I must preface this article: I am a big proponent of doing whatever is reasonable to stop or reduce the spread of COVID-19. But what I am fearful of, and what I am unfortunately seeing, is that draconian, over-the-top, and scientifically unsupported positions are undermining the this goal. People – both guests and crew – have been left with conflicting information, some nonsensical constraints, and, thus, are confused, frustrated and – to some extent – feeling like they are abandoned and need to just do what feels right.
Another preface: I express many questions and concerns. I ask, “Why?”. But please do not read this article as if I believe I have any answers. I don’t. That is what the U.S. Centers for Disease Control is supposed to have, but as you will see, it has failed us miserably.
In an effort to better understand the situation as it relates to travel (and, especially, the horrific treatment of cruise ship crew who have been trapped for months without any signs of illness), I have been in communication with the United States Centers for Disease Control over the past weeks. It agreed to answers written questions that I submitted, stating it didn’t have the ability to provide a live interview.
It was an incredibly frustrating experience, but the experience was – as you will see – quite valuable. How? By exposing that the CDC has gone from a truly respected entity to a bureaucratic quagmire that is actually hurting the public and, to be sure, the cruise and travel industries with a focus less on science and more on creating and enforcing regulations based upon agendas rather than science, statistics and economics .
Just one example: I asked the CDC:
Why are medically screened and asymptomatic crew, especially those that have been on cruise ships with no COVID-19 infections reported for over 30 days, required to comply with Interim Guidance for Mitigation of COVID-19 Among Cruise Ship Crew During the Period of the No Sail Order regarding disembarkation and travel when others who are in higher risk categories (doctors, nurses, first responders, essential workers, meatpackers, grocery workers, transit workers, airline crew, etc.) may travel with virtually no restrictions, no less similar ones?
The CDC response was, in relevant part, “At this time, given the limited availability of testing onboard ships and inconsistent reporting from cruise ships, CDC does not have confirmation or evidence that any cruise ship is free of COVID-19…” Leaving aside it didn’t identify what the alleged inconsistencies were, if it was systemic of one or two ships not involved in the current situation, etc. the CDC refused my follow-up question, “Why then does the CDC not provide tests for the crew members so that can either fly home or, if necessary, be quarantined on land for 14 days and then fly home?” Wouldn’t it seem logical to have ships come into port to have everyone tested (or have the tests and a lab tech brought to the ships by tender) to test everyone?
In the last 24 hours there have been renewed pleas from the International Maritime Organization, the International Transport Workers and, among many other organizations, American Society of Travel Advisors have been essentially pleading with the United States Centers for Disease Control and other governments to act in a consistent, science-based, logical manner. As ASTA just wrote to the CDC:
To date, the CDC’s communications with regard to travel has been uneven at best – very specific on cruise travel (see the Center’s “No Sail Order” issued in March and renewed in April) but less so on other travel modes. In the absence of clear communication, the entire population remains essentially in the dark, left to rely on a patchwork of regional, state and local pronouncements to inform their decision making with respect to travel. Airlines, hoteliers, cruise lines, tour operators, car rental companies, insurance providers and others are similarly left to their own devices as to when to restart operations in the face of an unprecedented global pandemic. This uncertainty is, unquestionably, inhibiting the pace of the revival of the travel industry, a goal we know you share.
The arrogance, lack of transparency, and seeming lack of scientific supported positions, no less simple logic, of the CDC, has not simply frustrated me, it motivated me to take a closer – scientific and economic – look.
Below I discuss facemasks versus social spacing, the fact that COVID-19 transmission from surfaces is actually very difficult and from food is essentially impossible. You will also see below, the United States Centers for Disease Control has become a bureaucratic nightmare that is more intent on flexing its regulatory muscle than providing scientific and statistical based guidance and regulations. It, in fact, appears to be intentionally seeking to avoid providing same…as you will better understand when you read on.
Meanwhile, and as a relevant aside, I am also frustrated by all the articles pontificating about what travel and cruising is supposedly going to be like upon their return. I am similarly frustrated by those asserting that whatever is going to be required now will be required in six months or a year from now, like there is some sort of permeance requirement. Remember, at least as of now, once a vaccine or effective antiviral is available all of these requirements will probably go away. And, of course, who are these people speculating or worse? Are they doctors or scientists? Nope. I cannot think of one such article authored by anyone of scientific merit.
Bringing some sanity to this troubling media barrage is Arnold Donald, CEO of Carnival Corp. Yesterday in a online interview he did what finally…FINALLY…need to be said: The Truth! Nobody knows what will be the condition on cruise ships and in travel in three months no less in a year!
The CDC has failed us miserably. And it clearly knows it as indicated by its lack of transparency, inconsistency and failures to follow known science. Read on to find out why.
With my science background (B.S. in Biology, member of Sigma Xi – the scientific research honors society – and a stint with the U.S. National Marine Fisheries Service, etc.) I have a bit more inquisitive (skeptical?) approach to the repeatedly changing CDC regulations and guidelines and the ever-changing “best information” that is pushed out by it and the World Health Organization, etc. As ASTA stated above, the uncertainty and inconsistency has created a physical and emotional nightmare for the general populous.
For example, in California (at least where Phase 3 is in place) there is a requirement that there be six feet between tables in a restaurant, but 10 unrelated people can go to the restaurant and ask to be seated together and the restaurant cannot deny them. In some bars there are plexiglass screens between the staff and the patrons, but in others there are none. You can walk into a restaurant without a mask, but you can’t walk into a store without one if the owner has that requirement. Meanwhile you can walk outside without a mask, but if you walk down a somewhat crowded street without a mask, you are committing a social sin. (The other day I walked into a tap house in Nevada and nobody, not even the bartender, wore a mask but social spacing was in place – kinda sorta – but the restaurant next door delivered food to my outdoor table and the runner was wearing a mask…outside.)
Suffice it to say the awkwardness of not knowing what is “correct” or “socially acceptable” is subsumed by the insecurity of what one is supposed to do that EFFECTIVELY protects oneself from being infected with COVID-19 and from unintentionally infecting someone else. And, then, of course, there is the balancing of effectiveness and the probabilities that which you are protecting against will happen. In other words, using an extreme case as an example, building a bomb shelter to protect you from a nuclear blast may very well be effective, but the probability of the nuclear blast is so low that building the shelter doesn’t make sense…when the science, statistics and economics are considered. On the other hand, requiring and wearing a seatbelt when in an automobile does…and requiring airbags based on the economics of injury makes even more sense.
Surface Contamination and Food Safety
Literally at the same time the CDC provided me with its “answers” it published “revised guidance” that “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.”
But, guess what: The CDC actually published this identical information months early (https://web.archive.org/web/20200401131120/https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html) but pitched a different narrative to the public raising scientifically improbable concerns over surface spread. In fact, in an earlier version of this page (https://web.archive.org/web/20200511163242/https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html) the CDC affirmatively stated COVID-19 “does not spread easily…From touching surfaces or objects.”
So why the heck is the CDC calling it “revised guidance” and why has it caused billions of dollars to be spent on sanitizers while literally creating paranoia about touching anything, even leaving your mail outside for three days, shutting down the New York City subways, etc. happened? Businesses were shut down, not because of social distancing (see below), but because you might touch something.
But…and I will never understand this…supermarkets and superstores (Costco, Target, etc.) have remained open while mom-and-pop stores selling the same items have been mandated closed. (I mean lets get hundreds of people in an enclosed environment and line them up by the dozens to check out rather than have maybe six people in a store with no check out line.)
Related to this, the United States Food and Drug Administration states that “Currently there is no evidence of food or food packaging being associated with transmission of COVID-19.” This not only underscores that COVID-19 transmissions on surfaces is a very difficult thing to assert needs so much care, it makes all the pontification about buffets being a thing of the past. I am pretty certain we won’t see “self-serve” for a while (even if we hand sanitize), but full service buffets (despite the pontificators “expert” statements) will not go away – per the cruise lines. As Arnold Donald noted, with norovirus the cruise lines have had full service buffets for years; the current issue to be addressed in practical terms is social spacing…for now (lining up…kinda like at Costco).
I am not saying “Damn the Sanitizer”. I have Goldring Travel hand sanitizer in my pocket at all times, but I don’t use it every time I get the mail or touch my car door. I do use it in public settings, but mostly as a courtesy to others who are more concerned…usually because they don’t know what you have just read.
Listen, I like – as caring human beings – the “television personalities” of CNN’s Sanjay Gupta and Dr. Anthony Fauci. But from instructions on how to wash your grocery bags and its contents before letting them in your home (see above that is scientifically pretty much a net worthless effort) to wildly inconsistent and doomsday predictions, I take what they say with two grains of salt. I do not immediately discount their words, but I listen, research and then consider them in measured terms. and I also ask, “Where is the CDC?”
What bothers me is that this should not be necessary. There should be accurate, consistent and coordinated information provided that doesn’t skew towards the worst case or the best case. I mean is Dr. Fauci of the National Institutes of Health coordinating with the CDC or FDA or anyone? Is Dr. Gupta taking an super-cautious view taking into account all of the information or – with the nicest personality around – engaging in media hype?
I don’t know the answers to these questions. What I do know is there is horrific inconsistency and that isn’t helping anyone. So again I ask, “Where is the CDC?”
Social Distancing versus (YES versus) Facemasks
I have struggled mightily (as we all have) with facemasks and what they do. We were first told don’t wear them as they are ineffective and that wearing them might actually assist in spreading the disease (by causing one to touch his/her face more often while not blocking COVID-19). Then we were told to wear them not to block COVID-19 infecting you, but you infecting someone if you have COVID-19. Then we are told the type of mask matters, but anything is better than nothing.
If you delve into finding any research on the efficacy of wearing a facemask to curtail the spread of COVID-19, you will actually find a firestorm, with arguments on both sides of the issue (more on the pro-facemask side), but little science. I mean it does make sense that if you cough into a piece of cloth a significant amount of what you cough out of your mouth will be blocked. But is what is blocked what matters or are the smaller droplets that can pass through more relevant? How much does it matter what goes around the sides of the mask?
And, of course, my biggest unanswered question: If you are not coughing, sneezing or shouting, does wearing the mask effectively do anything of relevance? And if it does anything of relevance, how much does it do?
Personally, I am of this position: Since wearing a mask is a pretty painless exercise and we don’t really know the answer, but there is some logic to having something blocking something…and without testing we can’t know if that I or the other guy has COVID-19 why not put it on…when it makes some scientific sense.
And that brings me to the inconsistency with Social Spacing (a/k/a/ Social Distancing)
Social Distancing (or as I prefer to call it Social Spacing)
We have been told that if you are social distancing (six feet or more) you don’t need to wear a mask, but yet you see many wearing them anyway…or my favorite, when alone in a car. As you will see, there is a real question, not of combining the two concepts, but of whether that six foot distancing is even relevant if you are not coughing, sneezing or shouting? Or you are outside? Or it is windy? Or Or Or???
So I asked the CDC to explain the “scientific” and “statistical” bases for its recommendations. It’s (non) answer short and unresponsive: “CDC uses the best available science in formulating its guidance and recommendations. See CDC’s guidance regarding social distancing: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html.” But to me the frustrating “beauty” of its response was included in that link, “COVID-19 can live for hours or days on a surface, depending on factors such as sunlight, humidity, and the type of surface. Social distancing helps limit opportunities to come in contact with contaminated surfaces and infected people outside the home.”
Wait! Huh? Didn’t we just discuss that according to the same CDC COVID-19 is not mainly spread through contact with surfaces and the FDA states that you cannot be infected by COVID-19 through food or food packaging! So what is the CDC actually saying?
My take is the CDC’s position is that if you stay away from everything you will not have contact with anything…even if taking such an approach to effectively stop the spread of COVID-19 is nonsensical and unsupported by science. (I can’t get my head around the metaphysical concept of how if I am moving in an area and I keep six feet from someone else who is also moving I am somehow limiting my contact with immoveable surfaces…but that is something to be contemplated further over a couple of whiskies where I might be able to find some “logic” if not science.)
So I guess being generous the reality is that the CDC’s actual concept of Social Distancing is “limit your opportunities to come in contact with…infected people outside the home”. As keeping away from sick people is both logical and a tried-and-true method of not getting sick (I mean you do need to get the infection from somewhere!), I can logically and scientifically accept that premise. The question then becomes, “How far do I need to be away from an infected person so that I am reasonably limiting my chance of being infected by him/her?”
Let me get you a little crazy right up front. The World Health Organization states that three (3) feet (one meter) is the appropriate social distancing measure; not six feet! The CDC says six feet (and we will leave the facemask aspect out of this for the moment). So I took a deep dive to find the science behind CDC’s standard of six feet of distancing.
It is, again, because the CDC says so. The CDC actually does not have a scientific basis for the measure. The CDC’s 2007 Guidance that it “may be prudent” was based upon observational inferences in indoor hospital settings…not social settings. But as Dr. Lisa Brousseau, recently stated in her article COMMENTARY: COVID-19 transmission messages should hinge on science: “In contrast to its recommendations for healthcare, the CDC makes no mention of airborne transmission in public settings.“
I won’t bother you with the few…and there are only a few…unpeer-reviewed studies. But what you should know is that air movement (be it on air conditioning, fans, airplane vents, areas were people are moving or, without limitation, outdoors) can obviously reduce or make the six (3?) feet distance irrelevant not only because of dispersal of droplets may spread far and wide and in such dramatically reduced amounts in any one place that the viability of the virus itself becomes nil. Think of it sort of like of a discussion of homeopathic “medicines” where something that could make you ill is diluted and diluted and diluted to the point where you can hardly (if at all) measure it.
You know what else reduces the viral load? The lack of a cough, sneeze or shouting…which is the mantra we keep hearing from the CDC. So I ask myself, if someone is infected but asymptomatic is three feet, per the WHO, safe? The CDC won’t answer that question!
Social Distancing with Facemasks
I had a mean, nasty, English teacher who used to say, “Enough is enough and too much is plenty!” I know it doesn’t actually make sense (nor did all the grammar rules she tried to pound into my head during the hours of detention I received for not paying attention during class), but the concept is simple: When does doing more than enough do more harm than good?
At first it reminded me of my youth when I would get a “bad cut” and insisted that I be given two Band-aids when one was effective in covering the injury. It did nothing but waste the second Band-aid.
But then I realized it was not that simple. I mean where is the benefit of making things more uncomfortable and more cumbersome than it need be with no scientific or economic benefit? It can easily cause people to just be totally turned off and reject all of it. (There is a definite portion of the population that has taken that position to the fullest.) How does that help the population where the only seeming response is, “I wish they would wear a mask.”
The Centers for Disease Control’s Pathetic Non-Responses
Clearly frustrated by the lack of science, the lack of consistency and the lack of logic I posited a number of questions primarily focused on the effective blockade against repatriating crew and fostering indefensible positions (such as prohibiting use of commercial flights), but with some more general concepts…and the answers were as full of bureaucratic double-talk as they were absent any science, statistics or logic.
I posed to the CDC this question:
What is the scientific, statistical and economic basis (ex. effective reduction of spread) [for] the CDC requiring cruise passengers to engage in mandatory social spacing…if they have been medically screened prior to boarding the ship, when they are able to engage in similar activities without mandatory CDC requirements everywhere else and where the number of COVID-19 infections on cruise ships have been extremely limited and now are known how to better control those with a suspected infection?
The CDC’s response was to refer me to this over two month old page: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm that focused on the two Princess ships and the fact that due to being in close quarters infections might spread. But, and it is a big BUT, it ignored the issues of medical screening of guests, the medical screening and surveillance of crew, the limited number of cases on ships other than the two Princess ships and, most importantly, the lack of any such requirements from where the international infections really came: International Air Travel. (Not from the flights themselves, but individuals who carried the disease onto and off the planes.)
In short, the CDC is saying, “Because I said so!“
As I have discussed above, we live in a world with probabilities. So here what I was asking is “With all the screening and monitoring to be done, what is the probability someone with COVID-19 would get on a ship more so than a plane, subway, restaurant, etc. (logically it would be far less as none of those have screening and monitoring systems in place) and with that seeming very low probability, how effective would social distancing actually be in reducing the already lower probability of infecting others?
The CDC refused to answer that simple question.
The CDC Needs to be Transparent and Science-Based
While Ending its Bureaucratic Bullying
I have I ponder how the CDC caused consumers around the world (a) Not to wear masks and (b) to spend billions of dollars on sanitizing gels, wipes, sprays, etc. only to then claim that (c) you need masks and (d) that COVID-19 “does not spread easily from touching surfaces” to (e) a softer it is “not the main way” to be infected.
I have pondered how the CDC came up with six foot social distancing.
I have pondered how, and sought a rationale for, refusing crew to disembark
And, of course, let us not forget the CDC’s initial report that COVID-19 was found in staterooms on the Princess Diamond after 17 days; only to then admit they told Princess not to clean the staterooms and that there was no live virus, but only remnant RNA (proteins). Leaving me with the CDC refusing numerous requests by others as to why they sent out such a misleading (dishonest?) press release.
As I said at the beginning of this article, I have no answers; only questions.
I will leave you with one last questions to ponder:
Why has the CDC attacked the cruise industry and been forcing requirements upon it that have little to no scientific basis and even less statistical validity?
I am hoping it is not because the person in charge of this fiasco hoped for an upgrade and didn’t get one. Do you have a better idea? Just askin’.