JeffB

Correction: In my post above I incorrectly sequenced how the USCA will review the defendant's appeal. The first step is to review the request for a stay of the injunction pending a review of the appeal. Reverse those two steps. The motion for a stay gets reviewed first The CDC's basis of the motion for a stay is that things are going along smoothly with regards to the cruise lines restarting in compliance with the CSO, i.e., the cruise lines operations make the case for the CSO. The CDC bolsters this claim with their continued claim that cruise ships are inherently riskier, wrt disease transmission, than other forms of public conveyance. The emerging facts don't bear that claim out. Other than those stubborn facts that keep arising and causing the CDC's lawyers problems, there is nothing fundamentally wrong with this basis or documentation that bolsters it. Where there is another obvious problem is the restrictions on full cruise ship operations both in the past (the FL lawsuit notes that harm was done to the state and Meryyday concurred) and going forward. These will continue under the CSO with the attendant loss of revenue to FL unless that document is enjoined according to Merryday's ruling. More precisely, if the cruise lines had been able to restart almost 6 months ago under the guidelines of the Healthy Sail Panel - which have very obviously worked outside the US - none of the economically costly cold and warm storage of cruise ships would have happened. None of the staggering global impact on the economic engine that the cruise line industry is would have happened. A more robust and less expensive, less complicated cruise ship restart under the Healthy Sail Plan alone, without the CDC riding herd, would have occurred. More cruises from FL, the more the tax revenue. More cruise ships that restart the quicker the cruise lines reverse the global economic and unemployment nightmare created by the CDC's unnecessary and unlawful NSO and subsequently the CDC's CSO. A stay continues that unfair and costly happenstance until the appeal is reviewed and acted upon. My previous argument that the CDC's appeal is weak and will fail on it's own makes a successful appeal on review by the USCA unlikely. For heavens sake, don't grant a stay to prolong this craziness.

Certainly your guess is as good as mine. But I don't think the stay will be granted. Remember, this is not a re-trial. The defendant moves for an appeal in the district USCA (step one). They submit documents supporting the request for the stay to the court (step 2) Either the entire court or a single judge can review the material and make a decision sequentially on both steps. Based on what I know of that submission, I've already argued it is a weak appeal (step one). On that basis alone and if I'm correct about the strength of the appeal, the USCA will defer to Judge Merryday's ruling and not entertain step 2. While the defendant can submit documents and testimony to support a stay, I don't think the USCA can move ahead to consider that if the Judge(s) rule that the grounds for an appeal that I listed in my previous post are not satisfied and I don't think they will be. I disagree with this argument. Let's take a look at the argument that congress has recognized the (CDC's) authority by adopting a law that relies on the CSO as part of the law. Judge Merryday shot this argument down when the CDC's lawyers presented it. Why he did that is contained in his ruling. There was some case law cited on this specific argument in Merryday's ruling. The precedent was established in several other cases where similar arguments were presented to the court and the rulings did not support them. Let's look at your scope of authority argument. You are correct. He provided a history lesson in his ruling but that was for the purpose of illuminating the precedent setting case law that limited the CDC's authority. Merryday ruled that precedent certainly did not authorize the CDC to shut down an entire industry's shipping operations for the period of time that they did. This was one of the five claims FL made in it's original law suit and it was firmly supported in Merryday's ruling. I will grant that the USCA's roll is to determine if the law was interpreted and applied correctly so, Merryday's ruling in this specific instance is subject to review. Next you ask, " they don't have the authority unless they use it in a way he agrees with?" Yes, the role of a federal judge is to do precisely what he did....... interpret the law using precedent, where it is available, to determine, in this case if the CDC has the authority to do what they did. Merryday ruled they did not and what they did do was, in fact, create law, the CSO, that only the US congress has the authority to make. This is a classic, and entirely correct, interpretation of the separation of powers provisions in the US Constitution and laws between the 4 branches of government. I'm arguing that: Defendant's haven't presented sufficient evidence that the Merryday trial wasn't fair and/or he interpreted the law incorrectly to grant the appeal (step one). Pretty sure they have to cross that bar before a judge will entertain and review documents supporting the CDC's request for a stay Failing that, a request for a stay can't be granted (step 2) The clock is ticking on FL's request to Judge Merryday for an emergency hearing. For all intent and purpose, that was granted. Since the CDC gave Merryday the finger, refusing to rewrite a CSO that comported with existing law, and filed an appeal with the USCA, if the appeal is denied, and I think it will be, and a stay not granted, the CSO becomes unenforceable recommendations in 11 days on July 18th. TBF, my argument has no more or no less value than @MrMarc's. JMO, YMMV.

You can't make stuff like this up. If it weren't so detrimental to one of the globe's major economic engines and provider of good jobs in countries where nothing like that is available and your typical cruise line, service level employees come from, it would be absolutely hilarious.

OK, great. Not unexpected although I thought the Merryday ruling was lock tight and I think the US Court of Appeals (USCA) will say the same thing and defer to the lower courts decision. An apeal isn't a new trial. Becerra cannot introduce nw evidence or add addtional testimony. Reading the documents, they did just that. It is entirely possible that the appeal, once it is reviewed by the USCA, is heard and the defendants are told, sorry no dice. The Merryday ruling is affirmed. So, what's the time lime? Lets go back to the original suit filed by the stat of FL. You'll recall that FL moved and was granted an expedited (emergency) hearing. That was more or less granted. The CDC lawyers presented their arguments, Merryday considered them in light of the state of FL's submissions and arguments and sent the CDC packing. Subsequently Merryday said you have until July 2nd to submit a rewrite of the CSO that conforms with your authority granted under U.S.C. 42, Chapter 264. Then the CDC asked for an extension and Merry day gave them until 7/22. The clock is still ticking on that original FL request for an expedited hearing. I'm not entirely sure but I think submitting an appeal makes everything Merryday instructed the CDC to do (rewrite the CSO) moot. It now moves to the USCA with the clock ticking and if the appeal fails, and I feel confident it will, Merryday will default to enjoin the CSO. This will turn oout to be a failed last ditch effort by the CDC in all or nothing sort of circumstance. The CDC will get NOTHING. You'll recall Merryday's ruling included the conclusion that the FL suit would prevail on it's merits. Only a successful appeal can change that. No way to predict but it is such a weak appeal, technically flawed (more testimony and more evidence submitted - can't do that) and the FL request for an exeditied hearing clock is still ticking. I suspect if it is a possibility, the USCA simply won't hear it..... I think that's how it works. The USCA can do that. It shuts down the CDC and invites Merryday to move forward with enjoing the CSO Given this chain of historical events in the case and what I think is the outcome of the appeal if it is even heard (see above) - go directly to jail, do not pass go - the CSO gets enjoined. It could be a couple of days, weeks or months and I think the former - in weeks rather than days - is more likely. Look, this is typical legal maneuvering so, fine. Becerra wants to drag this out until the CSO expires and he and the CDC don't have egg on their faces. But on the merits, its's ridiculous and a waste of the court's time. Gut feeling tells me the judge sitting on this case at the USCA will see that. Let's move along here people.

To further understand the two sides of the issue - mask up or don't - have a look at what amounts to a pretty significant shift - and one I think is long over due and needs also to come from the BIDEN administration - in the UK's official position on COVID ......"we are going to have to live with the virus." Boris Johnson is saying we're going to remove most COVID mitigation measures and restrictions on July 19th with an update to that plan on the 12th. As is typical here in the US, Conservative MPs in GB have been urging Johnson to do this while Labor MPs are calling it reckless. I can make a case for both mask-up or don't. There are facts that support both positions. Right now, the UK is dealing with an increase in new cases due to the Deltas but not an increase in hospitalizations or deaths. That is what vaccines promised to do and are delivering. They never promised to reduce transmission or mild illness although they seem to do a pretty good job at that too. Johnson went on to say in this announcement that we can't just keep closing everything down when cases rise. Its too costly on many levels. We have to keep reopening British society and life and deal with the virus spread as best we can. And don't believe for a minute he doesn't have some solid facts to support that position. That the virus is peaking - running out of spike protein places to mutate - means it will recede on it's own with some help from vaccines and our own human immune systems capacity to learn about and fight the virus over time. That's exactly what happened with the Spanish Flu and then there were no vaccines. That has a happened with every pandemic or endemic causing virus in history going back to the Bubonic Plague in the 1300s. https://apnews.com/article/europe-coronavirus-pandemic-business-health-government-and-politics-650b09e7babe362e1777606e6b1a369b

Here is the wording within CDC's January 21st order requiring the wearing of masks by people on public transportation conveyances or on the premises of transportation hubs to prevent spread of the virus that causes COVID-19. Later in the original order, cruise ships are identified as a transportation conveyance. The following is found at the long and cumbersome verbiage that is the basis of the shipboard mask mandate (indoors only) released 01/21/21: *CDC also plans to amend the January 29, 2021, Order, as soon as practicable, to grant cruise ship operators subject to the Conditional Sailing Order with greater flexibility regarding how mask requirements are implemented on board cruise ships. Until it can amend the Order, CDC will exercise enforcement discretion regarding mask requirements applicable to operators of, and crew and passengers on board, such cruise ships and will view cruise ship operators as in compliance with the January 29, 2021, Order provided the operators continue to follow the requirements of any technical instructions and the operations manual available on the Cruise Ship Guidance webpage. This order was ISSUED 6 MONTHS AGO!!! ARE THEY STILL PLANNING? I would assume that RCL management knows the CDC is about to release the promised update that will allow cruise ship operators some flexibility to determine when and where masks need to be worn. What might reasonably happen is that the CDC will say something like on sailings with X% of vaccinated passengers, no one needs to wear masks at all indoors. If all we were dealing with was all vaxed guests, then it would follow and be consistent with CDC's latest mask guidance for vaccinated people - you don't need to mask. I believe that is the protocol for sailings out of everywhere else from US ports except FL. The few FL sailings that have occurred so far are hitting 93%-99% vaxed. No mask wearing in a 70% vaccinated crowd is reasonable and consistent with the CDC's guidance so far. I'd guess that will be the number that the CDC sets ..... it's an easy bar to get over and everyone sailing from FL ports will be happy.

Trip insurance is complicated. There is no simple answer to your questions. I provided a link below that helps explain "trip costs." The link is to a popular web site for pricing insurance called InsureMyTrip. There's lots of helpful information within the web site. I've used if forever. Handy. https://www.insuremytrip.com/travel-insurance-policies-and-claims/trip-cost/ Figuring out what your pre-paid trip costs are is the key to getting the insurance you need, no more, and determines your cost for the insurance. Here's a link that discusses this very important area: https://www.insuremytrip.com/travel-insurance-policies-and-claims/trip-cost/ An important thing to do is purchase your insurance plan to cover whatever advance/prepaid costs your shelling out to start with. You can add new costs later, of course, at a price. There are disadvantages to waiting until you are past the insurance companies "buy by" date. Those are explained at InsureMyTrip. Basically, you loose some benefits if you don't buy the plan by the company's "buy by date." Assess your medical risk. If you have one, assess what your existing health insurance policy covers. Most US based insurance plans won't cover medical costs you might incur outside the US. You can't predict injuries that require medical care. You can predict (estimate is a better term) your health risk from chronic disease. These are higher as you get older. Smaller at younger ages. It would be nice if you could buy "only what you think you need on medical coverage." That's not how it works. You have tiered coverages for medical expenses, e.g., $10K, $20k $100K, etc. The younger and healthier your family is, the less coverage you need - to a point. It's not unusual for a complicated fracture to cost upwards of $10K. Without question, the most expensive thing that can happen to you on a cruise is if you become ill or are seriously injured and have to be medivaced. TBH, the chances are small but they exist and increase with age as stroke and heart attacks become more likely. Those two events are likely to exceed the capability of the medical department aboard to care for you. Sepsis (really bad infections) is another. You are going to get transferred, possibly by air, to a hospital that can provide the appropriate level of care. a bill for that for $250K isn't unreasonable. There is tiered coverage here also. If it fits in your budget and you evaluate your risk of something happening requiring you to be air-lifted off a ship is high don't get coverage under $250K. If you risk of that happening is low, you can go with less. I'd recommend not less than $100K for medical evac but seek out other views on this from professional agents. TBF, if you have a questions, the selling insurance agents from reputable insurance companies will provide good information. Spend some time looking around the web for information. Forget social media, you are more likely to get misinformed. Another option is to find an independent travel insurance broker in your area. They're around and can help guide you through the process.

Correct. The Desanits ban and the line's choice to not challenge it created the issues attendant to the hybrid pax manifest. If it were not for that, vaccinations would be uniformly required for guests over 16/12. At present it is only sailings from FL ports that unvaccinated guests have to deal with imposed inconvenient mitigation measures. Whether these are justified or not from a purely health standpoint is debatable. That the microscope that the cruise lines are under making these measures justifiable is not. I'm completely empathetic with the conundrum families with unvaccinated kids or guests who chose not to get vaccinated face. For those who love the cruising life and after nearly 2y forced official government denial from it - some of it highly questionable as to its constitutionality - there has to be some aggravation with the RCL policies and chomping at the bit. Still, it does come down to choice ..... which it seems is what everyone I see posting here on this subject have. When I think about this from the perspective of the corporate view, you have to know that the legal teams looked at all the applicable law, the finance teams looked at the costs and the operations teams looked at the impact on the guest experience and landed on this approach. You can bet it was well thought out and planned.

Hmmmmm ...... not sure. Certainly the CSO expires 10/31/2021 but it's not the CSO that is directing this policy. It's RCL. To my knowledge there isn't any language or protocols in the CSO that direct guests to have travel insurance. I just did a quick review of the CDC's Technical Instructions and didn't see anything doing this. The best information from RCL is going to be we will continually monitor, yada, yada and update protocols as necessary. It's not much to go on but if you're sailing before October 31st and are traveling with unvaccinated pax, per RCL, you'll need travel insurance. It is a PITA. I think we are all finding that as we plan for and then embark on a cruise ship in this era, there are a lot of hoops to jump through and inconveniences like masking on board. I posted this in the Celebrity thread but will repost it here. It's a chart that lays out pre-boarding hoops, terminal and shipboard health requirements (including the wide array of vaccination, mask or no masks required protocols) in an easy to locate and learn what you need to know and do. (link below). https://www.celebritycruises.com/content/dam/celebrity/pdf/Celebrity-Healthy-At-Sea-Protocols-v2.pdf To sooth nerves of those having pending cruise plans, I'm sailing on Apex from Paireus (Athens) on July 9th. I am receiving regular updates that include everything an arriving, then boarding guest needs to have done in advance or will be subject to at the cruise terminal. I'm obsessive about not encountering surprises so, i''ve been checking and rechecking stuff daily (we fly out of Miami on Thursday July 8th, fortunately a couple of days after Elsa passes through!!!) Everything Celebrity sends me via email is a repeat of what I already know on my own but it gets reinforced and reaffirmed as official and is nicely presented in clear language and illustrations. The whole thing is too big to capture and paste but I did paste the first page to demonstrate how Celebrity (and I assume RCL) will present what you need to know and/or do before you go and during all phases of your travel/cruise. Following this header, each of the tabs in the header are fleshed out in detail.

I too had to read the language twice. My first read was the same as yours then I read it again and, although not as straight forward as one might like it, it says any EOs and all local COVID related restrictions will expire on July 1st. I read this to include the state's PHE under which all this stuff was issued. At that point the provisions of SB2006 - and these cover all manner of emergency preparedness of which a PHE is included - take effect. The body of SB2006 and the announcement of Desantis' signing of it make it very clear that its intent is to prohibit government overreach, the kind of which occurred during the SARS2 Pandemic, in the state of FL. The language in SB2006 also lays out the steps that are required for the Governor to declare a future PHE making it clear that balancing the costs of mitigation measures with the potential public health benefits is required. It also lays out who participates in deliberations and final decisions on these. Participants include both state public health officials, Commerce and Transportation Department officials. It is a model piece of legislation that the US legislature needs to look closely at in coming up with legislation that more clearly limits the authority of the CDC to shutter an entire industry as it did to the Cruise Lines. I think in light of the Merryday ruling, th US Congress cannot duck responsibility to do that. Pretty sure something is already in the mill and has sponsorship that includes FL's TX's and AK's congressional reps.

It does not matter what the the Desantis EO says. That is because Senate Bill SB2006, among other things, made it unlawful in the state of Florida for a business or school (I did not realize schools were included until I read the bill) to ask for proof of vaccination. The Bill was passed by both houses of the FL legislature, forwarded to the governor to sign and he signed it on May 3rd, 2021. Also in the bill was a provision that cancelled all previously issued emergency orders effective July 1st, 2021. Here's the wording for banning passports: 381.00316, F.S.; 141 prohibiting a business entity from requiring patrons 142 or customers to provide documentation certifying 143 vaccination against or recovery from COVID-19; 144 prohibiting governmental entities from requiring 145 persons to provide documentation certifying vaccination against or recovery from COVID-19; 147 prohibiting educational institutions from requiring 148 students or residents to provide documentation 149 certifying vaccination against or recovery from COVID150 19 A couple of references: the bill itself (42 pages) and an announcement of the signing of the bill and it's intent (a lot clearer than the bill itself). https://www.flsenate.gov/Session/Bill/2021/2006/BillText/er/PDF https://www.flgov.com/2021/05/03/governor-ron-desantis-signs-landmark-legislation-to-ban-vaccine-passports-and-stem-government-overreach/

So what does this mean vis-a-vis the questions about ship's COVID protocols and how strict or how lenient they should be? Right now, not only in the cruise industry wrt to protocols for handling COVID cases that show up as you described them - the 65yo who has been vaccinated, and who is just emerging as detectably COVID positive, is asymptomatic but is spreading virus particles - but everywhere. We are at a tipping point. The higher the global vax rate, the more quickly this thing ends and the less time SARS2 has an opportunity to mutate, become more transmissible or more lethal. At the level we are discussing this - the risk of COVID becoming wide spread aboard ship - because of the current mutations and the risks attendant to these, I still support a more aggressive COVID protocol approach ..... for now. I have a subscription to the Economist. I just finished reading an incredibly interesting article that detailed exactly how mutations form and why the currently known mutations seem to grow in their capacity to be more transmissible. The article is pay-walled so I'll provide some takeaways: SARS2 has demonstrated some unique properties in the way viruses mutate. These include multiple substitutions and deletions in a specific protein - the "spike proteins" that bind to ACE2 cells in bats and humans. Bats have many more ACE2 cells and that makes them a perfect reservoir for viral evolution to occur. Humans have relatively less ACE2 cells than bats but humans are still a good reservoir for mutations and that includes asymptomatic people who have been vaxed but get re-infected like the guest you describe. Has that guest been exposed to and been infected by a SARS2 variant that has an R(0) up to 8X more transmissible than the original SARS2? I'd be overly cautious with this guest. The good news is that SARS2 may have run out of places on the spike proteins to evolve. The point is made that the behavior of all viruses become limited by this phenomena. While SARS2 has demonstrated its capacity to evolve into more transmissible and potentially more lethal forms, like all viruses, they run out of room to evolve and eventually recede. At some point, this will happen. Right now, as I said, we're at a tipping point. For now, be aggressive. In humans, the immune system also evolves when it encounters a new threat like SARS2. So, it's a battle that involves SARS2 becoming limited in it's ability to evolve and the human immune system continuing to get better at fighting it and surviving. In the end, humans win. That is a historical perspective that goes way back to when this sort of thing was first recorded and studied, the Bubonic Plague in the mid 1300s. Indeed, it takes a while for this to happen. We aren't there yet. Be aggressive.

Good stuff @LizzyBee23 thanks for posting that. I'm not an alarmist by any measure but the increased transmissibility of the Deltas is a real factor in prolonging this thing. I see this circumstance as a bogey that is imminent and should be dealt with appropriately. I still don't think we should or will see major and widespread restrictions to mobility and business activity but there will be inconvenient re-imposition of mitgation measures in places where vax rates are low or risks of transmission high..... indoors in congregate setting. It is not too hard to see the potential for SARS2 obtaining greater capacity to evade our immune systems, vaccines and therapies when it is left to percolate globally. See below:

I am also uncertain but I think that if Desanits had not advanced legislation to make his EO - which was issued under authority granted to him in the state's PHE - the EO ban on asking for prrof of vaccination would have also expired. But it's now law in the state of FL. It could be challenged but it would be an uphill road to do that.

I just noticed this today and it really doesn't bear on FL V. Bacerra but there's no other good place to put it. Governor Desantis let Florida's PH Emergency declaration expire last Saturday. The only thing I saw in the news is that his failure to extend it will eliminate compensation/reimbursement for telemedicine. Apparently, the FL legislature will submit a bill to extend the financing for that "in the next session" whenever that is. I suppose it isn't starling news and not in the category of "if it bleeds, it leads" journalism. OTH, if I have this right, there is a ton of stuff tied to it and the expiration of the PH emergency pulls the rug out from a lot of it. For example, let's say that Miami-Dade county discovers a cluster of COVID within cramped living quarters for migrant farm workers. The county PH agency is going to be restricted as to what mitigation measures they have at their disposal to do anything about it. The PH emergency was fundamental to giving the counties authority to do something like that. Of course, although I don't know the details, when Desantis made the move a couple of weeks ago to forgive any COVID related fines or charges along with him previously saying the counties can't do anything that restricts mobility, closes businesses, requires masks, none of that stuff is authorized any longer. Same for schools that are doing summer school right now or summer camps. So, letting the declaration of a PH emergency expire last weekend may be a nothing burger from a standpoint of how residents and businesses might be affected. But when financing for COVID related projects, funded by the state or the feds, gets cut off there's an impact. I could see the same for health and safety protocols already put in place for summer school and camps - we'll see what it is, I guess. Some journalist will pick up on a "catastrophe" related to this and pin it on Desantis.

I agree with the thrust here @LizzyBee23. The current level of hysteria about the variants in the US, especially given the high vax rates among vulnerable populations is unnecessary. In countries with high vax rates, we should be thinking endemic pathogen of interest and managing clusters of it discreetly. I think this is what you mean. One thing to keep in mind is that while COVID is a URI, the possible outcomes from contracting it, unlike a URI or Flu, are significant across select age and medical status cohorts. You do make the point that each cruise ship has to be equipped to care for COVID cases that go south and to quickly off-load passengers whose clinical status depends on a level of care not available on the ship. I don't know the details of the capability to do that across the RCL fleet. Can they intubate and ventilate on board? Administer anti-cytotoxic therapies, Administer antibody treatment? These are all life saving early interventions and then the question becomes, as you say, what happens if there are 15-20 cases, 10 of them are over 65 and at risk and 5 of them are already starting to go down hill with low O2 Sat levels. I have a gut feeling the medical staff has the same kinds of protocols for dealing with a very ill COVID case that looks a lot like how they treat an MI or CVA case (Advanced Cardiac Life Support, Stroke Prootcol - both complicated with specific drug and imaging requirements.) So, I'm not ready to say, "treat COVID like any other URI. What I am ready to say is that you manage a shipboard COVID positive, unlike a URI, very aggressively with isolation of the positive(s), aggressive contract tracing and quarantine (note isolation and quarantine are different animals) until a diagnosis is confirmed or rejected by a molecular test (PCR and others - and I don't know for sure what RCL is using among molecular tests. It should be RT-PCR as this test is the most reliable diagnostic test but it also requires special and specific handling and processing in a Clinical Laboratory Improvement Amendments (CLIA) certified lab. That's a big deal. Failing to aggressively manage a shipboard positive case just presents so many possible untoward outcomes that it just isn't worth the risk of less aggressive approaches and I don't think you're suggesting that. A no-kidding outbreak involving an older cohort could quickly overwhelm the ship's medical facility. A death aboard a cruise ship, during transport or immediately after admission to a hospital's COVID wing would quickly end cruising.

Your points are taken, @smokeybandit I read the article. I was unaware of Prasad whose made a name for himself pummeling the CDC. Nevertheless his 5 failures section of the article is a worthwhile read in forming perspective and listening to both sides. There is no question that how the CDC presents its data and how others do is subject to legitimate debate. Despite this, I think the predominant messaging from the scientific and medical community is that the risks of COVID among unvaccinated children is higher than the risk of myocarditis in that cohort. that is a nation wide perspective and I think regionality is missed as @Jkaczanonotes. There are those that disagree with the CDC's recommendations. Prasad is one of them. I practiced medicine as a PA for 22 years. One thing I learned: Doctors don't agree on much. One can parse the data and Vinay Prasad does a lot of this in an effort to disparage the CDC's position on vaccinating kids ..... it's like piling on. They've made errors. It's easy. Walenski, whenever she opens her mouth, usually inserts her foot. As I've held all along the CDC is terrible at messaging. I read a short Twitter exchange between Vinjay and Rochelle. He's merciless. OTH, the CDC collects the data and does a pretty good job of doing that and interpreting it. Others might disagree and that is understandable in science and among researchers that are looking at this emerging PH threat. Like I said, nothing in science is certain until it is absolutely proven so and that rarely happens.

Thank you for your response @Jkaczano New Hampshire has been recognized as a leading state in managing the SARS2 pandemic. The low seroprevalence does mitigate toward the rationality of your viewpoint on vaccinating your children. I've always held that COVID and it's impact is regional and generalizations that consider the entire US can, themselves, be misleading. Having said that, the level of regional transmission in your state is still considered high (see the link below). So, to me, that would seem to mitigate toward vaccinating them. This statement, also at the link, seems to indicate a low occurrence rate of myocarditis such that, as the chart I posted above shows, the risks of Myocarditis from the mRNA vaccines are exceedingly low while the risk of COVID infections inthe cohort we are talking about is still fairly high: There was not a safety signal identified at time of last VaST report (May 17th): reports of myocarditis after COVID-19 vaccination did not differ from expected baseline rates – Multiple causes of myocarditis, including: viral infections (cold viruses, COVID-19), bacterial infections (Lyme disease), etc. https://www.dhhs.nh.gov/dphs/cdcs/covid19/documents/hcp-call-presentation-052721.pdf I respect your position though vis-vis your children not getting vaccinated. Just keep an open mind and be convincible.

At the request of @cruisinghawgI'll reluctantly respond to this and a few other comments: Not really ........American Citizens have no Constitutional protection from being told by a state vaccinations are required. Nearly 100 years ago, the U.S. Supreme Court issued its landmark ruling in Jacobson v. Massachusetts,33 upholding the right of states to compel vaccination. The Court held that a health regulation requiring smallpox vaccination was a reasonable exercise of the state’s police power that did not violate the liberty rights of individuals under the Fourteenth Amendment to the U.S. Constitution. The police power is the authority reserved to the states by the Constitution and embraces “such reasonable regulations established directly by legislative enactment as will protect the public health and the public safety” (197 U.S. at 25, 25 S.Ct. at 361). It is good to understand the history of how the requirement for vaccinations emerged in the US. I's all right here: https://www.cdc.gov/vaccines/imz-managers/guides-pubs/downloads/vacc_mandates_chptr13.pdf Look, I get the concern about children being vaccinated and putting thier safety above any sense of duty to the public health. This is true especially given the short history of the COVID vaccines approved in the US. One needs to be on point when they take that position. In a that was then, this is now sort of dialogue, distrust of the state has increased dramatically since Jacobsen v. Massachusetts. But the FDA has remained as apolitical and balanced as any government agency in this pandemic - the rigorous testing protocols that pharma has to comply with in brining a drug to market, even under EUA, and with the exhaustive review process the FDA conducts, all the US approved vaccines are very safe. Yet misinformation about their effectiveness and safety flood social media platforms as in, "that decision (not to vaccinate a child) is a no brainer." It is? Really, based on, "Right now, with cases averaging 22 per day on a population of 1.4 million and multiple cases of myocarditis locally." I doubt both the validity of the numbers and how these are being presented. These are the facts: CDC numbers through late May estimated that 16 cases of myocarditis or pericarditis would be reported for every million second doses given to people ages 16 to 39. That works out to 0.0016%, or roughly 1 in 62,000. By contrast, de Lemos said the best studies on college athletes put the chances of a young person getting myocarditis after COVID-19 at between 1% and 3%. That's roughly 1 in 50. https://www.heart.org/en/news/2021/06/21/should-rare-cases-of-heart-inflammation-put-your-covid-19-vaccine-plans-on-hold There's more: Though fewer children contract COVID-19, and fewer kids and young adults experience serious illness, there’s still some risk of contracting the virus. Since the beginning of the pandemic, at least 7.7 million COVID-19 cases have been reported among people ages 12 to 29. In May, that age group represented 33% of COVID-19 cases. Since the beginning of the pandemic, 2,767 coronavirus deaths have been reported among this age gr https://whyy.org/articles/myocarditis-and-the-covid-19-vaccine-what-to-know-about-rare-heart-inflammation/ And then there is this: All of the foregoing facts seem to indicate that it is a no-brainer to not get your kids vaccinated. Profiteering by big pharma as an underlying cause of distrust of vaccines is also a frequently held parental concern. IMO, that denigrates the work of 100s of dedicated scientists that worked on these vaccines and deployed them in record time. I don't think that circumstance is fully understood by critics of big pharma. That pharma developed these in a public private enterprise is perfectly good reason for these companies to be rewarded and the public to benefit from the miracle drug the mRNA vaccines are. I reject that concern as largely baseless. Now of course you could argue that the Chinese and the Russians who deployed Sinovac and Sputnik through government nationalized production did just fine. But they didn't and countries that received these vaccines in a form of vaccine diplomacy are battling reinfections. https://www.nytimes.com/2021/06/22/business/economy/china-vaccines-covid-outbreak.html One final comment on another set of stats that are floating around on social media platforms that vaccine nay-sayers grab on to without checking them out. The conflations and missuses of absolute and relative risk along with vaccine efficacy abound in social media platforms then trickle down to casual conversations. The link will take you to a great article that describes these misuses, how believable they appear and how utterly dangerous they are to rational, well informed thought on getting vaccinated or not. https://www.reuters.com/article/factcheck-thelancet-riskreduction/fact-check-why-relative-risk-reduction-not-absolute-risk-reduction-is-most-often-used-in-calculating-vaccine-efficacy-idUSL2N2NK1XA All of this sounds like lecturing and badgering those who aren't vaccinated or don't want their kids vaccinated. I apologize for that because it is the least effective way to change people's minds on any number of COVID and Pandemic related views and especially in the hotly debated arena of vaccinations. Generally it's hard to do. But judgements based on inaccurate or misleading information are dangerous. What I encourage is not blindly rejecting or accepting, even being moved by what I've posted here but rather keeping an open mind to views contrary to your own. Become convincible. Join legitimate focus groups led by doctors and scientists. Ask questions.

On a whim? (1) we're talking about a public health crisis involving a pandemic that has caused the death of 1/2M people in the US. There are medical therapies that can be used to subdue it's impact that include vaccines. (2) There are laws that allow businesses to fulfil their moral and ethical responsibility to create a save environment to do business. Taken together I can argue we have a civic duty as Americans to follow the law and be ethically and morally responsible. YMMV, JMO, I am heavily biased as a medical professional toward vaccination ....... I am also stepping over the lines that Matt has established for discussions like this. I'll read but that's the last of my post on this thread on vaccinations, whether or not they work and whether or not those able ought to get them. that's reared its head again and I'm guilty.

Its an unpopular position to articulate support for the CDC. Their public messaging hasn't been good. They have themselves to blame for that. However it is the politicians and the press that "politicize" their recommendations and public statements that come from the CDC. I'm not a fan of Anthony Fauci either and the reasons for that go beyond his credentials as a virologist - those are solid. He is always very careful - hedging is the operative term - not to get pinned down. Listeners don't like that but he's a scientis and few things are certain in science, especially emerging science on SRAS2 and COVID. The CDC, in most circumstances that do not involve regulatory authority (I'll get to that), provide recommendations for PH matters. They don't direct anything and since the mask debacle in February 2020 and the Trump administration telling CDC folks to go sit in the back of the room and shut-up, CDC spokespersons have been very careful to make that clear. The most recent clarifying statements wrt that involve the position they took on masking when their recommendations (no masks for vax'ed) differed from the WHO's recommendations (masks indoors regardless of vax status....... Walenski's response when asked about this (paraphrased) "we are recommending no masks for the vaccinated in the US but leave decisions in that regard to local PH authorities." I think the CDC is spot on regarding no mask wearing required for vaccinated people in the US. I'm pretty sure you would not disagree with that. The CDC does, in fact, have regulatory authority over the cruise lines through the Vessel Sanitation Program (VSP). The authority I am most familiar with is what is granted under 42 U.S.C, Section 264. Regulations pertaining to preventing the interstate spread of communicable diseases are contained in 21 CFR parts 1240 and 1250 and 42 CFR part 70. https://www.law.cornell.edu/cfr/text/42/71.1 When Merryday ruled in FL v. Bacerra, he did not say the CDC doesn't have regulatory authority. They do. What he said is that aspects of the CDC specifically directed at the cruise industry were, for all-intent-and-purpose, new laws that the CDC does not have the power to write. Most of the legal arguments presented by FL's attorneys revolved around the limited time frame that free pratique can be denied via the VSP. That argument carried the day and the details of why it did, including pages of citing case law going back hundreds of years is in his written ruling. The link below describes the CDC's regulatory authority for the cruise line. https://www.cdc.gov/nceh/vsp/default.htm I can't agree with this generalized statement. There is some uncertainty about responses to vaccines v. natural immunity with certain T-Cell types. With others there is no uncertainty - for example, CD4 and CD8 T-Cells showed a marked decrease following infection with SARS2 that are not seen with vaccines. In fact, the T-Cell response with the mRNA vaccines is robust (confounding factors in several studies were not isolated. The article linked below pertains. https://www.news-medical.net/health/What-are-T-Cells.aspx WARNING: we can easily both get in over our heads in this area. What I try hard to do within this forum when I post about COVID is to eliminate my biases or admit them and not make generalized statements that may not be supported by the facts. Nevertheless, in social media platform like this is authoritative statements frequently become gospel when the statements conform with a particular readers biases and preconceived beliefs. It's not easy to remove biases from posts. Admission of a bias and links to facts supporting a viewpoint are helpful. I really have a problem with sweeping generalizations intended to support a POV.

Immunity from SARS2 is immensely complex. My review of the literature on this subject indicates that there is plenty of disagreement among research scientists about how much and how long immunity is conferred by a previous infection. Fundamentally, your body has two types of immunity: humeral and adaptive. You've all read about B Cells. A previous SARS2 infection resulting in even mild cases of COVID trigger a humeral, B Cell response. Your bone marrow produces these. Exposure to SARS2 also produces an adaptive T-Cell response. In both cases, it is not yet known with any certainty how effective your immune system will be in protecting you against reinfection if you've had COVID in the past or how long that immunity might last. It is also not conclusively known that any of the currently US FDA approved vaccines will produce better or worse protection against COVID. Research trends suggest that vaccines produce a more robust and complete immune response (humeral and adaptive) v. COVID than natural immunity from a previous infection. Research trends also suggest that people who have had COVID benefit from a further increase in immune response to SARS2 by getting vaccinated. I am knee deep in the controversy over vaccination. I still believe in choice but as the pandemic plays out it is getting harder and harder for opponents of vaccination, those who are eligible and able, for any number of reasons, to justify that position. The CDC, even though they have made missteps, is still a solid collector and interpreter of available data. Sure, they've lost the trust of many of us. I am not among those mainly because I follow the research literature on this closely. But, I'd call the position that the CDC has taken, opposite to that of the WHO on masks is solid and is better reflective of the SARS2 transmission situation in the US. The WHO has a more global perspective and where viral transmission is at high levels, it is generally believed masking helps reduce it ........ all the controversial aspects of human behavior and other factors that bear on how masks are worn, how effective they are, not withstanding. As far as the cruise lines are concerned @AshleyDillois correct. They are not going to allow those who have been previously infected by SARS2 with proof of antibodies be considered immune. Frankly, I don't think anyone should consider themselves immune from infection by SARS2 if one has had COVID. I would add that the current crop of AB tests have flaws - and there are a lot of them , including home tests that you can buy over the counter. Cruise line health and safety experts are also going to go with the most conservative approaches to all COIVD related practices.

I read several of the briefs that were submitted to journalists by the primary supporters of the large cruise ship ban from Key West. Not one of them provided any solid science that the Key West reefs, surrounding waters or environment were threatened by large cruise ships. It was all voodoo science foisted on the Key West public who then thought, yeah, this is bad, ban them! The port and local businesses didn't really get involved until it was too late (their fault). Of course the ban supporters have accused Desantis of paying back a Key West developer who has money in the port for a large contribution he made to the Desantis campaign. Fine. I don't care. That common sense prevailed over a bunch of environmental loonies is good for Key West and good for the state. There is always compromise paths to walk that take inot account the needs of both interests but environmental extremists are a tough lot to deal with and tend to drag along followers who really don't understand what they are getting into. JMO. That's not to say that Cruise lines don't need to be conscious of FL's environmental issues in the barrier reefs and that entire eco-system. I have no doubt that they do care and aren't willing to run afoul of the various regulations, enforced by the USCG designed to portect these sensitive areas. Seaman are a very conscientious lot when it comes to the oceans - of course the garbage and sewage dumping of a miniscule portion of maritime operators get the news. For every 1000 sailings, there may be one that breaks discharge laws. They get caught and suffer large fines.

Based on what we're seeing with both test cruises and 95%'ers that are being operated in full compliance with the CSO, whatever the CDC comes up with is going to be changes in the language of the current CSO to make it legal under the CDC's authority granted in 42 U.S.C. Section 264 Quarantine and Inspection Regulations to Control Communicable Disease. At the onset of this thing I was skeptical that FL would prevail. As the arguments unfolded it became more apparent that they would and Merryday's ruling was pretty clear. CDC overreached among other things. If Merryday feels that a good faith effort is made by the CDC to adjust some of the language. He could simply vacate the injunction. Iwould hope in any rewrite they do that they are consulting with the cruise lines on some of the more onerous requirements of the CSO like test cruises and volumes of reports and legal standards for contracts. While it's true that after the CDC does its work and submits it to Merryday, there's a period of mediation to follow. There are two outcomes: (1) FL agrees to the changes and there is a settlement, (2) FL does not agree and it goes back to Merryday like last time. I don't think Merryday wants to force a rewrite of decades of complex maritime law by enjoining the CSO and essentially sending an open ended set of unenforceable regulations back to Congress for a rewrite of parts of U.S.C. 42, Section 264. I have a gut feeling he will rule in favor of the CDC providing the CDC in it's rewrite meets Merryday's expectations. That might seem to leave FL out in the cold. That's how the cookie crumbles. He might throw them some crumbs. What that might be is uncertain.

Lots of stuff at play. If I'm reading the charts above correctly, they end in December 2020. Certainly, vaccines are going to dampen surges. I think most experts agree that there might be a rise in cases come fall and winter but disagree on the extent of it with vaccines in the mix of causal factors. The percentage causality of the many factors coming this fall is going to be hard to sort out. If you go to the home page of Hope-Simpson modeling (link below) there's lot to be learned from the graphs and charts. The link hopefully will take you to a side by side comparisons of the US, UK (both with high vaccination rates approaching 70%) compared to Norway (low vaccination rates around 42% and in the far northern hemisphere). The difference in new case numbers are similar both in terms of absolute numbers and trends. If a rise in case numbers we are seeing in low vax rate US states have "noting to do with Delta's (or variants in general) and more to do with cold weather associated with seasonal changes, you would expect to see new cases increasing in the colder Norway. They aren't. If the link goes to the home page you can either bleive me or use the various toggle to set up the comparison above. You took issue with my statement that, "The thing about the Deltas worth bringing up is that in states with low vax rates, hospitalization rates have started moving up for the first time in 2 months." To which you responded, "This has nothing to do with Delta, but with the seasonal viral effect in lower latitude states." The CDC thinks there is a correlation between the increase in a US state's new case number, seroprevalence of the Deltas and vaccination rates absent seasonal viral effect in the lower latitudes. Many aren't listening to anything the CDC has to say and I understand that but in this case the likelihood that they are interpreting the available data correctly in the US is pretty high. Part of my point in the original post was that as vaccination rates per region/country/locale/ increase cruises will trend toward increasing normalcy. The higher the vax rate on each ship, the better. That vaccines are dampening new case numbers in high vaccination rate places absent temperature variants is going to help a return to cruise normalcy. Every reasonable metric of disease burden points to the conclusion that vaccines work. It's hard for anyone to deny that and I don't think you are doing that. http://hsmap.rice.edu/map/gds