International Maritime Health Association issues advice on new coronavirus
The International Maritime Health Association (IMHA) has issued advice for shipping companies on the new type of coronavirus (2019-nCoV). The virus was first detected in Wuhan City, Hubei Province of China in December 2019. All cases in Wuhan were connected to the ‘Huanan Seafood Market’. The source of infection is clear but human-to-human transmission is possible.
Isolation means: to separate the sick from the healthy. Quarantaine means to put all contacts of a sick person in isolation as well.
Cases have been exported from Wuhan to other Chinese provinces and to Thailand, Japan, South Korea, Taiwan, Macau, Hong Kong, Singapore, Saudi Arabia, Vietnam, USA, France and Australia. Further global spread to other countries is possible. The Chinese authorities have installed travel restrictions in the affected areas in China. Health measures such as fever measurements are installed at Chinese airports, bus and train stations and at ports. Signs and symptoms of 2019-nCoV sickness: *Fever *Acute respiratory symptoms (cough, breathing problems, pneumonia) *Average time from infection to disease: 7 days *Infection from humans-to-humans may occur during incubation period (before persons shows signs of sickness) Currently, the World Health Organization (WHO) does not recommend travel restrictions. IMHA advises people to follow up what local authorities recommend and stay up to date on the latest advice.
How to protect yourself from getting infected with 2019-nCoV*Frequently clean hands by using alcohol-based hand rub or soap and water; *When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands; *Avoid close contact with anyone who has fever and cough; *If you have fever, cough and difficulty breathing, seek medical care early and share previous travel history with your health care provider; *When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals; *The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.
Specific advice to shipping crew and companies (as of January 26, 2020)*Do not restrict embarkation/disembarkation of seafarers in non-affected ports. *Do not restrict necessary ship visits by port agents, chaplains, service personnel and others. *Do not visit food markets in China. Avoid provision of fish and poultry in China. *Do not consume raw eggs, milk, meat. *For galley: Observe strict food hygiene to avoid cross-contamination. *Store facial protection for all crew (5 pieces per person). *Provide influenza vaccination, alcohol-based hand rub and facial protection to ship inspector and other company employees who travel to China. *If a person on board falls sick AND has been travelling to affected areas 2-12 days before embarkation, the person must stay in his cabin. Consult a Medical Doctor in the next port. *If a sick person is on board of the ship, fill the Maritime Declaration of Health and notify port authority
Medical assistance to seafarers in ports with Covid-19*Medical assistance to seafarers in ports with Covid-19. *The system of medical assistance to seafarers in ports is now limited due to the Covid-19 crisis. *Therefore before sending a seafarer on land for medical care the ship should bein di rect contact with the receiving medical service. *This can be arranged through the normal intermediary used in ports: shipping agent or others. *This dispatching is necessary because hospitals and clinics are not allowed and do not want to receive patients that are a risk for infection or a waste of resources because not urgent. *If a seafarer cannot land for medical care, the ship has to seek advice from a Telemedical Advisory Service or other medical advice service with experience in the matter and possible contacts on land. * If a seafarer has not had contact with anyone for 14 days with Covid-19 and is not showing any symptoms of Covid 19 they are unlikely to pose a risk and port government authorities should use discretion in dealing with non-covid cases and identify suitable aid and assistance. * Ship visitors and other intermediaries in ports should be aware of this difficult situation of seafarers and try to mediate where possible.
Testing seafarers on Covid-19*Testing a person with no symptoms by a throat swab (PCR)* is never indicated. Even if a person tests negative on day one, he/she may feel sick on day two and test positive. *Testing asymptomatic people is a waste of valuable resources. *For the same reasons, health certificates that declare an asymptomatic person “Corona-free” cannot be trusted and should not be accepted**. *A ship is a form of collective housing and therefore any person on board with respiratory symptoms has to be isolated*** in his cabin, use separate sanitary facilities and food should be put in front of cabin door, strictly avoiding any personal contact. *The condition of the patient should be followed up every day, and twice a day the body temperature has to be taken. *If possible test every seafarer with respiratory symptoms with a throat swab (PCR) to identify if they have Covid-19. If however it is clear that seafarers on board have had covid-19 or tested positive with it, caution should be exercised. *The asymptomatic part of the crew have to be followed up as “near contacts”, this means that they can continue their normal duties as long as they are asymptomatic but should exercise social distancing. Asymptomatic near contacts should pay extra attention to basic hygiene and should follow their health closely for two weeks, thereby avoiding unnecessary social interaction and wearing PPE in contact with
