Cruise report: HAL Nieuw Statendam transatlantic with teens

The kids and I sailed with Holland America Line once before, when they were fairly young. Embarking on HAL’s Nieuw Statendam in August 2022 was my husband’s first cruise with this company. We spent 24 days together on this grand vessel, visiting four countries in addition to the United States, and briefly crossing into the Arctic Circle.Certificate signed by Captain Barhorst showing crossing Friday, 8/12/2022 at 20:25

The experience was good enough for us to purchase Future Cruise Credits (FCC)—a minor commitment to future travel with the same company—while still on board.

Link to explanation of FCC’s at The Points Guy site

Our transatlantic (TATL) cruise itinerary called for boarding the ship in Boston, calling in several Canadian ports, followed by stops in Greenland, Iceland, Greenland again, Canada again, France in the form of the island of St. Pierre, Canada third time, then Bar Harbor, Maine, and finally back to Boston.

The round trip itinerary—no flights required from our New England home—absolutely sold us on this particular itinerary. HAL transatlantic cruise itinerary round trip Boston

If we hadn’t had a credit to use from a scheduled 2020 trip cancelled due to the pandemic, it’s unlikely we would have gone anywhere during the rampant snarling of summer travel in 2022. If we’d had an international flight planned, I can guarantee we would have called off any trip as reports of hours’ long lines snaking outside of airports proliferated in the lead up to our departure.

While our cruise wasn’t perfect, the hassles were fairly minimal and we found the experience well worth the bumps in those road that we did encounter.Holland America line vessel, rear view

I plan to publish a series of posts covering ports we visited, but, today, I’ll begin with an overview of embarking on transatlantic travel on HAL as a family with teens. I hope this perspective is helpful to other potential family cruisers since Holland America has a reputation for catering to an elderly crowd.

My kids enjoyed the trip, but there were very few people their age on the ship. We socialized with each other and with adults with whom I’d become acquainted on Cruise Critic prior to the voyage.

In addition to a lack of youth-oriented trip reports, I also couldn’t find much information for travelers with special needs regarding Polar-adjacent travel in the North Atlantic. I live with a chronic condition that sometimes affects my mobility and energy levels. Here’s hoping I can offer relevant tips for future adventurers with similar limitations in this and future posts.

First impressions

As it happens, one of the first SNAFU’s of our trip occurred at its very beginning: embarkation from Boston’s Flynn (formerly Black Falcon) Cruise Port was a mess. More frequent cruisers than I commented later that they’d never endured such a poorly executed boarding elsewhere or in Boston.

Here’s the official Massport site for the cruise terminal.

It’s easy to mock social media and blame it for many of society’s ills, but the utility of crowdsourced information cannot be denied. If I weren’t an active member of Cruise Critic—and a participant in a Roll Call for our August voyage—my embarkation experience could have been even worse. Tips from passengers who arrived at the port earlier than we did saved us at least a couple of hours of unnecessary waiting on site since we could elect to leave our home later to drive to the terminal.

To begin with, HAL sent notification a day ahead of boarding offering a completely revised boarding plan with new times for each passenger, all of which superseded the information given on one’s boarding pass. By not updating boarding passes—offered in digital format for cruise passengers just like most of us use on flights!—Holland America missed an opportunity to reduce confusion instead of sowing it.

Screenshot of HAL's recommended cruise app, NavigatorHAL reaped what it sowed. Thousands of people waited outside for hours beyond the embarkation time on their documents.

Nowhere in their last minute, change-of-plans missive did HAL inform embarking passengers that their digital documents would fail to update to reflect the new instructions. It’s bad to have a communication system that can’t update digital docs in real time; it’s worse not to confess to this fact up front to help reduce confusion!

At least two ambulances were required to whisk away people who weren’t up to the physical demands of standing in line for so long. We were incredibly fortunate that a recent heat wave ended before this marathon queue, but even 80°F became uncomfortable to many, and, while much of the line was shaded by adjacent buildings, there was no other shelter. Almost no seating was available, either.

Purple aluminum HurryCane walking stick freestanding on a wood floorBecause my own mobility limitations wax and wane, I always register a request with common carriers at the time of booking for wheelchair assistance. I’m often well enough to decline the requested service upon arrival at a terminal, but it is harder to get help on demand when it is needed if I haven’t initiated the process in advance. At Boston’s cruise port, it was lucky I was having a pretty good day.

When we arrived at the port, I checked in with an employee and noted we’d requested wheelchair assistance. According to that agent, “So did 1/3 of the people here waiting to board!”

Massport was short by at least dozens of personnel to offer wheelchair assistance. I believe that the lack of “timely assistance” was in violation of U.S. law. It reflected poorly on the port and on the city of Boston.

While the kind Massport employee I’d encountered couldn’t do much for me or anyone else, this lady did find folding chairs for a few of us who were concerned about walking the length of the line that disappeared out of sight across at least two long city blocks. Later arrivals sat on the curb.

My husband and kids trekked to the back of the line, and I waited in tolerable conditions if not comfort with the “special assistance” crowd. It was from that vantage point near the entrance that I saw one woman collapse and get taken away by ambulance.

By the time I boarded, I had yet to see a single passenger escorted onto the ship via wheelchair pushed by port employees. That period of time extended for well over an hour. The fortunate disabled passengers were those traveling with their own mobility aids and friends or family members capable of providing assistance.

After about an hour waiting alone, my family made it to the front of the line where I was sitting. Since no wheelchair assistance passengers were being taken aboard the ship as far as I could see, I rejoined them. My kids took my carry on bag, and I walked myself carefully through the disorganized thicket inside the terminal building with an occasional hand from one of my able-bodied relatives.Embarkation crowdThe gangway with which we boarded Nieuw Statendam was set at a particularly steep angle, too. A fellow passenger said they’d heard that the usual “jet bridge” style boarding ramp for Boston was broken and awaiting repairs, but I have no confirmation for that rumor. I was glad I’d brought my cane to help negotiate boarding, though, fortunately, I didn’t need it much once we were at sea.

Again, according to people who have cruised Boston more than I have, there is a port building here with some features of a modern travel terminal. We were not in that space! Instead, the Nieuw Statendam passengers were being processed in an open, warehouse-like space that might’ve felt familiar to our forebears’ experience at Ellis Island.

The flooring was uneven asphalt, there was no climate control, and there was no reasonable signage to help anyone self-select the correct lines. With various levels of “self check in” one might have performed prior to arriving at the port, there were at least three different types of confirmations that might be required to complete check in on site.

Through dumb luck, we were in the correct line for those who had performed the maximum online steps ahead of time, and we spent only ten to 20 minutes finishing up the check in process before preceding to the gangway that led onto the ship. The new facial recognition software did speed up check in, and, interestingly, could identify ³⁄4 of us with our N95 masks still in place.

One member of the family had to remove a protective mask to be correctly ID’d by the computer.

Some of the confusing requirements befuddling our embarkation day may be laid at the feet of COVID-19. There are national directives demanding certain steps or paperwork, it’s true. Failing to post signage to correctly direct thousands of boarding passengers into the correct lines based upon the status of government and health requirements, however, was entirely the fault of the Flynn Cruise Terminal and its staff.

The communication from HAL that changed boarding times at the last minute stated that a mandatory Coast Guard drill was the cause of the adjustment. That is probably true, but the Coast Guard didn’t prevent HAL from updating information on our virtual boarding passes or within the cruise line’s own app which they tout as an innovation in cruising convenience.

Neither was the Coast Guard responsible for inadequate staffing on the part of Massport, the government agency that runs land-side port operations.

Once we made it on board, the giddy relief of dropping our bags in our beautiful staterooms quickly eased the frustrations of the long morning day. Running the gauntlet of Boston’s cruise terminal was sufficiently exhausting that all of us—even the teens!—spent some part of our first afternoon aboard napping instead of exploring or reveling.

We were told in advance that we would board at 11:40; the port actually seemed to begin embarkation proceedings closer to 14:00 from our vantage amongst the crowds. My first photos from our cabin were taken at 15:45. We were scheduled to sail at 16:00. Nieuw Statendam actually cast off from its Boston mooring at 19:31.

port employees releasing ropes holding Nieuw Statendam to dockI think I’m being generous when I say we experienced a delay of at least three hours. For those who view lunch on the ship as the start of their vacation, our embarkation must have been particularly painful. It was certainly debilitating to those of us with health issues, and proved tiring even to young travelers.

Aside from mentioning that disembarkation three weeks later was similarly hideous—with poor communication again being the element for which HAL itself should be held fully accountable—I won’t go into detail for the latter fiasco. Suffice to say that I will still sail in or out of Boston because “not flying” remains on my list of “good to have” vacation characteristics, but I will always travel through this port carrying as little as possible to preserve my energy, and I will assume zero mobility assistance will be offered regardless of what’s legally mandated or promised.

I cannot, in good conscience, recommend embarking on a cruise out of Boston’s port for anyone with severe mobility restrictions at this time unless that person can afford to travel with sufficient personal assistance to cover all boarding needs. I hope the situation will improve if staffing levels recover, but I wouldn’t bet a friend or loved one’s comfort on it personally.

Also, on the subject of advance communication, I think it is worth pointing out that Holland America Line mandated the wearing of masks indoors, when not eating or drinking, for all passengers as well as crew for the duration of our sailing. This was not announced in advance of embarkation, though it could have been. The captain announced the policy on board the ship, and reminders were broadcast by him and other officers once or twice a day over the public address system.Disposable surgical mask

Most destinations, and all excursions, appeared to have dropped all COVID prevention rules or requirements, though the majority of our fellow travelers opted to wear masks on the one tour bus we joined.

Our group enjoyed a much greater degree of relaxation and feelings of safety due to the enhanced precautions, but some cruisers felt deceived and complained bitterly about the unexpected need to mask. At least one Cruise Critic member in my Roll Call group bragged about “always carrying a drink” in order to intentionally and spitefully subvert the protocols as much as possible.

Most Nieuw Statendam passengers appeared to make a sincere effort to adhere to the mask rules, in our personal experience on the ship. We elected to exceed HAL’s requirements, and we all avoided catching COVID-19, testing negative on our own home tests multiple times during and after the journey. There were reports of viral spread on the ship, however, and visibility of guests in isolation increased over time.

We believe that it was possible for cruise passengers to make personal choices to increase the odds of avoiding getting sick, but that the mask mandate made it many times easier for cautious travelers to do than it would have been otherwise. For example, I would have felt far less comfortable without the face covering requirement when I squeezed onto any of the crowded ship’s tenders required to visit the smaller ports on which we called.

Our family felt fortunate that HAL mandated masks; other passengers felt cheated out of the freedom they thought they’d been promised on the same voyage. Continue reading

Sustainable masks & face coverings for 2022 & beyond

My personal evaluation of three consumer grade elastomeric respirators is available further down in this post: Breathe99 B2, FLO Mask, and ZShield Reveal.3 brands of reusable face mask: B2, Reveal, FLO

As of July 2022, many people claim to be “over COVID;” I’m not one of them. I continue to mask regularly. I cover my face to protect a high risk member of my household, and because I have enough uncomfortable health issues of my own already. The specter of long COVID looms large enough to make indoor masking my preference.

Long COVID is most common in middle aged people, affecting as many as one in four recovered patients according to a Nature news feature. The CDC gives me better odds than 25% in their Data for Long COVID section, but, the fact is, no one yet knows the true prevalence of the condition.

Long term, I see no reason to ever stop masking in crowded conditions such as boarding a flight or on mass transit, though my specific level of vigilance will probably vary as this pandemic wanes and flu season comes and goes.Disposable surgical mask

The particular genesis of today’s post was a New York Times article by Andrew Jacobs published July 3, 2022. It’s worth reading, but the gist is that American hospitals should have learned the supply chain lesson of the COVID-19 pandemic and switched to elastomeric respirators for essential healthcare workers by now.

Elastomeric respirators are reusable face coverings using replaceable filter elements that work as well as disposable N95s to block the flow of germs. Many are domestically produced, to boot, in marked contrast to the largely imported supply of disposable masks.

Widespread adoption of elastomeric respirators would solve the problem of being dependent upon a hostile foreign nation for vital supplies while offering equal or better protection to each wearer with a better fit and simultaneously creating less waste.

Win-win-win.Merriam-Webster online dictionary defines elastomer as a noun, "any of various elastic substances resembing rubber"

The “elastomeric” part of the elastomeric respirator just means the body of the filtering face mask in question is stretchy or otherwise like rubber.

If the NYT article is to be believed, elastomeric respirators are often judged more comfortable by the wearer than N95s. Disposable filters are still required, but they might require only annual replacement for a few dollars, while the main body of the device—composed of washable silicone—should last a decade at a one time cost of $15-40 each.

For about two thirds of the money spent by the Trump administration attempting to sterilize and re-use N95s, we could have outfitted each of the nation’s 18 million health care workers with an elastomeric respirator according to Nicolas Smit as quoted in Jacobs’ article.Pile of money

Or, to harp on the affordability point from a different angle, a paper published in the Journal of the American College of Surgeons showed: “Outfitting… workers [with elastomeric respirators] was one-tenth as expensive than supplying them with disposable N95s. A separate study found that after one year, the filters were still 99 percent effective.”

And, given the chance to switch back to N95s after the study period in question, none of the employees opted to do so. I take that to mean those healthcare workers found the alternative masks easier to wear or use.

Toward the end of the New York Times piece was a mention of just one particular small business that’s giving up in the face of the healthcare system’s irrational insistence on sticking with disposable, imported masks. Breathe99—whose elastomeric respirator made the cover of Time magazine in 2020 as an innovation prize-winner—is winding down operations at the company’s Minnesota plant.

I followed the link, and found that I could purchase Breathe99’s B2 mask at retail as of early July 2022. Since I still see daily death reports in my newspaper, I remain in the market for comfortable, effective face coverings. I decided to resume exploration of better Personal Protective Equipment (P.P.E.), hoping I can reduce waste while staying safe.

I don’t buy disposable water bottles or accept single use plastic cutlery when I get takeout food, so why should I continue to rely upon paper face masks when more comfortable, equally effective alternatives exist?

One caveat: there are officially approved elastomeric respirators for clinical use, but consumer grade options are unlikely to be officially NIOSH approved. Whether this is due to pandemic backlogs or if it is just a regulatory grey area, I’m not informed enough to say. Just be aware that we still have no official designation for effective, FDA-approved consumer grade face coverings.

Now that mask mandates have ended and masking is a voluntary, personal choice in most settings, the up side to all of that reckless abandon is that no one is likely to complain about any specific face covering I acquire or wear. There should be no push back to the lack of an official protection rating for any mask I select.

On the down side, I’m left having to hope these products actually work as designed, and as represented by their manufacturers. I’m “doing my own research” here because I have no choice if I want a comfortable, well-fitting, effective face covering. I do go all the way to published papers from scientific journals and material spec sheets whenever possible.

For example, here’s a USA Today fact checking story about why filter media with a physical pore size of around 0.3 micron can be quite efficient at stopping SARS-CoV-2 viral particles which are themselves closer to 0.1 micron.

One clear takeaway of the past couple of years is that any mask offers better protection from airborne viruses than a bare face does. I do feel confident that I won’t end up worse off than I would be wearing a cloth mask or an ill-fitting surgical one when I don a tight-sealing face covering utilizing an effective filter medium at the point(s) where all my breath enters or exits the device.

The author wearing an improvised home-made face covering in 2020

This improvised face covering was my first attempt at masking when the idea was introduced to the general public in 2020. This loose, single layer of fabric is obviously not protective in the way a fitted non-woven medical mask would be, but I crafted it for passing strangers on walks around my neighborhood, so, in hindsight, I wasn’t at high risk when I wore it.

I will compare and contrast three intriguing designs that I’ve purchased at retail and tested for myself for the reader’s convenience. Because these elastomeric products are relatively expensive—from $60 to 90 per starter kit—I hope my comparison will help others pick a useful style.

Because of the note of doom sounded by the NYT article that sent me down this path, I advise anyone picking up one of these expensive face coverings to stock up on specialized, custom fit filters while they are still available. We as a society seem to have learned very little from the deprivations and death wrought by COVID-19. Even top quality, well designed products may be dropped from the market if their makers go out of business.

I ordered three different face coverings direct via their manufacturer’s web sites, paying the stated retail price. Here’s the list including the July 2022 list price:

  1. B2 mask by Breathe99 as referenced in the NYT article ($59.99)
  2. FLO Mask for adults or children though I’m only testing the adult version ($89.99)
  3. ZShield Reveal rigid mask which I pre-ordered and got in 2021 ($89.99)

Continue reading

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.

Season’s Greetings to all people of goodwill

Season’s Greetings to All!

I’d like to offer a Merry Christmas to everyone celebrating today, but also Warm Winter Wishes to the rest.Mom's idea of a restrained Xmas with dozens of gifts piled high under tall tree

I believe we all win when we give others the benefit of the doubt: if I tell you Happy Holidays instead of Merry Christmas, I don’t intend to denigrate your savior. Instead, I hope you recognize that my own beliefs differ, but you have my respect for your Joyeux Noël.

My favorite Christmas lyric is “peace to men of goodwill!” May this message find every reader safe, secure, feeling cozy and full of joy.

A December 23rd article in the New York Times informed me that for many—especially women, people aged 18-44, and independents or Republican voters with modest incomes—2021 might be the source of even more stress over the holidays than 2020.

So many are exhausted and demoralized.

I immediately sent a text to my sister-in-law upon reading that story. I thanked her for all that she does, especially when I’m on the other side of the country, and told her how grateful I am that she married into our family. What a delight to enjoy—and like!—one’s relatives.

It’s easy to overlook kindness when life feels hectic. Extending a hand to someone else is a surprisingly effective way to find one’s own balance.

Let someone know they are appreciated today, and perhaps you can ease some of that holiday stress afflicting a loved one or yourself. If your home is beautifully decorated or you’re dining in relative splendor, make sure whoever provided such bounty to you knows it matters.

And offer to do the tidying up if someone else arranges most of your holiday cheer! A shout out to my kids who washed all the dishes after our festive dinner last night.

For all that I am firmly aware of the rising caseload of the Omicrom variant, and the lingering specter of inflation punishing our pocketbooks, December of 2021 offers good news that I feel compelled to acknowledge. Let’s look at those sunny spots on the horizon.

Without being totally divorced from reality, it is definitive that we are seeing some of the highest daily COVID-19 case rates of the entire pandemic. I agree that this sucks! Omicrom is a rip-roarin’ beast of infection; it’s many times more infectious than Delta, which superseded those original strains of SARS-CoV-2 from early 2020.

In spite of that ugly, hospital-cramming fact, the amazing step forward of mRNA vaccinations means that the novel coronavirus is now, finally, actually only approaching the flu in terms of order of magnitude of lethality.

According to David Leonhardt’s Dec. 23rd article in the New York Times, here’s some hard data on the current degree of risk from COVID-19:

The risks here for older people are frightening: A rate of 0.45 percent, for instance, translates into roughly a 1 in 220 chance of death for a vaccinated 75-year-old woman who contracts Covid.

You’ll want to view the article to see its excellent graphs to get the fullest picture.
That is frightening, but what about when we consider other common ailments? From the same article:

One reassuring comparison is to a normal seasonal flu. The average death rate among Americans over age 65 who contract the flu has ranged between 1 in 75 and 1 in 160 in recent years, according to the C.D.C.

Until I read this story, I wasn’t aware that COVID-19 has become, for a vaccinated senior citizen, less deadly than an average flu. What a powerfully reassuring data point! I find this a reason for great hope.

bandage on upper arm

Before I go on, allow me to make obvious this other point: the unvaccinated are not nearly so safe. COVID-19 is much deadlier for the unvaccinated than flu is.

The last flu outbreak to kill millions, plural, was the “Asian flu” of the mid-1950’s, with a total death count estimated around 2 million souls worldwide.

An otherwise similar unvaccinated elderly woman is 13 times more likely to die of COVID than the vaccinated hypothetical person above. There remains a much, much higher probability of death for that unvaccinated 75 year old woman than she would face in a typical flu season.

COVID-19 leaped onto the charts as the third leading cause of death for Americans in 2020, and the elderly bear the brunt of this burden. We lost 1.8 years of life expectancy last year; that’s the worst decline in over 70 years, since WWII saw so many killed between 1942-43.

It is wonderful that we’re moving toward taming the novel coronavirus from killer of millions to “only” fatal to hundreds of thousands. While not enough, that is good, and it should be appreciated…when it actually happens.

As of November 22, we’d lost more Americans in 2021 than we did in 2020. No one should ever forget that.

Yet savor the positive news as much as you dwell on the negative and your life will be better. If you are fortunate enough to have been vaccinated, your personal risk now pales compared to those who’ve mostly been tricked out of taking a life-saving inoculation

happy face smile
.

In addition to the lifesaving wonder of vaccines that measurably reduce deaths amongst our most vulnerable population, we’ve also seen two new drugs approved as treatment options for COVID-19 in the USA this week. Where the latest variant has rendered ineffective some of our most effective earlier therapies, these new treatments arrive just in time.

They could also save us a lot of money.

To have new treatments people can self-administer at home—thus sparing exhausted, overburdened hospital staff while our total case numbers reach record heights—is another blessing. It’s hard for me to quantify how much I would prefer to pick up a prescription from my local pharmacy for a few days’ worth of pills if I had COVID over making repeated visits to a hospital or clinic.

The antiviral COVID pills from Pfizer and Merck will initially cost the federal government around $700 per dose. This represents an enormous savings spread over millions of doses vs. pricier monoclonal antibody treatments all of which cost $1200 or more at the heavily discounted government bulk purchase rate.Pile of money
Patients will also be spared unpredictable fees for visiting those staffed locations necessary to administer IV therapies. In an era of high inflation—and personally facing a mandatory switch to a new health insurance plan from a different provider starting January 1st—I find this a great relief.

I’ve never had a confusing or even shocking bill after visiting a pharmacy, unlike every time I’ve been a patient at a hospital. Reflecting on the fact that I’m so incredibly privileged that I’ve never had a gap* in my insurance coverage, it seems likely that others fear surprise bills far more than I do.

The pandemic isn’t over. Thoughtful individuals should still be wearing masks and making efforts to improve ventilation while meeting with those outside their households. That said, we understand more than ever about how COVID-19 spreads. Many of us are vaccinated, thus protected against the worst outcomes of the disease. Available treatments have expanded from desperate guesses to multiple effective therapeutics.

This ugly, lonely, uncomfortable period in history will end, though those of us who’ve lived through it may well spend the rest of our lives processing the experience. For example, many of us grew up with grandparents whose behavior was permanently affected by surviving the Great Depression.

Right now, on Christmas Day, 2021, I encourage you to look for the positive anywhere you can. Experiencing terrible events isn’t the only predictor of future suffering; so is how one responds to those challenges, and what one makes with the memories.

Things could be better, but, of course, they could also be worse. Having made it to my father’s house and remained in good health in spite of the journey, I find so much to celebrate this year.

May all these little celebrations be less fraught in 2022.

Wishing every reader good health, good cheer, and a large measure of optimism for the year ahead!

It was a painfully frustrating message replete with disinformation from an old friend the other day that prompted me to research and think about these comparisons. For the vaccinated, COVID may now be similar to a “mere” flu; for the unvaccinated elderly, endemic COVID-19 is still a virulent threat to be taken seriously.

Publicly available data makes all of this very clear. In 2020, 3 million people died from COVID-19. In a usual year, flu kills between 290,000 and 650,000 around the world. No math degree is required to calculate that somewhere in the ballpark of four to 10 times as many deaths occurred in 2020 than we would have expected from “mere” influenza.

The two most commonly prescribed antibody treatments, those made by Eli Lilly and Regeneron, don’t work against the Omicrom variant. Only GlaxoSmithKline’s sotrovimab—the most recently approved monoclonal antibody therapy—offers protection from Omicrom. These therapies cost thousands of dollars per dose (retail of ~$3000-5000 according to this news story, though other sources state that the federal government bought in bulk for $2100 per Regeneron dose and $1250 each for Eli Lily’s) and are administered intravenously, requiring a trained health care professional’s presence for every dose.

*Though the Affordable Care Act has led to a major increase in how many Americans have health insurance at any given time, in 2020, 9.5% had some coverage but also experienced a “gap” in continuous care, whereas another 12.5% remained completely uninsured.