News: Contingency planning onboard ships in response to the Coronavirus (COVID-19)

A sharp increase in the number of deaths and infected cases with Coronavirus disease 2019 (COVID-19) was reported on 12 February following a new test scan method which is now being used in Hubei province, China. WHO has stated that it was “way too early” to predict the end of the epidemic and the director-general has warned that “this outbreak could still go in any direction”.

Due to the global nature of the maritime industry it is imperative that ship owners prepare a contingency plan to deal with an unfortunate situation if one or more crew members were to get infected.

Research is ongoing on the surveillance, epidemiology, diagnostics, clinical care and treatment to manage the disease and limit onward transmission. WHO states that human-to-human transmission can occur through droplets, contact and fomites like the previous SARS and MERS outbreaks.

The club has prepared the following advice basis the guidelines issued by WHO and health ministries of various governments. It can be used as a basic reference for ship owners in preparing and educating the crew about the Coronavirus disease 2019 (COVID-19). The club strongly recommends that in a real situation, advice should be taken from experts and in accordance with the flag state and local health authorities.

Generic precautions

• Wash hands frequently with soap and water or use an alcohol-based hand rub (with at least 60% alcohol concentration) as it eliminates the virus if it is on your hands.
• Practice respiratory hygiene when coughing and sneezing, cover mouth and nose with flexed elbow or tissue – discard tissue immediately into a closed bin and clean your hands/arm with alcohol-based hand rub or soap and water.
• Maintain social distancing of at least 1 meter (3 feet) between yourself and other people, particularly those who are coughing, sneezing and have a fever. Avoid shaking hands or touching surfaces. Coughs or sneezes can project small droplets containing the virus. If you are too close, you can get infected by the virus.
• Avoid touching eyes, nose and mouth as the hands touch many surfaces which could be contaminated with the virus. If one touches their eyes, nose or mouth with contaminated hands, then they can transfer the virus from the surface to themselves.
• If a crew member with recent travel history to an infected area (or if he might have interacted with someone who has a recent travel history to an infected area) develops symptoms such as fever, cough or difficulty in breathing, then seek medical care early
• If a crew member has mild respiratory symptoms and no travel history to or within China then they should still practice basic respiratory and hand hygiene and stay isolated until they recover.
• Avoid consumption of raw or undercooked animal products

Advice on the use of medical masks

• Wearing a medical mask is one of the prevention measures to limit spread of certain respiratory diseases, including COVID-19, in affected areas. However, the use of a mask alone is insufficient to provide the adequate level of protection and other equally relevant measures should be adopted.
• Individuals with respiratory symptoms should wear a medical mask and seek medical care if experiencing fever, cough and difficulty breathing.
• Place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask.
• While in use, avoid touching the mask.
• Remove the mask by using appropriate technique (i.e. do not touch the front but remove from behind).
• After removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled.
• Replace masks with a new clean, dry mask as soon as they become damp/humid;
• Do not re-use single-use masks.
• Discard single-use masks after each use and dispose of them immediately upon removal.
• If medical masks are worn, appropriate use and disposal is essential to ensure they are effective and to avoid any increase in risk of transmission associated with the incorrect use and disposal of masks.

Advice on caring for a patient

In the unlikely event that the patient is unable to be transported to a medical facility below guidelines should be followed as far as practicable:

• Communication link with a health care provider should be established for the full duration of the care period until the patient fully recovers or is transported to a medical care facility ashore.
• Health care personnel should be involved in reviewing the current health status for the progression of symptoms.
• The patients and other crew members should be educated on personal hygiene, basic infection prevention and control measures, on how to care for the suspected infected crew member as safely as possible, and to prevent spread of infection.
• Place the patient in a well-ventilated single room.
• Limit the number of caretakers of the patient, ideally assign one person who is in a good health without risk conditions. No visitors.
• Other crew members should stay in a different room.
• Limit the movement of the patient and minimize shared space.
• The caregiver should wear a medical mask fitted tightly to the face when in the same room with the ill person. Masks should not be touched or handled during use.
• Perform hand hygiene following all contact with ill persons or their immediate environment.
• When using soap and water, disposable paper towels to dry hands is desirable.
• Respiratory hygiene should be practiced by all, especially ill persons, at all times.
• Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves to provide oral or respiratory care and when handling stool, urine and waste. Perform hand hygiene before and after removing gloves.
• Gloves, tissues, masks and other waste generated by ill persons or in the care of ill persons should be placed in a lined container in the ill person’s room before disposal
• Avoid other types of possible exposure to ill persons or contaminated items in their immediate environment (e.g. avoid sharing toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths or bed linen).
• Eating utensils and dishes should be cleaned with either soap or detergent and water after use and may be re-used instead of being discarded.
• Clean and disinfect frequently touched surfaces such as bedside tables, bedframes, and other bedroom furniture daily with regular household disinfectant containing a diluted bleach solution (1-part bleach to 99 parts water).
• Clean and disinfect bathroom and toilet surfaces at least once daily with regular household disinfectant containing a diluted bleach solution.
• Clean clothes, bedclothes, bath and hand towels, etc. of ill persons using regular laundry soap and water or machine wash at 60–90 °C with common household detergent, and dry thoroughly. Place contaminated linen into a laundry bag. Do not shake soiled laundry and avoid direct contact of the skin and clothes with the contaminated materials.
• Use disposable gloves and protective clothing (e.g. plastic aprons) when cleaning or handling surfaces, clothing or linen soiled with body fluids. Perform hand hygiene before and after removing gloves.
• Persons with symptoms should remain isolated until they can be transferred to a medical facility
• All crew members should be considered contacts and their health should be monitored.

Sanitation and Hygiene in accommodation and galley

a) Personal Hygiene

• Monitor temperature twice daily.
• Crew should report to their supervisor, and stay away from fellow colleagues if they feel unwell.
• Wear a mask if they have a cough or runny nose.
• Cover their mouth with a tissue paper when coughing or sneezing and dispose of the soiled tissue paper in the rubbish bin immediately.
• Wash hands thoroughly with soap and water.
• Cover all wounds or cuts on their hands with waterproof plasters.
• Practice good toilet habits (e.g. flush toilets after use and then wash hands).
• Practice good personal hygiene (e.g. after clean-up is carried out, after handling refuse or other dirty items, and after visiting the toilet).
• Use gloves when carrying out cleaning work and when handling waste.
• Use gloves when clearing items discarded on the tables such as used tissue papers and tooth picks.
• Refrain from touching their exposed body parts such as face and arms with soiled gloves.
• Wash and disinfect cleaning equipment thoroughly immediately after use.

b) Food Hygiene

• Food workers must wash hands

-  before starting work

-  before handling cooked or ready-to-eat food

-  after handling or preparing raw food

-  after handling waste

-  after cleaning duties

-  after using/flushing the toilet

-  after blowing nose, sneezing or coughing

-  after eating drinking or smoking

• Do not prepare or handle food if you feel unwell (for e.g. vomiting, diarrhea or fever) or if you have infected wounds, skin infections or sores.
• Ensure all products are obtained from licensed food sources and are within their use-by dates.
• Cook food thoroughly. Keep hot food above 60^oC.
• Cover food properly to prevent contamination.
• Provide serving spoons where deemed necessary.
• Do not keep personal belongings in food preparation areas. A separate locker area should be provided for storage of personal belongings.
• Do not use cracked or chipped crockery as germs can harbour in the cracks.
• Use separate chopping boards, knives and other instruments for raw and cooked foods to prevent cross contamination.
• Use clean disposable gloves when handling food.
• Store raw food and cooked/ready-to-eat food separately.
• Keep food preparation areas and premises clean and pest-free, and ensure preparation surfaces, utensils and cooking equipment are clean, and ensuring good housekeeping practices.

c) Housekeeping/Refuse Management

• Assign a dedicated team of staff to carry out cleaning and housekeeping daily.
• Disinfect frequently touched areas such as doorknobs and tabletops with disinfectants regularly.
• Goods must be properly stored and stacked above floor level to facilitate cleaning of the premises.
• Provide sufficient refuse pedal bins lined with plastic bags with tight covers in the common areas.
• Ensure crew quarters, cooking, dining and laundry facilities are maintained at high level of cleanliness at all times.
• Ensure refuse bins are covered at all times and clearly marked. Bins in common areas should be cleared daily.
• Clean up any refuse spillage immediately.
• Wash and disinfect all refuse bins in common areas and galley daily.

d) Toilets

• Disinfect frequently touched areas such as water taps, door/towel/cistern handles, seats and cover flaps, wash basins, doorknobs, buttons and switches with disinfectants regularly.
• Provide adequate supply of toilet paper, paper towels (if provided) or hand dryers and liquid soap at all times.
• Ensure toilet-flushing apparatus is functioning at all times.
• Ensure that all sanitary pipes and fittings are in good working condition.
• Avoid sharing the same toilet as the patient where possible. If it is not practical to do so, avoid using the toilet at the same time and clean toilet surfaces more frequently.
• You may also wish to allow some time to pass between toilet usage, in order to allow any remaining water droplets after showers to settle to the ground.
• Sharing the same roll of toilet paper is safe as long as the toilet roll is not stained, soiled or wet. 
• Sharing of towels is not advised.

e) Pest Control

• Keep the premises free of food scraps to keep pests away.
• Check the premises daily and remove all potential vector breeding sites.
• Look for signs of pest infestation such as rodent droppings or burrows and cockroach droppings.
• Engage a registered pest control operator to implement a pest control programme if required.

f) Recreational Facilities

• Disinfect any exercise or recreational equipment including remote controls for electronic devices, telephones, bridge/Engine control panel buttons etc with disinfectants daily.
• Ensure the premises is free of litter and pest.

Members should remain vigilant and we recommend members to check with the local agents and club correspondents on the latest information required before entering port and contact us in case they need any assistance. We strongly recommend the member to follow the advice from WHO which is available here and stay safe.

Category: COVID-19