so maybe cruise ships are not petri dishes

[Toofarfromthesea]

3 hours ago, chengkp75 said:

I don't think there are too many who are "bummed out" that the tests were inaccurate, but it does worry me, and should worry many, that the tests have proven to be inaccurate.  This reflects on covid testing in general, but also the reliance on these tests to accurately reflect the health of the passengers and crew boarding a ship.

 

I wasn't saying anyone was bummed out because the tests were inaccurate.  I was saying that a lot of folks are very entrenched in their "no cruising until XXX" positions, usually where either XXX is not possible or something that doesn't matter.  And if cruising resumes successfully, as has been the early experience so far, they will be mad that it is happening without their XXX being in place.

[Toofarfromthesea]

38 minutes ago, clo said:

Another exactly. We still have few answers to many questions. I don't think that cruising should restart at this time.

 

And yet it has, with success so far.  Hopefully it will happen here very soon.  And people who don't think it is safe shouldn't go on one.

[clo]

10 minutes ago, Toofarfromthesea said:

 

And yet it has, with success so far.  Hopefully it will happen here very soon.  And people who don't think it is safe shouldn't go on one.

I'm guessing if the CDC allows the no sail order to expire they will issue strict rules for the lines to abide by. And I'd guess it would take several months for all that to be pulled together. Countries will need to not just allow ships to dock but I'm sure there will have to be lots of legal documents executed as to liability(s). And who knows what physical changes to ships to make them compliant. And if vaccinations are going to be required, well, who knows? I'm guessing six to twelve months, the latter if vaccinations are required. But lots of guessing. Maybe we'll actually get some answers in the coming months which should make it easier.

[sanger727]

4 hours ago, SelectSys said:

 

 

This passage from the article caught my eye:

 

"Dr. Robert H. Shmerling, senior faculty editor for Harvard Health Publishing, wrote that the rate of false-negative molecular tests (PCR) ranges from 2% to 37%. But false positives are more rare, and are likely in 5% of cases or less. "

 

If I was designing tests, I would want my false negative rate to be way below my false positive rate.  Gaining a false positive result and retesting seems to be the conservative way to design these tests. 

 

The way the text is written it seems the opposite is true where more false negatives exist and allow spread to continue.

 

The problem with false negatives is people taking the test too early in the incubation period.  And there's not much you can do about that. Think of the flu, most people don't just go around getting flu tests when they feel perfectly healthy as a precaution or because someone they were near had the flu. But we are with COVID. So, you are around your cousin saturday, he gets sick sunday, gets a postive test monday and you freak out and get tested. But you are still very early in the incubation period so your Tuesday test is negative, you figure phew, I'm good. And friday you get sick. 

[clo]

29 minutes ago, sanger727 said:

 

The problem with false negatives is people taking the test too early in the incubation period.  And there's not much you can do about that. Think of the flu, most people don't just go around getting flu tests when they feel perfectly healthy as a precaution or because someone they were near had the flu. But we are with COVID. So, you are around your cousin saturday, he gets sick sunday, gets a postive test monday and you freak out and get tested. But you are still very early in the incubation period so your Tuesday test is negative, you figure phew, I'm good. And friday you get sick. 

Thank you. That puts it in the most basic terms. More and more I'm thinking that testing is almost a waste and especially for cruising.

[SelectSys]

1 hour ago, sanger727 said:

 

The problem with false negatives is people taking the test too early in the incubation period.  And there's not much you can do about that. Think of the flu, most people don't just go around getting flu tests when they feel perfectly healthy as a precaution or because someone they were near had the flu. But we are with COVID. So, you are around your cousin saturday, he gets sick sunday, gets a postive test monday and you freak out and get tested. But you are still very early in the incubation period so your Tuesday test is negative, you figure phew, I'm good. And friday you get sick. 

 

I don't think you understood what I am saying.  False negatives are worse than false positives.  My belief is that tests should be tuned such that false positives are more common than false negatives.  I am not sure if this is possible, but that's what I would do.

 

With COVID most travel is requiring tests even when people don't show symptoms for the problems you state.  These tests obviously help contain the disease.   No system or test is 100% foolproof.  However the more problems you catch up front, the better off you'll be dealing with the limits of your system and the inevitable misses. 

 

Life is all about balancing risks and rewards.  Staying at home hiding isn't an option for most although I understand it if someone is old or has severe underlying health risks.

 

 

 

[capriccio]

According to Axios reporting a few hours ago, the CDC is extending the ban until October 31st.  Axios also reported that the CDC wanted to extend the ban until February 2021 but was overruled by the White House.

 

See this cruise critic thread for links to the two Axios articles: 

 

[sanger727]

10 hours ago, SelectSys said:

 

I don't think you understood what I am saying.  False negatives are worse than false positives.  My belief is that tests should be tuned such that false positives are more common than false negatives.  I am not sure if this is possible, but that's what I would do.

 

With COVID most travel is requiring tests even when people don't show symptoms for the problems you state.  These tests obviously help contain the disease.   No system or test is 100% foolproof.  However the more problems you catch up front, the better off you'll be dealing with the limits of your system and the inevitable misses. 

 

Life is all about balancing risks and rewards.  Staying at home hiding isn't an option for most although I understand it if someone is old or has severe underlying health risks.

 

 

 

 

I understand what you are saying. I'm trying to explain why that is an impossible goal. There is no test that will correctly identify that you have been exposed to the disease within seconds, minutes, hours of exposure. It takes take for the virus to interact with your body, multiple, begin to infect your body, and ultimately get to the point when you are sick, contagious, and shredding the virus. With COVID, this can take up to 14 days. So there's a long lead up period where you have no outward symptoms of virus infection for them to test for. As far as I can tell, how all these tests work is they test some sort of body fluid from you - nasal secretions, salvia, blood, etc. and look for the virus in those. If the virus is still in the very early infections/replicating stage - it's incredibly unlikely that you will have the virus in whatever tiny of body fluid they test. This is when the false negative rate is high. There's nothing they can do to change that. As the virus progress into a full blown infection, the false negative rate decreases but it's much much more likely that they will see the virus indicators in your body fluids. 

[Joebucks]

On 9/28/2020 at 5:06 AM, chengkp75 said:

Cruise ships have never been, nor are they now, petri dishes, any more than any area where large numbers of people congregate.  The problem is that the industry, and the regulators have focused on the most prevalent form of disease at the time.  When the VSP was initiated, this was salmonella, botulism and e-coli.  When the measures of the VSP virtually eliminated these pathogens from the ships, another fecal/oral transmission agent, noro, moved in, and new measures were implemented.  However, the problem today, and this is what epidemiologists (and bio-weapon scientists) always fear is an airborne pathogen, and how difficult it is to control a pathogen once it is airborne.  Sanitation measures can help, but contact transmission of covid is a small percentage, so even the best sanitation won't appreciably control an outbreak.  Masks and distance are the only true methods of controlling an airborne pathogen (anthrax, legionella, measles, whooping cough), short of vaccines, and cruising, just like the rest of the world, will have to adapt to these measures, or go by the wayside.  Crew were not trained to prevent, contain, or remediate airborne pathogens, and so the early incidents on cruise ships ballooned out of control, exacerbated by national health agencies natural desire to quarantine the disease on the ship, but without providing the necessary guidance, training, or assistance to remediate the situation within the quarantine.

 

Very well-said.

 

Cruises are one of the media's favorite industries to tear apart. Any large gathering of people can spread illness. The CDC had an article a few years back that stated .01% of cruisers had contracted noro. As with all of the other fear in the world today, those types of odds aren't anything to change your life over. On top of that, your odds go down even more if you display reasonable caution. 

[SelectSys]

3 hours ago, sanger727 said:

 

I understand what you are saying. I'm trying to explain why that is an impossible goal...

 

Fine we can agree to disagree.  Doing nothing but stayed locked in the basement isn't going to cut it either. 

 

As an example, State of CA just sent a bunch more people to unemployment yesterday by refusing to reopen Disney.   Easy to do when you are on a guaranteed paycheck without consequences.  Tough when one's  life's work is going down the drain.  I have a friend who hasn't been able to make a single dollar in over 6 months in his Disney-related small businesses.  Obviously all his employees are laid off as well - maybe forever!

 

It's that classic difference between depression and recession.  Depression is when I lose my income.  Recession is when you lose out.

 

2 hours ago, Joebucks said:

 

Very well-said.

 

Cruises are one of the media's favorite industries to tear apart. Any large gathering of people can spread illness. The CDC had an article a few years back that stated .01% of cruisers had contracted noro. As with all of the other fear in the world today, those types of odds aren't anything to change your life over. On top of that, your odds go down even more if you display reasonable caution. 

 

So I guess you are against trying and want to stay inside as well and simply ride it out.  I hope you have a guaranteed income to  avoid the consequences of the shutdowns. 

 

Why are countries willing to take on tourists right now?  They need the money and can't simply borrow indefinitely. 

[sanger727]

1 minute ago, SelectSys said:

 

Fine we can agree to disagree.  Doing nothing but stayed locked in the basement isn't going to cut it either. 

 

As an example, State of CA just sent a bunch more people to unemployment yesterday by refusing to reopen Disney.   Easy to do when you are on a guaranteed paycheck without consequences.  Tough when one's  life's work is going down the drain.  I have a friend who hasn't been able to make a single dollar in over 6 months in his Disney-related small businesses.  Obviously all his employees are laid off as well - maybe forever!

 

It's that classic difference between depression and recession.  Depression is when I lose my income.  Recession is when you lose out.

 

 

 

 

Huh?? what does that have anything to do with what I said. I said nothing about staying locked in a basement or closing businesses. In fact, I don't know of any businesses in the US that are currently using COVID testing as a preventative measure to stay open, re-open, or employ people.  The reality of the situation is that covid testing will never be "the answer". It will be a strategy, that employed with other strategies, like a vaccine, like mask wearing, like social distancing, will hopefully get us back to a relative normal within the next year. 

[SelectSys]

15 minutes ago, sanger727 said:

 

Huh?? what does that have anything to do with what I said. I said nothing about staying locked in a basement or closing businesses. In fact, I don't know of any businesses in the US that are currently using COVID testing as a preventative measure to stay open, re-open, or employ people.  

 

 

huh?? You are talking about keeping cruising closed as testing is impossible with the end result that the vast majority of their US-based employees - mostly low income - out of work.   This says nothing about the impacts on related business which are also closed because they support the cruise industry like my friend at Disneyland.  

 

Note the cruise lines are proposing exactly what you state.  Use testing as a part of an overall process.  HI is also using testing to open the state to tourist travel as well.  Businesses are helping to implement the policy.

 

Edited September 30, 2020 by SelectSys

[sanger727]

2 hours ago, SelectSys said:

 

 

huh?? You are talking about keeping cruising closed as testing is impossible with the end result that the vast majority of their US-based employees - mostly low income - out of work.   This says nothing about the impacts on related business which are also closed because they support the cruise industry like my friend at Disneyland.  

 

Note the cruise lines are proposing exactly what you state.  Use testing as a part of an overall process.  HI is also using testing to open the state to tourist travel as well.  Businesses are helping to implement the policy.

 

 

I said nothing about keeping cruising closed. and did not saying testing is impossible. I said that a test with a very low false negative rate is impossible. Because we are including people who get tested too early in the incubation period. Those are facts.  I made no conclusions linking that to cruising or re-opening. I was just responding to your post about them needing to create a test with a low false negative rate and me explaining the challenges in that.

 

https://www.sciencedaily.com/releases/2020/06/200610094112.htm

 

In a new study, Johns Hopkins researchers found that testing people for SARS-CoV-2 -- the virus that causes COVID-19 -- too early in the course of infection is likely to result in a false negative test, even though they may eventually test positive for the virus.

[SelectSys]

49 minutes ago, sanger727 said:

 

I said nothing about keeping cruising closed. and did not saying testing is impossible. I said that a test with a very low false negative rate is impossible. Because we are including people who get tested too early in the incubation period. Those are facts.  I made no conclusions linking that to cruising or re-opening. I was just responding to your post about them needing to create a test with a low false negative rate and me explaining the challenges in that.

 

 

OK - I understand your point.  A test will always have a limit in terms of sensitivity.  I understand there will always be a level of infection at the onset of a disease that is likely to not be detected. 

 

My perspective remains that it is better to design tests that are more forgiving of false positives than false negatives.  This means that more patients at any given level of infection would be picked up by the more sensitive test as compared against a less sensitive test - even at the expense of more false positives.   Retesting more patients seems a better tradeoff than living with a less sensitive test that lets more people slip through - again at any level of infection above the absolute floor of the test sensitivity.