Will people on biologic drugs (Humira, Entyvio, Stelara, Remicade, et al) be allowed to sail anymore?

[Cruising Forever!]

Because I have ulcerative colitis (since 1983), I am currently on Entyvio, a drug known as a biologic.  Entyvio acts (as do all biologics) by lowering the immune system (an overactive or malfunctioning immune system is thought to be the cause of ulcerative colitis).  Since being on Entyvio, my UC is completely under control... I live a pretty normal life.  During the pandemic, my doctor has advised me to self quarantine just as a precaution.  I didn't need to worry about this as on the same day he told me this, my state shut down.  I might be forced to go back to work once my state reopens (hopefully not any time soon).  The rules here are a bit fuzzy.  But if I have to I have to, and I'll just take the steps necessary to be as safe as possible since I work with the public.

 

New cruise travel guidelines (as reported on Cruise Critic's Cruise News on 4/24/20) seem to indicate that those with impacted immune systems will be denied boarding any (?) cruise vessels (along with people over 70 who don't have a doctor's note saying they are healthy enough to travel).  Here's an excerpt from the Cruise News article with Carnival's wording (and Royal Caribbean seemed to have the same or similar wording):

 

Carnival will deny boarding to all guests 70 years of age or older unless they have a letter from their physician confirming they are fit to sail. Additionally, all guests will be asked if they have been hospitalized in the past two months for or if they have a history of chronic or severe medical conditions. The CDC defines chronic conditions as an illness persisting for a long time or constantly recurring, such as diabetes, heart, kidney or lung disease. Additional severe medical conditions include: suppressed immunity (active cancer, taking steroids) or if the person requires oxygen for any reason. Guests with chronic or severe medical conditions will not be allowed to sail.

 

Since Carnival is Princess' parent company, my guess is that Princess will follow these guidelines as well?

 

So, if I'm reading this correctly, I'm no longer allowed to cruise?  Forever?  I've been on biologics since 2015 and have cruised frequently (six cruises since, actually) without any issues whatsoever.  Why would anything be different now?  Further, if you are blocked for using biologic drugs, this means many many people will no longer be allowed on ships!  Those using Humira for arthritis for instance.  I think these CDC guidelines are a little too broad.  I know that this is all in response to Covid19, but there isn't any language here to show that once the pandemic has fallen off that people with say, diabetes, can resume cruising again.  Further, what if someone had Covid19, but is still somebody who has fallen into the new restricted travel guidelines?  Do they get to cruise?  Or are you forever a travel pariah?

 

I also think that the "70 years of age or older" needing a doctor's note screams of discrimination.  I'm sure there are attorneys out there getting ready to file massive lawsuits against any cruise agency that demands a doctor's note for cruise travel because you're 70 or older ("Paging AARP!").  I'm not nearly 70, but I find this offensive in the extreme.  I absolutely agree that passengers with transmittable infectious diseases (noro or corona viruses) should be kept off ships, but keeping people off ships with chronic conditions that are not contagious in any way is ridiculous!  Another caveat: cruise lines will not allow you a refund if you are deemed unfit to travel under the guidelines above.  Instead it's a future cruise credit.  How nice... you can't cruise any more... and here's your FCC that you can never use.  Have a nice day.  (Some might offer a full refund... but watch the wording.)

 

Seriously, I hope the cruise lines work with the CDC to figure this all out... otherwise it's going to be much uglier for my beloved cruise industry.  

Edited April 25, 2020 by Cruising Forever!

[Julia’s Journey’s]

It’s going to be interesting to see how this plays out. I have a cruise booked in December with my son. He is only 22 but has UC and RA in both hips and on Stelara. So wonder if he will be allowed to cruise again.

life is already tough for him and now they are going to take the enjoyable of traveling away from him too 😡

[Cruising Forever!]

6 minutes ago, Julia’s Journey’s said:

It’s going to be interesting to see how this plays out. I have a cruise booked in December with my son. He is only 22 but has UC and RA in both hips and on Stelara. So wonder if he will be allowed to cruise again.

life is already tough for him and now they are going to take the enjoyable of traveling away from him too 😡

I was first diagnosed with UC in 1983 at the age of 22!  I'm 59 now.  I was on some AWFUL drugs over the years.  In 2015, my doc put me on my first biologic, Simponi.  That worked well for a few years then stopped working.  Now I'm on Entyvio which is working fantastically.  God bless your son... he's too young to have all that thrown at him.  But tell him about me.  I'm still fighting!  🙂

Edited April 25, 2020 by Cruising Forever!

[Julia’s Journey’s]

4 minutes ago, Cruising Forever! said:

I was first diagnosed with UC in 1983 at the age of 22!  I'm 59 now.  I was on some AWFUL drugs over the years.  In 2015, my doc put me on my first biologic, Simponi.  That worked well for a few years then stopped working.  Now I'm on Entyvio which is working fantastically.  God bless your son... he's too young to have all that thrown at him.  But tell him about me.  I'm still fighting!  🙂

 

He was diagnosed at 15, he has been on remicade, Humira, entyvio, methotrexate and plenty others some worked for a while and some not at all. He was supposed to get double hip replacement at 19 but we decided to try put it off as long as possible. He has been on stelara and doing better. Trying to get college finished up 😳

He sure is tough and a fighter.

Thanks for the good thoughts and hopefully you all get to cruise soon, stay safe and remember health is more important than work and hopefully your company work with you.

 

 

[caribill]

2 hours ago, Cruising Forever! said:

Carnival will deny boarding to all guests 70 years of age or older unless they have a letter from their physician confirming they are fit to sail.

 

Since Carnival is Princess' parent company, my guess is that Princess will follow these guidelines as well?

 

 

What is in italics is what Carnival Cruise Lines is saying they require.

 

Carnival Cruise lines is not the parent to Princess Cruise Lines. Both are owned by the Carnival Corporation. Each sets its own policies.

 

So far, Princess Cruise Lines has not in any way, shape or form said they require a physician's letter confirming fitness to sail.

[Cruising Forever!]

1 hour ago, caribill said:

 

What is in italics is what Carnival Cruise Lines is saying they require.

 

Carnival Cruise lines is not the parent to Princess Cruise Lines. Both are owned by the Carnival Corporation. Each sets its own policies.

 

So far, Princess Cruise Lines has not in any way, shape or form said they require a physician's letter confirming fitness to sail.

Fingers crossed!!!  🙂

 

[Pam in CA]

8 hours ago, caribill said:

 

What is in italics is what Carnival Cruise Lines is saying they require.

 

Carnival Cruise lines is not the parent to Princess Cruise Lines. Both are owned by the Carnival Corporation. Each sets its own policies.

 

So far, Princess Cruise Lines has not in any way, shape or form said they require a physician's letter confirming fitness to sail.

As said, Carnival Cruise Lines doesn’t own nor is the parent company. Carnival Corporation is and if the corporation’s policy is doctor’s note or chronic condition, it would affect not only Princess but HAL, Cunard and Seaborne which tend to have older demographics. 

[iancal]

I would not get too excited.  It is early days yet.  I have no doubt that cruise line guidelines will change multiple times before cruising commences, and after.   

 

I would take a lot of this as 'first draft' material.  It will be partly for PR reasons and partly for medical reasons.  The cruise lines will no doubt be taking customer feedback and medical feedback into advisement as the move forward to a some sort of standard. 

 

 I expect that a standard will be adopted by most cruise lines if only because the industry probably does not want this to become a competitive advantage or an issue.

Edited April 25, 2020 by iancal

[gmjc2]

18 hours ago, Cruising Forever! said:

Because I have ulcerative colitis (since 1983), I am currently on Entyvio, a drug known as a biologic.  Entyvio acts (as do all biologics) by lowering the immune system (an overactive or malfunctioning immune system is thought to be the cause of ulcerative colitis).  Since being on Entyvio, my UC is completely under control... I live a pretty normal life.  During the pandemic, my doctor has advised me to self quarantine just as a precaution.  I didn't need to worry about this as on the same day he told me this, my state shut down.  I might be forced to go back to work once my state reopens (hopefully not any time soon).  The rules here are a bit fuzzy.  But if I have to I have to, and I'll just take the steps necessary to be as safe as possible since I work with the public.

 

New cruise travel guidelines (as reported on Cruise Critic's Cruise News on 4/24/20) seem to indicate that those with impacted immune systems will be denied boarding any (?) cruise vessels (along with people over 70 who don't have a doctor's note saying they are healthy enough to travel).  Here's an excerpt from the Cruise News article with Carnival's wording (and Royal Caribbean seemed to have the same or similar wording):

 

Carnival will deny boarding to all guests 70 years of age or older unless they have a letter from their physician confirming they are fit to sail. Additionally, all guests will be asked if they have been hospitalized in the past two months for or if they have a history of chronic or severe medical conditions. The CDC defines chronic conditions as an illness persisting for a long time or constantly recurring, such as diabetes, heart, kidney or lung disease. Additional severe medical conditions include: suppressed immunity (active cancer, taking steroids) or if the person requires oxygen for any reason. Guests with chronic or severe medical conditions will not be allowed to sail.

 

Since Carnival is Princess' parent company, my guess is that Princess will follow these guidelines as well?

 

So, if I'm reading this correctly, I'm no longer allowed to cruise?  Forever?  I've been on biologics since 2015 and have cruised frequently (six cruises since, actually) without any issues whatsoever.  Why would anything be different now?  Further, if you are blocked for using biologic drugs, this means many many people will no longer be allowed on ships!  Those using Humira for arthritis for instance.  I think these CDC guidelines are a little too broad.  I know that this is all in response to Covid19, but there isn't any language here to show that once the pandemic has fallen off that people with say, diabetes, can resume cruising again.  Further, what if someone had Covid19, but is still somebody who has fallen into the new restricted travel guidelines?  Do they get to cruise?  Or are you forever a travel pariah?

 

I also think that the "70 years of age or older" needing a doctor's note screams of discrimination.  I'm sure there are attorneys out there getting ready to file massive lawsuits against any cruise agency that demands a doctor's note for cruise travel because you're 70 or older ("Paging AARP!").  I'm not nearly 70, but I find this offensive in the extreme.  I absolutely agree that passengers with transmittable infectious diseases (noro or corona viruses) should be kept off ships, but keeping people off ships with chronic conditions that are not contagious in any way is ridiculous!  Another caveat: cruise lines will not allow you a refund if you are deemed unfit to travel under the guidelines above.  Instead it's a future cruise credit.  How nice... you can't cruise any more... and here's your FCC that you can never use.  Have a nice day.  (Some might offer a full refund... but watch the wording.)

 

Seriously, I hope the cruise lines work with the CDC to figure this all out... otherwise it's going to be much uglier for my beloved cruise industry.  

Wow! my gastro guy is impressed that I have survived 30 years with UC but you have me beat!! 

I have Entyvio infusions but unfortunately I am not getting the great results I hoped for.

Back to the topic!  We have 55 cruises under our belts with only one on board health issue. I have border- line Diabetes and P.S.C( A rare but potentially fatal condition.) I am in great control on meds and have not had an episode in 6 years.  Also take meds for A.Fib and have no indication of still having the condition after 2 and half years.

In summary-- not a high risk for causing issues for the cruise line even though on paper it does not look great! So will I be banned from cruising?

[gmjc2]

P.S.  Hubby is 75 with controlled Diabetes type 1 so will need a letter from the Doc? The cruise lines will have to think again about these restrictions or they will lose 60 % of the cruisers!

[Cruising Forever!]

16 hours ago, Pam in CA said:

As said, Carnival Cruise Lines doesn’t own nor is the parent company. Carnival Corporation is and if the corporation’s policy is doctor’s note or chronic condition, it would affect not only Princess but HAL, Cunard and Seaborne which tend to have older demographics. 

That was my thought as well...

 

[Roger88]

Well, first of all you will not be checked on whether you take them or not. Moreover, how are they considered drugs if you can take them to places and its not like you have to consume them all the time. Basically, if its not a prohibited drug or marijuana you can safely take it on board as long as you keep it in the safe place and dont share the use with other passangers

[Cruising Forever!]

8 hours ago, gmjc2 said:

Wow! my gastro guy is impressed that I have survived 30 years with UC but you have me beat!! 

I have Entyvio infusions but unfortunately I am not getting the great results I hoped for.

Back to the topic!  We have 55 cruises under our belts with only one on board health issue. I have border- line Diabetes and P.S.C( A rare but potentially fatal condition.) I am in great control on meds and have not had an episode in 6 years.  Also take meds for A.Fib and have no indication of still having the condition after 2 and half years.

In summary-- not a high risk for causing issues for the cruise line even though on paper it does not look great! So will I be banned from cruising?

 

See, this is what I'm talking about... how could we be just fine as cruisers last month, but suddenly we're cruise line outcasts? I've been cruising since 1994, and as I said in the original post, I've had UC since 1984.  I'm healthier (Thank God and modern medicine) then I've ever been before.  And now, I might be blocked from cruising?

 

Where is the logic in these "guidelines"?  My disease and treatment never has and never would render any sort of hardship for the cruise line or other passengers (unless there was a pressing need for them to use my cabin's bathroom while I'm using it :) ).  And what in the world could this have to do with Covid19 and the problems it has caused?  My UC would never strand a cruise ship at sea.  It's stupid...

 

I'm 59, so it's not my ax to grind... but how is being 70 or over a sudden burden?  My uncle is in his 90s and he only stopped running marathons a few years ago!  I'm surprised that this "gotta get a doctor's note" hasn't caused a major outcry yet.

 

I think that the cruise lines are following CDC/CLIA guidelines, here?  So who do we actually file a complaint with on this issue?  I agree this all might collapse on review and that everything is in flux right now... but it's often best to voice protests early rather than sit back and watch the chips fall where they may.

 

(gmjc2- hang in there with the Entyvio... don't know how long you've been on it, but I think in some people it takes several months to begin to work.  It's been so great for me that it's the only drug I'm on... I used to have to drag a carry-on full of meds around with me everywhere!  Stay healthy!) 

[Cruising Forever!]

11 minutes ago, Roger88 said:

Well, first of all you will not be checked on whether you take them or not. Moreover, how are they considered drugs if you can take them to places and its not like you have to consume them all the time. Basically, if its not a prohibited drug or marijuana you can safely take it on board as long as you keep it in the safe place and dont share the use with other passangers

 

Good point.  But biologics (except some rare ones in pill form) are infused (IV drip) at a doctor's office... so even less of a problem.  They aren't seen at all by cruise lines.  These drugs are infused every few weeks or months (mine is every 8 weeks) at a doctor's office or infusion center (often in the doctor's office).  I went through all sorts of hoops (with my doc's guidance) to make sure my (now canceled) cruise wouldn't fall within the cruise dates this year.  Sigh.

 

There was a time that I had to take bottles of liquid meds, and bottles of pills on airplanes and cruises... up till 2018, actually... and that was a hassle only for me.  Occasionally TSA would look over the drugs and shrug it off.  No problem.  Entyvio ended all that for me.

 

But it looks like you are being required to declare your personal health issues pre-boarding in far more detail?  They go so far as to say (in articles I've read) that if a discovery that you haven't been forthcoming in all of your medical details arises, that you'll be put off at the first port!  So, does this mean they will have some access to your medical records???  I'm wondering if that means some sort of requirement that you turn over your HIPAA rights to them?!?  Now that would be ugly if true!  If cruises do that, it's going to be the end for them.

 

As has been said, it's early in all this, and things might (SHOULD!) change.  If this is just a temporary thing to ease people back into cruising (and it's still illogical), then they should explain that up front rather than present it as the new normal.

[gmjc2]

3 hours ago, Cruising Forever! said:

 

Good point.  But biologics (except some rare ones in pill form) are infused (IV drip) at a doctor's office... so even less of a problem.  They aren't seen at all by cruise lines.  These drugs are infused every few weeks or months (mine is every 8 weeks) at a doctor's office or infusion center (often in the doctor's office).  I went through all sorts of hoops (with my doc's guidance) to make sure my (now canceled) cruise wouldn't fall within the cruise dates this year.  Sigh.

 

There was a time that I had to take bottles of liquid meds, and bottles of pills on airplanes and cruises... up till 2018, actually... and that was a hassle only for me.  Occasionally TSA would look over the drugs and shrug it off.  No problem.  Entyvio ended all that for me.

 

But it looks like you are being required to declare your personal health issues pre-boarding in far more detail?  They go so far as to say (in articles I've read) that if a discovery that you haven't been forthcoming in all of your medical details arises, that you'll be put off at the first port!  So, does this mean they will have some access to your medical records???  I'm wondering if that means some sort of requirement that you turn over your HIPAA rights to them?!?  Now that would be ugly if true!  If cruises do that, it's going to be the end for them.

 

As has been said, it's early in all this, and things might (SHOULD!) change.  If this is just a temporary thing to ease people back into cruising (and it's still illogical), then they should explain that up front rather than present it as the new normal.

Unfortunately I still lug a boat load( pun intended!) of pills with me, same for hubby. The cruise lines will realize that they are preventing about 60% of their customers from cruising if they actually implement these policies when they resume business!  Crossing fingers!

[joe d]

19 hours ago, iancal said:

…...  I have no doubt that cruise line guidelines will change multiple times before cruising commences, and after.   

 

 

I agree. The problem I have is that I am not prepared to book a cruise until I know what the guidelines are.  Even then I would be concerned that they would change between the time of booking and the date of the cruise.

[RocketMan275]

On 4/24/2020 at 10:37 PM, Cruising Forever! said:

I also think that the "70 years of age or older" needing a doctor's note screams of discrimination.  I'm sure there are attorneys out there getting ready to file massive lawsuits against any cruise agency that demands a doctor's note for cruise travel because you're 70 or older ("Paging AARP!").  I'm not nearly 70, but I find this offensive in the extreme. 

It isn't discrimination if it can be shown that there is a rational justification for the action.  

[gmjc2]

43 minutes ago, RocketMan275 said:

It isn't discrimination if it can be shown that there is a rational justification for the action.  

Would that rational justification be that old people are a liability?  If so, they will not have many cruising customers.

Actually I do not have a real issue with the letter idea except for the logistics of obtaining the letter in a timely manner and without cost to me!

Funny thing is that hubby is 75 but has little in the way of health issues but I am 68 with three potential issues. Yet I will not need a doctors note?  

[RocketMan275]

1 hour ago, gmjc2 said:

Would that rational justification be that old people are a liability?  If so, they will not have many cruising customers.

Actually I do not have a real issue with the letter idea except for the logistics of obtaining the letter in a timely manner and without cost to me!

Funny thing is that hubby is 75 but has little in the way of health issues but I am 68 with three potential issues. Yet I will not need a doctors note?  

If you research the statistics on the virus, you'll find that the mortality is concentrated in persons over 70 with those chronic conditions.  IOW, those persons are far more likely to have issues requiring medical support.  

[gmjc2]

Just now, RocketMan275 said:

If you research the statistics on the virus, you'll find that the mortality is concentrated in persons over 70 with those chronic conditions.  IOW, those persons are far more likely to have issues requiring medical support.  

No argument there but as I stated--if they turn away older people with chronic conditions they will lose 60% of their customers!

[iancal]

joe d......We will not even consider a cruise until we feel it is safe to do so.

 

Two things are for sure.   We would not give a cruise line a dime of our money at this point in time nor would we even consider an FCC in lieu of a cash refund.

 

We would never consider booking unless the health related embarkation rules (and remedies) were enunciated is very clear language...not mumbo jumbo that could be interpreted differently at will by various cruise line employees.

[RocketMan275]

10 minutes ago, gmjc2 said:

No argument there but as I stated--if they turn away older people with chronic conditions they will lose 60% of their customers!

So why worry about this?  Obviously, the cruise lines won't give up 60% of their customers.  These restrictions will not last long.

[BarbinMich]

Seems to me that trying get such a document from a busy physician's office (with multiple doctors and many, many patients) would be difficult--not exactly a high priority for them.

[Cruising Forever!]

6 hours ago, joe d said:

I agree. The problem I have is that I am not prepared to book a cruise until I know what the guidelines are.  Even then I would be concerned that they would change between the time of booking and the date of the cruise.

Yes!  Especially since it's not clear if they will actually refund you or give you a useless FCC (since you'd be forever "unfit" under new rules.).  I wouldn't invest in a cruise until the lines make it clear 100% on whether you can get a refund and not a useless FCC!

[Cruising Forever!]

3 hours ago, RocketMan275 said:

If you research the statistics on the virus, you'll find that the mortality is concentrated in persons over 70 with those chronic conditions.  IOW, those persons are far more likely to have issues requiring medical support.  

 

The new "guidelines" don't even mention this being related to covid19!  It's just a blanket declaration as far as I can see.  If it was about Covid19, what would people with chronic conditions have to do with this?  It's all stupid!