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What should happen so we can safely resume cruising ?


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As we are all wishing we can start to cruise soon here is some of my thoughts (as non expert) what need to happen before ?

1.  Vaccine  - For sure the best solution but per all the indications until it will ready for the general public it will be too late for the cruise industries as any solution needs  time to :  
a. Find the vaccine.
b. Test the vaccine is useful.
c. Test the vaccine is harmful for humans.
d. Check the vaccine impact time.
e. Manufacture the vaccine – the current methods takes several month to half a year.
f. Convince enough people to use it.

2.  Testing – This is the major game changer  , such test needs :
a. Test people on the spot – this exist already today , the testing is quite quick
b. Get prompt results – today it takes around 2- 4 days to get the results , in some places like hospitals they can get it in few hours but still its not good for what is require to allow cruises.
c. Easy testing – the tests should be quick and as less Invasive as possible so nothing like blood test.
d. Ability to repeat it on daily basis – One test will not be enough it will need to be done every day to dedicate people who become ill during the cruise.

There is some research going on to see if a test like the alcohol test (breathalyzer )  can work to detect the Corona – if a device like that will prove itself it will be a game changer as it will give prompt results.

3.  Ability quarantine people – If a someone will be tested positive to corona during the cruise its is necessary to be able and safely quarantine him in a way that the cruise can continue , that’s should work for passengers and crew. The key here is to allow the cruise to continue without the need to quarantine the full ship  

4.  Fast evacuation of infected people – Ability to evacuate people that were tested for Corona in few hours to reduce the risk to everyone else and to give them the right treatment.
a. Evacuate in the next ports – have facilities of the cruise lines on different ports to allow quarantine and treatment.
b. Using helicopters  to evacuate people.
c. Having few hospital ships one in each area were people can be evacuate into – such ships can be converted cruise ships and maybe even be shared by the major cruise lines …

5.  Mandatory insurance -  Every cruiser will need to have an insurance which will cover him for treatments , evacuation and anything around the Corona, this can be provided by the cruise lines or a 3rd party.

6.  No self-service Buffet – At least for the first few month it will be very important not to allow people to touch food that other going to consume, I guess heaving crew people handling the  food as we see after any norovirus  outbreak  will become the standard.

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My personal stance:

1. not interested due to latrogenic effects and past adverse reactions to flu vaccines as well as some of the ingredient lists (example, I have contracted the flu in years when I had the flu shot, and not contracted it in years when I haven't -- what would be different given all the conflicting information about how viruses evolve and mutate? --> a vaccine doesn't guarantee anything -- needs lots more time and research than the panacea of some expensive vaccine hitting the market quickly) -- I would prefer that my own immune system make adjustments with the knowledge that I could get sick. I get the need for sanitation on cruise ships (big cheerleader for the way they handle it -- I get teary when I hear the Wash Your Hands song), but people should be exposed to germs, both good and bad...it's why I take probiotics...I could go on and on, but I won't spam people with it...

2. I am good with testing as long as it is not invasive. I am all for taking temps and questionnaires. If I have to get documentation from a doctor, I am fine with that too.

3. cruise lines have always used this means with outbreaks of norovirus on cruises, I don't see anything different happening here

4. I don't think foreign countries that are not embarkation/debarkation ports would allow for this. We saw what happened with the Princess ship that was denied entry into its debarkation port in Buenos Aires recently...I think this needs to lead to stronger maritime law review...

5. Sweeping mandatory anything doesn't always solve the problems they are intended to solve, but in this case, if someone wants to cruise, I think it is always advisable to be covered, and in this case, I wouldn't object to a minimum mandatory requirement. I guess that thinking about car insurance coverage is a good analogy, but some people might use that analogy in other points to this thread

6. This bums me out because I take good measures for my own sanitation by always washing hands after touching buffet implements, but have also witnessed how gross people can be in buffets, and crew service would lessen risk. I really like the Windjammer when it isn't crowded, but like the MDR more and specialty dining is great too. I trust the measures Royal will be planning for when cruising resumes.

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Good points.  Although #1 is ideal, as you state, this won't happen in the near future for reasons you state.  Even if they determine a vaccine today, do we know there are no long term impacts?

#2 would be very beneficial...has to be quick for results and easy to administer (and not invasive....have heard the nose one is horrible).  And if someone tests positive once boarded, then they would follow #3.

#3 is huge.  If someone gets norovirus, they quarantine the person.  Not the entire ship. Need to do the same thing for coronavirus. 

#4 - yes to get people help in the worst case if cruise medical care is not sufficeint.

#6 - Yes I assume this will be one of the first easy change for cruise ships to make.  Also, they need to have paper menus (e.g. MDR), or sanitize them after each use.

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53 minutes ago, DunkelBierJay said:

1. not interested due to latrogenic effects and past adverse reactions to flu vaccines as well as some of the ingredient lists (example, I have contracted the flu in years when I had the flu shot, and not contracted it in years when I haven't -- what would be different given all the conflicting information about how viruses evolve and mutate? --> a vaccine doesn't guarantee anything -- needs lots more time and research than the panacea of some expensive vaccine hitting the market quickly) -- I would prefer that my own immune system make adjustments with the knowledge that I could get sick. I get the need for sanitation on cruise ships (big cheerleader for the way they handle it -- I get teary when I hear the Wash Your Hands song), but people should be exposed to germs, both good and bad...

A few caveats that should be kept in mind with this:

  • Variablity in flu vaccines is, as you noted, due to the rapid mutation in flu viruses; but also because those vaccines are made based on a best guess of which strains of the virus will be prevalent in the coming year.
  • Genetic analysis of Covid-19 has given a very strong indication it does not mutate much at all; this puts it more into the league of viruses like Measles and Polio, where vaccines have been effective for decades with essentially zero change
  • Much like Polio and Measles, Covid is a much more lethal and virulent disease than Influenza; I will absolutely agree with anyone who says we don't know the exact lethality of it just yet because we don't know just how many have actually been infected yet. That said, when the current lethality rate in my town is hovering around 7-9% even as we flattened the curve almost instantly, I am feeling reasonably certain that we'll find this to be a good deal worse than flu even after the final analysis is done
  • There is some evidence that indicates severity of the disease is tied to exposure level -- a single exposure of short duration appears to lead to milder cases, while people who were exposed over and over during the incubation period and built up a large quantity of the virus in their system have the worst cases

As such, I do believe a vaccine is going to be both necessary and worthwhile; provided it's properly researched and tested and not simply rushed out the door, per @Traveler's comments above.

 

I would add one more critical tool to the box for being able to safely resume -- reliable antibody testing. We already know there are many who likely have already had and gotten over Covid-19 without even realizing it. Having a test that shows a high level of antibodies present means travelers can get this test and show proof from their doctor that they are already immune, even if they haven't had the vaccine.

It also gives a means to know who should actually get the vaccine when initial quantities will be limited -- antibody test comes back negative (which should be a quick test, like wait a few minutes in the doc's examination room), and immediately get the vaccination. Then as the vaccine becomes more widely available, people who already showed antibodies can get a "booster shot" to ensure their immunity is strong and long-lasting.

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Sorry, one other tool that is already being worked on by governments, but will be absolutely critical in my view to resuming cruising with some sense of certainty and safety -- contact tracing (or if you prefer, exposure alerting).

The gist of it is that everyone's cell phones will actively watch for other phones passing close by and staying in range for more than a couple of minutes. Each contact has an anonymous identifier, so that if someone is confirmed to be positive for Covid-19, a notification can be sent to all devices recorded as having been in proximity to the person's own device.

This will absolutely be needed while still waiting for a vaccine, so that pockets of exposure can quickly be quarantined before another massive outbreak happens.

There are a lot of details around privacy, keeping the data centralized in some big government-owned system or just on people's devices, how to get people to opt in (or not opt out), and more. But, well... I kind of wanted to keep this brief (for a JLMoran posting, anyway). ?

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24 minutes ago, JLMoran said:

Sorry, one other tool that is already being worked on by governments, but will be absolutely critical in my view to resuming cruising with some sense of certainty and safety -- contact tracing (or if you prefer, exposure alerting).

I agree this could be a measure...what is being done in China now apparently has made Wuhan one of the places where no one will get the virus now. I've seen a couple YT videos, so you know how true that is ;p...I think the famous Black Mirror episode mirrors what is actually happening.

At any rate, I do not favor state involvement in tracking in any way at all, ever...even anonymously. The governor of my state admitted they already do it so they can clamp down on movement. Your earlier point about how many have had the virus is the big question, and the recent video of the two doctors in Bakersfield, CA make interesting points about how this is much more widespread, and has probably been in the country much longer than we have been told. If their assumptions are true, then the infection rate is 50x what the numbers are saying now...I always wonder why my state minimizes the number of tests they have completed, and seem to promote how many infections there are. If the actual rate of infection is this understated, the lethality rate plumets. I think the locations of deaths with a large ratio in nursing homes of people with co-morbidity issues can underscore this. When the history on tis is written, we will have a clearer view as long as the writers aren't cya.

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53 minutes ago, JLMoran said:

he gist of it is that everyone's cell phones will actively watch for other phones passing close by and staying in range for more than a couple of minutes

Here we have such application , its working in a way that the phone gets updates were C-19 were detected and the phone compares its location and location history using this data.

It was done like that so people will not need to expose their locations to anyone/any database. Its working quite well although I got some falls alarms just by driving near a building were someone was dedicated with the virus. I agree its important tool .

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2 hours ago, JLMoran said:

A few caveats that should be kept in mind with this:

  • Variablity in flu vaccines is, as you noted, due to the rapid mutation in flu viruses; but also because those vaccines are made based on a best guess of which strains of the virus will be prevalent in the coming year.
  • Genetic analysis of Covid-19 has given a very strong indication it does not mutate much at all; this puts it more into the league of viruses like Measles and Polio, where vaccines have been effective for decades with essentially zero change
  • Much like Polio and Measles, Covid is a much more lethal and virulent disease than Influenza; I will absolutely agree with anyone who says we don't know the exact lethality of it just yet because we don't know just how many have actually been infected yet. That said, when the current lethality rate in my town is hovering around 7-9% even as we flattened the curve almost instantly, I am feeling reasonably certain that we'll find this to be a good deal worse than flu even after the final analysis is done
  • There is some evidence that indicates severity of the disease is tied to exposure level -- a single exposure of short duration appears to lead to milder cases, while people who were exposed over and over during the incubation period and built up a large quantity of the virus in their system have the worst cases

As such, I do believe a vaccine is going to be both necessary and worthwhile; provided it's properly researched and tested and not simply rushed out the door, per @Traveler's comments above.

 

I would add one more critical tool to the box for being able to safely resume -- reliable antibody testing. We already know there are many who likely have already had and gotten over Covid-19 without even realizing it. Having a test that shows a high level of antibodies present means travelers can get this test and show proof from their doctor that they are already immune, even if they haven't had the vaccine.

It also gives a means to know who should actually get the vaccine when initial quantities will be limited -- antibody test comes back negative (which should be a quick test, like wait a few minutes in the doc's examination room), and immediately get the vaccination. Then as the vaccine becomes more widely available, people who already showed antibodies can get a "booster shot" to ensure their immunity is strong and long-lasting.

The virus already has 30 different strains. This will make a vaccine pretty darn hard to develop 

https://www.google.com/amp/s/futurism.com/coronavirus-already-mutated-30-strains/amp

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4 minutes ago, Jill said:

The virus already has 30 different strains. This will make a vaccine pretty darn hard to develop 

https://www.google.com/amp/s/futurism.com/coronavirus-already-mutated-30-strains/amp

The good thing that non of the mutations had  change the mechanism which 99% of the vaccines are going to attack (the way the virus is entering the cell) so we are still OK . 

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30 minutes ago, Jill said:

The virus already has 30 different strains. This will make a vaccine pretty darn hard to develop 

https://www.google.com/amp/s/futurism.com/coronavirus-already-mutated-30-strains/amp

25 minutes ago, Traveler said:

The good thing that non of the mutations had  change the mechanism which 99% of the vaccines are going to attack (the way the virus is entering the cell) so we are still OK . 

Exactly as @Traveler said, and I should have been clearer in my earlier statement. There are mutations that are being seen and used to identify different strains -- European, Chinese, Australian, etc. But none of those mutations are in functional RNA that changes how any of the virus' proteins function, nor modifies any of the "marker proteins" that are being targeted for vaccination purposes. They're in "junk" parts of the genetic sequence, which all organisms have; the core sequences that actually make proteins and other bits of the virus are all quite stable, even as we see these different "strains" of the virus that have circled the globe.

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I don't have a problem with being a little more aggressive in pre-screening ...

Excuse me sir, you seem to have stuff pouring out of your nostrils and are dripping in sweat sitting here in the air-conditioned departure lounge, could you step aside and chat with the doctor please.

 

Apart from that i am good to go. 

 

There are lots of diseases and no guarantees.

We had the Zika scare a few years ago ... if it scares you to risk it, then dont risk it, stay home.

Malaria is still a thing if you go to some parts of the world, not your thing, dont go.

Is COVID dangerous, yes, am i flaunting the rules and running around hugging people trying to get sick .. no. But I would like to live my life and i'm willing to take the risk if the world would allow me to.

Crossing the street is dangerous, riding in a car is dangerous, its all a matter of risk you are comfortable with.

 

There are only 2 reasons i am not getting on my cruise on Thursday:

1. No guarantees they would let me off again - this is fine if we just keep going around the Caribbean for a few more laps, not so fine if we are just sitting at the port for 2-3 weeks.

2. They wont let me on - something about not being allowed to sail yet.

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12 minutes ago, Traveler said:

Another option to check for any outbreak on the ship is to check the sewage systems . 

There is a research  showing  that you can find the virus in the sewage and using it to monitor areas . In ships the way the sewage system is built you can monitor groups of rooms for any outbreak. 

I pity the ensign who draws that short straw! ?

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2 hours ago, Traveler said:

Another option to check for any outbreak on the ship is to check the sewage systems . 

There is a research  showing  that you can find the virus in the sewage and using it to monitor areas . In ships the way the sewage system is built you can monitor groups of rooms for any outbreak. 

sounds like some mega hazard pay

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17 hours ago, DunkelBierJay said:

sounds like some mega hazard pay

I guess an automatic system can be deployed , 

The sewage  system in a ship is continuously being treated ,  since the system is being build using hubs and clusters the sewage can be tested few times a day in the main sewage hub and only if something is found to start and check the main floor hubs and the room hubs to isolated the cluster of rooms were the outbreak is. Its much better than testing daily everyone on the ship ... 

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Good news, 

The FDA just approved the first "home" C19 test , its based on saliva check.

Such tests can help to expedite resume  cruising as first step  , currently the kit is just to collect the sample while the analyze being done in the library . 

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-diagnostic-test-using-home-collection-saliva

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If this is easy enough and cheap enough the workforce can be tested monthly at every employer to monitor employees. Its a way to open up everything. How this helps cruises I don't know but I know this, I want to cruise on our Oasis cruise is Sept. I don't want to social distance on a cruise and I don't want to wear a mask/face covering so things need to be figured out. I'm not smart enough to know the answers but social distancing and face coverings on a cruise is not the answer. If I have to personally buy 7 of these tests for each day of the cruise I will do that and take one each day. I do not want to be restricted in who I interact with or how man people I interact with and I do not want to wear a face covering everywhere I go on the ship. Sorry, just my thoughts.  

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7 hours ago, Traveler said:

Not sure if its any indication but some European countries published when they are planning to start and allow tourists to visit : 

Cyprus - June 
Italy  , yes Italy , Bulgaria , Greece - July.
Spain  Turkish - August 
France - currently only 2021 

My contact in Iceland told that even though they are down to just 20-something confirmed cases, they will not be "Back to Normal" for tourism until 2021. Now, this is a guy doing a small business arranging tourist activities and helping to answer questions about the country, not a high government official or anything. But he's generally got his ear to the ground so I'm assuming no chance of them opening before winter, or later if they want to see vaccine availability or some other way to ensure detection / tracing / prevention.

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10 hours ago, JLMoran said:

My contact in Iceland told that even though they are down to just 20-something confirmed cases, they will not be "Back to Normal" for tourism until 2021. Now, this is a guy doing a small business arranging tourist activities and helping to answer questions about the country, not a high government official or anything. But he's generally got his ear to the ground so I'm assuming no chance of them opening before winter, or later if they want to see vaccine availability or some other way to ensure detection / tracing / prevention.

When countries are going to open for tourist it dose not mean they will open for all , they might put some restrictions to open it for tourist that are coming from countries that has low mew  C19 cases comparing to the population. 

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4 hours ago, Traveler said:

they might put some restrictions to open it for tourist that are coming from countries that has low mew  C19 cases comparing to the population. 

Which won’t be the US for quite some time, going by current measurements. ?

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4 minutes ago, JLMoran said:

Which won’t be the US for quite some time, going by current measurements. ?

Well if we compare the numbers in the US to other countries we should see them going down until the end of this month. That why I think NYC area will be safer than other. For sure there is also the summer effect. There is so much we do not know about this virus but we know more and more as time passing. Lets hope that the summer will really be a factor here.

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Some good news which might be a game changer here.

An Israeli University researcher developed a C19 - breathalyzer (this is a different analyzer than the other company is developing)  it is based on some electronic chip that dedicates the difference in the electricity filed once someone with the virus exhaling into it. 
And here are the really good news :

1. The device was tested on 150 people (50% with Corona virus 50% without) and it was showing 93% success in dedicating the virus (which is more than the serologic test and equal to the accuracy of the PCR test ) .they are in a process to make it even  more accurate.

2, The results including the test itself takes up to 1 minute so it can be used in airports and cruise ports.

3. Since I guess they did not developed the chip from scratch its already manufacture .

The cost is estimate to be around 50 $ per test  (the PCR test is around 150$) .

Next steps is sensitivity test   and a test to see how its reacts to other virus (not to get falls alarms from cold virus for example). 

Since this is not the only place that are working on such test I believe soon we will see such test as standards in many places which will allow flights and more important cruise . 

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1 hour ago, Traveler said:

Some good news which might be a game changer here.

An Israeli University researcher developed a C19 - breathalyzer (this is a different analyzer than the other company is developing)  it is based on some electronic chip that dedicates the difference in the electricity filed once someone with the virus exhaling into it. 
And here are the really good news :

1. The device was tested on 150 people (50% with Corona virus 50% without) and it was showing 93% success in dedicating the virus (which is more than the serologic test and equal to the accuracy of the PCR test ) .they are in a process to make it even  more accurate.

2, The results including the test itself takes up to 1 minute so it can be used in airports and cruise ports.

3. Since I guess they did not developed the chip from scratch its already manufacture .

The cost is estimate to be around 50 $ per test  (the PCR test is around 150$) .

Next steps is sensitivity test   and a test to see how its reacts to other virus (not to get falls alarms from cold virus for example). 

Since this is not the only place that are working on such test I believe soon we will see such test as standards in many places which will allow flights and more important cruise . 

Very awesome news. There is an answer here besides of course a vaccine that works. There will be something, possibly this that gives people confidence. Something like this would be great, and a very effective medicine/treatment where even if you have it you won't get deathly sick. 

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5 hours ago, Traveler said:

1. The device was tested on 150 people (50% with Corona virus 50% without) and it was showing 93% success in dedicating the virus (which is more than the serologic test and equal to the accuracy of the PCR test ) .they are in a process to make it even  more accurate.

Were the people doing the test of the device aware of who was infected and who was not? If they were, the tests would have to be validated via at least single-blind testing to really confirm it's that accurate and not just confirmation bias. I don't see how it could be done double-blind -- someone handing the device to a sick or non-sick person will almost certainly be able to tell the difference. But I can think of a couple ways they could do a single-blind.

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14 hours ago, Traveler said:

Some good news which might be a game changer here.

An Israeli University researcher developed a C19 - breathalyzer (this is a different analyzer than the other company is developing)  it is based on some electronic chip that dedicates the difference in the electricity filed once someone with the virus exhaling into it. 
And here are the really good news :

 

There's a group working on Covid-19-sniffing dogs, too, which sounds WAY cooler to me.

sniff.PNG.e5ed50ef7e6cf5ebcc5fd3c3ba8c0461.PNG

Ooopssss!!!! That's not the right photo!!!!!!!!!!!

Here:

2067067367_correctsniff.PNG.1673526d8c08e98f78b659c77b45f632.PNG

https://animals.howstuffworks.com/animal-facts/dogs-sniff-out-coronavirus.htm

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On 5/14/2020 at 4:26 PM, JLMoran said:

Were the people doing the test of the device aware of who was infected and who was not? If they were, the tests would have to be validated via at least single-blind testing to really confirm it's that accurate and not just confirmation bias. I don't see how it could be done double-blind -- someone handing the device to a sick or non-sick person will almost certainly be able to tell the difference. But I can think of a couple ways they could do a single-blind.

Not sure about the blind test but testing will continue and some of them for sure will be blind tests.

The good thing is that not like medicine it dose not need to be tested for safety and long term influence.

The issue now that there very few new cases to test it on so they might need to shift some of the test to Europe or US. 

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More and more companies are announcing on new ways to deal with the C19.

Here is another company that starts soon test using antibodies  cocktail , 

They are talking about using it not just as a treatment but also as a prevention.

https://www.cnbc.com/2020/05/08/sorrento-therapeutics-mount-sinai-develop-covid-19-antibody-shield.html 

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Today Moderna announced they finish a successful first test with their vaccine (8 people got it and show good results with ).

The time line is to start massive phase 3 testing on July and have it approve by the end of the year. 

The interesting thing was raised during an interview with Moderna lead doctor , he said they are already started in massive production , which means it will be available to market at leas tin the US once it will be approved.

Lets hope.

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Some more good news , 

The results of a research to check the risk to be infected from surfaces  with C-19 was done in two  different hospitals .

They have collected samples from surfaces which are located inside the C-19 units in the hospital , they took the samples and tried to grow the virus (using host cells) . The results were very clear , the virus trace from the surfaces can not infect (they could not grow it while direct samples could easily grow)  . 

The research is being done now also in an hotel that was converted to quarantine location for people that found positive to the C-19 but were only lightly impacted by it.

 

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2 minutes ago, Traveler said:

Some more good news , 

The results of a research to check the risk to be infected from surfaces  with C-19 was done in two  different hospitals .

They have collected samples from surfaces which are located inside the C-19 units in the hospital , they took the samples and tried to grow the virus (using host cells) . The results were very clear , the virus trace from the surfaces can not infect (they could not grow it while direct samples could easily grow)  . 

The research is being done now also in an hotel that was converted to quarantine location for people that found positive to the C-19 but were only lightly impacted by it.

 

That would be a pretty big deal. Do you possibly have a link because that is extremely interesting?

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Just now, Traveler said:

I do have the link but unfortunately its not in English ... 

Ah ok, sounds great though. I'm reading a ton on the Moderna vaccine, and it sure seems promising. I mean when you have 8 people that wood have otherwise contracted Covid 19 and with this vaccine didn't that sounds pretty awesome especially with how contagious this virus is. Let's hope this is the big one. 

Google Sorrento Therapeutics because they found something extremely interesting that could they thing possibly "cure" Covid 19. 

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1 minute ago, RCIfan1912 said:

Ah ok, sounds great though. I'm reading a ton on the Moderna vaccine, and it sure seems promising. I mean when you have 8 people that wood have otherwise contracted Covid 19 and with this vaccine didn't that sounds pretty awesome especially with how contagious this virus is. Let's hope this is the big one. 

Google Sorrento Therapeutics because they found something extremely interesting that could they thing possibly "cure" Covid 19. 

Yes ,  I need to change it as it was not just 8 , there were much more people they tested the vaccine , they just split it to groups and each group got different portion. Anyway they start now phase 2 with several hundreds and then phase 3 On Jul. I hope it will work .
I have read about Sorrento , its very interesting  , they are working on antibodies as I understood and for sure it might serve as a cure. There are hundreds of companies which are in different phase of develop/test both vaccines and medicines to the treat the C19 , one of them for sure will be successful.  

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1 hour ago, RCIfan1912 said:

Google Sorrento Therapeutics because they found something extremely interesting that could they thing possibly "cure" Covid 19.

They've made the ship's pizza into a Covid-19 cure?!? OMG, I don't care how unlike NJ pizza it is, I'll eat that $*%& all day if it keeps me safe! ?

 

 

Sorry, couldn't resist. ?

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