The World Travel & Tourism Council (WTTC)/Carnival Corporation Global Scientific Summit on COVID-19 was moderated by Gloria Guevara, president and CEO of WTTC, and Arnold Donald, president and CEO of Carnival, to, as he said, “cut through the noise” and stay “grounded in science and the latest facts.”
Three panels of doctors — many of whom are working with Carnival to inform its future cruise protocols — discussed the science, treatment and prevention of COVID-19 with some 17,000 registered attendees. (Watch the recordings here.)
Epidemiology
Dr. Steven Gordon, chair of the department of infectious disease at Cleveland Clinic Respiratory Institute, said that in the time before widespread vaccines and treatments, travelers should not “approach this virus with hubris,” especially when traveling internationally. Optimistically, Gordon remarked that the novel coronavirus will affect most people mildly, with only 20% or so requiring medical care.
Transmission
The cruise world is “very acquainted with norovirus” being highly transmissible via surfaces, said Dr. Stacey Schultz-Cherry, professor in the department of infectious diseases at St. Jude Children's Research Hospital. However, it is believed that COVID-19 is not nearly as transmissible via surfaces — surviving for up to 10 to 24 hours depending on temperature and humidity, she said. COVID-19 is most commonly transmitted via large respiratory droplets as there is less evidence for smaller aerosol droplets and fecal-oral routes.
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Gordon added that the virus can spread from a contagious carrier two days before the recognition of symptoms and the following five days. But, there are no definitive cases for transmission by the host after those first five days.
Also contributing to the transmission equation, as applicable to ships and other travel venues, HVAC systems are generally good at exchanging air should they avoid recirculation, according to Dr. Joshua Wolf, medical director of antimicrobial stewardship at St. Jude Children's Research Hospital.
Current Testing
For the moment, there are basically two coronavirus metrics to test for, according to Dr. William Morice, chair, department of laboratory medicine and pathology at Mayo Clinic, and president of Mayo Clinic Laboratories: whether or not a person currently has the virus, or if they once had it (via present antibodies).
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Prevention
Even though COVID-19 is not as contagious as measles and chickenpox, there remains an emphasis on physical distancing and wearing masks to avoid any coronavirus spread via respiratory droplets. Regarding face coverings specifically, Dr. Jewel Mullen, associate dean for health equity at University of Texas Austin Dell Medical School, said “they offer some protection.”
She added, “Crowding is important to think about.”
According to Mullen, the odds for infection increase as people amass. She said her biggest comfort is remaining home and away from gatherings of six or more individuals.
Therapies
While transmission of COVID-19 is similar to that of influenza, there are several major differences. With no preexisting immunity to COVID-19, “everybody’s susceptible to be infected,” said Dr. Adolfo Garcia-Sastre, co-director of the Global Health & Emerging Pathogens Institute at The Icahn School of Medicine.
In the meantime, there are inhibitors of viral replication that can help.
The drug remdesivir is more efficient than hydroxychloroquine, Garcia-Sastre said. Also potentially available are therapeutic antibodies derived from the plasma of previously infected persons.
Vaccines
Of course, vaccinations are viewed as being the golden ticket, but in order to safely introduce one, there is “a balance between being as quick and efficient as possible and also being careful enough,” said Dr. Vivek Murthy, author and former vice admiral at Public Health Service Commissioned Corps.
Unfortunately, he does not see vaccine distribution at scale until mid-2021 and population-wide implementation until the end of next year, provided there is an effective global campaign.
New Testing
Until that time, there may be a simpler solution.
"The virus cannot live outside the human body,” said Dr. Stuart Schreiber, professor of chemistry and chemical biology at Harvard University. If future testing frequently covers even asymptomatic carriers, precision quarantine would isolate the sick only and effectively burn out the virus in a relatively short period.
This, in combination with masking and physical distancing, would only require two of the three to be done well to overcome COVID-19, according to Dr. Michael Z. Lin, associate professor of nuerobiology, bioengineering and chemical and systems biology at Stanford University.
“The virus can be defeated by personal actions alone,” he said.
In short, “it’s a solvable situation,” said Dr. Thomas J. Cahill, founder and managing partner at Newpath Management. “It’s not the boogeyman.”
The Details
World Travel & Tourism Council/Carnival Corporation Global Scientific Summit on COVID-19
www.covidsciencesummit.com
