COVID TESTS for B2B

[Prometheus1]

While it remains to be seen what the protocols will be actually be (since they are subject to change) when cruising starts in the US,  my question pertains to Back to Back cruises whether on the same line or a 2 different cruise lines. If we are suppose to get a COVID test 3-5 days before our cruise, how would this work if we are already on a cruise. Will we be able to buy a COVID test on the ship?  I know many including myself have B2B cruises booked. May not be an issue if you are on the same ship /same cruise line but what if you are getting off  one cruise line and getting on a different cruise line?  Bare with me, I tried to find info on this.  I also realize things may change, this B2B isnt until May 2021 but I have read others have B2B's much sooner

[ColeThornton]

1 hour ago, Prometheus1 said:

Bare with me, I tried to find info on this

 

No thanks, I'll keep my clothes on.  🙂   And, like you said in your first sentence, no one knows what the protocols will be.

Edited October 28, 2020 by ColeThornton

[mom says]

No one knows yet.  Firm, approved,  procedures and policies have yet to be publicly provided by any of the US based lines. However, I believe the lines currently operating in Europe have a policy specifically denying the booking of B2Bs. Just because you have them booked now does not prevent the lines from cancelling one of them in the future. 

[CruiserBruce]

Agree...no policies have been announced, so who can know?

 

The cruise lines that are sailing are testing at the gangway, not 2 or 3 days in advance. Its Hawaii that currently requires a test inside of 72 hours for FLYING in.

 

For a B2B on the same ship, it wouldn't seem outlandish to test again at the gangway before the second cruise. On different ships, I would expect you would be REQUIRED to test before boarding the second ship. Seems reasonable and common sense.

[Essiesmom]

On a B2B, might it be reasonable for the medical center onboard test you the night before?  Or morning of....?  EM

[sanger727]

I think it’s way too soon to even consider this. 1. MSC is doing rapid testing at embarkation and I personally think there’s a good chance of that happening when US cruises restart, 2. There are cruise lines making a policy of denying b2b so that’s always a possibility to that you won’t be on a b2b. 
 

the unfortunate side effect of being booked on a cruise right now is not to know what the policies will be yet.

[taglovestocruise]

1 hour ago, mom says said:

No one knows yet.  Firm, approved,  procedures and policies have yet to be publicly provided by any of the US based lines. However, I believe the lines currently operating in Europe have a policy specifically denying the booking of B2Bs. Just because you have them booked now does not prevent the lines from cancelling one of them in the future. 

It would be a PIA dealing with changing flights and hotel bookings if things were changed only a month or so before a B2B cruise. 

[njhorseman]

3 hours ago, CruiserBruce said:

Agree...no policies have been announced, so who can know?

 

The cruise lines that are sailing are testing at the gangway, not 2 or 3 days in advance. Its Hawaii that currently requires a test inside of 72 hours for FLYING in.

 

For a B2B on the same ship, it wouldn't seem outlandish to test again at the gangway before the second cruise. On different ships, I would expect you would be REQUIRED to test before boarding the second ship. Seems reasonable and common sense.

Pre embarkation day testing is likely to be part of US rules. The Healthy Sail Panel recommendations developed by NCL and Royal Caribbean, subsequently adopted by CLIA and likely to be the foundation document for CDC rules state that passengers should be tested between 5 days and 24 hours prior to boarding:

https://www.royalcaribbean.com/content/dam/royal/resources/pdf/healthy-sail-panel-full-recommendations.pdf

 

"Testing for Guests Recommendation 4: All guests joining a ship, regardless of method of travel to the ship, should be tested for SARS-CoV-2 between 5 days and 24 hours before boarding and receive a negative result that is shared with the cruise operator, before coming on board."

Edited October 28, 2020 by njhorseman

[njhorseman]

3 hours ago, mom says said:

However, I believe the lines currently operating in Europe have a policy specifically denying the booking of B2Bs

Costa apparently is or was allowing B2B bookings per this article about some passengers, including a B2B passenger, who tested positive for COVID-19:

https://www.cruisecritic.com/news/5666/

 

"Port stops were made as usual in Civitavecchia and Naples. On October 14, another case was developed becuase of contact tracing. The passenger was a "back to back" guest, who had been travelling on the first cruise. He disembarked in Naples and the ship was cleared by the Italian health authorities to resume."

[CruiserBruce]

22 minutes ago, njhorseman said:

Pre embarkation day testing is likely to be part of US rules. The Healthy Sail Panel recommendations developed by NCL and Royal Caribbean, subsequently adopted by CLIA and likely to be the foundation document for CDC rules state that passengers should be tested between 5 days and 24 hours prior to boarding:

https://www.royalcaribbean.com/content/dam/royal/resources/pdf/healthy-sail-panel-full-recommendations.pdf

 

"Testing for Guests Recommendation 4: All guests joining a ship, regardless of method of travel to the ship, should be tested for SARS-CoV-2 between 5 days and 24 hours before boarding and receive a negative result that is shared with the cruise operator, before coming on board."

"Likely to be part" is not anything final, and as CDC has not issued any rules yet, hard to say what the resolution will be. For the reasons or problems brought up by the OP, advance testing may not work, but I can see the reason cruise lines would push it...they put the cost on the cruiser, unlike the at gangway testing MSC is doing. Rapid results testing is becoming highly accurate (98-99% accurate for the NAAT tests Hawaii requires), so testing at the gangway can definitely work.

[njhorseman]

14 minutes ago, CruiserBruce said:

"Likely to be part" is not anything final, and as CDC has not issued any rules yet, hard to say what the resolution will be. For the reasons or problems brought up by the OP, advance testing may not work, but I can see the reason cruise lines would push it...they put the cost on the cruiser, unlike the at gangway testing MSC is doing. Rapid results testing is becoming highly accurate (98-99% accurate for the NAAT tests Hawaii requires), so testing at the gangway can definitely work.

Hawaii requires the NAAT test to be taken within 72 hours before the passenger's flight departs in order to avoid quarantine upon arrival. Rapid testing upon arrival in Hawaii is not being done.

 

As for B2B passengers, if retesting is required before the second leg I think it's quite possible that the cruise line will do it .

 

https://hidot.hawaii.gov/coronavirus/

 

"The pre-travel testing program for COVID-19 will start Oct. 15, 2020. Pre-travel testing enables travelers to avoid a mandatory 14-day quarantine if they are tested within 72 hours before their flight to Hawaii departs with an FDA-approved nucleic acid amplification test (NAAT) and can show proof of a negative test result. The State of Hawaii will ONLY accept test results from TRUSTED TESTING AND TRAVEL PARTNERS. Please see list at https://hawaiicovid19.com/travel-partners/  Travelers also will have their temperatures checked upon arrival and must fill out the Safe Travels travel and health form. Upon arrival in Hawaii, passengers unable to provide proof of an approved negative test will be required to go into quarantine for 14 days or until they can provide proof of negative test results. For more information and an FAQ please visit https://hawaiicovid19.com/travel/"

Edited October 28, 2020 by njhorseman

[Tapi]

3 hours ago, mom says said:

However, I believe the lines currently operating in Europe have a policy specifically denying the booking of B2Bs.

MSC is currently selling back to back cruises in the Caribbean. I do hope that they don’t ban B2B’s because I’m currently booked on one for Feb 2021. 

[CruiserBruce]

7 minutes ago, njhorseman said:

Hawaii requires the NAAT test to be taken within 72 hours before the passenger's flight departs in order to avoid quarantine upon arrival. Rapid testing upon arrival in Hawaii is not being done.

 

 

Actually, the Big Island is doing a second, rapid,  test upon landing. They did have a number of false positives in the first few days...about 15. A third PCR test was then done...only one actually turned out to be positive. Since, the number of false positives seems to have almost ended totally. I am monitoring closely, as we plan to go to Maui in December.

[njhorseman]

16 minutes ago, CruiserBruce said:

Actually, the Big Island is doing a second, rapid,  test upon landing. They did have a number of false positives in the first few days...about 15. A third PCR test was then done...only one actually turned out to be positive. Since, the number of false positives seems to have almost ended totally. I am monitoring closely, as we plan to go to Maui in December.

The point is that everyone arriving in the state has to have a negative pre-flight test, so Hawaii's rules don't serve as a road map for how cruise lines could avoid pre embarkation day testing. The Big Island is just adding an additional test requirement.

 

You also made a statement about the accuracy of rapid tests. That assertion is not supported by the results on the Big Island...in fact  their experience shows anything but that. Of  the 15 arriving passengers testing positive when administered the rapid test, only one was confirmed as positive by a subsequent PCR test.

 

https://www.hawaiitribune-herald.com/2020/10/23/hawaii-news/almost-4000-tested-after-arriving-on-the-big-island/

 

"Between Oct. 15 and Wednesday, Kim said, 3,891 travelers took the second test at Big Island airports, 407 of whom did so in Hilo.

Kim said people 15 tested positive on the rapid-response test administered at the airports. Of those 15, only one tested positive again on a follow-up polymerase chain reaction test, or PCR test."

 

 

Edited October 29, 2020 by njhorseman

[CruiserBruce]

1 hour ago, njhorseman said:

The point is that everyone arriving in the state has to have a negative pre-flight test, so Hawaii's rules don't serve as a road map for how cruise lines could avoid pre embarkation day testing. The Big Island is just adding an additional test requirement.

 

You also made a statement about the accuracy of rapid tests. That assertion is not supported by the results on the Big Island...in fact  their experience shows anything but that. Of  the 15 arriving passengers testing positive when administered the rapid test, only one was confirmed as positive by a subsequent PCR test.

 

https://www.hawaiitribune-herald.com/2020/10/23/hawaii-news/almost-4000-tested-after-arriving-on-the-big-island/

 

"Between Oct. 15 and Wednesday, Kim said, 3,891 travelers took the second test at Big Island airports, 407 of whom did so in Hilo.

Kim said people 15 tested positive on the rapid-response test administered at the airports. Of those 15, only one tested positive again on a follow-up polymerase chain reaction test, or PCR test."

 

 

Huh...didn't I give the exact same "15 positives in secondary tests, only one actual positive" stat? 

 

14 false positives (one actual positive)  out of 4300 tests is an incredibly accurate test, both on the false side, and the positive side, assuming the vast majority of those people were negative before they got on the airplane. The rapid NAAT test is the one I am, and was referring to, in term of of it's accuracy.

 

And, no, Hawaii CAN NOT require a pre-flight test. That would require federal requirement, and the feds refused. If you don't come in with a negative test, plan on a 14 day quarantine. The state, nor the airlines, can require a negative test before you get on the plane. 

[njhorseman]

1 hour ago, CruiserBruce said:

Huh...didn't I give the exact same "15 positives in secondary tests, only one actual positive" stat? 

 

14 false positives (one actual positive)  out of 4300 tests is an incredibly accurate test, both on the false side, and the positive side, assuming the vast majority of those people were negative before they got on the airplane. The rapid NAAT test is the one I am, and was referring to, in term of of it's accuracy.

 

And, no, Hawaii CAN NOT require a pre-flight test. That would require federal requirement, and the feds refused. If you don't come in with a negative test, plan on a 14 day quarantine. The state, nor the airlines, can require a negative test before you get on the plane. 

You clearly don't understand the statistics.

14 of 15 positive tests results were later proven to be wrong . That is a horrible failure...over 90% of the positive tests were false. 

 I suspect you're also incorrectly assuming that all the negative tests were accurate. In fact you don't know that. Those people with negative test results are not retested so you have no idea what percentage of the negative tests were false negatives.

I'm fully aware of the fact that you have to quarantine for 14 days if you arrive without a negative test result in hand. That effectively assures that almost everyone arriving in Hawaii will have the negative test in hand, making it nearly as good as a pre-flight test mandate. And since we're discussing cruising here...how does that approach help  cruise lines construct their testing protocol? It doesn't. Passengers arriving for a cruise don't have the "luxury" of going through a 14 day quarantine in lieu of having a negative test result.

[2wheelin]

1 hour ago, njhorseman said:

You clearly don't understand the statistics.

14 of 15 positive tests results were later proven to be wrong . That is a horrible failure...over 90% of the positive tests were false. 

 I suspect you're also incorrectly assuming that all the negative tests were accurate. In fact you don't know that. Those people with negative test results are not retested so you have no idea what percentage of the negative tests were false negatives.

I'm fully aware of the fact that you have to quarantine for 14 days if you arrive without a negative test result in hand. That effectively assures that almost everyone arriving in Hawaii will have the negative test in hand, making it nearly as good as a pre-flight test mandate. And since we're discussing cruising here...how does that approach help  cruise lines construct their testing protocol? It doesn't. Passengers arriving for a cruise don't have the "luxury" of going through a 14 day quarantine in lieu of having a negative test result.

I believe you don’t understand statistics. 14 false positive out of 4300 total tests is 0.3%

If there was one false positive out of 1000 tests you can’t say that one out of one is 100% failure!

[sanger727]

11 hours ago, Tapi said:

MSC is currently selling back to back cruises in the Caribbean. I do hope that they don’t ban B2B’s because I’m currently booked on one for Feb 2021. 

 

Well, haven't they also been selling Caribbean cruises that they ended up cancelling? At this point I don't think anyone, including MSC knows right now if you will A. Be on a caribbean cruise in Feb or B. Be on a B2b caribbean cruise in Feb.

[Tapi]

1 hour ago, sanger727 said:

 

Well, haven't they also been selling Caribbean cruises that they ended up cancelling? At this point I don't think anyone, including MSC knows right now if you will A. Be on a caribbean cruise in Feb or B. Be on a B2b caribbean cruise in Feb.

Very true. I’m not holding my breath for it to happen, but still optimistic that, if any ships are sailing in February, mine will be one of the few, since it’s a short cruise, out of Port Canaveral, and on a cruise line that has been operating post pandemic for months now. Still, it’s far from guaranteed. 

Edited October 29, 2020 by Tapi

[CruiserBruce]

8 hours ago, 2wheelin said:

I believe you don’t understand statistics. 14 false positive out of 4300 total tests is 0.3%

If there was one false positive out of 1000 tests you can’t say that one out of one is 100% failure!

Thank you!!!

 

The point of my post is that at the gangway tests can work fine, if the better quality tests are used.

[njhorseman]

10 hours ago, 2wheelin said:

I believe you don’t understand statistics. 14 false positive out of 4300 total tests is 0.3%

If there was one false positive out of 1000 tests you can’t say that one out of one is 100% failure!

OK...I don't want to belabor the argument, but I'm a mathematician and retired actuary and understand statistics.

 

There's a real misunderstanding of the meaning of medical testing accuracy because it's a complicated subject that can be difficult for the average person to digest. Press reports on the topic feed the misunderstanding because the persons writing the frequently over-simplified reports often don't know much, if anything more, about the subject of their writing than the audience reading the report. 

 

Rather than going through a long-winded explanation here if you're interested in learning more about this topic try reading this article:  https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/understanding-medical-tests-sensitivity-specificity-and-positive-predictive-value/ . Hopefully it will help you understand the complexity of the issue. 

Edited October 29, 2020 by njhorseman

[donaldsc]

21 hours ago, Prometheus1 said:

While it remains to be seen what the protocols will be actually be (since they are subject to change) when cruising starts in the US,  my question pertains to Back to Back cruises whether on the same line or a 2 different cruise lines. If we are suppose to get a COVID test 3-5 days before our cruise, how would this work if we are already on a cruise. Will we be able to buy a COVID test on the ship?  I know many including myself have B2B cruises booked. May not be an issue if you are on the same ship /same cruise line but what if you are getting off  one cruise line and getting on a different cruise line?  Bare with me, I tried to find info on this.  I also realize things may change, this B2B isnt until May 2021 but I have read others have B2B's much sooner

 

If you are on 2 different cruise lines, it is not a B2B so I can almost guarantee that you will have to be retested.  If you are on 2 different ships w the same line, I would also suspect that it will be considered 2 separate cruises.  Now if the cruise was a true B2B, you might get away w/o being retested.  Who knows on that one?

 

DON

[ldubs]

17 hours ago, 2wheelin said:

I believe you don’t understand statistics. 14 false positive out of 4300 total tests is 0.3%

If there was one false positive out of 1000 tests you can’t say that one out of one is 100% failure!

 

Ahhh, I'm not going to agree with your "stats" on this one.   The point that is being made is about how many positive results are truly positives.   And, this ignores how many of the negative findings are false negatives, which the experts say are much more likely.     

[2wheelin]

7 hours ago, njhorseman said:

OK...I don't want to belabor the argument, but I'm a mathematician and retired actuary and understand statistics.

 

There's a real misunderstanding of the meaning of medical testing accuracy because it's a complicated subject that can be difficult for the average person to digest. Press reports on the topic feed the misunderstanding because the persons writing the frequently over-simplified reports often don't know much, if anything more, about the subject of their writing than the audience reading the report. 

 

Rather than going through a long-winded explanation here if you're interested in learning more about this topic try reading this article:  https://www.healthnewsreview.org/toolkit/tips-for-understanding-studies/understanding-medical-tests-sensitivity-specificity-and-positive-predictive-value/ . Hopefully it will help you understand the complexity of the issue. 

Then I guess you are one of the statisticians who make the numbers appear to agree with their argument. To calculate the validity of a test, you do not just take one set of results and calculate the percent of error in that subset (positives). You need to calculate the number of errors in the whole test group. I am a laboratory statistician.

[njhorseman]

23 minutes ago, 2wheelin said:

Then I guess you are one of the statisticians who make the numbers appear to agree with their argument. To calculate the validity of a test, you do not just take one set of results and calculate the percent of error in that subset (positives). You need to calculate the number of errors in the whole test group. I am a laboratory statistician.

I think if you look back at the thread you'll see my statement was made in response to CruiserBruce's statement

"Rapid results testing is becoming highly accurate (98-99%)" . That is at odds with what I've seen, but more importantly the word "accuracy" really got the hair on the back of my neck up, as "accuracy" as I believe he's implicitly defined  it is not particularly meaningful as the article I've cited notes. So, yes...I fired back the 14 false positives out of 15 total positives and also noted that we also have no idea what their false negative rate is...something that is an important component of the measurement .

I'm not an idiot...I know you can't draw any firm conclusions from an initial small batch of tests, but neither should CruiserBruce go unchallenged about what he said.