Bivalent COVID boosters are available & exciting

An article I read in the New York Times says that many Americans aren’t even noticing that the new, bivalent COVID-19 vaccines are now available. The public has lost interest in all things coronavirus, and the government is running out of funding for effective reminders or elaborate, coordinated delivery campaigns.

It falls to us, concerned citizens, to spread the word about how we can protect ourselves and others. In the interest of fighting misinformation, I will also share reputable resources for those wishing to do their own research.

The new boosters, authorized by the F.D.A. last month, are “bivalent” because they protect against:

  1. the Omicron subvariant still circulating in addition to
  2. the original version of the COVID-19 virus.

The Latin root bi– means two.

Merriam Webster dictionary page highlighting prefix definition of BI means TWOPut simply, a single shot now offers two kinds viral defense: more of the same protection from the original booster, plus, for the first time, the specific power to fight Omicron. That named strain of the virus, also known as lineage B.1.1.529, caused the enormous spike in coronavirus cases early in 2022. It’s estimated that the “mild” Omicron strain was responsible for killing 117,560 people in America. Source: MedRxiv.

More than one million Americans have died from COVID-19 since the pandemic began. This virus has been far deadlier than any recent influenza outbreak. The worst annual flu statistics in the past decade saw 52,000 people die in the US, for comparison, while an average year sees  ≈34,000 flu deaths. Source: CDC.

Allow me to do the math for those who struggle with the subject: with COVID-19 having a major impact over the past three years, one million lost lives (1,000,000) averages out to roughly 333,000 American deaths in a single pandemic year. (1,000,000 ÷ 3 = 333,333 ¹⁄3) This means COVID kills 10× as many as an average annual flu does in the U.S.A.

  • 34,000 × 3 = 102,000 this is how many flu would probably have killed over three years
  • 102,000 × 10 = 1,020,000 this is how many flu would probably have killed if it were 10 times worse
  • 1,020,000 is close enough to one million to be considered the same for this kind of analysis

Flu vs. COVID death rate comparisons are usually the work of the innumerate… or liars.

It’s vaccination, not vaccines, that saves lives.

Personally, I’m with Zeynep Tufekci, whose opinion piece in the Times marveled at the awesomeness of vaccination’s potential… while exploring the inadequacy of current messaging to motivate our citizens.

Tukekci writes: “[I]t’s vaccination, not vaccines, that saves lives.”

And she’s right about that.

bandage on upper armThe most impressive technology can solve no problem if it isn’t deployed where it is needed and at the right time. Safe, modern, effective vaccine boosters against COVID are being provided at no cost by the U.S. government. Those shots are available today.

As of now, everyone over age 12 in America is entitled to a free bivalent booster shot as long as at least two months have passed since the most recent dose.

Boosters reduce your chance of catching Omicron, and they substantially reduce an infected person’s risk of being hospitalized with—or dying of—COVID-19. Sources: New England Journal of Medicine, CDC, United Kingdom Health Security Agency.

Boosters will also help you avoid long COVID. Source: JAMA.

Aside from spreading personal misery, long COVID is also costing our economy hundreds of billions of dollars, with just lost wages from the disease estimated between $170-230 billion annually. Note that this figure approaches 1% of the total U.S. gross domestic product. Sources: World Economic Forum, Brookings Institution, Federal Reserve Bank of MN

Getting vaccinated and boosted is a patriotic choice as doing so protects our faltering economy.

I was delighted to take my teen in for a bivalent booster dose this week. His previous shot was last winter, he attends classes in person while being the only kid in most rooms electing to mask, and our household includes a high risk loved one. A few hours with a sore arm and one long nap later, my child has no lingering side effects, but he can more safely spend time with his grandparent.

There’s no way to put a price on the value of those hours. COVID vaccines are a miracle, a blessing, and quite literally wonderful.

The rest of my family will be getting bivalent boosters soon, having had age- and risk-related doses more recently than a healthy teen.Redacted official CDC COVID-19 Vaccination Record Card

Opting in for your bivalent booster dose is choosing life over death, wellness over infirmity, civic engagement over cynicism, and family values over selfishness. Vaccination protects our society by safeguarding both individual health and overall economic function; sick people are less productive.

I’m fully vaccinated—and boosted—because I love America, and because my religion teaches that life is a sacred gift.

What’s your reason?

Dip a COVID-cautious toe in cruise waters

We maintain a COVID-cautious* household as the third pandemic summer waxes. Where one member of our family is at high risk, we all choose to modify our daily behaviors to continue to protect him.

This is a cost of multi-generational living, though I find the personal and familial benefits of sharing our home with an elder abundant and easily justified. Since we can afford all the masks and testing we need, expending this trivial effort is well worth it. That’s the calculus in our home.Disposable surgical mask

Given our status, then, as “more careful than most,” it may surprise some that we plan to embark on a cruise with our teens in a little more than a month. Cruising, after all, gave the world its first widely reported COVID-19 super-spreader event.

Read a CDC research paper on the epidemiology of the Diamond Princess outbreak in February 2020 here.Cruise line booking page headlined 37 days before you leave with photos of Icelandic ports

There’s no doubt that the closed environment of a cruise ship offers a unique opportunity for certain germs to infect a captive audience of susceptible passengers. Many minds will leap immediately to norovirus. In truth, however, norovirus is common everywhere, but an outbreak is much more noticeable when a group of thousands travels en masse for seven or more days and management is required to track cases on board.

Similarly, though COVID-19 is definitively joining current passengers on cruise ships—in spite of requirements for vaccination and pre-embarkation testing—there is little evidence that the virus passes between personal staterooms via HVAC or other means. Actual contact tracing of ship-acquired infections, as on land, suggests spread directly from infected person to uninfected person.2012 Carnival cruise Saint John NB Canada - 3

The greater risk on a cruise comes from queuing to board or partake in activities, eating or drinking in common facilities, or from socializing with other guests. More bodies in close proximity invites more infections. It’s math, not a magical zone of infection brought on by taking a ship out to sea.

Why, then, if we remain vigilant and siloed on land, is my family setting sail?

Like many, the pandemic disrupted our travel plans in 2020. For us, the result was a Future Cruise Credit (a.k.a., an F.C.C.). Cruise Critic defines Future Cruise Credits here.

We could have requested a cash refund when COVID-19 kept us from our 2020 voyage between Copenhagen and Boston. Instead, we opted to gamble on the future solvency of Holland America Line (HAL) and took the F.C.C. instead. Part of my personal rationale was the simple desire to see HAL survive the economic hit of the sudden shutdown.

The major down side to any credit like this is the set of contingencies for spending it. Unless we wanted to argue over the details of the F.C.C. we’d accepted, we had to book a cruise before the end of 2022.Pile of money

Here’s the key to why my family is cruising this summer: we’re not all going. While our 2020 trip would have included a grandparent, our 2022 party consists only of parents and children. All of us are vaccinated, boosted, and at statistically low risk of COVID-19 complications if infected. Our high risk loved ones are not inclined to sail at this time.

For those of us embarking on a pandemic-era Holland America Line cruise, we are opting in based upon a few important understandings:

  • We realize that we will be taking a greater risk of catching COVID-19 than we do at home, but we have decided that this risk is worth the benefit of a relaxing vacation together with the reward of a chance to visit foreign destinations long on our wish list(s).
  • We prefer the risk of being cruise ship passengers over that of unmasked air travel for the summer of 2022, especially given recent frequent flight cancellations and spectacular, hours’ long delays reported at major airports worldwide. We don’t have to fly to get to our embarkation/debarkation port, and we won’t have to leave** our cabin once aboard a ship unless we want to.
  • We booked two staterooms for our party of four, and one of them is a suite° with an extra large balcony. This is more space than we have ever paid for in the past, but we believe we might prefer to remain mostly cloistered while at sea, depending upon COVID case rates when and where we sail. We decided we wouldn’t travel without private access to fresh air, i.e., a balcony.
  • We reserved an additional, extra-fee private outdoor space for this sailing—on HAL’s fleet, these are dubbed Cabanas, placed in a restricted access area called the Retreat, and, again, booking one is a first for us—so we will have a dedicated area beyond our cabins to spend time if case rates exceed our comfort thresholds.
  • We’re prepared to skip going ashore at early stops in easily reached ports close to home in order to increase the odds*** we stay healthy for visits to rare, “bucket list” destinations further afield.
  • We’re each packing extra amusements that will allow any one of us to spend days on end alone in a room, and I’ve beefed up the travel medicine kit.
  • And, perhaps most important of all, we are setting sail having decided in advance that even isolating in our staterooms—aside from accessing our cabana via the stairs, no elevators—would be “enough” vacation to make the entire trip worthwhile. Dining on room service and entertaining ourselves on a balcony at sea will be sufficient, if not ideal. If we also get to enjoy the rest of the ship’s public amenities, all the better.

Until our embarkation, we won’t really know which activities will or won’t meet our risk tolerance and feel worthwhile. This is a higher than usual level of uncertainty for me to embrace. I acknowledge I can be prone to anxiety; I’m better known for demanding control than going with the flow.2012 Carnival cruise Saint John NB Canada - 1

Living through a pandemic serves to remind me, though, that life is short, and opportunities not taken can be lost forever. We have educated ourselves about the current situation with the virus, and we’ve prepared as best we can for such unpleasant scenarios as believing the risk of infection too high to risk socializing aboard ship or catching COVID at sea.

My kids are growing up fast. One will be moving away from home for the first time in just a couple of months. I want to take us all on one more vacation before it becomes necessary to negotiate with yet another adult life and all its mature entanglements to get away together.Woman hugs child

COVID-19 stole from everyone: lives, time, opportunities… I can’t know for certain that our cruise will be smooth sailing, but, if my analysis is correct, it should be worth the risk.

* Since there is no universal definition for “being careful” with regards to COVID, I’ll post mine. Our household choices in June 2022 continue to include:

  • limiting time inside any building beyond our home with the exception of one child who goes to school/camp in person,
  • wearing masks indoors anywhere but at home,
  • requesting that all visitors or tradespeople entering our home wear a mask,
  • wearing masks outdoors where social distancing isn’t possible,
  • antigen testing the kid who attends school/camp every weekend before he spends one unmasked afternoon per week with his grandfather (otherwise, that kid masks around Grandpa),
  • antigen testing our occasional visitors before eating or drinking with them,
  • only eating or drinking with visitors to our home outdoors or at a distance of ~10+ feet indoors.

We use—and offer those entering our home—several styles of N95, KN94, and surgical masks to ensure all this masking is as efficacious as possible. Even within the family, our faces don’t fit the same masks well.

See the CDC epidemiology paper referenced in paragraph three. The following quote comes from the Discussion section of that report, and it matches what I’ve read elsewhere over the past two years following pandemic news coverage:

“Spatial clustering was not identified on a specific deck or zone, and transmission does not seem to have spread to neighboring cabins, implying that droplet or contact transmission to nearby cabins was not the major mode of infection. Risk of infection did increase with cabin occupancy, but a relatively small proportion of cases in the same cabin had >4 days between their onsets, implying a common source of infection. Beyond that, however, the major transmission routes might include a common source outside the cabin and aerosolized fomite or contact transmission across different deck levels.”

I feel it is only fair to disclose that we had only paid a deposit for a fraction of the total cost, not the full fare for our cancelled 2020 vacation. Wagering many thousands of dollars would have felt foolish to me in support of a corporation, but a few hundred was an amount I could afford to lose with equanimity.

In particular, I found the crew aboard my past HAL sailing to be simultaneously professional and amiable. Keeping this subsidiary of Carnival Corporation in the black seemed likely to keep more of these excellent employees on the payroll during a bleak time.

**Apart from the mandatory muster—or lifeboat—drill. Cruise ships rightly enforce the requirement that every person aboard learns what to do in the unlikely event of an emergency at sea. Due to COVID, these are now conducted with less crowding and standing around in large groups than they used to entail.

°This will be our first experience of the Holland America Line suite category NS, or a Neptune Suite. The corner aft NS we chose is known for its exceptionally large balcony that wraps around the side and back of the ship, offering seating with more likelihood of shade-, sun-, or wind- protection than a standard balcony would.

***Testing positive for COVID-19 aboard a ship means a passenger will be quarantined according to that ship’s specific procedures. On HAL, last I heard, quarantined passengers are required to move to a balcony stateroom in a reserved section of rooms set aside and dedicated to housing those with COVID. On other lines, passengers quarantine in the stateroom they originally booked. In most cases reported by Cruise Critic board members, partners are given the option to stay together or lodge apart assuming only one tests positive.

We aren’t sure what will happen if both parents test positive but the young adults don’t, but we’re ready to live with the consequences either way.

These policies could change at any time, however, and I have read anecdotal evidence of ships adjusting rules on the fly by necessity when more passengers require quarantine than there were dedicated cabins for the sick.