Coronavirus - overview and shipping guidance for Members
By: Nigel Griffiths, The Marine Advisory Medical Service, Singapore
The shipping industry is likely to be impacted in a number of ways by the emergence of COVID-19: not only through disruption to voyages to and from China, but also from delays in other countries as a result of quarantine and port checks due to cases, or suspected cases, of the coronavirus amongst crew and passengers on board vessels.
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. The continued increase in the number of cases, and the number of affected countries over the last few days, are clearly of concern. The virus found to cause COVID-19 was initially isolated from a clinical sample on 7 January. It is notable that within weeks following the identification of the virus, a series of reliable and sensitive diagnostic tools were developed and deployed.
The main signs and symptoms of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, myalgia or arthralgia, sore throat, and headache. Nausea or vomiting has been reported in a small percentage of patients (5%).
WHO epidemiologists have been monitoring developments continuously and have now increased the assessment of the risk of spread and the risk of impact of COVID-19 to very high at a global level. The key to containing this virus is to break the chains of transmission. The virus is transmitted from a sick person to a healthy person through respiratory droplets when the sick person coughs, sneezes or talks close to another person. Current diagnostic tests have occasionally yielded positive results from seemingly asymptomatic people. These positive results are not a conclusive indication that asymptomatic people are contagious. People may have been exposed and infected but are NOT necessarily transmitting the disease. More investigations into potential other routes of transmission are ongoing. What has been reported so far it that the main driver of transmission is droplet transmission from people with symptoms.
COVID-19 is spreading with astonishing speed; COVID-19 outbreaks in any setting have very serious consequences; and there is now strong evidence that non-pharmaceutical interventions can reduce and even interrupt transmission.
WHO Guidelines to reduce transmission are as follows:
First, as we keep saying, clean your hands regularly with an alcohol-based hand rub, or wash them with soap and water. Touching your face after touching contaminated surfaces or sick people is one of the ways the virus can be transmitted. By cleaning your hands, you can reduce your risk.
Second, clean surfaces regularly with disinfectant – for example kitchen benches and work desks.
Third, educate yourself about COVID-19. Make sure your information comes from reliable sources – your local or national public health agency, the WHO website, or your local health professional. Everyone should know the symptoms – for most people, it starts with a fever and a dry cough, not a runny nose. Most people will have mild disease and get better without needing any special care.
Fourth, avoid traveling if you have a fever or cough, and if you become sick while on a flight, inform the crew immediately. Once you get home, make telephone contact with a health professional and tell them about where you have been.
Fifth, if you cough or sneeze, do it into your sleeve, or use a tissue. Dispose of the tissue immediately into a closed rubbish bin, and then clean your hands.
Sixth, if you are over 60 years old, or if you have an underlying condition like cardiovascular disease, a respiratory condition or diabetes, you have a higher risk of developing severe disease. You may wish to take extra precautions to avoid crowded areas, or places where you might interact with people who are sick.
Seventh, for everyone, if you feel unwell, stay at home and call your doctor or local health professional. He or she will ask some questions about your symptoms, where you have been and who you have had contact with. This will help to make sure you get the right advice, are directed to the right health facility, and will prevent you from infecting others.
Eighth, if you are sick, stay at home, and eat and sleep separately from your family, use different utensils and cutlery to eat.
Ninth, if you develop shortness of breath, call your doctor and seek care immediately.
Tenth, it’s normal and understandable to feel anxious, especially if you live in a country or community that has been affected. Find out what you can do in your community.
Considerations for Masters of vessels:
- Only persons cleared by local port officials, authorities and the Master should be allowed on board, including marine/harbour pilots, technicians, ship agents, etc.
- Limit visitor access to the vessel as much as possible.
- Crew disembarkation from the vessel whilst in port must be minimised and allowed only in absolute need situations.
- Minimise interpersonal exchanges with persons from ashore, avoiding contact with people who show symptoms of flu or high temperature and taking care of personal hygiene including more frequent handwashing, etc.
- Limit, as much as possible, shore side persons direct access to internal spaces of the vessel.
- If possible, designate a central location/room with direct access from the outside and enclosed toilet to receive authorized persons from shore in order to avoid unnecessary physical contact and possible contamination inside the vessel.
- The Masters should take precautions to minimize the potential spread of the virus among seafarers if symptoms appear. Isolate the seafarer to a location preferably with segregated ventilation and different than the common areas used by seafarers such as, seafarers lounge, gym, mess rooms, etc.
- If authorized persons need to enter the vessel, ensure they are wearing or, if possible, provide them with applicable mask and gloves.
- Avoid shaking hands.
- Wipe down areas and items visitors have touched or may have touched with disinfectant wipes and/or sprays.
- Handwashing is the best way to reduce the risk of infection being transmitted from one person to another.
- Ensuring proper training and providing information and education on the virus for the workforce including how the virus spreads, how to prevent the virus in order to prepare workers and how to dispel myths, fears and misconceptions.
- Keeping up to date with details of the affected areas through WHO’s Disease Outbreak News.
- Be aware and respect any quarantine restrictions that any country / port may apply, and of any requirements by Port Health in this respect.
- Engaging with safety managers and ensure there is continual and ongoing communication with workers, providing updates on the outbreak and training refreshers and drills as and when required.
Dr Tedros Adhanom, Director General of the WHO tells us that whilst scientists are looking for way to manage the disease, “Our greatest enemy right now is not the virus itself. It’s fear, rumours and stigma. And our greatest assets are facts, reason and solidarity.”
Coronavirus - overview and shipping guidance for Members » the above text in pdf format (2 March 2020)
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