Question- Monoclonal Antibodies onboard?

[nocl]

2 hours ago, zitsky said:

 

How do you get someone home if sick with covid?  Throw them on a plane filled with healthy people?  Would really like to know. 

Get treatment where ever they get off ship.  If mild then quarantine there.

 

Otherwise it would take medical evacuation, not commercial.

 

That is one of the issues with travel today.  You need to plan on the potential of a positive test with poor timing and having to quarantine someplace unexpectedly until you can travel home.

[nocl]

1 hour ago, canderson said:

Have to get supplementary insurance covering only that.  It's not horribly expensive since they don't have to cover cruise costs, etc.  Many offer both annual and per trip coverage.  One mentioned around here with some frequency is MedJet.  There are others.

Except Medjet has some limitations.  It will only transport you if you are hospitalized in a location where there is a runway that can handle their medical evacuation jet.  Not in hospital it doesn't, no long enough runway it doesn't cover.  Main reason it is as cheap as it is, the odds that one will actually use it is low.

 

 

[nocl]

55 minutes ago, Ipeeinthepools said:

 

Trekker is the annual plan for typical cruisers and it does not cover evacuation.  The plans you cite are intended for people that live overseas for at least 3 months and are not designed to be an annual travel policy.

Geoblue Trekker Choice does cover medical evacuations (500,000) for medically necessary evacuations.  It is the plan I normally use.

 

There are a whole range of companies at various prices that include both medical and security coverage such as Global Rescue, Redpoint, etc.

 

There is one company, Covac Global, that will bring you home (private aircraft) if you test positive anywhere in the world, but that one is about $5000 per year for a family of 2 or about $3000 for an individual for COVID 19 and medical membership. Security Upgrade (covers things like special ops extraction and SAR if you travel to iffy locations)  adds about another $700 

Edited September 2, 2021 by nocl

[nocl]

25 minutes ago, nocl said:

Geoblue Trekker Choice does cover medical evacuations (500,000) for medically necessary evacuations.  It is the plan I normally use.

 

There are a whole range of companies at various prices that include both medical and security coverage such as Global Rescue, Redpoint, etc.

 

There is one company, Covac Global, that will bring you home (private aircraft) if you test positive anywhere in the world, but that one is about $5000 per year for a family of 2 or about $3000 for an individual for COVID 19 and medical membership. Security Upgrade (covers things like special ops extraction and SAR if you travel to iffy locations)  adds about another $700 

For Covac global medical membership only is $1045 per year for two.  Covid-19 coverage only is $4750 for 2.  So clearly the risk premium is much higher for Covid coverage since one is far more likely to test positive compared to needing tradition medical evac.

[Babr]

6 hours ago, nocl said:

For Covac global medical membership only is $1045 per year for two.  Covid-19 coverage only is $4750 for 2.  So clearly the risk premium is much higher for Covid coverage since one is far more likely to test positive compared to needing tradition medical evac.

I looked at that company last night. It excludes cruise ship travel. Found that bit of information in the FAQ’s.

Edited September 2, 2021 by Babr

[Fredric22]

Considering how fast and how effective the monoclonal antibody treatment is, the cruise lines absolutely should have this treatment available to anyone at high risk who tests positive. The treatment includes 2 injections in the stomach.  This would be easy to give on board and would really help eliminate most of the risk of someone ending up in the hospital (even after the already low risk since they are vaccinated). I think this is a win win and I do hope the cruise lines can get their hands on the treatment. 

[sanger727]

8 hours ago, nocl said:

Geoblue Trekker Choice does cover medical evacuations (500,000) for medically necessary evacuations.  It is the plan I normally use.

 

 

GeoBlue Trekker does generally include medical evacuations. However, they specifically exclude covid related medical evacuations. 

[bandp407]

39 minutes ago, Fredric22 said:

Considering how fast and how effective the monoclonal antibody treatment is, the cruise lines absolutely should have this treatment available to anyone at high risk who tests positive. The treatment includes 2 injections in the stomach.  This would be easy to give on board and would really help eliminate most of the risk of someone ending up in the hospital (even after the already low risk since they are vaccinated). I think this is a win win and I do hope the cruise lines can get their hands on the treatment. 

Thank you Fredric22. This exactly was my thought! 

[nocl]

3 hours ago, Fredric22 said:

Considering how fast and how effective the monoclonal antibody treatment is, the cruise lines absolutely should have this treatment available to anyone at high risk who tests positive. The treatment includes 2 injections in the stomach.  This would be easy to give on board and would really help eliminate most of the risk of someone ending up in the hospital (even after the already low risk since they are vaccinated). I think this is a win win and I do hope the cruise lines can get their hands on the treatment. 

Where are you getting the injections in the stomach?  Have not seen that in any administrative procedures I have seen.

 

The following is extracted from the Omnicare infusion manual

 

Casirivimab/Imdevimab is administered as a single intravenous infusion of 1,200 mg of casirivimab AND 1,200 mg of imdevimab over a minimum of 60 minutes

[nocl]

4 hours ago, Babr said:

I looked at that company last night. It excludes cruise ship travel. Found that bit of information in the FAQ’s.

Interesting

[nocl]

3 hours ago, sanger727 said:

 

GeoBlue Trekker does generally include medical evacuations. However, they specifically exclude covid related medical evacuations. 

We have not looked at any policies since COVID so have not looked at their recent exclusions.  Thanks.

[Babr]

1 minute ago, nocl said:

Interesting

Yep. It does not look like anyone is going to evacuate positive only or mild cases. I’m wondering if even Celebrity will do it from any port. I’ve read of people being returned from the Bahamas and Alaska. Was that part of their port agreement? Are there other examples?

 

I’m beginning to think the policy will be quarantine as necessary and return by commercial air with financial assistance from Celebrity.

[wrk2cruise]

Yesterday a vaccinated couple was disembarked in Curacao and flown home via air ambulance according to the live posts where one of the posters is being isolated onboard for close contact although testing negative.  Waiting for another test tonight.

[canderson]

27 minutes ago, wrk2cruise said:

Yesterday a vaccinated couple was disembarked in Curacao and flown home via air ambulance according to the live posts where one of the posters is being isolated onboard for close contact although testing negative.  Waiting for another test tonight.

Yes, that was the 2nd pair evacuated from Equinox. And evidently there are a fair number waiting for their 2nd contact trace test today.  Goofysmom reported that security had a list they started working yesterday.

[Homosassa]

4 hours ago, nocl said:

Where are you getting the injections in the stomach?  Have not seen that in any administrative procedures I have seen.

 

 

The information about subcutaneous injection was included in the EAU for Regeneron.  The subcutaneous route is only permitted when infusion is not available.

 

I am attaching a link for the EAU. The information about sites for subcutaneous injection is on page 13.  Two -four injections may be necessary.

 

The EAU also states that the product should only be used in those where the person has been diagnosed and is likely to develop severe Covid 19 disease requiring hospitalization. 

 

The EAU also specifically states that the monoclonal antibody is not approved as a means to prevent the development of Covid 19.  That is the role of the vaccine.

 

So any vaccinated person who has a breakthrough Covid infection is already  considered not to be at risk for a severe  Covid 19 infection which would lead to hospitalization.

 

Given the high percentage on a Celebrity cruise of vaccinated passengers, there would be very few to none that would meet the indications for use in the EAU.

 

What is missing in the rah-rah posts about the use of an unapproved treatment is the warning about the incidence of adverse events after either infusion or injection and that patients should be monitored for one hour after treatment.

 

Then there is the question of cost. While the US government negotiated a price of $1,250 per dose in its purchase of the product, there is no guarantee that cruise lines would not be charged a higher price. I would not be surprised to see a cost of $2,000+ for dose if done on a cruise ship and also additional hospital charges for the required monitoring after the treatment.

 

That would be a nice hefty addition to one's one board account that would need to be paid before debarkation. I also would not assume that any insurance would pay after the fact for what is considered an unapproved drug.

 

I can hear the arguments now that the vaccines have been paid by insurance so it would follow that the monoclonal antibody should also be paid for. The fallacy in that argument is that only those at risk of severe disease should be given the treatment and there is already something available to prevent that risk - the vaccine.

 

 

 

https://www.regeneron.com/downloads/treatment-covid19-eua-fact-sheet-for-hcp.pdf

Edited September 2, 2021 by Homosassa

[cangelmd]

4 hours ago, nocl said:

Where are you getting the injections in the stomach?  Have not seen that in any administrative procedures I have seen.

 

The following is extracted from the Omnicare infusion manual

 

Casirivimab/Imdevimab is administered as a single intravenous infusion of 1,200 mg of casirivimab AND 1,200 mg of imdevimab over a minimum of 60 minutes

That's, I think Regen-Cov and it has been reformulated to 3 injections given over a ?few minutes? followed by an observation period, takes a total of about an hour. They were doing up to 70-80 patients a day at the height last week. So much Covid spreading that there is much less pre-screening, almost everyone regardless of age with more than just a runny nose and feeling bad was getting it, although there are still criteria. The injections have pretty much replaced the infusions here.

[nocl]

36 minutes ago, cangelmd said:

That's, I think Regen-Cov and it has been reformulated to 3 injections given over a ?few minutes? followed by an observation period, takes a total of about an hour. They were doing up to 70-80 patients a day at the height last week. So much Covid spreading that there is much less pre-screening, almost everyone regardless of age with more than just a runny nose and feeling bad was getting it, although there are still criteria. The injections have pretty much replaced the infusions here.

Thank you.    Are those injections to the stomach?  or just normal injections?

[nocl]

51 minutes ago, Homosassa said:

The information about subcutaneous injection was included in the EAU for Regeneron.  The subcutaneous route is only permitted when infusion is not available.

 

I am attaching a link for the EAU. The information about sites for subcutaneous injection is on page 13.  Two -four injections may be necessary.

 

The EAU also states that the product should only be used in those where the person has been diagnosed and is likely to develop severe Covid 19 disease requiring hospitalization. 

 

The EAU also specifically states that the monoclonal antibody is not approved as a means to prevent the development of Covid 19.  That is the role of the vaccine.

 

So any vaccinated person who has a breakthrough Covid infection is already  considered not to be at risk for a severe  Covid 19 infection which would lead to hospitalization.

 

Given the high percentage on a Celebrity cruise of vaccinated passengers, there would be very few to none that would meet the indications for use in the EAU.

 

What is missing in the rah-rah posts about the use of an unapproved treatment is the warning about the incidence of adverse events after either infusion or injection and that patients should be monitored for one hour after treatment.

 

Then there is the question of cost. While the US government negotiated a price of $1,250 per dose in its purchase of the product, there is no guarantee that cruise lines would not be charged a higher price. I would not be surprised to see a cost of $2,000+ for dose if done on a cruise ship and also additional hospital charges for the required monitoring after the treatment.

 

That would be a nice hefty addition to one's one board account that would need to be paid before debarkation. I also would not assume that any insurance would pay after the fact for what is considered an unapproved drug.

 

I can hear the arguments now that the vaccines have been paid by insurance so it would follow that the monoclonal antibody should also be paid for. The fallacy in that argument is that only those at risk of severe disease should be given the treatment and there is already something available to prevent that risk - the vaccine.

 

 

 

https://www.regeneron.com/downloads/treatment-covid19-eua-fact-sheet-for-hcp.pdf

Thank you

[Silkroad]

3 hours ago, canderson said:

Yes, that was the 2nd pair evacuated from Equinox. And evidently there are a fair number waiting for their 2nd contact trace test today.  Goofysmom reported that security had a list they started working yesterday.

There was also a crew member who was taken off the same day as the first pair. I’m not sure how X handles evacuation of positive crew members. Fingers crossed that Goofysmom and the others test negative this evening.

[nocl]

8 hours ago, Babr said:

I looked at that company last night. It excludes cruise ship travel. Found that bit of information in the FAQ’s.

Interesting that they have lumped cruise ships with over 25 cabins along with countries with a government mandated stay at home order.  

[cangelmd]

16 minutes ago, nocl said:

Thank you.    Are those injections to the stomach?  or just normal injections?

I don’t know. I know it is 3 separate sites, so each arm and abdomen make some sense. Or it could be like a lovenox injection which has to be in a fatty area, like the abdomen.

[Babr]

8 minutes ago, nocl said:

Interesting that they have lumped cruise ships with over 25 cabins along with countries with a government mandated stay at home order.  

As well as an exclusion for attending large gatherings.

 

I think they have arrived at the obvious. Positive cases are likely to be common on cruise ships, and even when charging thousands of dollars per person in premiums, they are not going to break even ferrying folks home. I doubt that many would buy the policy in the first place; but those who do have a good chance of trying to collect.

[nocl]

17 minutes ago, Babr said:

As well as an exclusion for attending large gatherings.

 

I think they have arrived at the obvious. Positive cases are likely to be common on cruise ships, and even when charging thousands of dollars per person in premiums, they are not going to break even ferrying folks home. I doubt that many would buy the policy in the first place; but those who do have a good chance of trying to collect.

If I was doing my normal level of international travel this year (75-100 days) I would consider their policy.

 

This year we are remaining pretty close to home with lots of travel, but most in US.

[graphicguy]

Celebrity is accepting two types of COVID testing.  One is PCR, the other is Antigen.  Both are widely available at major pharmaceutical chains as well as from your personal physician(s).

 

PCR generally takes longer to get results (12-48 hours) but is more accurate and a more thorough test.

 

Antigen results are less thorough, but are thought to get quicker results (1-24 hours).  

 

The key to both, at least from Celebrity's perspective, is to have a negative test within 2-3 days of embarkation, provided by a qualified entity,  and for them to be observed and/or administered by a medical professional to make certain the results are accurate for the passenger who submits them.

 

Anyone who tests positive after having had COVID vaccines administered within two weeks of embarkation date, is provided transport home.  If you flew in, they'll charter a plane to get you back.

 

Can't remember the name of the person who actually posted here about his happening to her and her husband, but Celebrity was very accommodating and did exactly that.  They were quarantined until they were provided a plane ride home, on a private plane.

[graphicguy]

1 hour ago, Ipeeinthepools said:

So does anyone want to speculate how the cruise lines return to profitability?  If you can spread covid between passengers from crew on sailings at 30% capacity, what happens when you return to anything close to full capacity?  You will have many more close contacts and even more covid onboard.  They will likely be putting people off at every stop.  I just don't see the path to profitability.  

I concur.  That said, they're trying to find a path to do just that.  The key is, and always has been, to get to the 80% vaccinated rate.  It's been a slog to get there, particularly in states like FL, TX and LA.  But, I think they're getting the message in those states that the real risk is to those who aren't vaccinated and if you contract COVID, there will be no quarter left for you to be treated at your local hospitals.

 

It seem they're getting vaccinated at a higher rate in those states, currently.