Cruise Ships, Nursing Homes, and Prisons as COVID-19 Epicenters: A “Wicked Problem” With Breakthrough Solutions?

I was not surprised that some of the earliest signs of COVID-19 outside of China were outbreaks on cruise ships. Several years ago, during a month on a 500-passenger cruise ship, I learned firsthand how rapidly viral infections can travel through those floating communities. I was the trip physician; the month was December; respiratory virus season had arrived early that year; and we unknowingly welcomed several unwanted guests when our passengers boarded in Nassau. Within 2 weeks, more than half the passengers were actively coughing and the clinic was inundated.