What Does the CDC and the Media Have Against the Cruise Industry? Facts Should Matter…Egos, Hype and Ratings Shouldn’t

For reason that I believe are based upon prejudice/bias, lack of information, the need for sexy headlines, and even ego (among other things), there have been, and will continue be, an improper attack on the cruise industry; including a singular shift of responsibilities from individuals and governments to cruise lines and, to be sure, at higher levels than is imposed upon any other industry.

This is a long article which, in large part, is my personal journey analyzing the past, present, and probable future. It is not a “pitch”. It is not intended to be a persuasive article. But it is written as thousands of people cram onto certain beaches in Florida and California and others come together in groups ranging from 10 to 1,000 across the country with the response being little more than “Geez, I wish they wouldn’t do that” or “What do you expect. People want to get on with their lives.”

I preface this article further by stating I am not a virologist or medical doctor, but do have a degree in Biology (with honors) and am a member of Sigma Xi, the scientific research honors society among other things. As such, I am skeptical by nature (multiplied by my Jersey roots and prior life as an attorney involved in more than enough litigation – including medical malpractice cases) so I do not blindly listen to the “experts” or accept figures thrown at me.  Along those lines, you will see numerous links in this article, so you can see where I obtained my figures and assertions…and so you can dig deeper if you wish.

For example, the virologists look to see how viral a virus may be. They naturally take the “worst-case” scenario and then add a factor that increases it due to uncertainty. I have found no modeling which calculated the asserted possible 2,000,000 US deaths would be reduced to 70,000 (estimated eventual total US deaths) through social distancing; nothing even close. But the media and CDC ran with those numbers, including Dr. Anthony Fauci – the “ordained to be infallible” virologist. (BTW, self-congratulations are wonderful, but let’s not overstate those either. Social distancing was and is important, but we must not forget the virologists’ estimates were most probably highly inflated…a point that is quietly being discussed outside of the popular media and I will touch on herein.)

Related thereto, for weeks we were falsely pitched a death rate of over 3%…but then it was admitted that (a) the death rate is actually significantly skewed higher because of a very specific group (over 65 with underlying serious medical conditions; actually those over 80 is where the numbers really increase) and then (b) that there is a very significant amount of the population has been infected (we are still figuring out how many) and were either asymptomatic or had mild symptoms. Now a mortality rate of between 0.1 – 0.3% seems to be the reality…including the skewing of the rates by including those most vulnerable. In other words, the actual death rate appears to be 1/10th or less of that originally asserted. (On the other hand, the ability of this virus to spread was woefully underestimated, so a lower mortality rate with far more people becoming infected is where we are.)

We also need to keep in mind that the initial focus was on preventing the overwhelming our healthcare systems; not the elimination of COVID-19 from our daily lives (not that it shouldn’t be an ultimate goal). I will say what I have said before, the unfortunate fact is that people die every day in greater numbers from other usually preventable causes…and we have learned to balance that cost against the benefits of continuing on with life. According to the CDC US deaths from heart disease (650,000 per year),  cancers – primarily lung (600,000), diabetes (84,000), flu (yes, flu: 56,000) and suicide (47,000) are all things we have decided to live with though significantly preventable and thus haven’t shut down our lives.

We need to ask if – as with the 2,000,000 possible deaths and the 3+% death rate assertions – there is a middle ground that we need to look at rather than being dragged down the road of constant overstatements and overreaction?  Please don’t get me wrong, I am not saying COVID-19 is not serious or should be discounted. What I am saying is that in order to do the right thing we need to deal with facts and not emotions or prejudices.

And with that…

The phenomenon of the United States Centers for Disease Control having a tough and, I believe, improperly prejudiced view and, thus, handling of health issues on cruise ships is not anything new.  But there comes a time when the balance between regulations that keep us safe and healthy versus those that are punitive (whether intentional or not) with goals that go beyond reasonable health and safety concerns need to be called out.

Before I discuss how cruise ships are a huge focus of the CDC (and the media) while hotels, aircraft, trains, buses, restaurants, bars, nursing homes, etc. are not, during this COVID-19 pandemic,  let me point out a few important facts:

1.  An obvious fact regarding the relationship between cruise ships and COVID-19 (novel coronavirus) has been lost: COVID-19 spread around the world because of air travel; not cruise ships.

As the facts are being discovered, the real start of the COVID-19 infections in the eastern United States was primarily from travelers arriving from Italy (and to a lesser extent China) through airports (there are no winter cruises from Europe or China to the United States) and the real start of infections in Italy came from China (which has a long history of air travel to the northern areas of Italy; especially Milan). Meanwhile, it appears that the first west coast of the U.S. infections were not in Seattle, Washington, but about 1,000 miles away in California…again through air travel. [According to the US Department of Transportation there are (were at the relevant times) approximately 4,000,000 people that fly to the US every month from Italy and 8,000,000 from China. This dwarfs the cruise traveler figures. Overall, last year there were 4,540,000,000 air passengers versus 30,000,000 cruise passengers…most of which were also air passengers…or 0.6% of travelers if you exclude all other forms of travel; an infinitesimal number by comparison.]

Without looking for a scholarly article on the subject, I believe it is safe to say that more people have become infected on aircraft and in restaurants, bars, grocery stores, parks and even just walking down the street than have been infected on cruise ships.  (They had to get it somewhere if not on a ship.) And while it is easier to identify where a person probably became infected if they had been on a cruise, while that may well not be definite, it is most certainly easier to trace subsequent infections of contacts. Why? Because tracing is far easier than with a person whose place of infection cannot be so easily determined. Try figuring out who got infected by whom and where in New York City, for example! (By the way, this is why testing is so important. There is no luxury of knowing where people have become infected and testing gives that insight.)

2.  According to the most arguably reliable recent data (compiled by the Miami Herald and released on April 23, 2020) other than the Diamond Princess, there have been only 1,881 COVID-19 cases associated with cruise ships worldwide and of those no more than 1,000 have been associated with guests. That includes those guests who were not found to have it when they disembarked, but later were diagnosed after traveling and coming in contact with others.  Taking into account that there are approximately 500,000 passengers carried on 314 cruise ships on any given day, that comes out to an infinitesimally small number of COVID-19 infections. And, most certainly, far less than has been brought from one country to another via air, train, bus, car, etc.

3.  The Centers for Disease Control has a very stringent health inspection protocol for cruise ships that have any connection to the United States (which includes almost all cruise ships you may sail on).  This is known as the Vessel Sanitation Program, which are very rigorous inspections, done without notice, and take approximately 8-10 hours to be completed.

As an illustration of what it takes to fail the inspection, dings on February 1, 2020 inspection of the Regent Seven Seas Mariner included, among other things, apparently watered down soap at a handwash station; a single fruit fly landed on cut fruit; a single dead fly was found on the ice used in a buffet; buffet food placed too far forward of the sneeze shields while other food was put too far back; five decorative bowls weren’t sufficiently cleaned; two ice bins had black debris (probably mold) that wiped off with alcohol; and, a dairy storage area was found to be in a “temperature danger zone”. NOTE:  This inspection scored an 88 is one of the lowest scores on a luxury cruise ship with most of the major problems limited to the buffet; not the rest of the ship and all of the hotel, pool, ventilation, common areas, etc. of the ship. ALSO NOTE that the vast majority of cruise ships, not just luxury ones, receive scores in the 95-100 range. 

While the failings noted above are of concern, they pale in comparison to what you encounter on an almost daily basis…even when you are at home. Think about what you have seen at that all you can eat salad bar, that hotel breakfast buffet, that hotel bathroom, that dirty rag wiping down your table in a restaurant, your concerns over whether anything is “living” on the hotel bedding from a prior guest, etc. And, of course, you have just been bombarded with how dirty an airplane tray table is (and don’t drink the water from the plane’s sink)! 

The list of books and television shows, including some with real star power, have informed you that what occurs on land is consistently and horrifically worse than anything even remotely possible on a cruise ship. Take a moment and read Anthony Bourdain’s Kitchen Confidential, watch an episode or six of Hotel Impossible or Gordon Ramsey’s 24 To Hell and Back. I have worked in, and otherwise been in, more than enough restaurants and stayed in more than enough hotels to know that what these shows depict are only exceptions as to the extent of the disgusting conditions, but not the ubiquitous existence of them.

We have all read and seen this media hype. But is there any basis for this?  Cleary, my answer is: No!  That is not to say that cruise ships are 100% germ-free, but rather that cruise ships are far cleaner than you will find in almost any hotel, restaurant, airport, aircraft, train, bus, etc.

From what I can tell, the “petri dish” concept arose out of a 2014 article on CNN.com. While the article’s title “Are Cruise Ships Floating Petri Dishes?” was clearly intended to hype the issue, if one actually reads the article it accurately states that in 2014 there were about 21,000,000 (that’s right, twenty-one million) land-based norovirus cases while in 2013 there were only 1,200 cruise ship based cases, or 0.005% of all norovirus cases, arising out of only 9 sailings and over 10,000,000 passengers.  The final sentence – not the first one – is a quote, “Bad things happen. If you stop your life for fear of what could be, you never experience anything.”  Do you wonder why that was put at the end of the article rather than the beginning? I  don’t.

Don’t think things have changed much, the false petri dish analogy arose again recently with the NewYork Times (among others) going for sensational article titles, such as “We’re in a Petri Dish”: How a Coronovirus Ravaged a Cruise Ship.

And the cruise writer for The Points Guy and I (long time business friends) have has some words about my perception of him doing the same thing: Hyped and Damaging Headlines followed by an accurate story. But, as I said, he is not alone…by a longshot.

The Washington Post, also engaging in seriously questionable and sensational attack of the cruise industry with its April 24, 2020, article, Pandemic At Sea.   The article asserts the cruise industry made the “decision to keep sailing for weeks…despite the efforts of top U.S. health officials to curtail voyages”.  You will see below, it is not only inaccurate, I dare say it is intentionally false and misleading.

As quoted below, on March 8, 2020 Dr. Fauci, the U.S. top spokesman, said that if you were healthy there is no reason not to take a cruise. On March 16, 2020, the cruise lines all changed their procedures, denied boarding to anyone who had been to China or had a temperature, etc. in accordance with CDC guidance. On March 13, 2020, the cruise lines suspended all cruises with a U.S. port, and then on March 17, 2020, the CDC issued a “no sail order” consistent with the previous voluntary action by the cruise lines.   Finally, on March 24, 2020, the cruise lines suspended all cruises through the beginning of May 2020 (which has since been extended) but had many ships already sailing with passengers and crew.

Please tell me where the cruise lines decided to keep sailing for weeks after CDC guidance. It simply is untrue. The worst case would be that a few days went by…and that is stretching it, if only to kinda sorta find a scintilla of justification.

Yet the Washington Post, with the damning quotes coming from relatives of passengers and passengers, and, of all the countries, an official from Jamaica, makes some pretty outrageous, emotional and unverified statements.  Further, contrary to the detailed Miami Herald article, it claims that by casually reading articles, but with no documentation, 55 ships allegedly one-fifth of the global cruise fleet, had COVID-19 infected passengers and crew…leaving out all but a handful by name and the number of cases on even less. Even the CDC in its April 9th statement stated, “In recent weeks, at least 10 cruise ships reported crew or passengers that tested positive or experienced respiratory symptoms or influenza-like illness”. I always worry about tossed about figures…because they are just that!  So again, the Washington Post published simply false information; which probably will be blindly quoted as some point in the future…just like the debunked petri dish analogy.

The article then goes on to damn the Celebrity Eclipse for sailing on March 21, 2020, and the Coral Princess (in total compliance with the CDC guidance).  You know, when the cruise lines were told by the CDC that setting sail was not prohibited, the rate and manners of transmissibility of COVID-19 were not known to be as high as now known, etc. Oh, “If we knew then what we will learn tomorrow!”.  

Not done, it states “scores of ships…continued voyages even after early outbreaks on other vessels” Huh? What? So there were no infections and the ships were supposed to immediately stop sailing? Oh, and the Washington Post, omitted the fact that many of the ships continued to sail with guests because port after port was (and remain) closed to them. So what were they supposed to do? This is a classic “Don’t step under my foot” argument. (I won’t get into the ethical argument of countries turning their backs on sick passengers needing medical care in this article.)

So with the sensational articles dealt with, let’s take a look at the question: Where is that petri dish?  

The answer is: If it exists, it is brought onto the cruise ship and an incredible effort is made to find it and then eliminate it.  Heck, even the tabloidesque Washington Post article admits that! 

When you get sick days after being at a hotel, conference, flight, etc. you don’t really know where you picked up the disease.

• Was it at the airport (and where)? 
• Was it the tray table on the plane? 
• Was it the chicken? 
• Was it that pen when you checked in?
• Was it the elevator buttons?
• Was it the television’s remote control? 
• Was it that less than clean bathroom? 
• Did they really change the sheets and, ugh, that blanket?
• Was it room service or the phone you picked up to place your order? 
• Was it the rental car?
• Was it that bar you went to?

And the CDC does little, if anything, to address this litany of issues…except on a cruise ship.  (Let’s not get into the CDC allowing bacteria-laden chicken to be sold to you and then you being told it is so infested you shouldn’t wash it for fear of spreading it around your kitchen.)

Taking this just one step further, disease does not spontaneously create itself on cruise ships. Leaving COVID-19 aside for the moment, the disease (for example, norovirus, flu, common cold, etc.) is brought onboard; usually by a guest who doesn’t feel great, if not overtly ill, but is going to go on their vacation no matter what. And where has that person, or those that are asymptomatic, been before boarding? Yep, the pretty much unregulated by the CDC airport, airplane, hotel, rental car, restaurant, etc.

So how does a cruise ship deal with this once an issue is known? We all know this because, in addition to the rigorous Vessel Sanitation Program, we have seen the additional steps taken if a viral infection appears on a ship:

• No self-service at buffets, etc. 
• Mandatory use of hand sanitizers. 
• Limiting access to items that can be reused by guests without cleaning each time. 
• More rigorous disinfecting of handrails, doors, public toilets and lavatories, and other high-touch part of the ship.
• Mandatory quarantine for those that admit or are otherwise found to have gastrointestinal illness. 

Is there more that goes on cruise ships to keep guests healthy? Of course, there is! Think about your suite before you ever enter it:

• All sheets and towels replaced
• The duvet is replaced
• The mattress pad is replaced
• The bath mats are replaced,
• The water bottles are replaced, etc.
• All surfaces are disinfected.  

And that is before you get into your suite!  During your cruise your bed linens are changed every 3-4 days, bath mats are replaced, every hard surface is wiped down daily (even baseboards at least once a week).  On my last cruise I had a whirlpool tub and it was disinfected with bleach four times in 24 days…and even when I clearly hadn’t used it.

In addition, most cruise lines keep a sharp eye out for those individuals that fail to use hand sanitizer, breach buffet protocols, try to hide signs of illness, etc. Why? Because the cruise lines have a vested interest in keeping their guests and crew safe from more than rough seas.  A healthy ship is a happy ship and that which can reasonably be done is done…more so than any other public area. (I won’t get into the entire issue of the percentage of people that enter a hospital with one medical issue and wind up with another!)   

Armed with this information, why does the Media hype this? Attention-grabbing headlines! But then, and I have seen in this on CNN, Fox, MSNBC, etc. reporters who clearly have never been on a cruise speak with alleged authority making misstatements and after misstatements in efforts to justify the headlines. There is a reason there are so many articles on the issues, but almost none on what cruise lines do to protect their guests not only from disease generally, but from each other.  (I won’t go down the rabbit hole of these same reporters calling a three-day rust bucket cruise to the Bahamas a “luxury cruise”.)

In 2017 Yosemite National Park had over 170 people who suffered from norovirus. That did not make the headlines. May 2019 a Canadian hotel was shutdown after 100+ people came down with norovirus. That didn’t make the headlines either. Nor did the March 2020 closing of a hotel in Guernsey for the same reason. There are dozens of examples of non-cruise ship norovirus outbreaks and they simply are not reported. Why? Because it is not “sexy”!

Now the argument is that on a cruise ship the focus is on having people gather in large numbers in the restaurants, the shows, the pools, the tour buses, etc. and that is a disaster scenario when trying to stop the spread of COVID-19. While it most certainly is an issue, let’s go back to the statistics of how many cases have been found on cruise ships (other than the Diamond Princess debacle caused by both the Japanese government and the cruise ship): Less than 1,900 guests and crew…and that was, “If we knew then, what we know now…no less what we will learn tomorrow!”

While nobody knows the ultimate requirements (even the CDC changes its position as the days change – see for example today’s new guidance…not requirements…for meat packing plants) here are some of my conjectures; noting I do not believe all of these are necessarily effective. [I do have to note before setting them out that years ago I was on a panel with regulators of the superyacht industry and it was asserted that stricter requirements for glass windows were required. When I pressed them on how many deaths or injuries occurred from failed yacht glass they said it was irrelevant. When I pressed further about how many of these undisclosed (actually it was zero) injuries and deaths would be reduced with the proposed new regulations I was only met with a very loud, “Man, we are saving lives!” I responded, “As you haven’t been any identified lives lost, maybe the only thing that might be saved by pushing these new regulations is your job!”]:

• Pre-Cruise Medical Screenings – Temperature is easy, but will there be others? Doctor’s Certifications (which raise all sorts of issues with recalcitrant doctors not wanting to be sued for malpractice, if you can even get a doctor to see you for a well-visit). Will there be a similar screening for the airlines?
• Requirements that Guests and/or Staff Wear Facemasks (and what type) –  At high density situations such as shows, tour busses, etc. where social spacing is not possible.
• Reduced capacity at restaurants and bars to accommodate social spacing – This may require staggered dining for a while and even additional “blue plate special” early dining…which creates issues regarding working hours for crew.
• More personalized supplies – Water bottles for tours provided in suites. Small bottles of hand sanitizers and wipes provided in each suite. 
• Specified Quarantine Areas – Avoiding intermingling of guests and unprotected/not fully trained crew. Use of more strategic disinfection techniques from room service trays to laundry.

Whether these things will continue after a COVID-19 vaccine or truly effective anti-viral treatment has become widely available, I cannot say.  But what I can say is that there are some pretty outrageous pitches being made such as having anti-microbial carpets and lockers in hallways for guests to put their shoes and clothes from the day and others for self-service linen changes and quarantine food delivery. Aside from such (what I will call) idiocy that clearly shows a lack of understanding of efficacy, practicality and deliverability, with all of the current and probably changes what exactly is the percentage decrease in infection these things are going to cause; noting that they cannot amount to much of any. (Think about how many hospital visitors get infections; or should I say don’t.)

The Centers for Disease Control: 

Prejudice & Ego Overshadows Its Legitimate Crucial Role. 

Consider the CDC’s lack of focus, accuracy, and constantly changing positions in just the past few weeks just on the use of facemasks:

• Social distance
• No facemasks are necessary unless you are sick because they won’t protect you.
• Facemasks are OK to use, but don’t because healthcare workers need them
• Facemasks should be used not to protect you, but to protect others from you.
• You don’t need to wear a facemask if you can social distance
• You should wear a facemask and social distance

Then consider the CDC’s refusal to confirm that preliminary test after test showed the hyped hydroxychloroquine not only does not appear to be effective, but increased death rates. And that was after numerous doctors advised against it because of the potential for heart damage.

So with this background, and its the foregoing information, what is new is the CDC’s current “puffing its chest” against the cruise industry because some ships allegedly sailed after the CDC issued an “Advisory” on March 17, 2020; only a month ago!

That CDC Advisory did not say anyone shouldn’t go on a cruise, but rather that if are going on a cruise:

I think if you are healthy young person, there is no reason — if you want to go on a cruise ship go on a cruise ship. Personally, I would not going to push it because I do not like cruises. But that is another story. But the fact is, if you have the conditions that I have been speaking about over and over again to this group, namely an individual who has an underlying condition, particularly in and early per person that has an underlying conditions i would recommend strongly that they do not go on a cruise ship.