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.

Facing pandemic persistence, I’ll spend where safety dictates policy

We have made it to August 2021. Sadly, the pandemic is not over, though the most vulnerable people in America have been tricked into behaving as if it is.

Decisions were made to re-open all venues while simultaneously dropping every protective precaution. Some of us believe that choice was precipitous, even reckless. I feel vindicated as my logic proves sound… but also so deeply disappointed.

I know I like redundancies more than most, but this seemed so obvious. “Better safe than sorry” may be trite, but it’s also wise where human lives are on the line.

How ’bout making one change at a time? After each change, observe the effect. It works for scientists, after all.

Oh, right, science is a tool for the liberal elite! Yet fools parroting such nonsense do it gasping through their fluid-filled lungs, crowding into our hospitals—institutions steeped in modern medical knowledge derived via the scientific method.

Some feel their lives aren’t worth living if they have to wear a mask to go shopping. Safety goggles, cloth face mask, and disposable gloves

I wonder how those precious snowflakes would hold up under conditions of true adversity. I imagine the oppressed population of Myanmar—or the people in Haiti or Tunisia, watching their fragile governments wobble under anti-democratic onslaughts—could offer lessons on what really constitutes a hardship to pampered American crybabies.

I would recognize that wearing a mask pales in comparison to being the target of genocide even had I never visited Auschwitz.

What a summer we could have had! If only we’d been cautious enough to resume access to theaters and restaurants, but with our masks in place for crowded, indoor conditions from the outset. It might have been the joyful reunion we all dreamed of during 2020’s isolation, loneliness, and despair.Woman hugs child

Hugging my grandma with a mask on didn’t lessen the joy of it. Visiting with my aunt over coffee on the patio instead of in the kitchen offered equal satisfaction. Espresso in demitasse cup on cafe table

Watching as my father’s “elective”—yet quality of life preserving—joint replacement surgery was postponed once, and then a second time, because no hospital bed was available was yet one more cost of the pandemic, but, this time, caused directly by bad actors, not a novel disease with unknown characteristics.

Now that stung.Analog wall clock showing 12:06

Frankly, I believe libertarian freedoms should be available… but only at a reasonable price. Partakers in those freedoms must give up the right to extort payment from the sensible majority.

Refusing vaccines? Fine, but wear a mask in public settings. Also, public funds—and even private insurance—should eventually cease to pay treatment costs incurred by those rejecting approved vaccines for endemic disease sufficient to be flagged by public health authorities.

The price of ignoring experts when an entire society experiences extreme events should be borne by those who choose to heed only their own counsel. That’s a fair trade off.

During outbreaks of any vaccine-preventable, endemic illness, refusniks must also give up the freedom to enjoy entertainment venues and public conveyances for all but essential purposes. Take your bus across town to work—while masked—sure, but recreational jaunts and all air travel unless, say, to receive urgent medical care out of state ought to be curtailed for those likely to spread disease.

NZ Chch bus MetroUnvaccinated kids should learn remotely unless masks are shown to be sufficient in preventing the spread of measles, chickenpox, the equally transmissible delta variant of COVID-19, and any future outbreak of similarly easily spread viruses.

If masks prove to work as well as that, I am 100% fine with unvaccinated kids—wearing masks—in schools forever. The point is to keep vaccine-preventable germs contained, not to dictate personal decisions that affect only oneself.

It should go without saying that the vaccinated should always be prioritized over the voluntarily unvaccinated when medical treatment becomes a scarce commodity that must be rationed. I hope and pray it doesn’t come to that, but, today, I fear for the people of Florida, Louisiana, and Arkansas. Mississippi and Alabama look pretty terrible, too.

Pandemic illness currently strains the pathetically insufficient “just in time” commercial hospitals in these and other states. An August 5th AP news story describes one Broward County hospital cramming beds into auditorium, cafeteria, and conference rooms to accommodate surging COVID-19 caseloads.

How pathetic that we allowed ourselves to fall back to this point more than a year after learning how and where this virus spreads!

Speaking to business owners and service providers, I reiterate that my personal spending will be concentrated in locations with high rates of vaccination. Pile of money

I will preferentially patronize restaurants and stores that demand proof of vaccination before letting anyone remove her mask.

It shouldn’t fall to commercial interests to manage a public health crisis, but dysfunctional politics brought us to that point. Re-opening—with precautions—allows for increased economic activity without excessive deaths. That’s the course I’ll vote for with my wallet.

Here’s hoping leadership by accounting departments can make up for the inadequacies of incompetent elected officials.

Celebrating full vaccination against SARS-CoV-2… with a mask on

Today, I celebrate the fact that I’m officially fully vaccinated against the novel coronavirus responsible for the pandemic and all of its miserable restrictions. It’s been 14 days since my second Moderna jab.

I encourage everyone eligible and not medically contraindicated to pursue the same happy state.Person celebrating by blowing into unfurling pink butterfly party toy

The uncomfortable side effects weren’t the greatest thing ever, but they are long gone. My confidence, on the other hand, only grows stronger that I won’t catch or spread COVID-19 to those I love or innocent strangers.

My commitment to protecting others is a product of both my patriotismand my Jewish faith’s teachings on the inherent dignity and value of human life.

My behavior won’t change too much, however, given that I’m only the second person in our household of six people to achieve this milestone. My father-in-law, at a venerable age ≥75, was part of our state’s Phase II, given access to scarce vaccine appointments back in February.Patients during mandatory observation for side effects after coronavirus vaccination jab

Two thirds of us* have had second shots, and my youngest got his first jab within days of his cohort becoming eligible. The others in our household will reach full immunity over the course of the next four and a half weeks.

Knowing that even just the first dose of Pfizer vaccine reduces my youngest’s odds of symptomatic coronavirus infection by more than half, he will be able to rejoin his class for in person learning for at least the final couple of weeks of the school year.

What a blessing!School tents for COVID-19 - 1

It is especially poignant given my son’s love for this special school, which has been his academic home for more than half of his life, added to the fact that he’s moving on to his next level of education at a different institution in the fall.

Schools here rightly are still required by law to enforce masks for pupils indoors; my child will continue to wear a face covering at all times on campus, exceeding state regulations. He will continue to take care to keep social distance inside as well.

Because a frail, ill, elderly member of our family—and household—has a history of severe anaphylaxis triggered by medications and vaccine components, protecting ourselves from suffering severe COVID-19 is great, but not sufficient. She remains at elevated personal risk if she catches the coronavirus, yet unprotected by anything except her family’s caution.Safety goggles, cloth face mask, and disposable gloves

We will continue to guard against even mild infection, practicing indoor masking and social distancing in all public places, because no one knows yet exactly how contagious a vaccinated, asymptomatic or mildly symptomatic carrier really is.

Breakthrough infections after vaccination are rare and not usually severe, but they definitively exist and have caused some to suffer for prolonged periods of time.

I’m thrilled and grateful to live in a wealthy, powerful nation wherein my family enjoys the fruits of stupendous work on the part of scientists and clinicians fighting a novel disease. I understand and agree with the conclusion that a majority of fully vaccinated people can safely modify some behaviors at this point in the pandemic.

I also offer our situation as a cautionary tale to all those mocking and minimizing maintained vigilance even as rates of infection, hospitalization, and death improve. We aren’t just paranoid hypocrites who doubt or misunderstand science.

We are multi-generational households. We are people with allergies and other uncommon health conditions causing variable responses to vaccines. We are concerned parents, children, and grandchildren. We are traumatized family members of victims who lost lives to the pandemic.Woman hugs child

By most measures, COVID-19 is retreating. I celebrate that fact, too! My gaiety is merely tempered by the facts of my personal situation.

People of goodwill must continue to support each other—and everyone else in our communities—as each family negotiates the tail end of their own version of the pandemic. That’s how we recover, as a society.

I know of no greater way to honor those who’ve suffered, and those we’ve lost, than to carry on leading a joyful life including generous quantities of service and gratitude.

That process will look different from house to house, and community to community.

That’s not just okay, it’s a magnificent reflection of the vibrant diversity of modern America. Getting back to normal isn’t the best we can do; let’s move forward together to an even better future.

Respecting that others may do so differently from you is a powerful step in that direction.

Functional democracy—or effective government in a democratic republic such as the United States of America—depends upon civic virtue. Failing to protect others within my community would undermine everything I believe to be right, just, and good.

* i.e., us = my household

Teenagers such as my kids already have lower rates of severe or even symptomatic infection with this virus. In a population aged 65+, the first dose of either mRNA vaccine was protective against COVID-19 serious enough to require hospitalization at a rate of 64%. Subsequent studies show 12-15 year old adolescents mounting greater antibody responses to these vaccines than even young adults 16-25—who responded more vigorously than elders—likely due to the more robust immune system of youth.

Wear a mask, people of faith, or live in sin

Wearing a mask or other face covering to reduce the spread of coronavirus should not be a political issue because protecting members of our own communities is so obviously the right thing to do.

Safety goggles, cloth face mask, and disposable glovesThis partisanship doesn’t even make rational sense in the context of America’s “culture wars.” Republican party members often proclaim themselves pro-life,º yet many refuse to don protective gear during a pandemic, callously risking the lives of others because the price of a few dollars and mild inconvenience is too high.

GOP.com suggests that Republicans believe Culture should respect and protect life.

You should wear a mask—and follow government mandates ordering you to do so—for the same reason you shouldn’t drive while intoxicated: these rules are enacted to save human lives. We have always limited some freedoms via the common law when one person’s actions infringe upon the rights of others’ lives or property.

It’s none of my business if you are an adult who chooses to get drunk; it is anyone’s business to intervene if you callously murder other people by operating a motor vehicle in that condition. I make no moral or ethical distinction between that action and firing a gun with a bullet in its chamber into a crowd, nor should the law. Mask directives land squarely in this legal territory.

I’m not making accusations from a place of partisanship, either. Objective evidence suggests that Republicans are those least likely to wear masks. A New York Times article from June 2, 2020, referenced a Gallup poll showing fewer than half of Republicans had donned a mask in public. In the same poll, 75% of Democrats had worn one, as had 58% of my fellow independents.

While this inaction flies in the face of the GOP’s pro-life position, it also repudiates the Christian faith of the majority of its members. A 2017 Washington Post article gave me the figure that “73% of the Republican party is white Christian.”Jewish Torah, Good News Bible, and cloth face mask

The 6th Commandment: Thou shalt not kill

I grew up attending a United Methodist Church, though I converted to Judaism as an adult. My daily life is enriched by living amongst observant Christians. While I won’t pretend to be any kind of theological scholar and I personally believe much of the revealed truth of Torah/the Bible to be allegorical, I find the Ten Commandments clear and straightforward, especially this one:

Thou shalt not kill.

There are variations in understanding the Ten Commandments depending upon whether you ask a Jew, Protestant, or Catholic. Thou shalt not kill is usually cited as the 6th*.

Wearing a mask definitively reduces the chances that the wearer will infect someone else with COVID-19. Doctors and scientists are still working to unravel the many mysteries of this novel coronavirus, but there is solid evidence that many cases are transmitted by asymptomatic or pre-symptomatic individuals, i.e., people who don’t think they are sick. If you wait to wear a mask until you are sick with COVID-19, you may well have already infected another innocent victim.

COVID-19 has killed over half a million people around the world already, and it is especially lethal when it infects the elderly. I can’t help but leap from this fact to another of the Ten Commandments, number five:

Honor thy father and thy mother; in order that thy days may be prolonged upon the land which the Lord thy God giveth thee.

Excerpt of page of Torah/Bible showing Exodus 20:12-13From my again, admittedly, allegorical interpretation of this commandment, wantonly endangering the lives of any elderly person is quite literally a sin. Even according to a strict interpretation of the words, not wearing a mask to protect your own parents would be the sin. Taking part in a culture of resistance to protective measures makes you complicit in endangering this vulnerable population whether you’re the one who infects your mom or a member of her church does.

Refusing to wear a mask while a virus ravages the weak is an indefensible position for anyone purporting to ascribe to Judeo-Christian values.

The author wearing an improvised home-made face coveringI didn’t need more reasons to cover my face in public during a pandemic, but, upon reflection, I found two more in my faith.

º The Republican party website, on its Platform page, has a poll “Why Are You A Republican?: Tell Us Which Principles Are Most Important To You.” The choices are compiled from previous visitors feedback, and include the option: “Culture should respect and protect life.”

Dated September 6, 2017, but behind a paywall. You could try searching for “The stark racial and religious divide between democrats and republicans in one chart.” Please note that the racial aspect of this chart had nothing to do with my point, but this was the first recent and reliable source I found for statistics on the religious makeup of the Republican party. Presumably there are Christian people of color in the Republican party as well, so it is likely that more than 73% of party members consider themselves to be followers of Jesus Christ.

* Catholic interpretation would say this is the 5th, not 6th, commandment.

Catholics omit the second clause, but the shared portion makes my point. For them, it is commandment number four.

Note: The author’s improvised face covering shown in the last photo is not ideal COVID-19 protection for others as it fits too loosely around the face. See the CDC for further advice. This hat+mask combination was my first attempt when PPE was still scarce for health care workers, but the idea of home-made cloth masks was introduced as a reasonable alternative for civilian wear in daily life. It was comprised of a napkin and pipe cleaners and designed to be worn on local walks where social distancing could usually be expected. A loose mask like this is still better than no face covering, however, and it is much easier to breathe in during socially distanced exercise.

Teen wearing medieval plague doctor mask leaving house for a walkMy teen opted for a rather more historical mask that he happened to have lying about the house. My claustrophobia would make this style very difficult for me to wear, but we did get some great photos that day.