WHO (World Health Organization) has acknowledged that an outbreak of Coronavirus COVID-19 has turned into a true pandemic. At present there are 134 828 cases in more than 100 countries; and 4 984 people died. Meanwhile, the Director of WHO, Dr Tedros Adhanom Ghebreyesus, is quite optimistic and claims that COVID-19 still might become the first controlled pandemic in the human history.
In these conditions the International Chamber of Shipping (ICS) has issued a comprehensive guidance for seafarers and ship operators providing instructions for the crew and passengers against the disease. They recognize the danger for the maritime community exposed to the virus and inadvertently contributing to the spread due to the international nature of shipping.
The document has been prepared in cooperation with The International Maritime Health Association (IMHA), The European Centre for Disease Prevention and Control (ECDC), IMO and WHO; it contains 22 pages and is likely to become a regulation for the time of Coronavirus pandemic.
Protective Measures Onboard
It is now confirmed that Coronavirus COVID-19 is transmitted primarily by droplets released when a sick person coughs or sneezes. Therefore, crews and passengers are instructed to exercise simple hand and respiratory hygiene:
Suspected and Confirmed Cases Onboard
Meanwhile, despite the precautionary measures a crewmember or passenger might fall ill. They are considered suspect cases if:
According to ICS procedures Ship Medical Officer or Doctor should conduct an interview and if the patient falls into one of the above mentioned categories he or she should be treated as COVID-19 Suspect case.
ICS Instructions for Suspect and Confirmed Cases
1. The suspect case should be isolated into a separate cabin or ward;
2. All persons who contacted with the sick should be traced and categorized as high risk exposure (cabin mates, immediate colleagues, recently dined at the same table, etc.) and low risk exposure (have not been in close contact with a sick person). Crew members should be asked to self-monitor symptoms of COVID -19 during the next 14 days and self-isolate and report immediately should any suspicious symptoms manifest themselves.
3. Onboard cases are handled by designated medical care providers and records should include:
3.1 Interviews of suspect cases recorded in the medical log book (symptoms, travel history, concomitant diseases);
3.2 Records of anyone visiting medical facility as a high risk exposure and protective measures taken;
3.3 Contact details of low risk exposure cases if they plan to disembark (completed Passenger Locator Form (PLF) or Maritime Declarations of Health (MDHs));
3.4 Records about COVID-19 spread onboard, disinfection, etc.
4. As per the ICS procedure, the Master should alert the competent authority at the next port of call about any suspect case to ensure that facilities are available to transport, isolate, and care for the patient.
5. WHO insists that international trade should not be hampered; and cargo and crewing operations should proceed without disruptions as far as possible. However, many countries impose their own regulation and quarantine requirements. The complete map of port restrictions is here.
6. Controlled disembarkation takes place at the next port of call. The patient must wear surgical mask; while his escort should be gowned in the PPE (gloves, goggles, gown and mask).
7. The medical samples should be transferred to the laboratory for the diagnostics and their results then reported the ship officers.
8. The ship may proceed to the next port of call if competent authorities are satisfied with the following formalities:
8.1 The public health requirements at the port of call have been adhered to;
8.2 The COVID-19 suspect case has been handled in accordance with procedures and there are corresponding reports;
8.3 Contact tracing forms and PLFs (if appropriate) are filled in properly;
8.4 There has been a proper COVID-19 information campaign onboard and crewmembers are aware of symptoms and necessary precautionary actions;
8.5 Cleaning and disinfection measures in the cabin or ward have been conducted as required.
The ICS guidance is thorough as it contains not only instructions, but safety posters you can print out and pin on board; necessary PLF forms and updated list of medical supplies that should be on every vessel while the world in trying to take over the new pandemic.