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APPROPRIATE ACTIONS OR EXTREME MEASURES?


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1 minute ago, D C said:

Unfortunately, the number of false positives is greatly downplayed despite some very public instances recently.  In the general public, a positive is assumed a positive.  If the test was actually a false positive, it simply makes the patient an "asymptomatic" positive.  There is no consideration that they were falsely positive.

yea, what you said!

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20 minutes ago, D C said:

Unfortunately, the number of false positives is greatly downplayed despite some very public instances recently.  In the general public, a positive is assumed a positive.  If the test was actually a false positive, it simply makes the patient an "asymptomatic" positive.  There is no consideration that they were falsely positive.

 

SO true!!!!   

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There is a big time # of false positives. This is suppressed, by many, for of course, many very obvious reasons.  I remember Jimmy Johnson the NASCAR driver in July I think, having a positive test, then tested negative 3 x in a row. A more higher profile example of the false positive which in his case, would have resulted in him being denied boarding on a cruise ship.  Really?

 

I know 2 other people who have had false positives and it caused them significant grief. 

 

Just like the 2nd wave is false - increasing numbers is significantly related to increased testing in many jurisdictions.

 

Just spend an hr on the phone with my Dad's cardiologist - yep, she not impressed with the use of the word "2nd wave". It is not accurate and is inappropriately used by politicians and others.

 

 

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15 minutes ago, ABoatNerd said:

There is a big time # of false positives. This is suppressed, by many, for of course, many very obvious reasons.  I remember Jimmy Johnson the NASCAR driver in July I think, having a positive test, then tested negative 3 x in a row. A more higher profile example of the false positive which in his case, would have resulted in him being denied boarding on a cruise ship.  Really?

 

 

And that's the scary thing about pre-cruise testing.  A false positive and your vacation is ruined as there's little hope of getting a pair of negative results on tests taken 24 hours apart (CDC's rule for getting an all-clear) within that ~5 day pre-cruise window. 

 

 

And conversely, the tests are known to have a significant false-negative rate, so they may well be keeping healthy people off the ship while allowing sick to pass.  

Edited by D C
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25 minutes ago, ABoatNerd said:

There is a big time # of false positives. This is suppressed, by many, for of course, many very obvious reasons.  I remember Jimmy Johnson the NASCAR driver in July I think, having a positive test, then tested negative 3 x in a row. A more higher profile example of the false positive which in his case, would have resulted in him being denied boarding on a cruise ship.  Really?

 

I know 2 other people who have had false positives and it caused them significant grief. 

 

Just like the 2nd wave is false - increasing numbers is significantly related to increased testing in many jurisdictions.

 

Just spend an hr on the phone with my Dad's cardiologist - yep, she not impressed with the use of the word "2nd wave". It is not accurate and is inappropriately used by politicians and others.

 

 

 

Interesting post.  I have been to two different doctor's offices in the last 2 weeks and while the office staff does have masks on...at least at first I have found on both occasions that the doctor is either no longer wearing a mask or has it down around his chin.  This is a HUGE difference from just a couple of months ago, at the SAME offices.......it seems their fears are much tamped down.  Also did not get the usual questions "have you been near someone sick in the last 2 weeks"  "have you travelled anywhere in the last few weeks"  "have you been sick in the last two weeks"  before they made the appointment for me.  Again, 2 different doctors, totally unrelated to each other.....it seems some in the medical community are not taking things as seriously anymore....

 

Don't flame me, just relaying what happened....

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Have heard of many more false positives than negatives.   I have also read that our tests are too sensitive and you may get a positive but still have too little of the virus to infect others.   Still, I would rather anyone testing positive skip the Cruise.   The airlines are looking to get the quick test in the terminals to prevent positives from boarding.   This will be the new underclass unable to travel.   

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2 minutes ago, Covepointcruiser said:

Have heard of many more false positives than negatives.   I have also read that our tests are too sensitive and you may get a positive but still have too little of the virus to infect others.   Still, I would rather anyone testing positive skip the Cruise.   The airlines are looking to get the quick test in the terminals to prevent positives from boarding.   This will be the new underclass unable to travel.   

Suppose someone tested positive 6-8 weeks prior, had symptoms, saw the symptoms improve, and met every CDC criteria for a return to daily activities, yet they had enough virus present to be detected?   I don't think I'd exclude them from the ship.  We're not testing those people to see how long the virus remains detectable. 

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33 minutes ago, D C said:

Suppose someone tested positive 6-8 weeks prior, had symptoms, saw the symptoms improve, and met every CDC criteria for a return to daily activities, yet they had enough virus present to be detected?   I don't think I'd exclude them from the ship.  We're not testing those people to see how long the virus remains detectable. 

HUH????  They have traces...but let them board the ship?  Come on, in what world?!?  NO

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Folks, the false negatives are a BIG thing. Think about it and don't believe the media.

 

You spend $2,000 to get to Miami, false positive at the dock. What do you do?

 

This happens all the time. There is NO assured testing out there as of September 23, 2020.

 

Be really careful folks.

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6 hours ago, LGW59 said:

HUH????  They have traces...but let them board the ship?  Come on, in what world?!?  NO

Someone who meets every single CDC and/or WHO criteria for falling into the RECOVERED and not contagious category should absolutely be able to board a cruise ship.  Why should they not? 

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1 hour ago, ABoatNerd said:

Folks, the false negatives are a BIG thing. Think about it and don't believe the media.

 

You spend $2,000 to get to Miami, false positive at the dock. What do you do?

 

This happens all the time. There is NO assured testing out there as of September 23, 2020.

 

Be really careful folks.

Do you mean false positive? 

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53 minutes ago, ABoatNerd said:

Indeed, false positives are an issue and not properly addressed.

 

It is hard to address, though, isn't it? Retesting seems the most responsible avenue.

 

No test is 100% accurate, but there are also people who wouldn't believe the reported results even if a test was confirmed by labs to be 100%.

 

Look at how many people think the earth is flat.

 

Or that wearing a mask is part of a plot. Or that they are able to safely drive after a few.

 

 

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23 hours ago, phoenix_dream said:

A lot of speculation not backed up by facts.  How do you know cabin prices will be higher, much less double or more?  They may actually be lower initially to entice people.  How do you know dining will not be as satisfying?  There will be fewer people in the dining room which might actually make the experience more satisfying rather than less!  Getting on and off more "challenging"?  How do you know that?  It may be more staggered, but perhaps depending how they do it, it may very well be smoother with fewer lines and waiting around.  Sounds good to me.  And why is getting there "significantly more challenging"?  Flying may be more risky than driving, if that is what you mean by challenging.  Other than that I'm not sure what is more challenging, much less significantly more challenging.  I guess I'm a glass half full kind of person.  No one knows for sure yet, but some of the points you mention aren't givens at this point in time.  Will cruising be different and not as much fun overall?  Initially I would guess that would be true.  But maybe better than you are expecting.

Really?  Its shear fantasy to think that cruise lines will not recoup monies "lost" during the layups and the monies borrowed to keep "afloat."  Shear fantasy to believe that prices will drop or even be lowered to"entice" people back on board.  Selling off ships they believe will not be viable is one way.  The other is raising prices.  There is not doubt in my global travel experienced mind that prices will increase, and increase significantly. In fact, they already are on the significant increase - try booking a cruise for 2022 and look at the price.  "Dining" in the MDR is already a trying experience - noisy, bad food, poor service, two hours for dinner.  Ugh!  To manage "social distancing" cruise lines have already stated that they will add another seating (or two)...  The "points" mentioned require thinks and understanding of economics, the cruise industry and human interaction.  We will not be going back to the cruising experiences of even a year ago.  Hydroxychloroquine at each meal is not a solution.  "Cruising" will be vastly different and could become a venue for the wealthy retired.  In one way I hope so since we fit that description.  Ships at 50 percent or lower capacity, increased numbers of staff to include medical, all dining venues like specialty restaurants, and yes, even buffets. Much more relaxing and positive than "yesteryear's' cruising.

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5 minutes ago, Ride-The-Waves said:

Really?  Its shear fantasy to think that cruise lines will not recoup monies "lost" during the layups and the monies borrowed to keep "afloat."  Shear fantasy to believe that prices will drop or even be lowered to"entice" people back on board.  Selling off ships they believe will not be viable is one way.  The other is raising prices.  There is not doubt in my global travel experienced mind that prices will increase, and increase significantly. In fact, they already are on the significant increase - try booking a cruise for 2022 and look at the price.  "Dining" in the MDR is already a trying experience - noisy, bad food, poor service, two hours for dinner.  Ugh!  To manage "social distancing" cruise lines have already stated that they will add another seating (or two)...  The "points" mentioned require thinks and understanding of economics, the cruise industry and human interaction.  We will not be going back to the cruising experiences of even a year ago.  Hydroxychloroquine at each meal is not a solution.  "Cruising" will be vastly different and could become a venue for the wealthy retired.  In one way I hope so since we fit that description.  Ships at 50 percent or lower capacity, increased numbers of staff to include medical, all dining venues like specialty restaurants, and yes, even buffets. Much more relaxing and positive than "yesteryear's' cruising.

It is an experienced opinion by phoenix-dream and because it is different from your own self described experienced opinion then you call it shear fantasy.  Yes cruise lines are financially in trouble.  But let's see what happens with the number of people signing up for new cruises when operations resume and once the wave of delayed and Lift and Shift cruises are fulfilled.  If ships are not at capacity, prices will no doubt go down.  Supply and demand.

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19 hours ago, Covepointcruiser said:

Have heard of many more false positives than negatives.   I have also read that our tests are too sensitive and you may get a positive but still have too little of the virus to infect others.   Still, I would rather anyone testing positive skip the Cruise.   The airlines are looking to get the quick test in the terminals to prevent positives from boarding.   This will be the new underclass unable to travel.   

 

Wow. Knowingly & accepting that tests can be false positive and you would rather have people 'skip the cruise'. That's pretty selfish which is a shame. I wish this on nobody. I can't imagine my wife & I flying to Amsterdam, testing a false positive and not being allowed on the ship after dropping $10K.  

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4 minutes ago, Goodtime Cruizin said:

 

Wow. Knowingly & accepting that tests can be false positive and you would rather have people 'skip the cruise'. That's pretty selfish which is a shame. I wish this on nobody. I can't imagine my wife & I flying to Amsterdam, testing a false positive and not being allowed on the ship after dropping $10K.  

 

Absolutely.  Test positive and you aren't going unless you can prove it was a false positive.  That's what insurance is for.   I expect that the cruise lines will be providing such a product like TUI did.

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11 hours ago, mayleeman said:

 

It is hard to address, though, isn't it? Retesting seems the most responsible avenue.

 

No test is 100% accurate, but there are also people who wouldn't believe the reported results even if a test was confirmed by labs to be 100%.

 

Look at how many people think the earth is flat.

 

Or that wearing a mask is part of a plot. Or that they are able to safely drive after a few.

 

 

 

Retesting is definitely the best answer. 

 

The CDC recommendations for antibody testing sheds some light on the thoughts for how testing should be done.

Link below (see "Testing Strategies"), but to summarize:

1) Use a good test

2) Test people who you think were actually sick

3) Orthogonal testing (i.e. test each person more than once).

 

The problem with testing is those pesky statistics.  There are some key parameters of sensitivity and specificity that show whether a test is positive when it should/shouldn't be, negative when it should/shouldn't be and positive predictive value.   I'll simplify things and use a generic "accuracy" in place of those in order to convey the broader issue.

 

So far, according to the John Hopkins site, about 7 million of the 330 million people in the US have so far contracted the virus.  That's 3%.   For simplicity, let's say they're all still sick and will test positive, and let's say we can test a perfect cross section of 100 people. 

 

If I test 100 people, 97 of them will not have the virus and 3 will.   If I have a test that is "90% accurate", I'll have ~10 of those 97 get positive results when they're actually negative.  The 3 that are positive will receive positive results as well.   So I have 13 positive tests when there are only 3 positive people.   3/13 = ~25%  So a positive result only gives a 25% likelihood that you actually are positive.  That's dismal. 

 

Bump the accuracy to 95% and we get 8 positives.  That's still less than 50/50 odds of a positive being real.  

Bump it up to 99% and we have 4 positives.  Pretty decent now.  75% chance that your positive test is real. Sucks if you're the 1 wrong answer though. 

At 99.5% accuracy we're approaching 90%. 

 

On the flipside, at 90% accuracy, a negative test is 90% accurate since there are so few positives out there.   

 

(*this is an oversimplification but the figures are sufficiently close to convey the point)

 

 

 

 

 

Link: https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html

 

 

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On 9/23/2020 at 7:33 AM, K.T.B. said:

 

In answer to your questions:

 

1. Yes. BUT I'd have myself checked out prior to leaving for my cruise to make sure.  As everyone should do nowadays, for your safety and others'.  To not do so would be inconsiderate and possibly dangerous.  (Odds are, though, you'd be fine.)

 

2.  Nope.  Nor could they without your permission.  Because in doing so, that could put you at greater risk.  IF they forced it, I'd want all sorts of assurances that me and my wife would be safe wherever they moved us and that we'd be WELL compensated for the inconvenience.

 

3. They're going to charge double.  Please provide proof (legitimate proof, not hearsay) that this has happened.  Besides, I already only book excursions through the ship when I do take them.

 

4.  As always, I'd book a cruise I could handle financially.  If they increase the prices, so be it.  They're like any other business and have the right to charge what they feel they can get from the consumer.  

 

Finally, if people don't want to wear a mask, then don't cruise.  Don't be selfish.  This isn't about you, it's to make sure everyone is protected.  (Even IF it may not be needed eventually, why take the chance?)

 

Your...

#1 is a given. I'm pretty sure most people will not fly or even drive to a port w/o knowing if they test positive.

#2 is pretty laughable. If they're moving you, it's to protect others, not you.

#3 if you only book through the ship then you just don't know. Ship prices are double, give or take a few dollars in both directions. Fact. 

#4 Meh...pretty uch eveybody's thoughts on this. 

 

Sounds like you MIGHT have a wonderful cruise. Stay safe & cruise on. 

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I wasn't being cold and insensitive.   If the lines accept the recommendation for testing it will be a fact that if you test positive you won't be allowed to sail.   What I was really saying is if the financial impact of this is intolerable you need to have protection such as insurance.

 

I've been researching Covid insurance issues for the last few months after I figured out my annual travel medical coverage won't cover me if I need treatment for Covid while out of the country.  While the trips I have planned in the next year I can absorb cancellation but I'm not willing to risk the financial impact of requiring ICU level care either on a ship or out of the country if I were to be disembarked for medical treatment.   Also an issue is MediJet (and I assume other medical transport companies) won't transport anybody with an infectious disease.  I don't think people looking to resume cruising ASAP have been thinking of these things.

 

Now if this hypothetical false positive happens at the pier then I would assume that would be some sort of rapid test which hopefully could be repeated to verify that it was indeed a false positive.

 

I guess that would also be an incentive to get the test as early in the pre-cruise (5 day?) window as possible to attempt to get a retest in the event of a positive result.   The question you should have of the cruise line is would they accept a second negative test.

 

In my opinion the testing requirement is going to be a requirement of all lines for the foreseeable future and will be used as a gating requirement for boarding.

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There are different types of tests.  The RT-PCR test is highly sensitive and may be subject to false positives (maybe 1-5% range) if it is run at a high number of cycles and it is also most prone to contamination - so not sure if it will be administered properly by employees at departure ports.  So perhaps at least 30 people (or more) might test false positive on a 3000 passenger ship.  Yikes!  A second type of test (antigen test) might be more appropriate for cruise ports and can be done in high throughput machines and might be less subject to cross contamination.  The Ab test will not work in the timeframe for a cruise departure.  This whole testing thing will be problematic for sure.

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My understanding is that the way MSC does their testing (and they have had positive results now, during their pre-boarding testing). Is that they give everyone the rapid test. If you test positive on the rapid test they then give you the PCR (gold standard) test. You are not considered positive and therefore denied boarding until those are both positive. I'm not sure how they get the PCR test results so quickly, I know the test itself can be run in a matter of hours, if you can get first in line in the lab for it to be processed. I don't know what they would do if the rapid test was positive and PCR test was negative. But I would feel confident that if you were positive on two types of tests, it's not a false positive.

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29 minutes ago, TeeRick said:

There are different types of tests.  The RT-PCR test is highly sensitive and may be subject to false positives (maybe 1-5% range) if it is run at a high number of cycles and it is also most prone to contamination - so not sure if it will be administered properly by employees at departure ports.  So perhaps at least 30 people (or more) might test false positive on a 3000 passenger ship.  Yikes!  A second type of test (antigen test) might be more appropriate for cruise ports and can be done in high throughput machines and might be less subject to cross contamination.  The Ab test will not work in the timeframe for a cruise departure.  This whole testing thing will be problematic for sure.

At the 5% "error" or 95% "accurate" level, there will be more like 150 false positives out of 3000 negative people.  If there were also 100 real-positives booked, 5 of them would make it onto the ship (barring any other health screening of course)

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29 minutes ago, sanger727 said:

My understanding is that the way MSC does their testing (and they have had positive results now, during their pre-boarding testing). Is that they give everyone the rapid test. If you test positive on the rapid test they then give you the PCR (gold standard) test. You are not considered positive and therefore denied boarding until those are both positive. I'm not sure how they get the PCR test results so quickly, I know the test itself can be run in a matter of hours, if you can get first in line in the lab for it to be processed. I don't know what they would do if the rapid test was positive and PCR test was negative. But I would feel confident that if you were positive on two types of tests, it's not a false positive.

If the two tests disagree, you really need a tie-breaker to figure out which is right. 

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