A 2020 event that will overshadow the pandemic

2020-11-23

Health professionals like to use the metaphor of Swiss cheese when explaining how to build a defense against a virus, said former Utah governor Mike Leavitt during a Phocuswright panel on Monday. Leavitt, also a former Secretary of Health and Human Services, is co-chair of the Healthy Sail Panel, which came up with 74 recommendations for the safe resumption of cruising.

Why 74? Like Swiss cheese, every protective step taken against Covid-19 has holes that the virus can slip through, he explained. Masks, social distancing and hand-washing are all helpful in curtailing transmission, but none offers a 100% guarantee. That’s why it’s important to layer protocol upon protocol, each lowering but never quite eliminating risk.

The 74 recommendations were seen as instrumental in converting the No Sail Order issued in March to a Conditional Sailing Order in October.

Industry associations and companies have been promoting testing as the best option to try to jump-start travel, particularly as an alternative to quarantines. But it’s not a panacea, and its holes came to the fore this month after nine people on the SeaDream I — seven of 53 passengers and two of 66 crew — tested positive, canceling not only the cruise but the rest of SeaDream’s 2020 season.

Though testing is a critical layer in restricting the spread of the disease and a prominent feature of the Healthy Sail Panel recommendations, the SeaDream experiment laid bare its shortcomings. Despite requiring multiple negative PCR tests before a guest could board the ship and further testing during the cruise, the time gap between a person becoming infected and the infection being detectable by test was the cruise’s undoing.

The size of the SeaDream ship — it’s too small to fall under the CDC Conditional Sailing Order, even had it left from a U.S. port — was supposed to be a selling point. But interestingly, the additional layers of protection in the much larger ships sailing in Europe this summer made a critical difference: Onboard infections that occurred never led to an outbreak. There were procedures (and space) to isolate those who were infected.

Unfortunately, the SeaDream incident widened a hole that the cruise industry has been working steadily to fill: government skepticism. The work of the Healthy Sail Panel had led to significant progress in demonstrating to the CDC and the national Coronavirus Task Force that the cruise industry is systematically constructing processes that, together, reduce risk to an acceptable level. Nonetheless, the SeaDream incident was cited by two members of Congress as they called upon the CDC to reinstitute the No Sail Order.

Norway-based SeaDream had also sailed in Europe this summer and touted that it had no cases. But that was before the current surge.

The surge. It’s perhaps a sign of economic desperation that many of the countries that had closed their borders when transmission rates were lower — Costa Rica, Colombia, Ecuador, Chile, for example — are now opening them, their hopes, too, tied to effective testing.

In our darkening winter, the news of two vaccines with effectiveness in the mid-90% range buoyed spirits, the stock market and hopes that 2021 will see an effective turnaround for the travel industry. The vaccines’ effectiveness suggests they are the game-changer we’ve been waiting for. At their levels of efficacy, their holes are relatively small, and the one from the pharmaceutical company Moderna appears to have a therapeutic benefit for those who fall through its holes: People who became infected despite vaccination became less ill than those who received a placebo.

Most crises trigger an acceleration of existing trends or technologies that can end the crisis, for better, worse or an ambiguous middle ground (the development of an atomic bomb would not have had the urgency, or funding, if not for World War II). The Moderna and Pfizer vaccines have accelerated biomedical research into messenger RNA vaccines, a field of study that has broad medical applications, not only in viral immunology but potentially to fight certain cancers.

It may well be that in 10 years the pandemic will be viewed primarily as the trigger that accelerated huge advances in medicine.

But the Covid vaccine will only be effective if people receive it, and a recent poll suggests that as few as 58% of Americans are willing to get the vaccine.

That is discouraging indeed, though perhaps once it has demonstrated its safety and effectiveness, people will come around. A possible antidote to this hesitancy has been proposed: Pay people to get the vaccine, the cost to the economy being less than the impact of extending the pandemic.

Additional pressure to be vaccinated could also be applied by the travel industry, the sector that has been hit hardest by the pandemic and which has the most to lose by its extension.

To cross a border, require a vaccination certificate as well as a passport.

Courtesy of Travel Weekly

Facebook Comments