Preventing COVID-19 Outbreaks Onboard the Ship

By Dr Didoy Lubaton

Medical Director for Holistic Care, Nordic Medical Clinic

2020 has been a year of overcoming challenges for many due to the COVID-19 pandemic. The Maritime industry has been trying it’s best to hurdle each wave that crashes in.

A particular challenge that has been getting attention lately is the rise of COVID-19 outbreaks on the ships. This is detrimental to the health and well-being of the Crew, impact ship operations, and pose a huge problem to solve for ship and crew managers.

As we know, we can’t control the wind, but we could adjust our sails.

What makes a ship at risk for COVID-19 outbreaks and what can we do about it?

Investing on Testing

The entry of a single case in the vessel would lead to transmission to the entire crew. Thorough screening of people boarding the ship be exercised. RT-PCR testing is the best COVID test available and is recommended for everyone –signing on crew, pilots, marine superintendents, auditors, and everyone else who has business on going onboard. Timing of testing matters too. Validity of RT-PCR test is best if done within 72 hours before going on the ship. Rapid antibody or antigen test have higher chances of missing asymptomatic carriers and is not recommended as a routine testing prior going onboard.

There are circumstances that proper testing cannot be done or hard to come by, or worse—results mays sometimes be questionable or confusing. Yes, admittedly COVID tests are not perfect tests. Even if we do our utmost for testing, cases can still be missed. What we could rely on is the right behavior of people on the ship.

Mindful Behavior on the Ship

The Japanese learned quickly from the experience with Diamond Princess as the first ship to experience a COVID outbreak. Their early lessons from this wasn’t just for the ships, but eventually became crucial for a national health preventive movement that makes Japan one of the nations to have the mildest hit despite their aging population. Early on they understood that testing and quarantine may be helpful but it is not the full solution in curbing transmission of the virus. They focused on educating the people on the right mindset and behavior, empowering each person as responsible for their own health and the health of others. They promulgated avoiding the 3C’s:

  • Closed spaces with poor ventilation
  • Crowded places with many people nearby
  • Close-contact settings, such as close-range conversations

The risk of infection is high when these three C’s overlap. We can learn from this and add more, adapted to a ship setting.

Here are some recommendations:

  • Open the windows wherever possible as much as possible for good air flow. Especially on the bridge and mess halls where meetings could take place.
  • Conversations to be kept at max 30 minutes, with masks on, in spaces with good air circulation.
  • Have dedicated areas for ship visitors to stay, no unnecessary mingling with the rest of the crew.
  • Avoid crowding in the mess hall. Take turns during meals and observe physical distancing.
  • Everyone wears a mask onboard, especially during ship visits.
  • Temperature check, signed health declaration that the person is asymptomatic, with recent RT-PCR test (within 72 hours upon boarding) for ship visitors
  • No shaking of hands. Non-physical greetings would do.
  • Encourage frequent handwashing. Make alcohol disinfectant visibly available for everyone.
  • Items used by multiple people should be frequently disinfected
  • Signing-on crew should observe self safe distancing (SSD) for 14 days onboard, until a recent COVID test 48-72 hours prior boarding shows a negative result. Best if quarantine prior boarding was observed too.
  • Self-monitoring and self-reporting of symptoms. This is very crucial in the success of preventing outbreaks on board. If in doubt, observe cabin quarantine and seek help.
  • Crew vigilance on adhering to infection protocols onboard. Protect yourself and others!

In closing, everyone should keep their guard up. Take seriously the risk and complications of an outbreak. Breaks in infection protocol compromises everyone, and everyone suffers the consequences. Think that everyone may have COVID-19 until proven otherwise. Not because of paranoia, but because it encourages you to do the right thing, for your health and well-being, and for the sake of others too.

P.S. Great news of significant developments for COVID vaccinations. This may be of good help in mitigating the risk of outbreaks onboard soon. But even when it is already rolled out and made available, this only adds to the essentials of 1) COVID testing and 2) Mindful behavior 3) Adherence to Infection Protocols as prime preventive measures to keep our seafarers healthy and our ships safe.