Cruise Line Industry being treat as the Proverbial Step Child??

[UnorigionalName]

5 hours ago, Hlitner said:

Actually, we think flying is among the highest of all risks when it comes to highly contagious diseases.  We base this on a conversation we had, several years ago, with a CDC trainer who we met on a RCI cruise.  He was on the ship to conduct training for the crew and also consult with the senior staff on best practices.   At the time the major focus was Norovirus and influenza.  The CDC official told us that, based on some internal studies, they knew that most Norovirus was contracted by passengers/crew on airplanes and at airports.  These folks would then carry the bug onto the ship before they were showing any symptoms (it takes 2-3 days to often see any symptoms).   While the cruise lines were essentially blameless of most Norovirus outbreaks it fell to them to mitigate the bug.    And we are probably seeing a similar situation with COVID-19.  Folks get exposed to the bug on land and carry it aboard the ships.  Since they often have absolutely no symptoms at the time they board the ship there is nothing the vessel can do.  And even testing at the port would likely miss many cases since recent exposure would not result in a positive COVID-19 test.  

 

Hank

 

 

airlines are high risk in terms of globally spreading a pandemic; that is how it jumps from one continent to another.

 

But low risk on an individual flight perspective for SARS-COV2.  Thorough contact tracing has shown that individual air flights and airports are surprisingly low risk.  There have been many flights with known even symptomatic COVID patients where no one else on the plane or airport ended up contracting COVID.

 

Everyone assumed airplanes and airports would be huge potential sources of spread, but data does not seem to support it for some reason.    Contrast to cruise ships where one positive patient getting off one cruise leads to hundreds positive on next cruise.

 

I don't think any disease has had such intense scrutiny in such a short period.  A lot of assumptions are turning out false (like the droplet/aerosol dichotomy) and it's going to be interesting what we learn in the next few years.

Edited May 26, 2020 by UnorigionalName

[PrincessLuver]

17 hours ago, UnorigionalName said:

 

airlines are high risk in terms of globally spreading a pandemic; that is how it jumps from one continent to another.

 

But low risk on an individual flight perspective for SARS-COV2.  Thorough contact tracing has shown that individual air flights and airports are surprisingly low risk.  There have been many flights with known even symptomatic COVID patients where no one else on the plane or airport ended up contracting COVID.

 

Everyone assumed airplanes and airports would be huge potential sources of spread, but data does not seem to support it for some reason.    Contrast to cruise ships where one positive patient getting off one cruise leads to hundreds positive on next cruise.

 

I don't think any disease has had such intense scrutiny in such a short period.  A lot of assumptions are turning out false (like the droplet/aerosol dichotomy) and it's going to be interesting what we learn in the next few years.

 

I agree there is study after study that airplanes are less likely to circulate and spread a disease in a cabin then being on a cruise ship.

 

Because of how air circulates and is filtered, HEPA filters, on airplanes most viruses and other germs do not spread easily on airplanes. Although the risk of infection on an airplane is low, travelers should try to avoid contact with sick passenger. 

 

Also, because airline travel falls under Federal jurisdiction and laws I feel like people are going to do what is told of them to do on an airplane, or risk arrest for not following crew orders, then a cruise ship which people pretty much do whatever they want to do and have the attitude frequently  "of make meetups do it."

 

We will have no problem flying in the age of COVID-19 but no cruising until it is safe to be on a ship and people show more respect for the disease in the USA.

Edited May 27, 2020 by PrincessLuver

[Daniel A]

So I guess social distancing isn't necessary on an aircraft because they have filters.  It's the only business I know of that is allowed to functions during this crises without following the CDC recommendations.  I guess the airline industry has more political pull with the CDC than the 'proverbial step child.'

[chengkp75]

54 minutes ago, PrincessLuver said:

Also, because airline travel falls under Federal jurisdiction and laws I feel like people are going to do what is told of them to do on an airplane, or risk arrest for not following crew orders, then a cruise ship which people pretty much do whatever they want to do and have the attitude frequently  "of make meetups do it."

Well, when I traveled home from the ship a couple weeks ago, United did not follow their own policy of not selling middle seats on all flights, if the demand for the flight was sufficient to fill all seats.  Also, United "required" face coverings at all times on the flight, as announced in the safety briefing, yet there were several people who did not have a face covering, nor was there an effort by the crew to issue the coverings that they had announced they would give out if you didn't have one, nor was there any contact between the crew and the passengers without face coverings about not having face coverings.  You've got to be totally disruptive to receive any action by airlines, so I think your faith in the airline industry is misplaced.

 

Cruise ships have the same laws as the airlines.  The Captain is the legal representative of the flag state, and has full police authority to detain or punish people for failure to follow orders or affect the safety of the ship, crew, passsengers or environment.

[PrincessLuver]

2 hours ago, chengkp75 said:

Well, when I traveled home from the ship a couple weeks ago, United did not follow their own policy of not selling middle seats on all flights, if the demand for the flight was sufficient to fill all seats.  Also, United "required" face coverings at all times on the flight, as announced in the safety briefing, yet there were several people who did not have a face covering, nor was there an effort by the crew to issue the coverings that they had announced they would give out if you didn't have one, nor was there any contact between the crew and the passengers without face coverings about not having face coverings.  You've got to be totally disruptive to receive any action by airlines, so I think your faith in the airline industry is misplaced.

 

Cruise ships have the same laws as the airlines.  The Captain is the legal representative of the flag state, and has full police authority to detain or punish people for failure to follow orders or affect the safety of the ship, crew, passsengers or environment.

 

There are many videos of cruise line security personnel running the other way when stuff gets lawless on a cruise ships.  

 

I do not know what goes on in economy seating on airplanes because I always fly First Class or Business Class if they do not have First Class.   More room, more service and less contact with people.

 

You are right that cruise lines sail under the laws of the flag their ship is under.  The laws are not the same for airlines and cruise ships because US carriers fall under Federal Law.  It is not a federal crime if you disobey cruise ships personnel but it is on an airplane if they decide to enforce it which I have seen many times passengers being escorted off to waiting police.

 

Point is, study after study shows airliners are safe than cruise ships for the risk of getting a disease.

 

 

 

 

Edited May 27, 2020 by PrincessLuver

[DaveSJ711]

10 minutes ago, PrincessLuver said:

 

I do not know what goes on in economy seating on airplanes because I always fly First Class or Business Class if they do not have First Class.   More room, more service and more and less contact with people.

 

 

Not everyone has that luxury.

[chengkp75]

48 minutes ago, PrincessLuver said:

Point is, study after study shows airliners are safe than cruise ships for the risk of getting a disease.

Would love to see these studies, because I am not aware of any tracking that is done of airline passengers who get ill after their flight.

[chengkp75]

49 minutes ago, PrincessLuver said:

 It is not a federal crime if you disobey cruise ships personnel but it is on an airplane if they decide to enforce it which I have seen many times passengers being escorted off to waiting police.

It is, however, a federal crime in the flag state.  I don't know, I've been traveling for business for the last 45 years, and I've never seen anyone escorted off an airplane.

 

51 minutes ago, PrincessLuver said:

I do not know what goes on in economy seating on airplanes because I always fly First Class or Business Class if they do not have First Class

Oh, so the insensitivity of airline passengers changes at the divider between first/business and economy?

[Charles4515]

Well, when I traveled home from the ship a couple weeks ago, United did not follow their own policy of not selling middle seats on all flights, if the demand for the flight was sufficient to fill all seats.  Also, United "required" face coverings at all times on the flight, as announced in the safety briefing, yet there were several people who did not have a face covering, nor was there an effort by the crew to issue the coverings that they had announced they would give out if you didn't have one, nor was there any contact between the crew and the passengers without face coverings about not having face coverings.  You've got to be totally disruptive to receive any action by airlines, so I think your faith in the airline industry is misplaced.

 

Cruise ships have the same laws as the airlines.  The Captain is the legal representative of the flag state, and has full police authority to detain or punish people for failure to follow orders or affect the safety of the ship, crew, passsengers or environment.

 

While crew on some particular forms of transportation have authority the problem is that often managements do not really want the crew to actually exercise the authority. If a crew member exercises authority and a passenger complains they don’t back up the crew member and the crew knowing that treads lightly.

 

 

Sent from my iPhone using Forums

[UnorigionalName]

34 minutes ago, chengkp75 said:

Would love to see these studies, because I am not aware of any tracking that is done of airline passengers who get ill after their flight.

 

Schwartz, Kevin L., et al. "Lack of COVID-19 transmission on an international flight." CMAJ 192.15 (2020): E410-E410.

https://www.cmaj.ca/content/192/15/E410

 

edit: I'm not trying to say it doesn't happen on planes.  It probably does.  But given how virulent it seems to be, the assumption was if you were trapped in a tin can with a symptomatic patient, like at least dozens of surrounding people should get infected, but for some reason it's not acting like that.

 

Eldin, Carole, et al. "Probable aircraft transmission of Covid-19 in-flight from the Central African Republic to France." Travel Medicine and Infectious Disease (2020).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194574/

Edited May 27, 2020 by UnorigionalName

[PrincessLuver]

7 minutes ago, UnorigionalName said:

 

Schwartz, Kevin L., et al. "Lack of COVID-19 transmission on an international flight." CMAJ 192.15 (2020): E410-E410.

https://www.cmaj.ca/content/192/15/E410

 

edit: I'm not trying to say it doesn't happen on planes.  It probably does.  But given how virulent it seems to be, the assumption was if you were trapped in a tin can with a symptomatic patient, like at least dozens of surrounding people should get infected, but for some reason it's not acting like that.

 

Eldin, Carole, et al. "Probable aircraft transmission of Covid-19 in-flight from the Central African Republic to France." Travel Medicine and Infectious Disease (2020).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194574/

 

But there are plenty of anecdotal records and some research to let us know how COVID-19 spreads quickly on a cruise ship....cruise ships are truly floating petri dishes of germs.....thanks for the article and I have read many others supporting that flying is a safe way to travel regarding disease spread and COVID-19.

[Roberto256]

2 hours ago, chengkp75 said:

It is, however, a federal crime in the flag state.  I don't know, I've been traveling for business for the last 45 years, and I've never seen anyone escorted off an airplane.

 

 

On one of the recent flights I was on, a gent was behaving strangely.

 

He helped himself to liquor from the forward galley.

(I could not see other events that may have occured)

 

City Police were waiting to arrest him.

 

He had a rather belligerent friend, and the police graciously offered to arrest him if he didn't shut up.

 

 

[chengkp75]

2 hours ago, PrincessLuver said:

 

But there are plenty of anecdotal records and some research to let us know how COVID-19 spreads quickly on a cruise ship....cruise ships are truly floating petri dishes of germs.....thanks for the article and I have read many others supporting that flying is a safe way to travel regarding disease spread and COVID-19.

I was not aware you were speaking explicitly about covid, since you said "a" disease.

[chengkp75]

58 minutes ago, Roberto256 said:

 

 

On one of the recent flights I was on, a gent was behaving strangely.

 

He helped himself to liquor from the forward galley.

(I could not see other events that may have occured)

 

City Police were waiting to arrest him.

 

He had a rather belligerent friend, and the police graciously offered to arrest him if he didn't shut up.

 

 

Not saying it hasn't happened, just that I've never seen it, and the poster said that he/she had seen it "many times".

[Roberto256]

11 minutes ago, chengkp75 said:

Not saying it hasn't happened, just that I've never seen it, and the poster said that he/she had seen it "many times".

 

I've only seen it once.

 

Some guy passed out in the aisle towards the back of the plane, and we had to make an emergency landing ... only saw once.

 

Most unusual ... we're deplaning ... half the people are off the plane in the jetway. 

 

The ramp agent / ground person forgot to set 'auto height' on the jetway.

 

Just as I step off,  the jetway jumps up about 2 feet, bending the main cabin door in half.

I've only seen that once, too.   At least the slide didn't deploy.

 

 

 

 

[npcl]

9 hours ago, chengkp75 said:

Would love to see these studies, because I am not aware of any tracking that is done of airline passengers who get ill after their flight.

If someone is identified with Covid-19. During the tracing process the health department will identify if they had traveled on an aircraft during the period of concern.  Depending upon the location that information will be used in a number of different ways.  Where I live the flight number and date of the flight will be posted.  Due to privacy laws they are not allowed to provide any other details.  This also limits the health department from providing the  information that might result identification of someone that tests positive.

 

Unfortunately the Airlines in the US due not in general collect information that is necessary for contact tracing

 

https://www.nytimes.com/2020/03/31/business/coronavirus-airlines-contact-tracing-cdc.html 

Since this one is behind a fire wall I included another reference

 

https://www.independent.co.uk/travel/news-and-advice/american-airlines-coronavirus-data-collection-passengers-contact-tracing-a9440746.html

US airlines are continuing to refuse to collect passenger data that would aid in tracing and contacting those who may have contracted coronavirus.

The US government has been attempting to make carriers provide travellers’ information for 15 years, ever since health officials assessed the weak spots in their response to the Sars outbreak.

 

So while the health departments do collect the data from interviews with positive individuals during contact tracing.  It is very limited due to the lack of data from the air lines.

 

Here is an example of a county health department using that contact tracing data in the US

https://www.kdrv.com/content/news/Passengers-on-flight-to-Medford-may-have-been-exposed-to-COVID-19-health-officials-say-569078741.html

Officials listed three flights, only one of which came through Southern Oregon:

 

• March 16: United Flight #5827 from Los Angeles Airport to Arcata
• March 18: Delta Flight #4124 from Seattle to Medford, OR
• March 18: United Flight #5555 from San Francisco Airport to Arcata

 

Health officials said that the actual exposure risk for most passengers would have been low, but all passengers are still advised to quarantine at home for 14 days, and contact a healthcare provider if they become ill with a fever, cough, or shortness of breath.

 

 

In other countries where privacy laws are different more information is often provided.  For example in NSW Australia they post flights and the seats that may have been in close proximity.  

 

 

Domestic flights travelling to, through or from a NSW airport

Flights listed arrived in April or May. For previous flights, please refer to Other known flights with confirmed cases of COVID-19.

Flight	Airline	Origin/Destination	Date of departure	Date of arrival	Close contact rows
QF537	Qantas	Brisbane/Sydney	12 May 2020	12 May 2020	31, 32, 33, 34, 35
QF470	Qantas	Melbourne/Sydney	9 April 2020	9 April 2020	7-11
QF843	Qantas	Darwin/Sydney	4 April 2020	4 April 2020	All rows
QF840	Qantas	Sydney/Darwin	3 April 2020	3 April 2020	All rows
QF843	Qantas	Darwin/Sydney	2 April 2020	2 April 2020	All rows
QF840	Qantas	Sydney/Darwin	1 April 2020	1 April 2020	All rows

Edited May 28, 2020 by npcl

[npcl]

9 hours ago, chengkp75 said:

Would love to see these studies, because I am not aware of any tracking that is done of airline passengers who get ill after their flight.

Here is a link to the EU guidelines  dealing with infectious disease on aircraft, including data collection and contact tracing

 

https://www.ecdc.europa.eu/en/all-topics-ztravellers-health/infectious-diseases-aircraft

[npcl]

9 hours ago, chengkp75 said:

Would love to see these studies, because I am not aware of any tracking that is done of airline passengers who get ill after their flight.

While it is too early for academic papers concerning analysis on the data collected related to aircraft.  The information is not made public, except in limited use, but is often analysed after outbreaks.  Here are some examples of the multitude of research papers dealing with transmission on aircraft

 

https://pubmed.ncbi.nlm.nih.gov/20495017/?from_term=Infection+statistics+on+aircraft&from_pos=4

 

Transmission of Pandemic A/H1N1 2009 Influenza on Passenger Aircraft: Retrospective Cohort Study

 

https://pubmed.ncbi.nlm.nih.gov/23127863/

Patterns of Measles Transmission Among Airplane Travelers

 

Keep in mind that measles is one of the most infectious diseases out there when it comes to airborne transmission

 

https://pubmed.ncbi.nlm.nih.gov/27253070/

 

Review Article: Influenza Transmission on Aircraft: A Systematic Literature Review

 

The last article is an analysis of 14 papers dealing with H1NI transmission on aircraft

[npcl]

This link is a description of the process of contact tracing related to air travel

 

https://www.cdc.gov/quarantine/contact-investigation.html

 

Although the risk of getting a contagious disease on an airplane is low, public health officers sometimes need to find and alert travelers who may have been exposed to a sick passenger on a flight. The search for these travelers is known as a contact investigation. A contact investigation is one of the ways the Centers for Disease Control and Prevention (CDC) works with partners in the United States and other countries to protect the health of people exposed to an illness during travel and to protect their communities from contagious diseases that are just a flight away

 

A contact investigation often starts with a phone call to a CDC Quarantine Station located at a US international airport. The caller is a public health official who informs CDC about a recent air traveler diagnosed with a specific contagious disease

 

 

 

 

This deals largely with international travel because domestic contact tracing  resides with the appropriate health department within the US.

[chengkp75]

Thank you.

[chengkp75]

6 hours ago, npcl said:

This link is a description of the process of contact tracing related to air travel

I see that the studies you linked all deal with airborne transmission diseases, and while covid has become the poster child, and is probably the most intensely studied disease within a century, until now no real concern or attention has been paid to airborne transmission disease on cruise ships.  Conversely, much is made of the frequency of noro and contact transmitted disease on cruise ships, but relatively few studies, that I see (and most involve whole crew infections, or large numbers of passengers actually falling ill on the plane), of noro on airplanes.  I see that in the CDC page regarding contact tracing that again, it focuses on airborne transmitted diseases, and not on contact transmission.  I'm just saying that given the difference in focus that is apparent in disease study and tracking between airplanes and cruise ships, to say that one is more likely to get ill on one form of transportation than another may not be a true apples to apples comparison.

[skynight]

Chengkp75

Can you comment on the kind of filtering generally used in cruise ship HVAC systems? Is it sufficient to filter out most airborne viruses?

[chengkp75]

8 minutes ago, skynight said:

Chengkp75

Can you comment on the kind of filtering generally used in cruise ship HVAC systems? Is it sufficient to filter out most airborne viruses?

No, it is not.  Typically, they use a commercial air filter, not a HEPA filter.  The real issue is that the distance air covers between a return vent to the air handler and back to a supply vent means that a virus becomes so "dilute" and drops out of the air stream due to low velocity, that there is little chance of transmission this way.  The air handlers will have sanitizing pads in the drain pans to disinfect the condensation formed at the air handler to prevent formation of things like legionella.

 

And, as I've said many times in questions about air handling on cruise ships since the pandemic started, cabin air is not recirculated with other cabins.  Cabins are supplied with fresh, cooled air from outside, and warmer air is removed via the bathroom vent.  What the thermostat in the cabin controls is a small AC unit for that cabin that takes the air from that cabin, sends it over a small cooling coil via a fan (both of which are for one single cabin, and located within that cabin) and returns it to the same cabin.  Public spaces do recirculate air that can be intermingled with air from other spaces, since most of the public spaces are open to each other.  There is no evidence that covid has been transmitted via an AC duct system, whether in a cruise ship or a building.

[npcl]

4 hours ago, chengkp75 said:

I see that the studies you linked all deal with airborne transmission diseases, and while covid has become the poster child, and is probably the most intensely studied disease within a century, until now no real concern or attention has been paid to airborne transmission disease on cruise ships.  Conversely, much is made of the frequency of noro and contact transmitted disease on cruise ships, but relatively few studies, that I see (and most involve whole crew infections, or large numbers of passengers actually falling ill on the plane), of noro on airplanes.  I see that in the CDC page regarding contact tracing that again, it focuses on airborne transmitted diseases, and not on contact transmission.  I'm just saying that given the difference in focus that is apparent in disease study and tracking between airplanes and cruise ships, to say that one is more likely to get ill on one form of transportation than another may not be a true apples to apples comparison.

I searched for infections that transfer similarly to COVID-19.  Contact tracing applies to both contact transfer as well as air borne (as well as STDs). There are also lots of studies concerning Noro as well

 

https://pubmed.ncbi.nlm.nih.gov/19796107/

 

Risk of Norovirus Transmission During Air Travel

 

https://www.infectioncontroltoday.com/transmission-prevention/norovirus-transmission-airplane

 

Norovirus Transmission on an Airplane

 

As just two examples.  Just do a search "Norovirus transmission on an airplane" 

 

Here is one that tracks transmission over multiple flights due to 1 ill passenger.

 

https://academic.oup.com/cid/article/53/6/515/357038

 

Recurring Norovirus Transmission on an Airplane

 

So certainly Norovirus is also very well studied on aircraft.

 

The issue with cruise ships comes down to  a combination of large numbers, confined spaces, duration.  The large numbers simply means that the odds of an infected person being on a 3000 passenger cruise ship is much higher than being on a single 150 passenger air plane flight.  Both deal with confined spaces, but in an aircraft people are generally stationary so the odds of someone in seat 2A infecting someone in seat 23B is pretty low. On an aircraft the greatest risk for most is when people  move around during boarding or if someone goes back and forth to the rest room. On a cruise ship, during a multi day cruise there is considerable movement of both passengers and crew, so on a cruise ship one infected person may be in close contact with several hundred people in the course of a day.  Unfortunately most of that contact, for an airborne illness, takes place inside indoor space with limited ventilation  (hallways, stairs, elevators, lounges, theaters, etc.).  In being on a cruise ship is a fairly social activity.  How many people does one encounter and talk with at fairly close distance?  Keep in mind that during loud talking the virus may project as much as 9 feet.

 

One additional issue with a cruise ship is that the crew does not change, even some passengers do not change, so if one passengers makes it on board and passes on the infection, then the odds are high that following cruises will most likely be impacted. 

 

Disease transmission has been very well studied on aircraft, probably even more so than on cruise ships when it comes to academic papers.

 

 

 

 

[npcl]

3 hours ago, chengkp75 said:

No, it is not.  Typically, they use a commercial air filter, not a HEPA filter.  The real issue is that the distance air covers between a return vent to the air handler and back to a supply vent means that a virus becomes so "dilute" and drops out of the air stream due to low velocity, that there is little chance of transmission this way.  The air handlers will have sanitizing pads in the drain pans to disinfect the condensation formed at the air handler to prevent formation of things like legionella.

 

And, as I've said many times in questions about air handling on cruise ships since the pandemic started, cabin air is not recirculated with other cabins.  Cabins are supplied with fresh, cooled air from outside, and warmer air is removed via the bathroom vent.  What the thermostat in the cabin controls is a small AC unit for that cabin that takes the air from that cabin, sends it over a small cooling coil via a fan (both of which are for one single cabin, and located within that cabin) and returns it to the same cabin.  Public spaces do recirculate air that can be intermingled with air from other spaces, since most of the public spaces are open to each other.  There is no evidence that covid has been transmitted via an AC duct system, whether in a cruise ship or a building.

Exactly, the air handling between cabins on a cruise ship is not really an issue when it comes to COVID-19. Even with the Diamond, there was no evidence of transmission via air handling. Also the studies looking at droplet spread pretty much negate it  as well when one considers travel time, evaporation, distance. etc.