[Answer] How To Manage COVID19 Infections Onboard A Ship?

As the Coronavirus Pandemic charters its path across the world and epicentre moves to Europe, more and more ships are at the risk of developing COVID19 infection. Keeping that in mind WHO has issued a detailed guideline on how to handle such a situation.

So here’s what you need to do in order to tackle onboard infections.

Inform WHO State Parties at the Port

The authority at the port must inform immediately its IHR NFP if a suspected case of COVID19 disease has been identified. When the laboratory testing has been completed and if the suspected case is positive for the virus that causes COVID-19 disease, then the IHR NFP shall inform WHO.

The IHR NFP will pay attention to IHR Article 43 that concerns additional health measures,
which states that State Parties implementing any additional health measure that significantly interferes with international traffic (such as the refusal of entry or departure of international travellers and/or ships, or their delay for more than 24 hours) shall provide to WHO the public health rationale for and relevant scientific information about it.

Managing contacts

After you have informed the WHO authorities, the real action of containing the virus onboard begins.

In order to avoid delays in implementing health measures, contact tracing should begin
immediately after a suspected case has been identified onboard without waiting for
laboratory results.

Every effort should be made to minimize the exposure of other travellers
to and on-board environmental exposures of the suspected case, and close contacts must be separated from other travellers as soon as possible.

All persons o board should be assessed for their risk of exposure and classified either as a
close contact with a high risk of exposure or as having a low risk of exposure.

Who are the Close Contacts?

A person is considered to have had a high-risk exposure if they meet one of the following criteria:

1.  they stayed in the same cabin as a suspected or confirmed COVID-19 case;
2.  they had close contact (that is, they were within 1 m of) or were in a closed
   an environment with a suspected or confirmed COVID-19 case −

• for passengers, this may include participating in common activities on
  board the ship or while ashore, being a member of a group travelling
  together, dining at the same table;
• for crew members, this includes the activities described above, as
  applicable, as well as working in the same area of the ship as the
  suspected or confirmed COVID-19 case, for example, cabin stewards
  who cleaned the cabin or restaurant staff who delivered food to the
  cabin, as well as gym trainers who provided close instruction to the
  case;

3. they are a healthcare worker or another person who provided care for a
suspected or confirmed COVID-19 case.

Follow-up with close contacts

If a large outbreak occurs as a result of ongoing transmission on board the ship, both crew
members and passengers should be assessed to determine whether they were exposed to the suspected or confirmed case. If it is difficult to identify the close contacts and if widespread transmission is identified, then all travellers (that is, passengers and crew) on board the ship could be considered close contacts who have had a high-risk exposure.

Until the laboratory result for the suspected case is available, all travellers who fulfil the
definition of a close contact should be asked to complete the PLF (Annex 2) and remain on
board the ship in their cabins or, preferably, at a specially designated onshore facility (if
feasible and when the ship is at the turnaround port where the embarkation or disembarkation of passengers or discharge or loading of cargo and stores takes place), in
accordance with instructions received from the port health authorities.

If the laboratory result is positive, then all close contacts should be quarantined in specially
designated onshore facilities and not allowed to travel internationally, unless this has been
arranged following WHO’s advice for repatriation, which also discusses quarantine measures.

Persons in quarantine who had close contact with a confirmed case should immediately
inform health services if they develop any symptom within 14 days of their last contact with the confirmed case. If no symptoms appear within 14 days of their last exposure, the contact is no longer considered to be at risk of developing COVID-19 disease.

The implementation of these specific precautions may be modified depending on the risk assessments for individual cases and their contacts as conducted by the public health authorities.

If the laboratory result is positive, then all other travellers who do not fulfil the definition of a close contact will be considered as having had a low-risk exposure; they should be requested to complete the PLF with their contact details and the locations where they will be staying for the following 14 days.

The implementation of these precautions may be modified depending on the risk assessments conducted by the public health authorities.

Further instructions may be given by the health authorities.

How To Guide the Passengers?

Travellers considered to have had a low-risk exposure should be provided with information and advice about:

• the symptoms of COVID-19 disease and how it can be transmitted;
• the need to self-monitor for COVID-19 symptoms for 14 days from their last exposure to the confirmed case, including fever of any grade, cough or difficulty breathing;
• the need to immediately self-isolate and contact health services if any symptom appears within the 14 days.

If no symptoms appear within 14 days of their last exposure, the traveller is no longer considered to be at risk of developing COVID-19 disease.

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Source: WHO

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