep the cruise short, less than 5 day median incubation time, and even though you might have transmission it will not be noticeable on the cruise and the odds of a local public health departments tracking it back to the cruise and getting the CDC involved to quarantine the ships next cruise is probably also low.  Basically it might be like a subway system, transmission occurring, but not rising to the level where the ships get shutdown again because the visibility is low.  It would depend upon someone coming off the ship, testing positive and their local public health department raising the potential ship source to the CDC.  It would probably take multiple reports tied to a ship before any action would be taken, because with short cruises the issue of point of infection would be difficult, unless you had multiple reports tied to a particular ship, because of how wide spread the illness is now. Transmission lost in the noise so to speak.

 

Totally agree, as likely the 1000+ on a cruise come from several hundred different cities and flights all collecting contact risk into one central location for days to re-infect.  Same reason large gatherings at stadiums or 100x less in bars/restaurants etc. are progressing slowly.  We will indeed see how this reopening goes across the globe, for certain we will see new outbreaks, and renewed shutdowns, and if not too bad, full on life with large social gatherings increasingly unrestricted but with common sense safety ( distancing, masks, sanitation etc.  )  by fall, LOL

Edited May 25, 2020 by chipmaster

[npcl]

36 minutes ago, chipmaster said:

 

Totally agree, as likely the 1000+ on a cruise come from several hundred different cities and flights all collecting contact risk into one central location for days to re-infect.  Same reason large gatherings at stadiums or 100x less in bars/restaurants etc. are progressing slowly.  We will indeed see how this reopening goes across the globe, for certain we will see new outbreaks, and renewed shutdowns, and if not too bad, full on life with large social gatherings increasingly unrestricted but with common sense safety ( distancing, masks, sanitation etc.  )  by fall, LOL

Where I live we had not had a new case for three weeks. Then we had a demonstration in front of the country seat by a couple of hundred for the restrictions to be relaxed (the people at the demonstration were not wearing mask, not distancing). Since then we have had 10 new cases, most of which were people at the demonstration. 

Edited May 25, 2020 by npcl

[caribill]

9 hours ago, npcl said:

Where I live we had not had a new case for three weeks. Then we had a demonstration in front of the country seat by a couple of hundred for the restrictions to be relaxed (the people at the demonstration were not wearing mask, not distancing). Since then we have had 10 new cases, most of which were people at the demonstration. 

 

Proving you do not need to be confined to a cruise ship for days to be infected. A couple of hours on land in a demonstration is enough.

 

This past weekend there were many places in the USA where large crowds gathered. About a week from now we will know if those gatherings have resulted in a significant increase in cases.

[PrincessLuver]

7 hours ago, caribill said:

 

Proving you do not need to be confined to a cruise ship for days to be infected. A couple of hours on land in a demonstration is enough.

 

This past weekend there were many places in the USA where large crowds gathered. About a week from now we will know if those gatherings have resulted in a significant increase in cases.

 

I agree also that the virus takes no holidays and the crowds they showed at many places this weekend in the US show no respect for the frontline workers who have been battling this disease for months or their relatives who they could possibly give the disease to.  

 

I am sure they are going to be begging for their lives once they get COVID-19 and then they will be encouraging people to take the disease seriously as they fight possible death due to their own selfishness and foolishness.

Edited May 26, 2020 by PrincessLuver

[Hlitner]

18 hours ago, chipmaster said:

 

So fly is a reasonably low risk as if let's just round up 1-2 on an airplane, and you are likely to have lower probability sitting near the person or interacting, then should be pretty safe to fly.

 

On a ship where those 2-16 will be using the elevator, going to the theater, bar, use the same pool, buffet and dining room day over day and likely get a few other people infected and then so on and so forth.  I see a repeat of the Diamond, no?

 

The planes take the infected all over the world to spread their mahem, the cruise ship incubates it to the pandemic. 

 

 

Actually, we think flying is among the highest of all risks when it comes to highly contagious diseases.  We base this on a conversation we had, several years ago, with a CDC trainer who we met on a RCI cruise.  He was on the ship to conduct training for the crew and also consult with the senior staff on best practices.   At the time the major focus was Norovirus and influenza.  The CDC official told us that, based on some internal studies, they knew that most Norovirus was contracted by passengers/crew on airplanes and at airports.  These folks would then carry the bug onto the ship before they were showing any symptoms (it takes 2-3 days to often see any symptoms).   While the cruise lines were essentially blameless of most Norovirus outbreaks it fell to them to mitigate the bug.    And we are probably seeing a similar situation with COVID-19.  Folks get exposed to the bug on land and carry it aboard the ships.  Since they often have absolutely no symptoms at the time they board the ship there is nothing the vessel can do.  And even testing at the port would likely miss many cases since recent exposure would not result in a positive COVID-19 test.  

 

Hank

 

[caribill]

5 hours ago, Hlitner said:

Actually, we think flying is among the highest of all risks when it comes to highly contagious diseases.

 

 

 

Over 500 TSA agents have been shown to be positive with COVID-19.  Just going through the TSA checkpoints might be the most risky part of the trip.

a) Although you will scan your boarding pass yourself now instead of handing it to the TSA agent, I have not read how presenting your ID will be different. Will you still hand it to the agent or just hold it up?

b) You will need to remove your mask so the TSA agent can compare your full face to the ID. Sort of defeats the purpose of wearing a mask in public.

c) When TSA agents look into your luggage (either hand luggage as you pass through or checked luggage behind the scenes), they wear gloves. But they do not, I suspect, change gloves between each piece of luggage being touched and possibly opened.