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Cause for cautious optimism?


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Looking for some good news in these depressing times for our beloved industry, I found a very recent article in the New York Times stating that there are some 36 vaccines currently in human trials, with many more in pre-trial clinical development. Of these, some are  in the final Phase 3 stage. Interestingly, they work in different ways and a medical contact of mine told me that he has always felt that a ''combination'' vaccine may prove to me the ultimate saviour. Personally, I think that it has been remarkable to get so far in such a very short period of time . Of course, some will fail but ...keep those fingers crossed out there!

Also, last week we learned that in the UK a new covid diagnostic test has been approved and is being rolled out imminently, which will utilise a portable machine, giving an extremely reliable result at modest cost (currently less than $30 per test) in only 90 minutes. This would so obviously be a great fit for Crystal, especially when economies of scale come into play.

I sincerely believe that the cruise industry will eventually bounce-back and I hope that Crystal returns to its undoubted glories!

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Another reason for possible optimism is research that is being conducted as to whether we are acquiring some native resistance to Covid.  The possible native resistance being researched is whether: (1) we already have some resistance to Covid because of immunity we have obtained from past common colds, which is a Coronavirus; and (2) whether we are building up some immunity to Covid as a result of "micro exposures".  The second theory is that, unless we've been living in a bunker, we each may be getting micro exposures to Covid as we have gone out in public, or to indoor spaces such as grocery or other stores.  While the viral load may not be enough to make us sick, especially if we have been wearing masks, it may be enough to trigger our bodies to realize a threat, and to begin building an immune response.  This theory may explain why some states that previously were very infected, such as New York, now have lower infection numbers, and why there are a large number of asymptomatic cases.  I'm placing my hopes more in these two theories than in a vaccine, because Coronaviruses are tricky.  That's why we have never been able to develop a vaccine for the common cold.  Of course, even if we are obtaining some native resistance, this no reason to drop our defenses, such as wearing a mask, staying socially distanced, and frequent hand washing, but we can only hope.      

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44 minutes ago, bitob said:

 

All good thoughts .....

But

Dr Fauci (NY TIMES today) -- at best any vaccine will be only 50-60% effective.

Not trying to burst your bubble, but I like to keep it real.

 

And if that is the case, then all of this talk of "wait for the vaccine" is just another distraction.  Vaccine is not the panacea that folks are wanting.

 

The more I read, the more I believe that the only "solution" is what happened with the Spanish and Hong Kong flu.  It will run through the population until such time as herd immunity causes it to die out.  Everything else is merely stretching out the time frame before that happens.  Lockdowns don't "end" the virus, masks don't "end" the virus, social distancing doesn't "end" the virus, and obsessive disinfecting doesn't "end" the virus (though it may have negative effects by fostering more resistant strains of bacteria).  But we are a society obsessed with "solutions", especially governmental ones, so the game goes on and on.

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3 hours ago, FlyerTalker said:

 

And if that is the case, then all of this talk of "wait for the vaccine" is just another distraction.  Vaccine is not the panacea that folks are wanting.

 

The more I read, the more I believe that the only "solution" is what happened with the Spanish and Hong Kong flu.  It will run through the population until such time as herd immunity causes it to die out.  Everything else is merely stretching out the time frame before that happens.  Lockdowns don't "end" the virus, masks don't "end" the virus, social distancing doesn't "end" the virus, and obsessive disinfecting doesn't "end" the virus (though it may have negative effects by fostering more resistant strains of bacteria).  But we are a society obsessed with "solutions", especially governmental ones, so the game goes on and on.

 

I think I agree with you on these points, and no one is proposing a lockdown "ends" the virus, but we certainly used a 'nineteen-teens' equivalent of it as a means to manage the Spanish Flu outbreak in many parts of the country, including mine.  My local county fair famously only closed for the third period this year -- the other two were the Civil War (definite local challenge) and the Spanish Flu, as public gatherings were banned and many businesses closed to help control the spread.

 

Vince

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The purpose of masks, lock-downs, quarantines, and isolation of those who are ill is to manage the rate of increase in the incidence of the disease, and ultimately to decrease the actual number of those infected to a much more manageable level sooner.  It it never meant to completely wipe out the virus from the population.  However,  it is important to decrease the disease incidence, since, regardless of the disease, our medical system manages an epidemic much better (with better survival outcomes) when the incidence is lower.  Also, when the incidence is low enough, various public health measures, including contact tracing, quarantine, isolation, and even vaccinations work so much better.  For example, in the US, with the current incidence (approx 2.4 million/330 million, or 0.73 % confirmed, actual incidence probably much higher by factor of 10-15???), extensive testing, contact tracing (resulting in quarantines and isolations) is basically impractical because we cannot really contact trace and quarantine/isolate, say 10% of the population.  But if the disease incidence is low enough, these measures can be used to drive the incidence down even more.

 

And naturally acquired herd immunity does not work all that well  if the goal is to survive this epidemic with minimal mortality.  And even a fairly ineffective vaccine can augment control of a much less prevalent disease.

 

And with the assumption (based on scientific studies on this and other coronaviruses) that the genome of this virus is fairly unstable, as well as the fact that we are known not to develop long-standing immunity to other coronaviruses (which is responsible for about 25 % of all common cold cases) an idealized herd immunity alone, acquired naturally, may not be the answer.  Also, acquired immunity is not hereditary.

 

So, I don't think anybody knows for sure how long this outbreak will last, with or without a successful vaccine.  As I keep saying, it took decades of vaccination program to decrease the incidence of smallpox and measles to a very manageable level, but we have not eradicated either one of the viruses so far.

Edited by Psoque
fixed the typos
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I often use three simple words when it comes to items we are uncertain about and this is simply "Time Will Tell".

 

Those who I respect and follow in the science community believe if we are lucky a vaccine will be 70 to 75% effective but could be 50 to 55% effective.

 

Some believe even if it is not 100% effective by getting the vaccine should you get the virus the effects might be much less than if you didn't get the virus.  In other words, like influenza they believe there will be some benefits for everyone who gets the vaccine whether or not it works 100% for you.

 

The thought is also between getting people vaccinated and those who already will have had the virus and antibodies that it could potentially slow down and significantly reduce the virus.  In those cases where the virus can't go from one person to the other because of the combination of those who are vaccinated or have had the virus they hope this will be the start of its downfall.

 

Some say the virus will be with us for a few years.  Some say longer.  Hopefully between the vaccination, those who already have the antibodies from the virus and the ability to develop and/or use existing medicine to deal with side effects and with the use of stronger cleaning products and overall better prevention by all of us (eg, washing hands often and thoroughly would be beneficial for everyone all the time anyway) we will be in a better situation sometime in the future.  

 

Exactly when this happens, which vaccinations will be ready for primetime, whether one or more will be needed, how long the antibodies will last, whether or not the virus mutates, and a few other related items are not 100% certain so scientists can only speculate and this is why I say time will tell.

 

There is another saying which I follow from-time-to-time including wondering how rough the seas will be which applies to the virus IMHO.  Prepared for the worst.  Hope for the best.

 

I do believe the future is bright but we will have some bumps in the road to contend with and it will be a very challenging time for many businesses for the next 12 to 24 months.  However, with challenges brings opportunities and this gives me optimism.

 

Keith

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This particular coronavirus has been mutating, and that’s why we can tell the path in which different sub-strains have traveled.  It’s not whether this virus can mutate or not.  We know that it can, and it has.  What we don’t know (among many things) is how does the instability of its genome play out in how we can/cannot acquire useful immunity against it, and also if we have to keep changing the vaccine (like we do with influenza vaccine) annually, or more frequently.

 

Edited by Psoque
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FWIW, I was at my local CVS this morning. The 2020 regular flu vaccines are now available. The high-dose vaccines, recommended for those over 65, will be available starting next week. We will be among the first in line next week.

 

Rob

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On 8/8/2020 at 11:29 AM, FlyerTalker said:

 

And if that is the case, then all of this talk of "wait for the vaccine" is just another distraction.  Vaccine is not the panacea that folks are wanting.

 

The more I read, the more I believe that the only "solution" is what happened with the Spanish and Hong Kong flu.  It will run through the population until such time as herd immunity causes it to die out.  Everything else is merely stretching out the time frame before that happens.  Lockdowns don't "end" the virus, masks don't "end" the virus, social distancing doesn't "end" the virus, and obsessive disinfecting doesn't "end" the virus (though it may have negative effects by fostering more resistant strains of bacteria).  But we are a society obsessed with "solutions", especially governmental ones, so the game goes on and on.

 

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1 hour ago, ryndam said:

FWIW, I was at my local CVS this morning. The 2020 regular flu vaccines are now available. The high-dose vaccines, recommended for those over 65, will be available starting next week. We will be among the first in line next week.

 

Rob

I think the CDC is recommending not getting the vaccine right now.  I think immunity tends to wear off a bit and the best protection as I recall is to get the shot about September or October.

 

 

When should I get vaccinated?

You should get a flu vaccine before flu viruses begins spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.

Getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults.

Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

Roy

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Masks, shutdowns, and social distancing, along with quarantine of affected people can be used effectively to end the virus. The virus needs a host to survive, and If it can’t get to a host then it’s lifespan is limited and it will die. Unfortunately there is now so much virus out there in many communities, and so many people acting in such a way that the are willing hosts we have lost our opportunity to eradicate it in our country in the short term. And not having an effective and extensive national testing program that identifies nonsymptomatic individuals  contributes to the problem even more.

Herd immunity can offer some hope, assuming a significant number of infected individuals acquire immunity that is lasting, and a large portion of the population receives vaccinations that provide some immunity. Any effort that makes the virus unable to acquire a host will add to the eradication of the virus. Of course our ultimate safety will depend on this happening worldwide. 

 

 

 

 

 

 

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21 minutes ago, rafinmd said:

I think the CDC is recommending not getting the vaccine right now.  I think immunity tends to wear off a bit and the best protection as I recall is to get the shot about September or October.

 

Roy

 

I have a scheduled check-up appointment with my family practitioner in a couple of weeks. I'll defer to his guidance until then. Thanks, Roy.

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45 minutes ago, ryndam said:

 

I have a scheduled check-up appointment with my family practitioner in a couple of weeks. I'll defer to his guidance until then. Thanks, Roy.

Excellent plan.

 

Roy

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There is sooooo much contradictory Information out there that I believe NOTHING from any side.  Case in point:  The state of MD classifies positivity different than JHU.  In one case (the state site) MD is below the 5% positivity rate, in the other (JHU) they are not and this comes down to how and how often they classify the testing.  Also, hospitals are reimbursed more if they classify the cause of death as CV 19.  My son’s best friends grandpa who was in hospice for stage4 cancer and given 2 weeks to live, after being in a nursing home, died of “covid”.  He did not die of covid, he was going to die and had covid when he passed.  By classifing is as CV 19 the hospital got paid more.

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Our doctor has always told us October at the earliest for the flu shot.

We live in a warm climate so that may be why.

There are signs everywhere at pharmacies offering flu shots now.

 

We are taking nothing for granted during these chaotic times.  We will check with him this year to see if his recommendation has changed.

 

Only your doctor can tell you when it is appropriate to get a flu shot.  PLEASE don't take medical advice from Cruise Critic.

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On 8/8/2020 at 11:37 AM, bitob said:

 

All good thoughts .....

But

Dr Fauci (NY TIMES today) -- at best any vaccine will be only 50-60% effective.

Not trying to burst your bubble, but I like to keep it real.

He said he has no idea how effective a New vaccine will be but felt 70% would be a good outcome but even 50 to 60% would Be acceptable and receive FDA approval.

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I (used to) travel for a living, and my doctor always said my travel schedule was a lot more important to determine when I got the flu shot than any worry that it would wear off too soon.  
 

He said ideally you would get the shot about a month before you knew you were going to catch the flu, but lacking the ability to plan for catching it, because the protection slowly declines, anytime after mid-August would normally cover the whole season.  Whether I had 40% vs. 48% effectiveness by March 1st, for example, isn’t going to make a huge difference among all the variables of flu shot protection.  To @bitob’s point though, I was in my late 30’s when he said that though, and everyone’s medical conditions vary — your doctor’s advice should always prevail.

 

Im getting my shot next week.  My health insurance situation is unknown after the end of the month so I’d like to get it in now.

 

Vince

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Last year Anne Marie and I got the Vaccine in August and most everyone told us to get it later.  We did survive though.  LOL.  This year though I think we'll do it in September.  If stores are busy then we will just get it at our doctors office even if we have to pay for an office visit.  

 

This is from the CDC Website:

 

When should I get vaccinated?

You should get a flu vaccine before flu viruses begins spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.

Getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults.

Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

 

Keith

 

 

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While it doesn’t mean it will happen for the US I thought it was interesting to see what we’ve experienced here in Australia during our Flu season, remembering its winter moving onto Spring here now 

 

There has been an increase in those getting vaccinated and increased hygiene practice with remarkable results - number of cases well down and no deaths from the flu since April

 

Lets hope these results are mirrored during the Northern Hemisphere flu season 

 

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Edited by Stickman1990
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I usually recommend most of my patients to get the annual influenza vaccine between mid August and mid September, with an assumption that the disease season could start as early as mid October.  There’s no good epidemiological study to say that there is a benefit in waiting until October/November to receive the vaccine.  The scientific studies that show waning immunity later in the season are there, but these studies never showed that the waning of immunity (as it was measured in the studies) lead to reduced protection. 

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1 hour ago, Psoque said:

I usually recommend most of my patients to get the annual influenza vaccine between mid August and mid September, with an assumption that the disease season could start as early as mid October.  There’s no good epidemiological study to say that there is a benefit in waiting until October/November to receive the vaccine.  The scientific studies that show waning immunity later in the season are there, but these studies never showed that the waning of immunity (as it was measured in the studies) lead to reduced protection. 

Well that is interesting to hear although this is contrary to the feedback when I got mine in August of last year and mentioned it on this board a lot of people including some in medicine said too early.  At the time I referred to the CDC website which said what I posted earlier which was not to get it so early.  It might only be a month but logic tells me to wait till later in September rather than get it now as I did last year.

 

Either way this year I will get it at our doctors office.  I just feel extra precautions are taken when we enter the facility.


Of bigger concern to me is when the COVID-19 vaccine is available and after it goes to first responders and others based on priority how it will be rolled out in a manner where there won't be chaos.  This too I am hoping I can get with a scheduled appointment at the doctor rather than waiting on a line.  And if two vaccines are needed and within a specified time I hope it is handled better than when the updated shingles vaccine came out a few years ago.  Back then I got it about a month after it rolled out so my wife and I had no trouble getting the first and second vaccine but I remember some people got the first and couldn't get the second within the required time frame.  Thankfully, many places dispensing this learned a lesson which was if you get the first one to be sure they prioritize you for the second one within the required time frame.

 

Keith

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