Dive trip after 2nd virus shot?

9 hours ago, troporobo said:

I’d recommend caution on that point.  There are other credible studies that indicate asymptotic transmission could account for half of all cases.  Unfortunately there is still much uncertainty. 

I would agree, it'll take some time to analyse testing results and the impact of the vaccine, until something definitive is published it's a roll of the dice, more than likely you'll be fine but if you're not you could find yourself in trouble.  One of the issues is that travel insurance will probably have exclusions for some time so if you get in trouble you could find yourself on your own.

On 1/26/2021 at 10:05 PM, davec13o2 said:

I'm due for a second shot next month, and thinking of setting up a dive trip soon thereafter.  Anyone else have the same idea?

Most likely countries that are desperate to get tourists will be happy to get you in, there you will find none of your boat crew or resort to be vaccinated. On your return you may be forced to quarantine. It is a bit more complex than just thinking about you

In a recent JAMA study, it shows that for most of the current mutations, something like 60% of transmission is from asymptomatic patients, roughly half of that from people before they show symptoms and the other half from patients that never show symptoms. One big issue though is that there is no good test for live virus i.e. viral load. The typical PCR tests only look for RNA and that may or may not due to live virus. I will supposedly get my second shot in a week or so (Moderna) here in Los Angeles, but my wife is likely at least two months away. Certainly I would like to travel but getting a severe COVID infection in the wilds of Indonesia (think Triton Bay) seems like a bad idea.

Bill

Any travel is a calculated risk, as even after both Covid vaccine shots, if exposed one has a 5 to 10 chance of getting ill; but this is a guess, as not enough time has transpired to gather the necessary data. 

Each country's restrictions keep on changing, so it is best to look them up on-line.

For example, for Indonesian travel info one site is: https://www.indonesia.travel/gb/en/coronavirus:
for the Philippines: https://ph.usembassy.gov/covid-19-information/

It is also a good idea to keep in touch with one's travel agent whose business it is to know these details.

I would like to go to Bali, here are the current requirements, assuming I am already in Indonesia. But first, I would need to find out if a 5 day quarantine plus a negative test are needed to enter Indonesia:

"Balinese Government Imposed Obligatory PCR Test Result Requirements for Upcoming Bali Visitors. Sat, 9 Jan 2021

The Indonesian government requires national and international tourists planning to board a plane to Bali to take a polymerase chain reaction (PCR) swab test at least 2 x 24 hours before departure or rapid antigen test at least 1 x 24 hours before departure. 

Those traveling by plane must show a certificate of a negative result of PCR-based swab test no later than 2 x 24 hours before departure or a certificate negative result of rapid antigen test no longer than 1 x 24 hours before departure, and filling e-HAC Indonesia;

Those traveling using private vehicles through land and sea transportation must show a certificate of a negative result of PCR-based swab test no later than 2 x 24 hours before departure or a certificate negative result of rapid antigen test no longer than 1 x 24 hours before departure.

While you are in Bali, you must have a certificate of negative results of the PCR-based swab test which is valid for 14 days, or a negative result of a rapid antigen test which is valid for 7 days.

Domestic travelers departing from Bali can use their valid certificate of negative result of the PCR-based swab test or a valid rapid antigen test for the return trip from Bali.

For international travelers, please be mindful to always check the flight restrictions to Indonesia before planning to visit Bali. We will keep you updated with the newest information and regulations regarding traveling to Indonesia during the pandemic." 

As if this is not sufficient, we now have the new virus mutants which may be somewhat more contagious. And to get, say to Bali, one has to pass through other countries, such as Singapore or Malaysia, maybe with stops overs like Honolulu, all of which will have their own Covid requirements. 

A good travel agent does seem necessary.
= 

11 hours ago, bvanant said:

In a recent JAMA study, it shows that for most of the current mutations, something like 60% of transmission is from asymptomatic patients, roughly half of that from people before they show symptoms and the other half from patients that never show symptoms. One big issue though is that there is no good test for live virus i.e. viral load. The typical PCR tests only look for RNA and that may or may not due to live virus. I will supposedly get my second shot in a week or so (Moderna) here in Los Angeles, but my wife is likely at least two months away. Certainly I would like to travel but getting a severe COVID infection in the wilds of Indonesia (think Triton Bay) seems like a bad idea.

Bill

 

We’ll be visiting my MD son in Hawaii soon. They require an NAAT (nuclei acid amplification test), which we will get, or quarantine for 2 weeks. NAAT tests for active infection, at a cost of $150.  They do not accept PCR which tests for antibodies that could have been produced by prior infection.  I heard a report that no one in any country who has had a vaccine has had a serious COVID infection.  So, with vaccinations and an NAAT test you should be safe and likely not a carrier.  Of course, to be absolutely sure it would be wise to wait for peer reviewed published journal studies. 

People who’ve been vaccinated have been infected.  So while they may not become seriously ill, they remain vectors. 

Tropo,

Quote

People who’ve been vaccinated have been infected

Not sure what you meant. The vaccines develop antibodies in the persons who have had the shot(s), but having the shot(s) does not imply they have been infected. Think about it: if you get a flu shot, it does not give you the flu! You develop antibodies as a result of the shot.

Persons who have had the vaccine can still possibly transmit the virus without being infected, which is why the current advice is to continue with mask and social distancing. There are studies ongoing to confirm or reject this idea, so until those are complete the precautions are quite logical.

Tom

A couple of points. PCR tests are in fact nuclei acid amplification tests. They are not antibody tests. Antibody tests will tell you if you have been infected in the past, PCR tests will tell you if you have COVID RNA floating around in your blood. I THINK what Troporobo meant was that in fact some people who have been vaccinated can still get COVID (the vaccines are between 75 and 95% effective). Remember that the endpoints of the vaccine trials was not lack of COVID in the blood but rather it was symptomatic illness. No one knows for sure but it is certainly possible that a significant number of people in the vaccine trials (and now in the real world) might still get infected and as such still be able to infect others but they won't get sick enough to go to the hospital. It is still early days in terms of what we know about the vaccine and the new mutations so I think it is still prudent to be very cautious

Bill

I am a diving Medical + critical care  Physician and Underwater photographer and would like to chime in on this topic. 

Firstly, please do not fall into the trap of  news or facebook postings that are reflect the author's opinion. Only, peer reviewed Medical Journals should be referenced.

In summary, based on multiple medical literature searches, there are multiple vaccines already out and others completing phase 3 trials. All of these trials did not look at asymptomatic (believed to be about 60% of all covid infections) so it is not known if the vaccines will prevent asymptomatic infections or if vaccinated people that are asymptomatic can transfer the disease and infect others. Until detailed studies are completed 

The ones that are out there are the following:

Pfizer 2 injections  with about 50% efficacy two weeks after the first injection, 3 weeks between injections  and 95% efficacy 2 weeks after the second shot, this efficacy is against the original strain and the initial British strain, It has reduced efficacy against the Newer British, South African and Brazilian variants, efficacy against these strains are believed to be around 60% with the current vaccine.They are tweaking the vaccine in order to provide increased protection against the newer strains, a booster will be made available to those vaccinated with the original vaccine.  

Moderna 2 injections  with about 30-50% efficacy two weeks after the first injection, 4 weeks between injections and 94% efficacy 2 weeks after the second shot, this efficacy is against the original strain and the initial British strain, It has markedly reduced efficacy against the Newer British, South African and Brazilian variants, efficacy against these strains are believed to be around 50% with the current vaccine. They are tweaking the vaccine in order to provide increased protection against the newer strains, a booster will be made available to those vaccinated with the original vaccine.  

Astra Zenica, 2 injections, better efficacy with longer than 4 weeks between injections  with about 50% efficacy two weeks after the first injection, 4 weeks between injections  and 95% efficacy 2 weeks after the second shot, this efficacy is against the original strain and the initial British strain, It has reduced efficacy against the Newer British, South African and Brazilian variants, efficacy against these strains are believed to be less than  60% with the current vaccine

Johnson and Johnson, single injection, about 70% effective against the original strain, less than 50% effective against the new strains, not as yet approved by the CDC/FDA

Novovax  about 90% efficacy against all known strains of Covid-19  https://www.novavax.com/sites/default/files/2021-01/UK-SouthAfrica-Trial-Results--FINAL.pdf not as yet approved by CDC/FDA

Testing: PCR Covid tests: about 10% false positive and about 10% false negative results depend on adequate sample 

Rapid testing: about 20% false positive and 20% false negative

Hope this helps clear things up

21 hours ago, wydeangle said:

Tropo,

Not sure what you meant. The vaccines develop antibodies in the persons who have had the shot(s), but having the shot(s) does not imply they have been infected. Think about it: if you get a flu shot, it does not give you the flu! You develop antibodies as a result of the shot.

Persons who have had the vaccine can still possibly transmit the virus without being infected, which is why the current advice is to continue with mask and social distancing. There are studies ongoing to confirm or reject this idea, so until those are complete the precautions are quite logical.

Tom

I guess I wasn’t clear. To over simplify, vaccines may not prevent subsequent infection, they prevent serious illness.  So a person can get jabbed, later become infected with or without serious symptoms, and transmit the virus. I certainly did not mean to suggest vaccines cause infections!  

@troporobo

One point of clarification:
The amount of viral shedding from someone who has been fully vaccinated has been estimated to be 5x-20x less than someone who has not been vaccinated. This is basic virology - the virus needs to replicate in a host to shed - the current set of vaccines slow/reduce virus reproduction within a host.

There is currently no scientific evidence that suggests someone who has been fully vaccinated is either as likely/less likely/more likely to transmit the virus, there are only a few emerging reports on post vaccination viral spread so far (ex: from Israel).

On 2/5/2021 at 1:39 PM, davec13o2 said:

Where will you be staying and for how long?

I was at CoCo View resort, and was there for a week.  This was either our 12th or 13th trip there, I forget which.

You need at least 4-6 weeks to develop antibodies. Plus, with the new variants total immunity may not exist. 

Good news: As expected by virologists (but not proven so far), scientific reports start to show that vaccination not only prevents symptomatic infection, but also asymptomatic infection (= transmission of the virus, although the carrier is protected from development of (severe) sickness). It is well possible that transmission of Covid by vaccinated people will turn out to be a myth: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00448-7/fulltext

In addition, the study shows, that already after injection of  the first single dose (Biontech/Pfizer), a protection of 47% (1-14 days after injection) and 85% (15-28 days after injection) is achieved.

Of course virus mutations are an issue and it may turn out that we have to become vaccinated against the most recent strains at a regular basis (as it is e.g. the case with influenza vaccine), but, at present, who can predict the future so far?

Still we have to wait for the complete picture, how the situation is after complete vaccination (second injection) and with all the different vaccines, but I think after all this bad news is good to read something positive...

Wolfgang

On 2/19/2021 at 5:34 AM, Architeuthis said:

Good news: As expected by virologists (but not proven so far), scientific reports start to show that vaccination not only prevents symptomatic infection, but also asymptomatic infection (= transmission of the virus, although the carrier is protected from development of (severe) sickness). It is well possible that transmission of Covid by vaccinated people will turn out to be a myth: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00448-7/fulltext

In addition, the study shows, that already after injection of  the first single dose (Biontech/Pfizer), a protection of 47% (1-14 days after injection) and 85% (15-28 days after injection) is achieved.

Of course virus mutations are an issue and it may turn out that we have to become vaccinated against the most recent strains at a regular basis (as it is e.g. the case with influenza vaccine), but, at present, who can predict the future so far?

Still we have to wait for the complete picture, how the situation is after complete vaccination (second injection) and with all the different vaccines, but I think after all this bad news is good to read something positive...

 

Wolfgang

 

Yes, very hopeful, thankfully.

I've seen similar news releases, and waiting for the official publications.  But there is tentative agreement on the 85% reduction for combined asymptomatic and symptomatic infection (as opposed to 95% for symptomatic only).  And among vaccinated people who test positive, their viral load is reduced by 4-fold, meaning much less infectious.

Who knows, maybe we'll be able to travel knowing that there is low risk we'll be infected or we'll infect others, while waiting of course for the peer-reviewed journal articles to come out.  Of course, low risk doesn't mean zero risk.

2 hours ago, davec13o2 said:

Yes, very hopeful, thankfully.

I've seen similar news releases, and waiting for the official publications.  But there is tentative agreement on the 85% reduction for combined asymptomatic and symptomatic infection (as opposed to 95% for symptomatic only).  And among vaccinated people who test positive, their viral load is reduced by 4-fold, meaning much less infectious.

Who knows, maybe we'll be able to travel knowing that there is low risk we'll be infected or we'll infect others, while waiting of course for the peer-reviewed journal articles to come out.  Of course, low risk doesn't mean zero risk.

The rate limiting step may well be the availability of insurance, including evacuation insurance which will vary depending upon your country of residence and also depending where you propose to travel availability of flights might be an issue.   Evacuation to a decompression chamber may prove difficult or impossible depending on where you are as well. 

On 2/24/2021 at 5:11 AM, ChrisRoss said:

The rate limiting step may well be the availability of insurance, including evacuation insurance which will vary depending upon your country of residence and also depending where you propose to travel availability of flights might be an issue.   Evacuation to a decompression chamber may prove difficult or impossible depending on where you are as well. 

I agree, there are more obstacles to consider, not just personal infection and virus spread.

We will refrain from air travelling to distant destinations in the foreseeable future. It is too uncertain for us (we can not effort the time for cancelled flights and weeks of quarantine after holidays).

Only single day diving to nearby lakes at the moment. As soon as my wife will get her vaccination also (she is younger than me and not working in a hospital environment, so it may take many weeks from now), we will, however, make diving holidays by car to the Mediterranian, as always...

Wolfgang

Hopefully this will help. I had a job in Belize in February prior to me having my vaccine. I had spent 45 days down there prior to the pandemic and kept up with the locals weekly. They have taken the virus very seriously and still require a mask anywhere you go. Including going for a walk by yourself. After talking with them I felt that the job could happen. 

I was tested 4 days before, the day before, three days before I left Belize and 4 days after. At no point did I not feel safe or feel that I was endangering the people. We were smart, outside and masked up in the situations needed. I was in a small village that has only had 11 cases since the start. 

I know in Belize they are allowing people in without all the red tape IF you have been fully vaccinated. 

Be safe and be mindful of other people. If you are able to choose an airline that is still keeping middle seats open that is a great peace of mind. We used Delta who was doing this. 

-Dave

Good to hear that Belize is open again for vaccinated people...

In the meantime there are also guidelines from DAN for the safety of vaccinated divers (but beware and look again before diving, these guidelines are updated as more experience is gained): https://www.daneurope.org/readarticle?p_p_id=web_content_reading&p_p_lifecycle=0&p_p_mode=view&p_p_col_id=column-1&p_p_col_count=1&p_r_p_-1523133153_groupId=10103&p_r_p_-1523133153_articleId=14891675&p_r_p_-1523133153_articleVersion=1.0&p_r_p_-1523133153_articleType=General+Web+Content&p_r_p_-1523133153_commaCategories=NEWS&p_r_p_-1523133153_commaTags=&p_r_p_-1523133153_templateId=5993844&fbclid=IwAR0j_61Kk3nxRM65z32QqrWNx5WGLWSTA61VkvZVpCRp9xREF9NEvZUXjZQ

Wolfgang

On 4/5/2021 at 6:36 AM, DFason said:

Hopefully this will help. I had a job in Belize in February prior to me having my vaccine. I had spent 45 days down there prior to the pandemic and kept up with the locals weekly. They have taken the virus very seriously and still require a mask anywhere you go. Including going for a walk by yourself. After talking with them I felt that the job could happen. 

I was tested 4 days before, the day before, three days before I left Belize and 4 days after. At no point did I not feel safe or feel that I was endangering the people. We were smart, outside and masked up in the situations needed. I was in a small village that has only had 11 cases since the start. 

I know in Belize they are allowing people in without all the red tape IF you have been fully vaccinated. 

Be safe and be mindful of other people. If you are able to choose an airline that is still keeping middle seats open that is a great peace of mind. We used Delta who was doing this. 

-Dave

Can you recommend a dive resort with knowledge of trips out to Mayan ruins?  Planning on a trip late May-early June this year.