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Fully Vaccinated Cruise = No Kids


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Thought I'd post some interesting and good news today. We need that.

Read an interesting Bloomberg News piece on government's authority to mandate vaccines. A good deal of it dealt with Governor Desants' EO banning "vaccine passports." His intent was to ban such requirements for a patron to enter any business operating in FL under a FL business license. There was lots of misinformation about this pretty narrowly focused EO as you'd expect that implied it had broad effect and would include cruise lines. I had argued it won't as I understood it. The debate continues - mostly because controversy is newsworthy. Let's clear some things up:

  • A requirement to show proof of vaccine for entry wouldn't violate HIPA as has been claimed. That is because the entity requiring such information isn't a healthcare entity.
  • According to the lawyer quoted in the Bloomberg piece, "there is no statutory, regulatory or constitutional bar to that (a requirement to show proof of vaccination for entry) to happen as long as it is applied in a non-discriminatory manner."

I think that last legal opinion is definitive on it's face. Clearly that's not going to end the debate. What I think is clear is that the cruise lines have looked at the legal implications of requiring vaccinations to board and have decided that it is necessary layer of many other mitigation measures and requiring it is legal. Plan on getting vaccinated if you want to board a cruise ship when cruising restarts. I like that

Desantis was quoted as apparently implying the cruise industry would be required to comply with his ban. I can't find that direct quote. I also think that given his strong support for the restart of cruising, if he actually did say that, there are plenty of ways for him to side-step it.

In other vaccine news is you haven't heard it already, Pfizer has announced "a third shot (a booster) will likely be required 12 months from the date of your second shot." I never thought there was any question that SRAS2 would become seasonal much like influenza and that annual shots would be recommended to blunt it's effects. SARS2 is with us. I think this is good news. It indicates Pfizer thinks SARS2 will become seasonal and immunity will wane over time. It will need to be boosted. Like the influenza virus, its genomic makeup will vary. The one thing we have going for us is that these mRNA vaccines have 90-90% efficacy with effectiveness, even in the face of variants, around 80% effective in preventing death, serious illness and transmission. Flu vaccines are between 35 and 50% effective. 

A CBS's 60 Minutes segment aired on Sunday. It featured a scientist who works within DARPA (The Defense Advanced Research Projects Agency) who described two pretty amazing advancements that "would stop the next pandemic in its tracks." (Link belwo) The reason I mention this is that most of us are suffering from pandemic fatigue and have lost some hope for the future. We'll let me tell you scientists and researchers haven't lost hope and continue to advance technologies and therapeutics in ways unimaginable a decade ago.

https://www.cbsnews.com/news/last-pandemic-science-military-60-minutes-2021-04-11/

Unrelated to COVID, my daughter is such a researcher. She lives and works in Switzerland. Her work involves supervising a research project that builds synthetically derived tissues that when assembled become an organ. One can then test the effect of a therapeutic without involving human trials. The net result is speeding the introduction of advanced therapeutics through the regulatory process. A kidney and liver have already been assembled. Proof of concept is underway.  

Have nice day! 😄

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2 hours ago, JeffB said:

Desantis was quoted as apparently implying the cruise industry would be required to comply with his ban. I can't find that direct quote. I also think that given his strong support for the restart of cruising, if he actually did say that, there are plenty of ways for him to side-step it.

Look for his Port of Miami live event when he first announced the CDC lawsuit.  A reporter asked his about the EO and cruise ships, or at least we think they did because the reporter wasn't picked up by the microphones very well.

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I think HIPAA has context related to storing and accessing healthcare data beyond actual healthcare providers.  3rd party and cloud providers for healthcare companies for example.

I have to complete HIPAA training since I work around systems that may contain patient data even though I don't have an account on the system that can access any records.

So long as Royal or any business doesn't store patient healthcare data merely looking at a piece of paper or an app like passport doesn't equate to storing patient data.  Asking a question doesn't invoke HIPAA regulations unless you store the answer, even then there is more to it.

Users on many internet forums and social media platforms are posting their vaccine status.  Those platforms are NOT subject to HIPAA.

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9 minutes ago, twangster said:

I think HIPAA has context related to storing and accessing healthcare data beyond actual healthcare providers.  3rd party and cloud providers for healthcare companies for example.

I have to complete HIPAA training since I work around systems that may contain patient data even though I don't have an account on the system that can access any records.

So long as Royal or any business doesn't store patient healthcare data merely looking at a piece of paper or an app like passport doesn't equate to storing patient data.

I also have to take part in HIPAA training because of my work in IT at a Healthcare company.   The best way I've been able to explain HIPAA to people is like this.

 

HIPAA says that your "doctor" cannot share your medical information, it does not prevent you from sharing your medical information.

 

So yeah, if anyone asks you about anything medical you can freely share your own information (not your family members, without thier consent).  It's not like any company is going to be linked to your medical record, you would basically have to attest to it or show your card (or something similar)

 

 

Also, please stop writing HIPPA! 🙂 

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@twangster@Matt @Sharla Recommendation for hotel close to embarkation? (Adventure sailing) We usually stay at the Hilton right there but there are no rooms available for the 3 of us. I am just trying to do some leg work to get an idea of total costs on top of FCC's, before I bother Sharla. To waste her time is not an option. To clarify, do we have to fly in the same day as the sailing or can we get there a day before? I wondered if the Covid tests we submit to in the States would be accepted for entering the Bahamas as well as embarking the ship? I want to understand everything before commitment, I have a knack for screwing things up, after 32 years of marriage I try to avoid the "I told you so" as much as possible. LOL!! Lastly, we step off the ship, must go straight to the airport with our negative Covid tests from Royal or can we depart the next day? I wish Celebrity would honor Royal FCC's I would not mind spending extra time there if there was a sailing, Bahamas, not so much. MY HEAD IS SPINNING.....

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You can get there the day before. The only gotcha is if you're traveling with kids under age 10 who will (as of now at least) require a negative PCR test to board, but not to get in the country. Still no word yet on the lead time of the testing window to get on board and how it coincides with the Bahama 5-day test window

 

All indications are that the test you get to disembark will count towards any Bahamas re-entry a well a USA re-entry.  You could depart the next day, or even several days later. Just that disembarkation test may then be too old to count towards your USA re-entry.

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On 4/12/2021 at 3:23 PM, JeffB said:

There's mounting evidence from Michigan, among other states, that teens and kids are becoming infected with the more transmissible UK variant at fairly high rates. Fleshing out the actual numbers and comparing them to a baseline in the under 20 age group though is hard.

I've accessed several data bases and what is being said by Governor Whitmer in MI and echoed by Dr. Walenski of the CDC isn't precisely born out in the data I'm looking at. Youth sports, for example, is being touted by Governor Whitmer as a prime source of viral spread and increased new cases in MI. But, from a baseline, it's not under 18s - I would suppose that's who participates in youth sports programs -  that this increase is being seen. It is predominantly in the 20-39 yo group. So????? I've become very skeptical of COVID related pronouncements coming from politicians and the CDC. 

The issue for cruise lines and kids is not one of increasing disease burden in this age cohort (hospitalizations and deaths), it is one of the risks of undetectable viral loads in early infections that get missed by molecular (PCR) or antigen testing as part of a pre-boarding health screening process and then asymptomatic transmission aboard ship as the infection progresses. It's also one of the lines evaluating the risks versus the benefits obtained of allowing families with kids under 18 to sail in the current environment.

My take is that allowing under 18s to sail without vaccination (or 16s if you want to include soon to be available Pfizer vaccines) and with only a negative PCR test to board, does increase the risk of a shipboard COVID outbreak but probably only among other kids who boarded. It's still an outbreak, it should be a medical concern worthy of trying to avoid even though it's not likely to be one that produces serious illnesses. I also believe that the risk of transmission from an infected kid to a vaccinated older adult is very low. However, on any re-start scenario approved by the CDC and within the next few months the best strategy is to not take that risk of allowing kids to sail.

So, if I were providing input to the Healthy Sail Panel that involves decisions about sailing in the current circumstance, I'd say vaccines should be required for al. passengers. At some point, COVID will be a manageable infectious disease similar to influenza, norovirus or the common cold. Kids can sail then. That point gets moved up as kids and everyone else gets vaccinated. But until either of those points are obtained, I'd advice against unvaccinated persons being allowed to board regardless of a pre-boarding  negative test result.  

This is a great resume about vaccinations and sailings but did you know in Europe and Asia cruise lines have been sailing with unvaccinated guests for many months now?

Royal Caribbean has now passed more than 100 000 passengers in its cruises from Singapore and MSC and TUI have been sailing from Europe for many months with only one or two family break outs which were swiftly contained.

RC is sailing from Cyprus this summer on Jewel and kids are allowed on already with a negative PCR test. I fully expect there to be the usual temp checks testing and social distancing rules in place and I don't see any problems arising on their sailings. I think the American cruise industry is doing too much hand wringing about all of this and hope this bill to limit the CDC in cruise ship protocols works as they really have went far beyond their remit as far as cruising is concerned. 

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Let's be clear. The WHO is an organization with deep roots in policy recommendations and guidance that place equity and justice at the forefront. I'm not advancing the notion that is a bad thing. In some cases it is completely appropriate and under-recognized. TBF, developing policy that is both pragmatic and at the same time advances equity and justice is a very tough job.

Here's the key statement in the linked document:

  1. Do not require proof of vaccination as a condition of entry, given the limited (although growing) evidence about the performance of vaccines in reducing transmission and the persistent inequity in the global vaccine distribution. States Parties are strongly encouraged to acknowledge the potential for requirements of proof of vaccination to deepen inequities and promote differential freedom of movement.

 Earlier in the document, the WHO acknowledges the impact of vaccines in reducing COVID related deaths and illness as well as reducing the Transmission of SARS2. They correctly call for relying on the emerging science. They go on to say there's not enough evidence yet to definitively conclude that vaccines are as good as they seem to be. What?

This is the problem with the WHO. The last statement in the quoted text demonstrates that deepening inequities and differential freedom of movement are more important than improving global public health. IMO, it is blindingly obvious that requiring vaccines for entrée to specific venues (e.g., large gatherings to watch sports, airline travel, sailing aboard  cruise ships) will decrease both disease burden and transmission. Don't require these because it is unfair? The Israeli's have it right ...... "you will be left behind if you don't get vaccinated." That is being pragmatic. The WHO isn't being pragmatic.    

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40 minutes ago, JeffB said:

IMO, it is blindingly obvious that requiring vaccines for entrée to specific venues (e.g., large gatherings to watch sports, airline travel, sailing aboard  cruise ships) will decrease both disease burden and transmission. Don't require these because it is unfair?

Context of that statement I believe was in regard to "Health measures in relation to international traffic".

In the statement I'd say the meaning on entry was referring to entering a country. Don't think it was implying entry to venues.

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Quote

This is a great resume about vaccinations and sailings but did you know in Europe and Asia cruise lines have been sailing with unvaccinated guests for many months now?

Yes.

Let me be clear. The science favors multi-layered protocols for risk reduction. One of them is to require circulating virus be controlled in the locale from which a cruise ship is boarding passengers and crew then sailing. The metric by which this is assured varies but Singapore, for example, the last I checked has no deaths and no circulating virus as evidenced by new cases. There are other layers that have been discussed here. Requiring vaccinations is one the cruise industry has adopted when sailing into or from ports that aren't like Singapore or Haifa or Taipei, e.g., Nassau, St. Martin and other Caribbean ports. 

Why aren't we sailing from US ports yet? Well, the CDC's unworkable CSO and foot dragging is one of them. Another, however, and one that public health officials worried about SRAS2 transmission should consider before getting behind cruise ship operations from their ports, is the level of circulating virus present in and around them. Broward County, home of Port Everglades, and Miami-Dade County, home of the port of Miami, both have evidence of circulating virus (% positivity 6-8%. Generally accepted to be adequate virus control is demonstrated when new case % positivity is below 5% for 7 consecutive days). 

Now, given that reality, would you rather sail on a cruise ship out of either of those ports where everyone is vaccinated as an alternative risk reduction measure to insuring there is no circulating virus in both counties? In the US and globally, we will continue to see low levels of circulating virus for the foreseeable future. It might be close to 5% or approaching it but if it isn't there does that mean we shouldn't travel there?   I know how I'd answer both these questions.

Here's another tid-bit. Just last week the CDC produced a report that appeared on their web site that trumpeted new government data showing that 5,800 fully vaccinated Americans had contracted COVID. That may sound like a big number, but it indicates that a vaccinated person’s chances of getting COVID are about one in 11,000. The chances of a getting a version any worse than a common cold are even more remote. But what trumpeting news like that does do is to discourage vaccination - exactly what the Biden administration is working hard to avoid.

Vaccines are the best alternative that will allow a return to normalcy as a means of approaching and then achieving herd immunity in the US. A fully vaccinated boat-load of crew and passengers HAS herd immunity and an exceedingly small risk of anyone aboard becoming re-infected either aboard or ashore in a port of call or getting seriously ill from COVID even lower risk.

Here's a link to a cool model based on available data sets. The interactive graphs at the link are titled "A Path to Normality." The US approaches the stage when all mitigation measures can or should be removed in May and achieves it in June.

https://covid19-projections.com/path-to-herd-immunity/

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15 minutes ago, JeffB said:

But what trumpeting news like that does do is to discourage vaccination - exactly what the Biden administration is working hard to avoid.

Problem is they aren't working to avoid that by telling people that just because they're vaccinated they can't go back to a normal life.

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Well, yes and this negative Nancy messaging needs to stop. The example I gave of the CDC's announcement on reinfections properly condenses to the message that you have a 1 in 11000 chance of getting COVID once vaccinated. This is a hugely important one. It gets missed by the CDC and I think that is reflective of what's wrong there.

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I moved the link that appears at the end of this post to here. It was in the Bahamas thread. We've had a spirited discussion here about vaccines in general so, I wanted to comment on the CDC's announcement and my take-aways.

The CDC has conducted a study on what it calls "breakthrough infections." These are infections that occur after a person has been vaccinated. The study results are below. Since the study and starting now, the CDC will only report break through infections that result in hospitalizations or death. There's a good reason for that. If you look at the study numbers that considered all breakthrough infections reported by states, that it happens at all is rare. When it does happen, the numbers are miniscule:

Breakthrough.PNG.42222763acefa1d0c4015644499fe338.PNG

The CDC goes on to recommend this:

  • Vaccine breakthrough cases occur in only a small percentage of vaccinated persons. To date, no unexpected patterns have been identified in the case demographics or vaccine characteristics among people with reported vaccine breakthrough infections.
  • COVID-19 vaccines are effective. CDC recommends that all eligible people get a COVID-19 vaccine as soon as one is available to them.

This is good news. 93% of breakthrough infections did not result in hospitalizations. Only 1% resulted in death and of that 1% (88) 11 of those deaths were caused by other factors even though that patient had COVID. IOW, less than 1% of breakthrough infections resulted in death attributed to COVID.

If that is the case in the general population where about 50% of Americans mask and/or distance, how can a cruise ship environment be unsafe in terms of being spreaders of infectious disease when everyone sailing will be vaccinated and I suspect masked in any setting where physical distancing might be compromised? Keep following this line of thought. 

The good news about breakthrough infections should be followed by specific steps that Americans can take to resume normal activity if they are vaccinated don't ya think? But .....noooooooo. Then they go on to recommend this non-sensical low risk, out of an abundance of caution advice:

  • CDC recommends that fully vaccinated people continue tp take steps to protect themselves and others in many situations, like wearing a mask, maintaining an appropriate social distance from others, avoiding crowds and poorly ventilated spaces, and washing their hands often.

One other unsubstantiated boogey man the CDC reports and shouldn't becasue there's no data to support the allegation is that the numbers reported are probably undercounts. Really? Shut the door. No proof of that at all!

IOW, you still need to be scared of COVID.

I want to scream ....... "masks in many situations"? Does the CDC mean outdoors, indoors, gyms, bars, baseball stadiums, cruise ships? Where? Wash your hands? Generally a good idea but in the case of SARS2, which is what we're talking about here, your hands are not fomites that facilitate transmission of this bug. 

OK, look, it's America right? We can look at the data and make good choices, do our own risk analysis and determine what we are comfortable with, right? That would work except we have the CDC making policy, shutting down the cruise industry while state governments, some of them, continue to mandate all sorts of behaviors for residents and businesses. Over-reach. Big time! 

Anyway, stepping off my soap box. This is really good news and should have a significant impact on what we all want to have happen: start cruising from US ports again.

https://www.cdc.v/vaccines/covid-19/health-departments/breakthrough-cases.html

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  • 2 weeks later...
On 4/8/2021 at 6:10 PM, tonyfsu21 said:

will certainly take the family out of family vacation. 

True! I started cruising when I was young and continued after having children, my son and daughter love it so much. Cruising is our favorite type of vacation as it has something for everyone! 

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We are not going on our July 1 trip even in the small likelihood it sails. As parents, we are vaccinated. But my children are not yet due to age. Even if they could go, I'd feel uncomfortable what people might do or say knowing they are the apart of the unvaccinated 5% If some one gets sick and the cruise ends, they'll probably blame kids. These are very tense times for those on both sides of the vaccine spectrum.

Then on top of that, I feel bad going to foreign islands with thousands of other American tourists possibly spreading illnesses.  

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39 minutes ago, Matt V said:

We are not going on our July 1 trip even in the small likelihood it sails. As parents, we are vaccinated. But my children are not yet due to age. Even if they could go, I'd feel uncomfortable what people might do or say knowing they are the apart of the unvaccinated 5% If some one gets sick and the cruise ends, they'll probably blame kids. These are very tense times for those on both sides of the vaccine spectrum.

Then on top of that, I feel bad going to foreign islands with thousands of other American tourists possibly spreading illnesses.  

Royal has had some cases onboard even before there was a vaccine. It did not bring most cruises to a halt, only early on. Also, chance of children catching or spreading in a fully vaccinated crowd is so unlikely. Now people’s very unrealistic fear of unvaccinated children is another story and you bring up a great point to consider.

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