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Congress probing White House influence over CDC's cruise 'no-sail' order


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Have to agree with @twangster I COMPLETELY understand the dangers of COVID 19, but also understand that it is not as deadly as they first thought it was.  I also know that cruising can resume with certain things in place where it will be safer than going to the local Walmart.  I know that they will clean the surfaces far more than grocery stores do.  I know that they will also be more inclined to enforce social distancing as well.  I have no worries that they can and will do the right thing for their customers, there are too many cameras and people that are  going to be pointing the finger.  The cruise industry as a whole has way too much to loose! 

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It's pretty hard to discuss this without getting into politics, because the very question being asked is to what extent should political actors (the WH) have influence over the decisions of an agency that you'd expect to be fairly independent on matters within its competence (CDC).  

However, those who are eager to cruise should be very concerned by some of the language used by the Representative leading the investigation: " 'These ships shouldn’t leave port until we know passengers and crew will be safe and the ships won’t again become global vectors of disease,' Maloney said in a release."  

Even if cruises begin in December or early January, one wonders whether they'll continue after January 20th.

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38 minutes ago, danv3 said:

However, those who are eager to cruise should be very concerned by some of the language used by the Representative leading the investigation: " 'These ships shouldn’t leave port until we know passengers and crew will be safe and the ships won’t again become global vectors of disease,' Maloney said in a release."  

That verbiage is likely coming from someone at the CDC.  The CDC has publicly stated that ships should not sail until the virus is completely over.  I've interpreted that to mean the CDC doesn't want ships sailing until well into 2022 or 2023 when the last remnant of the virus has disappeared which is what I believe the CDC's end game really is.  The CDC would be perfectly fine if all cruise ships vanished from the earth.  This is their opportunity to create that outcome.

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CDC has a "misapplied"  authority for this particular industry.  They don't control the airline, hotel/resort or other industries.  But cruise lines sit in their laps because legislators never took the time (until now) to see where regulatory control should lie.  CDC is definitely a stake holder, but do not hold expertise on maritime operations or overall safety.  The proposed legislation from the FL senators can right the ship on this.   

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58 minutes ago, cruisellama said:

CDC has a "misapplied"  authority for this particular industry.  They don't control the airline, hotel/resort or other industries.  But cruise lines sit in their laps because legislators never took the time (until now) to see where regulatory control should lie.  

Please expand on this as it pertains/applies to "misapplied authority"??

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cruisellama's post makes sense. One has to understand how the NSO went down. CDC, as part of the Pandemic Task Force, recommended, the executive concurred and the DHS published and is responsible for enforcing the NSO.  The Task Force headed by Pence continues to take inputs from agencies and stake holders, decides on policy and has the appropriate agency execute.

In this context it's another politically motivated wild goose chase for Congress to "investigate inappropriate WH influence on the CDC." The WH in the form of VP Pence IS and very appropriately making pandemic policy.

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2 hours ago, princevaliantus said:

Please expand on this as it pertains/applies to "misapplied authority"??

Used an awkward word.   By "misapplied", I'm referring to the CDC being given sole authority for leading oversight of cruise industry by HHS. Authority is misapplied by HHS or other executive branch departments.  Would think DoT or DoC would have been a lead oversight agency, with HHS as a stakeholder.   CDC is not the right match for sole oversight of the cruise industry.  

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I've personally found it difficult to remain positive about the likelihood of cruising restarting given the torrent of "bad" COVID news. Let's take stock:

New case numbers are increasing. That is inevitable given exponential growth. More cases beget, well, more new cases ...... x, 2x, 4x,16x and so forth. Theoretically, unless you eliminate the virus there will be growth. The WHO and the CDC seem to have settled on a 5% percent positive rate in testing presumes containment of the virus.  

I've argued that managing your responses to the pandemic based on absolute new case numbers or any of its derivatives is a flawed approach. What is more important to look at regionally and locally is disease burden and there are numerous data points that enable officials to do that. The COVID Tracking Project is a good single source place to get data:

Hopkinshttps://covidtracking.com/data/charts/all-metrics-per-state

What conclusions you draw from it that guide policy formulation is another thing altogether. This is where we get into gray areas where it's hard to determine, for example, if one mitigation measure makes sense and one doesn't. The goal should be to limit disease burden. While you can argue that absolute case numbers and disease burden are intimately connected they often aren't. That is because we've learned that disease burden is very different by age grouping. We can also see, right now, with case numbers increasing, CFR (a proxy measure of disease burden) has remained almost constant if not down trending. Moreover the growth trends of other disease burden metrics like ED visits, hospitilizations, etc. are not accelerating at the same levels and, in fact in more regions than not, they are decelerating. Of course, there are local exceptions but one should not generalize a local occurrence to the nation and that is done all the time.  None of this gets reported by the lay press. NONE. Full stop. This should make us all skeptical of media reports describing dire consequences from increasing case numbers. 

Let's apply this to the NSO. The STS Plan is a reasonable, very complete mitigation plan given the risk of congregate settings the CDC frets about. It's being successfully practiced in Europe and Asia. Now let's place this up against the torrent of "bad" COVID news and the politically charged atmosphere, the terrible and unfair rap cruise lines got in March, ground staked out and reputations that have to be protected and I think it would be a miracle to see revenue producing cruise operations restart in 2020. It could happen but it's a long shot given the misinformation mitigating against a restart that is out there. 

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39 minutes ago, cruisellama said:

Used an awkward word.   By "misapplied", I'm referring to the CDC being given sole authority for leading oversight of cruise industry by HHS. Authority is misapplied by HHS or other executive branch departments.  Would think DoT or DoC would have been a lead oversight agency, with HHS as a stakeholder.   CDC is not the right match for sole oversight of the cruise industry.  

Aaaah....total misinformation. Let me try to clear what & how all this came about. Here goes:

A) On March 13, 2020, Cruise lines, hit hard by COVID-19 pandemic, announced they would voluntarily halt operations in the U.S. for 30 days.

B) At 3:21PM, same day, an announcement was made by President Trump which read, “At my request, effective midnight tonight, Carnival, Royal Caribbean, Norwegian, and MSC have all agreed to suspend outbound cruises for thirty days. It is a great and important industry – it will be kept that way!Trump has this authority and power under 50 U.S. Code §218-222.

C) Trump’s Pick for CDC Director was Robert Redfield. The CDC is a component of the HHC whom both report to Trump.
D) To protect the health of people living in the United States, Congress passed certain laws giving the U.S. Department of Health and Human Services (HHS) the authority to prevent the introduction and spread of contagious diseases in the United States. The HHS Secretary delegated this authority to the Centers for Disease Control and Prevention (CDC), and operations are carried out by the Division of Global Migration and Quarantine (DGMQ) within CDC. DGMQ works to fulfill this responsibility through its operations at ports of entry, administration of interstate and foreign quarantine regulations, and establishment of requirements for the medical examination of individuals coming to live and work in the United States.

Federal regulations apply to the following if they are coming in to the United States from another country by land, air, or sea:

  • Any person (including U.S. citizens, legal permanent residents, and foreign nationals)
  • Conveyances (airplane, ship, bus, or train)
  • Animals regulated by CDC
  • Articles (bushmeat, hunting trophies, or other animal products made from CDC-regulated animals; some goatskin drums; and other items that might be infectious to people)

E) In sum, the CDC are just enforcing said rules, regulations and laws passed by Congress.  The advisories from the State Department and the CDC were recommended by the White House coronavirus task force headed by V.P. Pence, and the administration stated Trump and Vice President Pence knows about these recommendations advance.

There's alot of political play going on and CDC is not the right person to take full blame. Trump closed the ports back in March. Trump should open it. What is Trump waiting for??

 

 


 

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26 minutes ago, JeffB said:

That is because we've learned that disease burden is very different by age grouping.

We have to allow for a variety of meanings with "disease burden", though, no? Among the elderly and high-risk patients with co-morbidity, increased illness means a "disease burden" of higher ER and ICU usage; increased needs for still-limited PPE, medicines, and other resources; and other near-term burdens to prevent death.

But in the younger cohorts there is a longer-term "disease burden". It does not overwhelm the hospitals with cases, since most recover at home. But we are seeing more and more that these younger people develop long-term health issues -- strokes and heart attacks in the worst cases; lung scarring, kidney damage, heart damage, even neurological and brain issues in the rest. And these long-term burdens also increase the toll on our medical systems, their families, and society at large; it's just not all at once.

Some of these people will die earlier than expected. Most will live a normal lifespan, but with random symptoms that go on for months, maybe even years. And we could discover years from now that just as Chicken Pox can remain in the body and reactivate as Shingles later in life, this virus might stick around in long-term patients and reactivate from time to time as something just as bad or worse than the original disease.

I wholeheartedly agree that the CDC is overstepping with its treatment of the cruising industry relative to everything else. But I don't think they're overstepping to want to keep this disease spread as small as possible among everyone, not just the elderly and high-risk. We have enough chronic conditions that a good chunk of the populace has to deal with for most or all of their lives -- asthma, diabetes, severe food allergies,... Let's not add long-term Covid-19 symptoms to that list any more than we have to.

 

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A small quibble princevaliantus although I thing you're on the right track. I don't believe that the CDC has any enforcement role on maritime operations although I get that they are providing an aspect of infection control through immigration enforcement by DGMQ.

Enforcing port closures, I believe, falls to the Department of Homeland Security (DHS). The agency doing the enforcing is the USCG. Therefore the Pandemic Response Team acting as the executive becomes the sole authority for either extending or letting the current NSO expire on October 31st. The CDC remains in an advisory role to the Pandemic Response Team. Pence can consider what the CDC recommends; he can consider the cruise industry's STS plan; he can weigh the costs v. PH benefits/risks and then decide whether to extend or let expire the NSO. If he decides to let the NSO expire, acting as the executive, he'll put into motion the steps necessary to call the USCG off.

 

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19 minutes ago, JLMoran said:

I don't think they're overstepping to want to keep this disease spread as small as possible among everyone, not just the elderly and high-risk. We have enough chronic conditions that a good chunk of the populace has to deal with for most or all of their lives -- asthma, diabetes, severe food allergies,... Let's not add long-term Covid-19 symptoms to that list any more than we have to.

Can you quantify the degree to which "long term Covid-19 symptoms" contribute to the public health impact of other known chronic conditions you wish to group these in? Is there evidence that "other near-term burdens to prevent death" that you mention haven't been completely overcome or at the least inovatively ameliorated?

I tend not to deal in "could." It is could happen but then doesn't that is inappropriately contributing to policy making errors when it comes to COVID responses. My take is we've seen a lot of that coming from the CDC.

I will deal in facts. We know what the CFR is and it is low, much lower in some age groups than others. We know which age groups are most likely to die from C-19. We know how many ED visits there are for ILI or COVID sx. We know, by age cohort, how many COVID and COVID like sx result in hospitalizations.

I've dealt with these and shown how these metrics are not increasing or accelerating at the same rate as new cases. If there are increases they are local, for the most part being managed and should not be extrapolated to the national level. There is plenty of good news out there with vaccine developments, with new medications and with improved in-patient management. ....... yet the torrent of bad news drowns the good news out. The "dire consequences" narrative and hand-wringing continues. It's absurd.

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17 minutes ago, JeffB said:

I tend not to deal in "could." It is could happen but then doesn't that is inappropriately contributing to policy making errors when it comes to COVID responses. My take is we've seen a lot of that coming from the CDC.

I will deal in facts.

It is a fact that there are long-term Covid-19 symptoms. There are documented cases and the number of reports of this is growing steadily.

It is a fact that the effects of these symptoms include debilitating effects such as neurological impairment (including memory problems, inability to think as clearly as before, etc.), long-term breathing problems, etc. that ultimately make individuals less productive in their jobs, take more sick time, etc.

It is a fact that the CDC's full name is "Center for Disease Control and Prevention".

If the medical staff that comes up with guidelines to present to their leadership are aware of these long-term effects, and are in any way behaving better than a Wall Street Analyst (that is, looking more than 3 months out), I argue that they will see it as their job to prevent this from happening as much as possible. Since it's actually something that's very reasonably preventable through interventions until we have a viable vaccine.

 

This is my view on the matter. Let's agree to disagree and leave it at that.

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18 hours ago, princevaliantus said:

Aaaah....total misinformation. Let me try to clear what & how all this came about. Here goes:

A) On March 13, 2020, Cruise lines, hit hard by COVID-19 pandemic, announced they would voluntarily halt operations in the U.S. for 30 days.

B) At 3:21PM, same day, an announcement was made by President Trump which read, “At my request, effective midnight tonight, Carnival, Royal Caribbean, Norwegian, and MSC have all agreed to suspend outbound cruises for thirty days. It is a great and important industry – it will be kept that way!Trump has this authority and power under 50 U.S. Code §218-222.

C) Trump’s Pick for CDC Director was Robert Redfield. The CDC is a component of the HHC whom both report to Trump.
D) To protect the health of people living in the United States, Congress passed certain laws giving the U.S. Department of Health and Human Services (HHS) the authority to prevent the introduction and spread of contagious diseases in the United States. The HHS Secretary delegated this authority to the Centers for Disease Control and Prevention (CDC), and operations are carried out by the Division of Global Migration and Quarantine (DGMQ) within CDC. DGMQ works to fulfill this responsibility through its operations at ports of entry, administration of interstate and foreign quarantine regulations, and establishment of requirements for the medical examination of individuals coming to live and work in the United States.

Federal regulations apply to the following if they are coming in to the United States from another country by land, air, or sea:

  • Any person (including U.S. citizens, legal permanent residents, and foreign nationals)
  • Conveyances (airplane, ship, bus, or train)
  • Animals regulated by CDC
  • Articles (bushmeat, hunting trophies, or other animal products made from CDC-regulated animals; some goatskin drums; and other items that might be infectious to people)

E) In sum, the CDC are just enforcing said rules, regulations and laws passed by Congress.  The advisories from the State Department and the CDC were recommended by the White House coronavirus task force headed by V.P. Pence, and the administration stated Trump and Vice President Pence knows about these recommendations advance.

There's alot of political play going on and CDC is not the right person to take full blame. Trump closed the ports back in March. Trump should open it. What is Trump waiting for??

 

 


 

They control and levied the "no sail order".  CDC should recommend; not act as the final determination agency for implementation for an undefined period of time.   In effect creating new rules not authored by Congress.

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