When Will The CDC Publish Their New Guidelines?

[retiredgram]

2 hours ago, cruisemom42 said:

 

 Just yesterday there were reports of a number of crew testing positive for COVID on one of the ships trying to start up cruising in the Mediterranean

 

The media jumped all over that story.  Then come to find out, the tests were bad.  Follow up test were negative. 

https://nypost.com/2020/09/29/first-cruise-ship-to-sail-post-coronavirus-docks-after-12-crew-test-positive/

Edited September 29, 2020 by retiredgram
getting clarity

[cruisemom42]

8 minutes ago, retiredgram said:

The media jumped all over that story.  Then come to find out, the tests were bad.  Follow up test were negative. 

https://nypost.com/2020/09/29/first-cruise-ship-to-sail-post-coronavirus-docks-after-12-crew-test-positive/

 

Even if the tests were bad, isn't that newsworthy in and of itself -- after all, these are the tests stocked onboard by which the cruise line is supposed to identify COVID cases and act appropriately to quarantine. If we don't even have a reliable test yet that can be trusted "at sea" then.... doesn't seem smart to start cruising yet. At least, that's the way I feel.

[ontheweb]

29 minutes ago, cruisemom42 said:

 

Even if the tests were bad, isn't that newsworthy in and of itself -- after all, these are the tests stocked onboard by which the cruise line is supposed to identify COVID cases and act appropriately to quarantine. If we don't even have a reliable test yet that can be trusted "at sea" then.... doesn't seem smart to start cruising yet. At least, that's the way I feel.

 

29 minutes ago, cruisemom42 said:

 

Even if the tests were bad, isn't that newsworthy in and of itself -- after all, these are the tests stocked onboard by which the cruise line is supposed to identify COVID cases and act appropriately to quarantine. If we don't even have a reliable test yet that can be trusted "at sea" then.... doesn't seem smart to start cruising yet. At least, that's the way I feel.

And what if the "bad" tests were the other way, false negatives, and then the cruise was on its way.

 

I agree that not being able to have faith in tests is a negative.

[ProgRockCruiser]

7 hours ago, chengkp75 said:

What has changed that would lead the CDC to issue new requirements?  They have set requirements, and it is then up to the cruise lines to develop action/response plans to meet those requirements.  To date, this has not happened.  The "plans" sent to the CDC amount to a negotiating position paper, with an expert board's recommendations, but they are a long way from being the type of plan that is needed to satisfy the CDC.  Anyone who is familiar with the ISM (International Safety Management) System that ships operate under knows how detailed these action plans need to be, and as an example, one only needs to look at the CDC's VSP (Vessel Sanitation Plan) to see the level of detail required.

I think the question being asked revolves around the expiration of the current No Sail Order.  It expires at (I presume) midnight tomorrow night.  As I understand it, unless the CDC extends it, the requirements they laid out have no teeth.

 

Is the CDC about to release a statement making the requirements permanent?  I haven't seen anything about that.

[jimbo5544]

5 hours ago, cruisemom42 said:

 

So much misinformation is out there, fomented by those who don't understand the process and/or don't agree with it.

 

For those under the impression that the CDC has done nothing, they made it clear way back when the "No Sail" order was issued what the path forward for cruise lines was. In short, CDC expected (and expects) the cruise lines to provide them with a detailed plan and procedures to " prevent, mitigate, and respond to the spread of COVID-19 on board ships."  Including all of the following items:

 

• Training of all crew on COVID-19 prevention and mitigation
• Onboard monitoring of crew and non-crew for signs and symptoms of COVID-19
• COVID-19 testing (onboard or onshore)
• Onboard isolation, quarantine, and social distancing
• Adequate medical staffing (this can include telehealth or telemedicine providers)
• Maintaining sufficient quantities of Personal Protective Equipment (PPE), oxygen, and other supplies and the ability to obtain additional resources, if needed
• COVID-19 outbreak management and response information
• Medical arrangements for onshore evaluation and hospitalization
• Screening of embarking or disembarking crew and non-crew
• A system to notify respective national, state, and local public health authorities

In addition, plans should address pre-boarding measures, preventive measures onboard ships, and other measures, all of which can be seen here:   https://www.cdc.gov/quarantine/maritime/recommendations-for-ships.html

 

For the first few months, the cruise lines apparently did nothing; then, when they realized the CDC was not going to just issue a re-start without having such plans, they started to scramble to put them together. 

 

Nothing I have seen so far includes the level of detail that I think CDC is looking for. However, it could be the lines are "floating" things like the Healthy Sails recommendations in order to get some response to CDC if they are on the right track. 

 

Those who think the 70-odd pages of Healthy Sails is enough documentation clearly have not worked in highly regulated industries. In mine, a single SOP dealing with a single step in a process could run to that length.

 

CDC is not the bad guy here. Just because everyone is frustrated and not being able to cruise doesn't mean that cruising should be allowed to restart when it is not necessarily safe to do so. Just yesterday there were reports of a number of crew testing positive for COVID on one of the ships trying to start up cruising in the Mediterranean.

 

Wrong. A million cases and 200,000 deaths.  If we all did our jobs like they did theirs we would be unemployed.  “Experts” do not usually fail so much, at least that would be my guess.  How many guest cases on those med cruises you mentioned?  I WILL WAIT.  If people are going to cherry pick pop ups, then e will never cruise.

Edited September 29, 2020 by jimbo5544

[chengkp75]

39 minutes ago, jimbo5544 said:

Wrong. A million cases and 200,000 deaths.  If we all did our jobs like they did theirs we would be unemployed.  “Experts” do not usually fail so much, at least that would be my guess.  How many guest cases on those med cruises you mentioned?  I WILL WAIT.  If people are going to cherry pick pop ups, then e will never cruise.

Jimbo, I know you think the CDC is the boogeyman, but please show where, in areas that are in their direct control, they have failed.  Remember what the CDC's mandate is, and what it's limitations are.  Could the CDC control the beach parties in Texas, the opening of colleges, or even the relaxation of restrictions on restaurants, bars, hotels, and social distancing or mask wearing, the supply of PPE or testing equipment, the decision to use nursing homes for quarantine facilities, etc?  The CDC may collect data globally, but their mandate and ability to control a situation is limited.

[chengkp75]

1 hour ago, ProgRockCruiser said:

I think the question being asked revolves around the expiration of the current No Sail Order.  It expires at (I presume) midnight tomorrow night.  As I understand it, unless the CDC extends it, the requirements they laid out have no teeth.

 

Is the CDC about to release a statement making the requirements permanent?  I haven't seen anything about that.

They still have the final say on what constitutes a clean bill of health for a ship to enter US waters, so even if they say, "sure, go ahead and sail", when you apply for "pratique" to enter US waters, here is what we will require, and it is the same as the no sail order requirements. They are actually allowed to board every ship, whether US flag or foreign flag, when entering the US from a foreign port, and conduct a full sanitation inspection, and to hold health interviews with passengers and crew.  This is every single time the ship calls at a US port after visiting a foreign port.  They could board, take temperatures, question those with symptoms, and then quarantine the whole ship, just like the Japanese did.  They have not released a statement about making the requirements permanent, but contrary to what most CC posters feel, the "request for information" was not a request for comments by the general public, it is a required step when changing federal regulations (even the no sail order mentions why this step was eliminated for the no sail order), so the only reason I see for doing this is that the new regulations will soon be posted, and I don't think the cruise lines will be happy with them.

[latserrof]

Agree.

[jimbo5544]

1 hour ago, chengkp75 said:

Jimbo, I know you think the CDC is the boogeyman, but please show where, in areas that are in their direct control, they have failed.  Remember what the CDC's mandate is, and what it's limitations are.  Could the CDC control the beach parties in Texas, the opening of colleges, or even the relaxation of restrictions on restaurants, bars, hotels, and social distancing or mask wearing, the supply of PPE or testing equipment, the decision to use nursing homes for quarantine facilities, etc?  The CDC may collect data globally, but their mandate and ability to control a situation is limited.

Chief, I understand and respect your view on this mess.  You have been straight forward in laying out responsibilities on both sides.  I do not think they are the boogeyman, of course they are trying to do the right thing.  The post I quoted pushed my button and here is why.  I will not go into the politics of the subject as it only degrades the conversation.  I expect organizations like this to excel during times like this, in every facet, in every way.  They have vacillated significantly on key items during tough times, sometimes in the same day.  We had projections of 50,000 deaths to 2,000,000 people sometimes in the same week.   We were told masks were mandatory, then not.  We were told it was contact transferred, then not.  We were told a vaccine was 4th qtr, then not.  We were told certain drugs worked well as treatment then not.  We were told 45 days would flatten the curve, then not.  They have contradicted themselves more times then I could count.  I do not care about the political pressure, do the job.  They are THE answer team.  The best of the best, forget about what people will do on their own be consistent in the message...always.  Be the guiding beacon out of the storm....always.

 

in regards to the cruise industry, they did what their mandate said to show what the requirements were for the return.  It was at the time delivered, untenable.  They knew that, the cruise lines knew that, and you and I both knew that.  I expected them to lead in that exercise, not sit back.  I expected them to reach out and assist THE hardest hit industry, not sit back and twiddle their thumbs.  I have a one sided view, I see other countries control organizations openly working the industry, where is the CDC, it is the 29th...silence.  Extremely disappointing, if I were their teach and giving them a report card, F-.

[chengkp75]

11 minutes ago, jimbo5544 said:

in regards to the cruise industry, they did what their mandate said to show what the requirements were for the return.  It was at the time delivered, untenable.  They knew that, the cruise lines knew that, and you and I both knew that

Funny that the most contentious and costly requirements, that the cruise lines have the ability to land ill passengers to private facilities, and to provide private quarantine facilities, is now accepted by the cruise lines as part of the Healthy Sail board's recommendations.  It went from the CDC recommending hospital, quarantine, and accommodation ships to a shoreside solution that accomplishes the exact same thing, placing no demands on public health infrastructure, yet it took months for the cruise line to see how it could be accomplished.  The CDC, as the regulatory agency, proposed "best practices", which was of course to keep the entire problem outside the US, on ships, but the cruise lines, as the regulated industry took months to even come up with an answer of "what is attainable".  As you say, leaving the politics of the pandemic aside, the CDC did, in my opinion, lead, by making the recommendations such that they do the utmost to protect the health of US citizens.  Why the cruise lines did not step up and follow is a mystery to me.

[cruisemom42]

25 minutes ago, jimbo5544 said:

Chief, I understand and respect your view on this mess.  You have been straight forward in laying out responsibilities on both sides.  I do not think they are the boogeyman, of course they are trying to do the right thing.  The post I quoted pushed my button and here is why.  I will not go into the politics of the subject as it only degrades the conversation.  I expect organizations like this to excel during times like this, in every facet, in every way.  They have vacillated significantly on key items during tough times, sometimes in the same day.  We had projections of 50,000 deaths to 2,000,000 people sometimes in the same week.   We were told masks were mandatory, then not.  We were told it was contact transferred, then not.  We were told a vaccine was 4th qtr, then not.  We were told certain drugs worked well as treatment then not.  We were told 45 days would flatten the curve, then not.  They have contradicted themselves more times then I could count.  I do not care about the political pressure, do the job.  They are THE answer team.  The best of the best, forget about what people will do on their own be consistent in the message...always.  Be the guiding beacon out of the storm....always.

 

 

Have the CDC made errors? Of course they have. No one anywhere is perfect. But this idea of a lack of consistency being a failing really needs to be strongly rebutted.

 

How is it possible to use the scientific approach and also to never change one's message?  The scientific method by its very nature demands a constant willingness to look at new data and facts and change one's interpretation. Close-mindedness has no place in science. Flip-flopping is a good thing when one's original thoughts are wrong. 

 

How is it possible that any person or group could know everything about an entirely new virus at month 1 or 2 or 6?  

 

CDC were not the ones actually creating the models, which did vary widely at the outset -- but it was not really possible then to know what we do NOW about exactly how infectious the disease is. Just look at the widely different scenarios that they were confronted with during those early weeks. The spread of the virus in Italy, for example, which was extremely rapid. 

 

The about-face on mask wearing is, IMO, one of the smartest things they figured out -- and again, it was once we gained a better understanding of how the disease was spread COUPLED WITH our understanding (once testing finally started) that we have a large population of asymptomatic spreaders.  Where compliance with mask wearing has been high, spread of the disease has been shown to decrease. 

 

Ever heard the saying "A foolish consistency is the hobgoblin of little minds" (Ralph Waldo Emerson)?

 

 

[jimbo5544]

1 minute ago, cruisemom42 said:

 

Have the CDC made errors? Of course they have. No one anywhere is perfect. But this idea of a lack of consistency being a failing really needs to be strongly rebutted.

 

How is it possible to use the scientific approach and also to never change one's message?  The scientific method by its very nature demands a constant willingness to look at new data and facts and change one's interpretation. Close-mindedness has no place in science. Flip-flopping is a good thing when one's original thoughts are wrong. 

 

How is it possible that any person or group could know everything about an entirely new virus at month 1 or 2 or 6?  

 

CDC were not the ones actually creating the models, which did vary widely at the outset -- but it was not really possible then to know what we do NOW about exactly how infectious the disease is. Just look at the widely different scenarios that they were confronted with during those early weeks. The spread of the virus in Italy, for example, which was extremely rapid. 

 

The about-face on mask wearing is, IMO, one of the smartest things they figured out -- and again, it was once we gained a better understanding of how the disease was spread COUPLED WITH our understanding (once testing finally started) that we have a large population of asymptomatic spreaders.  Where compliance with mask wearing has been high, spread of the disease has been shown to decrease. 

 

Ever heard the saying "A foolish consistency is the hobgoblin of little minds" (Ralph Waldo Emerson)?

 

 

Sounds like a lot of justification to me, when I hear flip flopping is a good thing.  I have no problem with adaptation to changes, but the is not what I see from them.  I see out of control and mismanagement.  I expected strong leadership, vision and stepping up to the plate, not what I saw.  I have said what I came to say, I posted not to go down a rabbit hole, but to make a point.  I wait for the CDC to step up t plate in the next 48 hours.....we shall see.

[jimbo5544]

28 minutes ago, chengkp75 said:

Funny that the most contentious and costly requirements, that the cruise lines have the ability to land ill passengers to private facilities, and to provide private quarantine facilities, is now accepted by the cruise lines as part of the Healthy Sail board's recommendations.  It went from the CDC recommending hospital, quarantine, and accommodation ships to a shoreside solution that accomplishes the exact same thing, placing no demands on public health infrastructure, yet it took months for the cruise line to see how it could be accomplished.  The CDC, as the regulatory agency, proposed "best practices", which was of course to keep the entire problem outside the US, on ships, but the cruise lines, as the regulated industry took months to even come up with an answer of "what is attainable".  As you say, leaving the politics of the pandemic aside, the CDC did, in my opinion, lead, by making the recommendations such that they do the utmost to protect the health of US citizens.  Why the cruise lines did not step up and follow is a mystery to me.

There was no plan to follow, they (the industry) was in free fall.  We can disagree this one.

[bigrednole]

The CDC has no action plan or direction. They wield a tremendous amount of power for failing at their primary job. It is very sad. Most of us would be fired from our employers if we performed so poorly. About the only good thing that has come out of this is that the failures have been found with what I would consider a minor pandemic. Minor being that the numbers out there are drastically exaggerated because there were no standards for collecting and verifying factual data. The first 3 months were clear that any death could be categorized as dying from covid whether they had it or not. A person dying of pancreatic cancer was permitted to have Covid on the death certificate. A person dying from the flu could be listed as covid. That is a tragic problem with the numbers. Not identifying who is most susceptible to covid early on caused preventable deaths. All of these things could have drastically reduced the number of deaths. 

 

What the failures of the CDC has opened is that a lot of work needs to be done if a real pandemic hits. If there is an outbreak in China (or where ever), all international flights and transportation shutdown. No returning to the US until a quarantine and safe return plan is in place. Mandatory quarantining in a captive facility, preferably an island that will prevent any chance of it coming to the mainland. 

[ontheweb]

3 hours ago, bigrednole said:

 Mandatory quarantining in a captive facility, preferably an island that will prevent any chance of it coming to the mainland. 

So, what you are proposing is basically the equivalent of a leper colony?

[bigrednole]

1 hour ago, ontheweb said:

So, what you are proposing is basically the equivalent of a leper colony?

Yes, if it prevents the pandemic from coming here. Or you could just let them fly into NYC and see what happens. We already know what happens there.

[bluesplayer]

CDC does their best with the information at hand that is presented to them. These are unusual circumstances. I disagree they are doing a horrible job.  No, they do not always have an answer, at this point no one does.  If they should be fired better fire all the oncologists for not curing cancer.  Scientists and physicians try to compile information and make wise choices.  35 year Registered Nurse who also wants to return to cruising asap..  when it is safe.

[K32682]

On 9/29/2020 at 7:47 AM, ray98 said:

Nah....the cruise industry presents a unique environment allowing you to see the big picture because you have a captive audience for a week.  The people still allowed to jet around the world, crowd in to their local grocery store or visit some amusement parks are no safer.  They are catching and spreading the virus at the same rate, they just disperse their impact into the community where it becomes some random unconnected number.

 

The cruise industry was low hanging fruit, it allowed the CDC to look as if they were doing "something".

 

Let us know when 82 percent of grocery stores, amusement parks and flights show positive cases.

 

https://www.cdc.gov/quarantine/pdf/CDC-NSO-Third-Extension-09-30-2020-p.pdf

 

Quote

Cumulative CDC data from March 1 through September 28, 2020, show a total of 3,689 confirmed cases of COVID-191 or COVID-like illness cases on cruise ships and 41 deaths. These data have also revealed a total of 102 outbreaks on 124 different cruise ships, meaning more than 82% of ships within U.S. jurisdiction were affected by COVID-19 during this time frame. In addition, four cruise ships still have ongoing or resolving COVID-19 outbreaks on board. Recent outbreaks on cruise ships overseas continue to demonstrate that reduced capacity alone has not diminished transmission.

 

 

Edited October 1, 2020 by K32682

[evandbob]

On 9/29/2020 at 6:21 PM, jimbo5544 said:

Sounds like a lot of justification to me, when I hear flip flopping is a good thing.  I have no problem with adaptation to changes, but the is not what I see from them.  I see out of control and mismanagement.  I expected strong leadership, vision and stepping up to the plate, not what I saw.  I have said what I came to say, I posted not to go down a rabbit hole, but to make a point.  I wait for the CDC to step up t plate in the next 48 hours.....we shall see.

 

 

Read Carl Sagan's explanation of the "scientific method" where he describes following the data wherever it leads.  That includes changing hypotheses as more and/or better data is collected and not formulating a theory until all data is analyzed.

 

He decries having a viewpoint and then searching only for data that will support that bias.  He applauds researchers who investigate, discover, amass and formulate conclusions based on the best available data at the time, and are willing to further amend their conclusions if and when other facts emerge.

 

We cannot reach a solid scientific conclusion by following pre-conceived ideas or being limited by constraints imposed by other disciplines.  True science by definition is flexible via the facts, and yet it shouldn't bend to individual personal, political, religious, economic or popular biases.

Edited October 1, 2020 by evandbob

[clo]

2 hours ago, K32682 said:

On 9/29/2020 at 4:47 AM, ray98 said:

The cruise industry was low hanging fruit, it allowed the CDC to look as if they were doing "something".

 

It allowed the CDC to have confined groups to look at.

[jimbo5544]

1 hour ago, evandbob said:

 

 

Read Carl Sagan's explanation of the "scientific method" where he describes following the data wherever it leads.  That includes changing hypotheses as more and/or better data is collected and not formulating a theory until all data is analyzed.

 

He decries having a viewpoint and then searching only for data that will support that bias.  He applauds researchers who investigate, discover, amass and formulate conclusions based on the best available data at the time, and are willing to further amend their conclusions if and when other facts emerge.

 

We cannot reach a solid scientific conclusion by following pre-conceived ideas or being limited by constraints imposed by other disciplines.  True science by definition is flexible via the facts, and yet it shouldn't bend to individual personal, political, religious, economic or popular biases.

I have no interest in scientific methodologies, I will leave whatever justification they want for their actions to them.  What I want is leadership.  Leadership to me means being the guiding light.  Showing everyone who is worried and being told that it is the end of the world by msm, that there is a positive way out.  It is not saying masks are good and then mask are bad.  It is not saying deaths will be 500,000 then 800,000 then 2,000,000 then 60,000 (none of which are right btw).  It is not having the head of the organization say something to congress then hours later a press statement says they made a mistake.  They screwed up, often and big.  They have totally lop sides draconian view of the cruise industry.  They are part of the problem, not the solution.  Someone go ask Sagan his view on that.  

[jimbo5544]

3 hours ago, K32682 said:

 

Let us know when 82 percent of grocery stores, amusement parks and flights show positive cases.

 

https://www.cdc.gov/quarantine/pdf/CDC-NSO-Third-Extension-09-30-2020-p.pdf

 

 

 

Not sure which 4 ships they mean (they do not tell us so we have to guess (hmmm wonder why that is), but my guess is it is the ones that have had crew sitting on them since March.  If you put infected people in a building, the same thing would result. Your grocery store analogy escapes me.  

[CruiserBruce]

3 hours ago, K32682 said:

 

Let us know when 82 percent of grocery stores, amusement parks and flights show positive cases.

 

Apples and oranges...Amusement parks haven't been open for months. Your stay on an airplane is a few hours...if exposure occurs, it won't be known for 10-14 days, minimum, and flights are down 70%. Cruise ships, are, as mentioned, a captive audience, where even if you test positive a week after your cruise, your location during the possible exposure time is clearly documentable. 

[K32682]

2 minutes ago, CruiserBruce said:

Apples and oranges...Amusement parks haven't been open for months. Your stay on an airplane is a few hours...if exposure occurs, it won't be known for 10-14 days, minimum, and flights are down 70%. Cruise ships, are, as mentioned, a captive audience, where even if you test positive a week after your cruise, your location during the possible exposure time is clearly documentable. 

 

The comment was a response to another poster who attempted to justify a return to cruising because flights, grocery stores and amusement parks were no safer.  

 

The best comparison to a cruise ship is a long term care home for seniors.  Neither are particularly appealing during a viral pandemic. 

[cruisemom42]

45 minutes ago, jimbo5544 said:

I have no interest in scientific methodologies, I will leave whatever justification they want for their actions to them.  What I want is leadership.  

 

Well it's unfortunate for you, then, because this is largely a medical and scientific crisis.

 

Data has to be gathered and interpreted from many different sources. Predictive models have to be created, run, challenged, updated, and run again. Behavior of a brand new viral entity has to be studied and described. Tests have to be developed and confirmed.

 

All this in real time and complicated by huge amounts of political pressure that should NOT be applied and by having to communicate to and inform a public that often has no idea of the scientific complexity, through the medium of a communications media that often "gets it wrong", has no idea how to interpret statistical and scientific findings and has a vested interest in sensationalizing the information.