Coronavirus: Implications for ships and crew

Coronavirus Peoplecopy

The following is text of a news release from Gard:

(ARENDAL, Norway) — The World Health Organization (WHO), in a statement on Jan. 30, declared that the outbreak of the novel coronavirus originating in Wuhan, China (2019-nCoV) constitutes a public health emergency of international concern (PHEIC). At the time, cases had been reported in five WHO regions in the course of one month, human-to-human transmission outside Wuhan had been confirmed, and knowledge about the virus’ transmission and infection was still limited. On this basis, the WHO decided that a global coordinated effort is needed to enhance preparedness in regions of the world that may need additional support.

Risk assessment

At time of writing, the WHO assesses the public health risk of this event to be very high in China, high at the regional level and high at the global level. The organisation does not recommend any travel or trade restriction at the moment, however, it is important to note that as the situation continues to evolve, so will recommendations and measures to prevent and reduce spread of the infection.

While outbreaks of novel virus infections among people are always of public health concern, risk depends on exposure and both the European Center for Disease Prevention and Control (ECDC) and the U.S. Centers for Disease Control and Prevention (CDC) currently considers the risk of 2019-nCoV infection to be low for the general European and American public.

What we know about 2019-nCoV

• This is a novel (new) coronavirus that has not previously been detected in people.
• The virus was first detected as the cause of respiratory illness in a group of people in the Chinese city of Wuhan but has later spread within China and to many of China’s neighboring countries, the US, Canada, Australia and Europe.
• The majority of infected people have connections to Wuhan.
• Fever, sore throat, cough, chest pain and breathing difficulties are reported as the main symptoms.
• The disease appears to be mild in many cases, but severe cases have been reported, with some fatalities.
• While the original source of this outbreak is likely an animal, human-to-human transmission has been confirmed.
• As with colds and influenza in general, transmission occurs via respiratory droplets produced when an infected person coughs or sneezes.
• There is no confirmed information about incubation time, but it is estimated to be between two to 14 days.
• There is no vaccine or specific treatment for the disease. Infected persons should receive supportive care to help relieve symptoms.
• Since this is a virus, antibiotics should not be uses as a means of prevention or initial treatment.

Port situation in China as of Feb. 6

According to local sources, no Chinese seaports have officially announced a lockdown, except for the inland river port of Wuhan. However, ports have implemented strict prevention and control measures, such as declarations of crewmembers’ health condition prior to ships’ entry, monitoring of crewmembers’ body temperature, gangway checks of people attending from ashore, etc. If there are any Chinese crewmembers on board, local authorities may ask if the crewmember has visited Wuhan or made close physical contact with anyone from Wuhan in the past few weeks. Websites of regional Maritime Safety Authorities (MSA), such as Shanghai MSA and Shandong MSA are useful sources of information for owners and managers.

Our correspondent has provided a summary of the protection and control measures implemented by authorities of each major Chinese port as of Feb. 3. However, measures taken at different ports can change quickly depending on development of the situation and even at the same port, different requirements may be in place at different terminals. We therefore strongly recommend that ship operators and masters check with their local agents to obtain up-to-date information in advance of calling at Chinese ports.

It is also worth noting that additional port control measures may adversely impact the rate of loading and discharging operations leading to delays. Besides seaports, there are strict restrictions on the land side in China such as lockdown of some cities and stoppage of public transport operations. As a result, ship operators could face operational issues, such as arranging for surveyors, service engineers and supplies, or even delays in port operations, due to labour shortage.

Quarantine measures in ports other than in China

We expect that most port health authorities will, as a precautionary measure, be on a heightened state of alert in order to identify crewmembers displaying relevant symptoms for ships and crews that have previously called at any Chinese port.

Many countries and ports have already implemented specific quarantine measures for ships arriving from China. One example is Singapore. The Maritime Port Authority of Singapore (MPA) has implemented temperature screening of passengers and crew at all sea checkpoints. In addition, persons with a travel history to China in the previous 14 days will not be allowed to enter Singapore. However, the MPA does emphasise that “ships can continue to berth at terminals to carry out operations." Other countries, such as the U.S., also require ships to proactively report any suspect or actual illness cases to local health authorities after arrival. Some ports authorities, such as the Port of New Orleans, may even impose a fine on ships that do not accurately report the health condition of crewmembers.

BIMCO has since Jan. 23 collected information on control measures implemented by port states and port authorities around the world. In a news article published Feb. 5, the organization summarizes its findings so far and states that the information gathered seems to point in the direction that the further away a port is from China, the less restrictive are the precautionary measures imposed. In general, ports and coastal states require a declaration on any of the following:

• Declaration on health
• Temperature measurements
• Information on sick or deceased crew or passengers
• Information on previous port calls
• Information on crew or passengers’ travel history, i.e. if they have been in China within the previous 14 days as a minimum.

The consequences depend very much on the port state, BIMCO says. It ranges from quarantine of individual crew members or passengers to quarantine of the ship until the expected incubation period of 14 days has passed.

Regular updates on control measures implemented by countries and ports around the world are also published under the health and medical support for crew section on BIMCO’s website (login is required but non-members can register for free).

The situation may change quickly and it can be difficult to maintain a full overview of port restrictions being enforced at any given time. We therefore strongly recommend that ship operators and masters stay in close contact with local port authorities and ships’ agents to obtain the most up to date and reliable information about the type of quarantine measures in force in a given port. 

Precautions which can be taken by ships and crew

It is very important to raise the awareness among crewmembers so that they are aware of the risks and precautions to be taken. The International Maritime Organization has provided some advice for seafarers and shipping. Some flag states have also highlighted the importance of ensuring seafarers are properly informed, such as in MS notice 02 of 2020 by the Directorate General of Shipping in India. Crew are recommended to:

• Cooperate fully with the health authorities and make an honest disclosure of the crew health on board.
• Practice good hygiene.

Some of the good practices mentioned by WHO are:

• Wash hands frequently.
• People with symptoms should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
• Avoid close contact with others if you have a cough and fever and seek medical help.
• Practice food safety, such as by cooking the food items thoroughly.

When calling ports in China and other countries experiencing an outbreak:

• Reduce ship-shore activities by reducing ship-shore exchanges, boarding inspections, internal audits, external audits, maintenance and other activities. Unnecessary boarding visits should be prohibited.
• Strengthen gangway or ladder control by implementing stricter ISPS procedures. It would include enhancing the stairway control, checking the credentials of all personnel boarding the ship, and checking their temperatures and logging it. If any shore personnel are suspected to have flu-like symptoms access should be denied.
• Entry of agents, tally, foremen, suppliers and other foreign personnel into the crew living area should be restricted to reduce contact between ship and shore personnel.
• Strengthen self-prevention, e.g. by wearing surgical masks, and not interacting with others on board or ashore if there are flu-like symptoms.
• Restrict shore leaves in ports. 

In the event of a suspected diagnosis of 2019-nCoV infection onboard a ship, seek immediate expert medical opinion. The master should report the event as soon as possible to the next port of call, to allow the competent authority at the port to arrange, depending on the situation, medical evacuation or special arrangements for disembarkation and hospitalization of the patient and laboratory diagnosis. In addition, consider implementing the following list of measures on board the ship when a crew member or passenger shows symptoms compatible with the disease:

• Keep the patient’s cabin doors closed, if not placed in a medical isolation room on board.
• Provide information about the risk of disease transmission to persons who will take care of the patient or enter the isolation area.
• Maintain a log listing everybody who enter the cabin.
• Anyone who enters the cabin to provide care to the person in isolation or to clean the cabin must wear appropriate personal protection equipment (PPE). A surgical protection mask is particularly important.
• Limit the movement and transport of the patient from the cabin for essential purposes only. If transport is necessary, the patient should wear a surgical mask.
• Start case investigation immediately. Wear appropriate PPE when interviewing the patient.
• Identify the patient’s close contacts and ask them to do passive self-monitoring of any symptoms.

At the request of a government port health authority, it may be necessary to provide information on passengers’ itinerary and their contact details. Ships may also have to complete and deliver the Maritime Declaration of Health as per Annex 8 of the International Health Regulations (IHR). Measures taken on board should be noted on the Ship Sanitation Control Certificate (IHR Annex 3).

By Professional Mariner Staff