WHAT ARE YOU WILLING TO ABIDE?

[JeffB]

What are you willing to abide by in terms of mitigation and containment measures for COVID-19? Before you think about that or post an answer, let's make sure we understand the risks of becoming infected with SARS-CoV-2 getting to, embarking and debarking from and living aboard a cruise ship. If you've been reading any kind of medical news available to the lay public or, if like me, you're studying the medical literature on SARS-CoV-2, you will know that the the greatest risk of transmission comes from person-to-person, airborne droplets 5 microns or greater in size expelled by an infected person talking, singing, sneezing or coughing. The virus is known to be carried in aerosols that, by definition, are smaller than 5 microns and can be as small as 1-3 microns. The kicker here is that research indicates that the virions (components of the virus capable of infecting another person) are of insufficient amounts to cause infections in healthy persons with competent immune systems. That means plumbing or AC systems aboard ship are not likely to be spreading the virus around the ship.  

Let's let that ride for a moment because we do know that there are at risk populations that will mount a less than robust immune response from exposure to the virus. These folks will be sickened by aerosolized SARS-CoV-2 where others won't, some seriously (but, less than 5%). If you are in one of those groups, cruising before a vaccine is widely available becomes riskier. You could be susceptible to infection from both droplets or low viral load aerosols. If you are not, your risk of getting infected getting to your cruise ship, embarking, sailing and debarking then getting back home is not high considering the mitigation measures already in-place and a 75% compliance rate. You might get minor symptoms. You might not get sick at all if you pay attention and do the things the travel and leisure industry is counting on us to do so they can operate safely. In the case of cruise lines, operate at all! If you are a healthy person, some healthy people even over 55 and even 65 (not over 80) and pay attention, your risk of getting seriously ill and dying is very low. The chance of dying while operating a motor vehicle and having an accident is about 16/100 (13%) The case fatality rate for COVID is thought to be around 6% or about 6/100.

One important point I want to make is that becoming infected by touching a contaminated surface with your hands and then transferring sufficient virions to cause COVID-19 (the disease from SARs-CoV-2) to your nose, eyes or mouth by touching them is low risk. There are 5 steps in that process and it is easy to interrupt the transfer at any of those points (e.g., wash your hands, don't touch your face). There appears to be an over-emphasis on this means of transmission when, in fact, it's not the major transmission pathway - not even close.  Airborne transmission is. Still, we'll see an increased focus on hand washing by various measures to make it easy for passengers to do that.

Based on the foregoing, the best mitigation protocols involve social distancing and wearing a mask when you can't - I can make the case for wearing a mask everywhere in enclosed places and even outdoors but it would take too many keyboard strokes and this is long enough. Trust me, masks are good at protecting against one infected person spreading it to others. Protection is even better and approaches 95% if both the infected person is wearing a mask and so are other people within 6 feet (2m) intermingling in public spaces. The scientific and medical evidence that supports that statement is overwhelming.

I am not saying virus mitigation measures involving cleaning surfaces and sanitation aren't needed - they are and can be increased - but all the talk of this, a seeming focus on it, is less important than distancing and masking. Requiring masks in public areas, to include casinos, bars, restaurants and entertainment venues doesn't need to be a deal breaker and definitely isn't for me. In fact, I believe they are crucial mitigation measures for cruise ships. I doubt cruise lines will mandate them with those mandates enforced by staff. They'll be recommended, and friendly reminders to mask up in certain settings will come from officers and information posted about the ship.

I'm fine with the kinds of distancing we're already seeing mandated by airlines (not necessarily enforced) in our local restaurants and casinos in Vegas as they re-open. I'd add that capacity limits to shipboard bars, restaurants, gyms, casinos, theaters, (shows) that allow for distancing are appropriate. This is easy to do and not terribly inconvenient if you're flexible, adaptable and willing to recognize humans are vulnerable to this thing when there is zero immunity to it.

Folks worry about enclosed spaces, especially gyms or ride studios where people are huffing and puffing. Mitigation in these places can take the form of air handling scrubbers, filters and purifiers - it can be expensive but these work when installed, filtering and capturing small particle sized virus down to 3-5 microns. Some smaller than that. These should have been on the AC systems in these places anyway and before SARS-CoV-2. I suspect you'll see them installed as part of the CDC's willingness to lift their no-sail order.

Finally, any success the lines have in keeping the spread of the virus checked on their ships will depend mostly on passengers taking the potential for spread of the virus  seriously aboard the ship they are sailing. Containment can be done and is done already for Norovirus. It can be done for SARS-CoV-2. Mitigation measures like I mention above are fine and we'll see them and probably more but the most effective preventative of virus spread is human behavior. If you aren't convinced this is a dangerous virus with the potential of creating serious illness and death and believe you can flaunt any mitigation measures put in place by the lines, please don't cruise. This isn't like going to the main dining room where some guests are wearing formal attire with a ball cap, no shirt, no shoes and shorts, expecting to be seated and served, because you can and don't like to be told what to do on vacation. Flaunting COVID-19 mitigation measures the lines are likely to put in place will surely shut the lines back down if such action causes a COVID-19 outbreak on any ship...... and it will. So, now being properly informed, what mitigation measures are you willing to live with if you want to cruise?