Screening Arriving Crew for COVID

Professional Mariner Forum
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I’m surprised there is no topic on this subject yet, which is vital for any maritime operation anywhere the world. How do you protect crew members rotating on a ship? There’s plenty of broad direction out there on the subject, such as, “Do it”, but few actual details.

Here is one company’s Infection Minimization Plan:

  1. For crew at home, scheduled to join a ship, the HR department contacts each crew member twelve days before sailing, and asks twelve questions about their health, and the health of the people they live with, all questions slanted toward possible COVID-19 exposure.
  2. The same questions are asked five days, then two days before the crew is scheduled to arrive in port.
  3. The system works on HR personnel knowing most of the crew pretty well. Honesty is important. If the crew member is new to the company, hesitancy in answering can lead to more questions being asked.
  4. Sometimes there are gray areas to answers. The company has a contract with a medical advisor company, and access to other telemedical services. If an answer falls in a gray area, the medical advisors are consulted.
  5. Crew within driving distance are told to drive to crew rotation. They are told to wear disposable gloves when gassing up, and to chuck the gloves before they get back in the car. All food must be brought from home.
  6. Crew flying in from other parts of the U.S. are told to bring plenty of gloves, because they must wear gloves for the duration of the travel, door to door, and change the gloves at least every half hour.
  7. As the crew assembles at the port, they have a final screening with questions. Temperatures are taken.
  8. The company has bought six RVs. The arriving crew is placed two to an RV for 48 hours. Food is stocked. They can get out, ride a bike around the facility, and even barbecue. They have WIFI. But they can’t get within six feet of the other crew rotating in.
  9. After the 48 hour quarantine they can go aboard the ship.

The system is meant to minimize the level of exposure to all respiratory diseases.

What are the other plans out there?

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Could save some gloves maybe by washing them every half hour when possible. In any case should wash hands after removing gloves if at all possible unless they’re well up on sterile technique.

Each crew member ought to demonstrate (not describe) proper handwashing technique before being signed off as fit.

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Are the crew members recieving pay plus benefits for the 2 day RV quarantine?

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I think people are looking at this in a manner similar to other ARDS causing illnesses like SARS, MERS, etc. What’s different about this one is the long period of asymptomatic transmission and the as yet to be understood role of asymptomatic carriers.

I would put more resources into preparing for an episode of COVID-19 caused ARDS aboard and how to replace that person before they became severe - medical facilities along the route and be on the front line of possible treatments - Hydroxychloroquine and Azithromycin seem to be promising. A ship is a good place to get effective data from, see the Diamond Princess.

Screening is effectively impossible currently. Screening without a test done from isolation right before embarking on a vessel with a tested crew and fully sanitized vessel is not going to be effective. That is a poor use of resources as well as being impossible at this time. This is not aerosol transmitted Ebola. Some people are treating this like Ebola, I’m aware, which is going to be a problem when we actually do have an outbreak like that occur. People are getting bad habits.

So sure, do some checks, but continue to do checks aboard and have a plan for disembarking a severe case before they are in a condition that requires medical intervention the ship can’t provide. People that fall into the high risk categories, whether age or medical history related, shouldn’t be sailing right now. Other mariners are going to get this if they don’t have it already, and attempting to completely exclude it will just use up resources and kick the can down the road a few months.

Unfortunately we work in an industry where diseases spread by aerosol transmission are either contained or just a matter of time. Containment failed months ago, before this was even in the news. Flattening the curve is not about containment. There is no ‘social distancing’ on a ship where aerosol transmission is involved. Good hygiene practices are always beneficial. Health theater joining security theater is not.

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How about closing returns in fanrooms if possible? I know my ship’s main blower takes suction from a trunk that has both the main return air duct and a fresh air intake both feeding it. It may mess with the pressure differential across doors in the house though right now is not a good time to have air recirculating in the house.

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Are you saying COVID-19 is not transmitted via aerosols? Or are you saying COVID-19 is not Ebola? Did you come up with that on your own or did you read that somewhere? Try to be more clear because the virus IS transmitted via breathing.

http://www.cidrap.umn.edu/news-perspective/2020/02/unmasked-experts-explain-necessary-respiratory-protection-covid-19

CDC Infection Prevention and Control

Here is an excerpt from the above CDC link:

Mode of transmission: Early reports suggest person-to-person transmission most commonly happens during close exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs or sneezes. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity. The contribution of small respirable particles, sometimes called aerosols or droplet nuclei, to close proximity transmission is currently uncertain. However, airborne transmission from person-to-person over long distances is unlikely.

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Basic reading comprehension would make it clear that I was referring to Ebola in that sentence.

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Have you looked at a crew list on a typical US ship lately? Most of my sailors could be my father they are at such an advanced age, and most have a laundry list of ailments and medications.

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Sounds like a good time to get the younger individuals some experience. I’m aware of the ‘greying of the fleet’. Maybe some of those individuals need to revise the lifestyle they want in retirement.

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Basic reading comprehension suggests that aerosol transmission is the difference from Ebola you are pointing to, because otherwise you’d have just said “This is not Ebola”.

So what is the difference you’re talking about, and how are people getting bad habits?

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In the sentence, aerosol transmitted are modifiers to the noun Ebola. You can try to argue grammar with me, but I’m married to an English major and you’ll lose.

A good example of bad habits would be the White House press room during the daily briefings we have been receiving. It’s great that they are sitting 6 ft apart and all, but they’re all sitting in the same room breathing each others exhalations in for several hours. If we were actually trying to contain a disease spread by aerosol transmission, people would come in one by one to ask their questions, instead of shouting ‘MISTER PRESIDENT!’ after each one, or better still asking their questions via video.

Communicable diseases are not new, and there is a good bit of literature out there on the proper PPE and practices to handle them.

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Yes, this is obvious. But why are you mentioning it? Is there a form of Ebola that is not aerosol transmitted? Ah, bingo! Ebola is not aerosol transmitted. I’d forgotten.

I’d call that a bad example more than bad habits. I thought you were talking about people on the ground. The politicians at the top have proved we can’t trust their behavior, and I’m sure the doctors are going along with bad grace.

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MickAK,
My comments on your post:

The screening precautions mentioned in the OP were created by doctors working under CDC and WHO guidelines. I’ll trust their informed guidance over that of an anonymous someone on the internet. Why? You post a newspaper article filled with “maybes”. It is speculation. I’ll stick with doctors and CDC/WHO guidance, every time.

You’re giving a layman’s opinion, based apparently on reading newspaper articles. Hydroxychloroquine and azithromycin? Here’ s what Dr. Fauci says about hydroxychloroquine:

When asked if the drug was promising Friday, Fauci, standing next to Trump, said “the answer is no” because “the evidence you’re talking about … is anecdotal evidence.”

This sentence is poorly crafted. You are correct in that the case of the Diamond Princess will result in data for scientists and doctors. But a layman cannot derive data from it, since data requires a rigorous protocol for gathering. The only things a layman can gather from the Diamond Princess case are impressions, and perhaps fear.

This statement is incorrect. One reason is the way the statement is written. There are tests for the novel coronavirus referred to as COVID-19. Hence, you can be screened for it, to the degree you can access the test. Hence, the first sentence is factually incorrect.

Also factually incorrect. On several levels:

  1. The screening steps mentioned in the OP are not meant to eliminate all chances of COVID-91 getting on a vessel. They are designed to reduce the chance meaningfully. Your statement is, however, an absolute statement (“… is not going to be effective”). Hence, it is incorrect.
    2)Your statement: "Screening without a test done from isolation right before embarking on a vessel with a tested crew” is categorical, and like most categorical statements made outside the realms of physics and chemistry, likely to be incorrect. What if the screened person you mention got aboard a vessel with a crew that had been at sea for 48 days with no COVID-19? Since neither groups have the virus, none can be transmitted. Hence your assertion is incorrect.

That’s not what doctors following guidance from CDC and WHO are saying. Why, therefore, are you saying it? How can screening be a poor use of resources? To make such a statement you must have knowledge of the resources available to each company, which you do not.

This statement relies on half truths and conjecture. Some mariners will get the virus: true. But most mariners, statistically speaking, won’t. This statement .…attempting to completely exclude it will just use up resources… is incorrect. See my reasoning above.

IMO, this is a poorly worded assertion, We have had “…diseases spread by aerosol transmission…” for all of human history, the common cold being one. The statement is so overly generalized as to be useless to the subject at hand.

Shipping is the life’s blood of the world. If shipping stops, people starve. Now I’d like to hear from the people who have to make screening plans.

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Security Theater is Bruce Schneier’s way of characterizing measures that are more showy than effective.

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I am not sure how ‘The above screening guidelines are not necessary and probably ineffective for this outbreak’ qualifies as fear mongering. I feel like you may have been arguing with people spreading misinformation and fear somewhere else, and your post was a knee-jerk reaction based on those interactions. Run some of the numbers and maybe we can have a discussion.

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I’ve exchanged some PMs, with MickAK. In one of my posts I suspected him of being a state actor troll. I retract this suspicion, and I apologize to him for that. He is a fellow American mariner, who believes in the strength of his facts and opinions. I do, however, stand by my own facts and opinions in this thread.

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Spoken like a gentleman.

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I assume most vessel operators have screening plans in place. Are they working? A side effect of a robust COVID19 screening plan, if it is working, is that it would screen out common respiratory illness, too, like flu.

So are the screening plans working? Are crew members coming aboard ill with common respiratory illnesses (colds, flus), or are even these being excluded from vessels, at a time of the year when they are all too common?

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A very good graphic article in the Seattle Times, with statistical information about the symptoms of COVID19. Good, because this type of information tends to be anecdotal, and on the internet skewed towards the exception, rather than the norm. The information comes from WHO, King County Public Health, and doctors with University of Maryland and University of California, among other sources.

  • 99% of the people who have the virus will have symptoms.
  • On average, symptoms appear 5-6 days after infection, but may appear as few as 2 days, or as long as 14 days after exposure.

Many screening plans rely on mariners self-isolating 14-days before boarding the ship. While a mariner could show symptoms after 14-days of robust self-isolation they are not likely to do so, and if this were the case the symptoms would likely show up before boarding the vessel. There are no guarantees to this, but the idea of a screening plan is to play the percentages.

  • 87.9% of people with symptoms have a fever.
  • 67.7% have a cough.
  • 18.6% have difficulty breathing.
    Why is this important? If you’re repeatedly checking with mariners in self-isolation to see if they can sail, a case of the sniffles without a fever has a very low chance of being COVID19. Of course, you would consult with a doctor. But if your job is to staff a vessel, or you are a captain at sea with a worried crewmember with the sniffles, knowing the statistics allows you to make informed decisions.

https://www.seattletimes.com/seattle-news/health/facts-about-novel-coronavirus-and-how-to-prevent-covid-19/

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A quick and dirty chart of how long the virus survives on common surfaces.

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