CDC extends no-sail order for cruises until Oct. 1

[fizzy]

1 hour ago, howiefrommd said:

This will not solely resolve with an agreed upon document from CDC and the cruise line industry, a vaccine/immunization nor will the virus magically disappear.   Eventually CDC and the involved parties will come to a mutually agreed upon plan to address CDC's issues.  As I have said before, once the agreed upon criteria is enacted, then the real hard work starts.  This will not be a matter of putting up a piece of Plexiglas or moving a few tables.

 

My entire life has been involved with both at the Federal level and upon retirement in the private sector dealing with health care quality analytics.  In the April 15th CFR notice, the following appears:

 

 "Onboard medical staffing, including number and type of staff, and equipment in sufficient quantity to provide a hospital level of care (e.g., ventilators, facemasks, personal protective equipment) for the infected without the need for hospitalization onshore;"

 

Although this may sound manageable, to execute such a task is not an easy one.  Over the years I have had the opportunity to either dine with the medical staff and/or get a tour of shipboard medical facilities.  The level of care as articulated in the April 15 CFR notice, is one of an ICU level of care.  This would require Physicians and Nurses with the appropriate level of training to handle tasks such as multiple patients on ventilators, etc.  In the United States this is primarily done by Critical Care Intensivists or Pulmonary Critical Care Physicians.

 

A few things that come to mind when I think of the many conversations I have had with shipboard physicians over the years.  Many are there for the same reason many of the workers are on the ships.  They come from countries with low pay, low employment prospects and need to support a family.  Most I have spoken with have usually been trained within general medical specialties (equivalent to Family and/or Internal Medical trained physicians in the US). 

 

Another issue, is the smaller ships (according to ACEP) usually have only one Physician and between one to two Nurses. Note that many cruiselines belong to ACEP, but the physicians staffing the ships are not.  Within the United States we have a tremendous shortage of critical care physicians.  Granted that the cruiseships historically do not hire US physicians (due to cost).  So the question is, where do all of the cruiselines get all of the Critical Care and trained Physicians and Nurses?  

I know I am asking for an opinion, but from your perspective, if an outbreak were to occur, how would it be decided and in what order would the passengers who have been clamoring for this non-essential form of travel be treated? With  so many unknowns....would crew be treated first?... we sure need them. Then would there be a hierarchy?...most days sailed?...fanciest cabins?  who knows who?   .....people who knowingly boarded who were at highest risk? It seems like an impossible to task at this time to safely get the industry restarted. I hope that everyone with these huge money investments are able to recover their outlays and sit tight until the time comes that this mess is under control.

[howiefrommd]

From a clinical perspective, patients would be triaged, prioritized and treated accordingly.   In some States, health care systems have developed prioritization protocols to address shortage of respirators, ICU beds etc.  What goes into those calculations are age, comorbidities and potential outcome, 

Edited July 18, 2020 by howiefrommd
Typo

[Ladys Mom]

Howie, I think you answered your own question.  There are many Experienced ICU nurses and Intensivist physicians from countries around the world who have successfully treated and conquered COVID.  If the cruise lines would pay them a decent salary, which they wouldn’t balk at given the alternative, they would handle the run of the mill cruise ship health issues and be prepared if passenger or crew came down with the virus.  I think the experience of mitigating and treating COVID has come a long way, if everyone follows the guidelines and patients are treated appropriately.  Not what is going on in the US right now.  As far as who gets treated first, I expect it would be based on The medical triage model.  The sickest go first.

[Travelcat2]

2 hours ago, howiefrommd said:

I think each sector has their own unique issues in dealing with an aerosolized virus such as COVID-19.  A cruise ship has many more unique challenges than a restaurant or hotel.   

 

The one big difference between airlines, hotels, restaurants or bars is one of their employees are not going to be your doctor (at least we hope so lol) when a medical crisis arises.  

 

Agree with you.  You really cannot compare a hotel, retaurant, bar, airplane and a cruise ship.  They are all completely different and have their own unique challenges.  On a cruise ship, you are onboard 24/7 without having the ability to leave (unless you are in port).  

 

Also, another poster mentioned getting a sick passenger off of the ship and into a medical facility.  While that sounds good, there are many places that the ships visit where the medical facilities are almost non-existent and certainly would not be a place to dump a passenger.  OTOH, there are some countries with wonderful medical care.  

 

In terms of air conditioning, there have been many articles on this topic lately.  It is worth checking them out.  Some places have hepa filters in their air conditioning systems - some ship have filtered air for individual suites, etc.  It is not as big of a problem as I originally thought.

[howiefrommd]

30 minutes ago, Ladys Mom said:

Howie, I think you answered your own question.  There are many Experienced ICU nurses and Intensivist physicians from countries around the world who have successfully treated and conquered COVID.  If the cruise lines would pay them a decent salary, which they wouldn’t balk at given the alternative, they would handle the run of the mill cruise ship health issues and be prepared if passenger or crew came down with the virus.  I think the experience of mitigating and treating COVID has come a long way, if everyone follows the guidelines and patients are treated appropriately.  Not what is going on in the US right now.  As far as who gets treated first, I expect it would be based on The medical triage model.  The sickest go first.

Actually, I was answering another persons question, but fully agree.  In the conversation I have had with Docs and Nurses working on cruise ships)  I have been amazed (not in a good way) at their salary and working conditions.  

[wristband]

NY Times today: "CDC Slams Industry For Spreading Coronavirus"...describes a "scathing order":

  

"the order from Dr. Redfield underscores the gap between the industry and the public health agency. The companies cannot begin to sail again until they come up with cohesive plans for prevention and mitigation of the illness.

 

Cruise ship companies submitted plans on how to safely evacuate crews, but nearly all the companies failed to meet the basic requirements necessary to stop the spread of the coronavirus, the C.D.C. said. Crew members still bunked together and shared bathrooms. Even ships that seemed to have gone a month without any coronavirus cases had crew members who tested positive upon reaching shore, Dr. Redfield said.

 

One company, Norwegian Cruise Lines, said it felt it had exceeded recommended C.D.C. guidance, because crew members were not just asked but “encouraged” to wear face coverings, the order said...

 

The companies created a task force to come up with recommendations on how to safely sail, but according to the C.D.C., the group will not produce its findings for several months.

 

If unrestricted cruise-ship passenger operations were permitted to resume, it would put “substantial unnecessary risk” on communities, health care workers, port personnel and federal employees, the order said, as well as placing passengers and crew members at increased risk."...

[Bellaggio Cruisers]

36 minutes ago, wristband said:

NY Times today: "CDC Slams Industry For Spreading Coronavirus"...describes a "scathing order":

  

"the order from Dr. Redfield underscores the gap between the industry and the public health agency. The companies cannot begin to sail again until they come up with cohesive plans for prevention and mitigation of the illness.

 

 

 

The companies created a task force to come up with recommendations on how to safely sail, but according to the C.D.C., the group will not produce its findings for several months.

 

If unrestricted cruise-ship passenger operations were permitted to resume, it would put “substantial unnecessary risk” on communities, health care workers, port personnel and federal employees, the order said, as well as placing passengers and crew members at increased risk."...

 

Note the bold, underlined sentence above......... me thinks it’s a very long time before we sail again!

sheila

[Dolebludger]

I must disagree that a vaccine, widely available and proven, would not fix the problem. I feel that it would be a fix, and the CDC is concerned primarily with pre-vaccine sailings. Possibly, no vaccine is 100% effective in all persons against all possible strains of a given virus. But a vaccine would prevent major outbreaks on ships and elsewhere. For example, smallpox was once a real problem as were measles. Most of us have been vaccinated against these, and they are very much gone as far as I know. Ditto for polio. 
 

When such a vaccine is available against Covid 19, a certificate of vaccination system could be developed, and all one would need do is show their certificate to enter a country, airplane, cruise ship — or anywhere else.

[Bellaggio Cruisers]

I think Regent did the right thing to waitlist all cruises until the December sailings. They are on hold, not canceled.....Its a step in the right direction, rather than take deposits on cruises that probably will not happen. 
sheila

Edited July 18, 2020 by Bellaggio Cruisers

[greykitty]

Just a small caveat - there have been measles outbreaks in the last few years, generally fueled by those who do not get vaccinations.  Measles has once again become a real and present danger to too many people.  

 

I'm actually trying to remember what sort of parental approvals were needed decades ago when the Salk and Sabin polio vaccines came out.  As I recall my mom and grandmother's reaction, it was the answer to prayers and I got that sugar cube no if, ands, or buts.  And I'm almost thinking the nuns at our parochial school would not take no for an answer, if any parent were ill-advised enough to venture such an opinion at that time.

 

https://www.cbsnews.com/news/samoa-measles-outbreak-father-loses-3-of-his-5-children/

 

And in the US

 

https://www.webmd.com/children/news/20190411/2019-measles-outbreak-what-you-should-know

[Bellaggio Cruisers]

Greykitty.... we live in a different world today. Sometimes, I wish we could go back.....

sheila

[howiefrommd]

33 minutes ago, Dolebludger said:

I must disagree that a vaccine, widely available and proven, would not fix the problem. I feel that it would be a fix, and the CDC is concerned primarily with pre-vaccine sailings. Possibly, no vaccine is 100% effective in all persons against all possible strains of a given virus. But a vaccine would prevent major outbreaks on ships and elsewhere. For example, smallpox was once a real problem as were measles. Most of us have been vaccinated against these, and they are very much gone as far as I know. Ditto for polio. 
 

When such a vaccine is available against Covid 19, a certificate of vaccination system could be developed, and all one would need do is show their certificate to enter a country, airplane, cruise ship — or anywhere else.

I agree that should a vaccine/immunization be developed that shows efficacy, it potentially would be a significant step in the right direction.  When I was in training in the early 1980's we were hit with the HIV/AIDS virus.  I remember professors (and well respected physicians) saying to us that a vaccine/immunization for this virus could potentially be available in five years or so.   When Norovirus was fist diagnosed in 1968, once again we were told that a vaccine/immunization could be developed. Here we are how many years later still without a vaccine.  At least when a patient gets a diagnoses of HIV today, there are very effective pharmaceutical treatments and it is no longer a death sentence. 

 

Vaccines are hard to develop, in fact, tremendously hard.  It is not a fact of how much money you throw at something, science takes time.  Eventually we will probably see somewhat of a hybrid, something similar to the flu shot.  

[Steve Q]

42 minutes ago, greykitty said:

Just a small caveat - there have been measles outbreaks in the last few years, generally fueled by those who do not get vaccinations.  Measles has once again become a real and present danger to too many people.  

 

I'm actually trying to remember what sort of parental approvals were needed decades ago when the Salk and Sabin polio vaccines came out.  As I recall my mom and grandmother's reaction, it was the answer to prayers and I got that sugar cube no if, ands, or buts.  And I'm almost thinking the nuns at our parochial school would not take no for an answer, if any parent were ill-advised enough to venture such an opinion at that time.

 

https://www.cbsnews.com/news/samoa-measles-outbreak-father-loses-3-of-his-5-children/

 

And in the US

 

https://www.webmd.com/children/news/20190411/2019-measles-outbreak-what-you-should-know

That is so funny. I can remember the exact same thing. I can remember the nuns marching us to the nurse’s office for our polio vaccine. I was so scared. We were just recently discussing whether our parents ever signed a permission form. I have no idea if they did. I also don’t remember my parents ever informing me that I was to receive a shot that day. The nurse just gave it to you. As you well remember, however, people were petrified of getting polio. I guess that was motivation enough.

[howiefrommd]

1 hour ago, greykitty said:

Just a small caveat - there have been measles outbreaks in the last few years, generally fueled by those who do not get vaccinations.  Measles has once again become a real and present danger to too many people.  

 

 

The funny (if there can be one) thing with the current measles outbreak is almost all of the younger docs have never seen measles.  When measles started presenting in the ER and offices, the docs went went right to google.  Things have changed lol 

[sanne]

1 hour ago, Dolebludger said:

I must disagree that a vaccine, widely available and proven, would not fix the problem. I feel that it would be a fix, and the CDC is concerned primarily with pre-vaccine sailings. Possibly, no vaccine is 100% effective in all persons against all possible strains of a given virus. But a vaccine would prevent major outbreaks on ships and elsewhere. For example, smallpox was once a real problem as were measles. Most of us have been vaccinated against these, and they are very much gone as far as I know. Ditto for polio. 
 

When such a vaccine is available against Covid 19, a certificate of vaccination system could be developed, and all one would need do is show their certificate to enter a country, airplane, cruise ship — or anywhere else.

Unfortunately it’s too easy to have a fake certificate of vaccination. Dr who owns hospital in Bangladesh caught charging for COVID tests, keeping the funds, no test, then just issuing a negative certificate.  There’s corruption everywhere you look. 

[CruisetheCs]

I find the NYT article fascinating as the CDC highlights failures of cruise lines.  

 

Unfortunately, it is quite easy to visualize a host of other entities just "encouraging" masks, or continuing to permit social gatherings, or having live music and pool parties or otherwise violating basic protocols to stop the spread of the virus. 

 

If the CDC did a similar assessment of the actions of various US government entities (Federal, State and local), airlines, other businesses,  confinement facilities, or yes, even political rallies, I have a feeling there would be many more scathing reports coming out.

[cruiseluv]

3 hours ago, CruisetheCs said:

I find the NYT article fascinating as the CDC highlights failures of cruise lines.  

 

Unfortunately, it is quite easy to visualize a host of other entities just "encouraging" masks, or continuing to permit social gatherings, or having live music and pool parties or otherwise violating basic protocols to stop the spread of the virus. 

 

If the CDC did a similar assessment of the actions of various US government entities (Federal, State and local), airlines, other businesses,  confinement facilities, or yes, even political rallies, I have a feeling there would be many more scathing reports coming out.

 

This disease has become totally politicized and I'm very skeptical of anything that comes out of the CDC or other entities. You have local governments , like New York City, Philadelphia, Los Angeles, etc, sanctioning, and even encouraging, huge marches and protests, but criminalizing other social gatherings, even going to church. Sorry, that's not "science". And the masks.... please...

[wristband]

I saw an interview yesterday with Melinda Gates.  She described how generous the Gates Foundation has been - along with the US government - pouring billions into the search for a vaccine.

 

In her informed view the "best case" scenario for a trial vaccine will be in mid-2021. Once approved and available,  Melinda was adamant those who will receive the vax first will be first responders and health care industry workers (hospital staff, doctors).  She thought it would be some time after that initial group when we in the public will gain access.

 

I also remember the polio vaccine - eating a sugar cube with my family in a long line so many years ago!

[Travelcat2]

I truly hope that most people will take the vaccine.  I heard on the news this week that up to one third of people living in the U.S. do not want to get the vaccine.  In terms of our cruising community, it is likely that proof of the vaccination will be required to embark on the ship.

[pappy1022]

1 hour ago, Travelcat2 said:

 In terms of our cruising community, it is likely that proof of the vaccination will be required to embark on the ship.

Based on what facts? If this is an opinion that’s fine.

[travelwell]

Regent and the CDC have a really tough decision. I am a RN who retired from a Covid unit last month. This is a very complex disease that presents in a variety of ways patient to patient. No one way treats all. Most patients on a ventilator die in spite of the best care. We can not predict who will get it and do ok. The 84 year old diabetic may live in spite of stastistics and the 34 year old with no comorbidities will die. The numbers of people who get sick can overwhelm a health care system fast. It is super contagious, we saw whole families sick, wedding parties and funerals. The nature of a cruise ship is close contact. Covid takes up  a lot of resources both staff and PPE that cruise ships do not have.  What about testing? Try to find a country that would help a ship load of Covid patients. Starting anything back too soon a price will be paid with deaths and overwhelmed ship hospitals (think Georgia and Florida).

I think an effective vaccine is probably best thing to get cruise ships rolling. I am guessing( just a guess) mid 2021. Fingers crossed to make 2022 WC. Until then I am doing everything I can do to stay healthy to make it on the cruise. 

[Mahogany]

3 hours ago, Travelcat2 said:

I truly hope that most people will take the vaccine.  I heard on the news this week that up to one third of people living in the U.S. do not want to get the vaccine.  In terms of our cruising community, it is likely that proof of the vaccination will be required to embark on the ship.

Is your opinion ("it is likely") based on your direct line to FDR? I get it. Your opinion is based on 34 Regent cruises. So? Modest you're not. I agree that masks are a good idea, but your (poor taste, IMHO) banner will hardly increase the number of wearers. Now you can block me too! 😀

[Wendy The Wanderer]

22 hours ago, Bellaggio Cruisers said:

 

Note the bold, underlined sentence above......... me thinks it’s a very long time before we sail again!

sheila

Yep.  It's sad, isn't it? 

 

3 hours ago, wristband said:

I saw an interview yesterday with Melinda Gates.

...

In her informed view the "best case" scenario for a trial vaccine will be in mid-2021....

 

Although I'm sure she knows much more about the huge efforts that labs all over the world are exerting to get this done, she is no expert.  Not a scientist, I believe.  No one knows when or if a vaccine's going to be available and effective.

[Bellaggio Cruisers]

There is nothing any one of us can change what is happening. No one knows when an effective vaccine will be developed, if ever. 
If it take two to three years or more, our country will collapse economically, socially and educationally. All cruise lines will go bankrupt, which is the least important. It will be the end of the US as we know it.
Those are the facts if we are all waiting for the almighty vaccine. 
So, let’s chill out and try Plan B. It’s so simple... for one month, wear a mask in public plus socially distance yourselves. Whether you believe in it or not, try it. Perhaps, the numbers will fall dramatically. And we can make it through this nightmare. 
But, lets not forget, this is a cruising blog. So a bit of humor about a mask and cruising, has led to too many nasty things being said. Chill out about a mask that says cruising and wear one that says anything you want, as long as you are wearing one and socially distancing. Let’s try it!
sheila

[Secondson]

I think I am not going on anymore regent cruises, after reading all the remarks in this section ,I am convinced there are to many nutty people. If all you people will cancel I will reconsider  my decision. I only hope all the other cruisers are normal. Still love  regent but!

Edited July 19, 2020 by Secondson