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March 4, 2024 – (BOSTON)
I am a former FDA COO and Harvard faculty member, and a decades-long infectious disease spread risk management expert. (It’s the rate, depth, and breadth of “spread” that most counts.) At the FDA, I co-led its last major internal reform. At Harvard, I taught policy, law, regulation, and management, including, most minently, risk management. I also served in the US Military during the Vietnam War. In my prior jobs, I stayed on top of how best to manage the risks facing our nation and its allies—and their businesses. I continue to do the same.
A few weeks ago, the CDC reported that a significant (and sometimes deadly or long-term otherwise dangerous) pathogen significantly harmed one hundred twenty-nine passengers and 25 crew members (roughly
150 people) on a cruise ship. The pathogen was undiagnosed. But based on its severe symptoms (such as some two days of diarrhea, vomiting, and dehydration), it is most likely Norovirus. This contagious disease harms 685,000,000 and kills 200,000 annually worldwide.
Although not as well known or feared as the more widely respected COVID-19, the Flu, or RSV, Norovirus is a viral disease whose spread we must take very seriously. It is not only sometimes deadly but is highly contagious for an extended period, as well.
The Nature of Norovirus and Its Threat
If one has Norovirus, they are contagious from the moment their symptoms start until they end, usually lasting two days and until at least three days post recovery—in other words, for five days on average. Some people might be contagious for as long as two weeks after they recover. Accordingly, many people are exposed, and the disease rapidly spreads.
Because of its nature and symptoms, Norovirus is the likely cause of many ship outbreaks, both past and present, whether they were confirmed or not by formal testing. And the CDC reports a 52% rise over the five-year average of Norovirus outbreaks (or their scale) not only at sea but also on land in the following US States: Alabama, Colorado, Massachusetts, Michigan, Minnesota, Nebraska, New Mexico, North Carolina, Ohio, Oregon, South Carolina, Tennessee, Virginia, Wisconsin, and Wyoming.
Growing Threat
Given these numbers, recent Norovirus outbreaks cumulatively are far less than a pandemic or endemic-sized set in the US. Still, the CDC is concerned about the number of outbreaks since each is significant, and the number is growing and will likely increase further, perhaps dramatically, throughout the winter. Its means of transfer from human to human is sometimes airborne but mostly transferred from person to person by the target’s contact with or consumption of an infected object, such as a doorknob or a dessert.
Adding this data to the frightening recent World Health Organization (WHO) warning, the hyper frequency with which dangerous infectious disease pathogens attack us (sometimes deadly and very contagious, i.e., spreadable), we must now be far more aware and alert.
A few weeks ago, in Davos, the Director-General of WHO warned all nations and people of the world that by one means or another, a pathogen capable of killing 50,000,000 people worldwide is coming at
any time and that it is not a question of if, only when, it will arrive. It could arrive in three months or ten years.
But it is coming. So, our government agency and business leaders better be prepared soon—we cannot afford from a people-sense and economy sense to let dangerous pathogens catch us off guard. I will comment further on WHO’s dire warning in a coming publication.
What are the details?
Contaminated food, water, surfaces, or humans cause the spread from which large numbers of people are significantly harmed. Significant risk factors are sharing meals and living or working in close quarters, such as overcrowding or crowding (for work, recreation, sleep, or dining) in public spaces or transport, such as busses, trains, planes, and ships—or homes.
These are the same factors for spreading other less well-known diseases, such as tuberculosis. We must prepare ourselves to combat these lesser-known dangerous pathogens in addition to the better-known ones.
Regrettably, there is no vaccine or effective specific treatment for Norovirus. Treatments all seek to reduce symptoms or prevent diarrhea, vomiting, or dehydration symptoms, all three of which, if not properly managed, can become life-threatening or otherwise dangerous, from getting out of hand.
Solutions
Norovirus attacks are common in both developed and developing countries. There are good PCR tests for it, though. Safely2Prosperity’s infectious disease spread risk management Safety Program can help prepare a ship, for example, to prevent, mitigate, or control the outbreak or growth of the number of infected individuals and, with the help of our platform products, trace and risk manage the source(s) of the outbreaks.
This way, specific crew work facilities or tourist areas can be closed off to stop the spread, forcing the pathogen’s spread to expire independently without closing other parts of the facility or ship, such as floors or rooms.
What preventive, mitigative, or control strategies work? Increased cleaning of knobs, air, and food preparation surfaces helps. CDC says this version of the pathogen is a “very contagious” strain. So, look out.
S2P’s Safety Program can help here. Cleaning of air and surfaces can be added to what we track for a customer and on which Norovirus events
give alarms and alerts. We can also track testing of received shipments of contaminated food or water and failures to use anti-contaminants before they are consumed.
Especially with food, Captains and crew can target a single freight car or box—rather than all food on the ship—or food from one restaurant for remedial cleansing or destruction.
Cruise Ships Are Especially Challenging to Risk Manage by Hand
There were two outbreaks on ships this year, 2024. The CDC diagnosed one (the Celebrity Constellation cruise ship having roughly 100 people becoming significantly ill). The other was strongly suspected (the Queen Victoria cruise ship, with approximately 150 sick people).
The first outbreak occurred in January 2024—the second in February 2034. There were 14 similar outbreaks in 2023. According to the CDC, 2024 will likely be twice as bad.
Cruise ships are more subject to viral attacks and present an extra challenging situation when a breakout occurs. They cannot isolate large numbers of sick people and quarantine massive numbers of exposed people due to limited space and large essential common areas.
Accordingly, especially they must be hyper-vigilant, highly prepared, and have effective spread preventive, mitigative, and controlling strategies and tools at hand and usable at a moment’s notice to “nip an outbreak in the bud.” S2P can be particularly helpful here.
Depth and Breadth of Potential Injuries to Passengers and Crew
Why should cruise ship owners and the hospitality industry related to ships be particularly worried? “Tourist-scare” alone is a significant factor. Are you going on a ship within six months of its considerable outbreak of a potentially deadly pathogen? Not I. Would you take your family on such a ship? Not I.
Many tourists regularly take whole families, including young children and babies. Or at least I did. Vomiting for two days is something I would not expose myself to. It’s a severe symptom from a comfort point of view, even if the bug does not kill you. You will never forget it, and you will tell all your friends. It is far from trivial. And it is more dangerous for children and babies.
Plus, for some people, symptoms last weeks or months—or cause long term inflammatory bowel problems, which also must not be taken lightly.
In a worse case, an infected person can spread the disease to coworkers and family members for two weeks after infection.
If you are in a cabin on a ship or a two-cabin suite, if you are infected, your spouse and then your children will likely catch the disease.
What’s Worse from a Financial Perspective?
These significant outbreaks damage a single ship (facility) significantly, both short-term (refunds) and long-term (significant reduction in market appeal, reputation, and value for tourists (customers) or crew (employees).
Also, the company that owns the vessel will dramatically suffer increased costs (refunds for infected ships to increased expenses for defending or settling lawsuits) and decreased revenue (a crash in market demand perhaps affecting demand for its other cruise ships as well). The industry likely will also begin to lose significant “curb appeal.” Why would you take a slow ship rather than a fast airplane if you no longer viewed a vessel, company, or industry as safe?
Dozens of Other Industries and Thousands of other Enterprises Are at High Risk
The case for cruise ship companies and the entire industry is but one example of dozens of companies and industries that must wake up. The level of danger to workers, customers, families, investors, and leaders— as well as enterprise survival—is high. Leaders beware.
For many companies, it costs less than 50 cents per employee per month to prepare for a pathogen attack if using Safely2Prosperity’s VirusVigilant IDS Safety Program’s ML (and soon, some AI) digital product.
The “assurance” associated with preparedness alone reduces the fears of employees and family members, especially spouses. What a precious employee, family, investor, enterprise, and customer benefits at a meager cost. If you want to learn more, you are welcome to text me at 617-680-3127.
Remember: The risk of doing nothing is exceptionally high. Nature, especially in its dangerous infectious disease-spread form, is highly aggressive. Moreover, humans can manipulate it to make it even worse—and our enemies know this.
© 2024 Safely2Prosperity LLC and Dr. John Norris. All Rights Reserved. Text: 617-680-3127.
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