Long read: The maritime world’s COVID-19 response

Workers wear protective suits and masks as they work in front of the quarantined Diamond Princess cruise ship, docked at the Daikoku Pier on February 20, 2020 in Yokohama, Japan. Credit: Tomohiro Ohsumi/Getty Images

Maritime stakeholders have reacted with varying intensities as the rate of infections and deaths from the coronavirus (COVID-19) outbreak surpasses that of SARS.

SARS and COVID-19 were caused by coronaviruses that originated from wild animals in China. Similar to SARS, COVID-19 spread beyond China, but has infected and killed many more people. As of 19 February, there were more than 74,000 COVID-19 infections and 2,000 deaths, mainly in China. SARS infected 8,096 people and killed 774 people in 2003.

Ship managers and owners contacted by Safety at Sea (SAS) said that they have been following guidelines recommended by the International Transport Workers’ Federation, which is following the International Maritime Health Association’s (IMHA’s) advice.

The IMHA has recommended regular washing of hands with soap and water, or using alcohol-based hand sanitisers, avoiding close contact with persons who are showing flu symptoms, and seeking medical advice if feeling unwell.

While IMHA has recommended that seafarers should be granted shore leave in non-affected ports, shipowners and managers should avoid procuring fish and poultry in China.

A spokesperson for Japanese shipping group NYK Line told SAS that the company is refraining from granting seafarers shore leave during calls at Chinese ports.

She said, “We are minimising crew changes in China, frequently checking [the] crew’s temperature, and reporting any flu-like symptoms to the health supervisors. Before entering any port, we gather information about restrictions related to COVID-19 from local agents. We are also minimising the intake of provisions and supplies to avoid exposing crew members to shore staff in Chinese ports. While in port, crew members have to wear face masks, as well.”

CF Sharp Shipping Agencies, a crewing agency that specialises in Filipino seafarers, said that while temperature taking of crew was conducted during the SARS and COVID-19 outbreaks, managing director Roger Storey told SAS that the COVID-19 has affected crew changeovers in greater China.

Storey said, “The Philippine Government has taken the lead by declaring a travel ban to Taiwan, China, Hong Kong and Macau and thus no seafarers can be deployed for joining ships in these countries. As a result, ship owners have rerouted their crew to alternative ports for crew change.

“Historically Singapore and Hong Kong have been the preferred crew change ports due to lower crew change costs (air fares, launch, etc) have been a lower cost. With the Philippine Govt’s travel ban to Hong Kong there has been an increase in crew changes in Singapore.”

While Hong Kong was affected by SARS as well, Storey recounted then that seafarers staying over in the territory were given strict instructions not to go out of their accommodation until the day they had to board the vessel or fly home.

COVID-19 surfaced in Wuhan city, the capital of Hubei Province, in December 2019. As it became apparent in January 2020 that the infection rate was rising, the Chinese government locked down Wuhan and various Hubei cities to stem the spread. The World Health Organization (WHO) promptly declared the situation a global health emergency.

With some ship operators advising vessels not to dock or restock supplies in certain areas of Asia, Marine Catering Training Consultancy (MCTC), a catering and training provider, issued guidelines to prevent cross-contamination in the kitchen.

MCTC’s managing director, Christian Ioannou, said, “The alarming spread of the coronavirus and the restrictions being implemented across the maritime sector mean that it’s important galley crew focus on hygiene and ensuring foods are prepared in their designated areas to prevent cross-contamination.”

MCTC said that galley crew should avoid preparing food if they are unwell and follow a robust food storage and handling regime, particularly with raw meat and dairy products.

Ships with Chinese links

Since the COVID-19 outbreak, certain maritime stakeholders became warier of ships arriving from China or which had carried Chinese passengers.

On 28 January 2020, the National Union of Seafarers of Peninsular Malaysia urged port officials to conduct stringent checks on crew members of ships arriving from China.

The union’s secretary, Zaini Nordin, noted that while Malaysian airports had begun screening passengers, the same was not yet done in seaports.

He said, “Only port health officials have the right to come on board and conduct inspections on all crew members. Health authorities should give printed handouts on the coronavirus outbreak to port workers nationwide to create awareness of the disease and to be cautious when they come in contact with workers suspected of carrying the disease.”

Subsequently, thermal scanners were placed at entry points of all Malaysian ports, repeating an action carried out during the SARS outbreak.

On 13 February, Malaysia’s Transport Minister Anthony Loke said that no cruise or cargo ships would be barred from calling at the country’s ports, saying that he was confident that screening equipment would weed out potential COVID-19 carriers.

By then, Malaysia and several other countries had refused entry to passengers who arrived from Wuhan.

Just three days later, Malaysian changed its position after COVID-19 was detected on a US passenger from Holland America Line’s cruise ship Westerdam, which had been turned away by various ports after picking up passengers from Hong Kong. The passenger was found to be unwell after arriving in Kuala Lumpur International Airport to catch her return flight home.

Deputy Prime Minister Wan Azizah Wan Ismail announced a temporary ban on cruise ships that departed or transited from Chinese ports.

Singapore and Australia went one step further, banning entry to all Chinese visitors and foreigners with a recent history of travel to China from 1 February.

Australia’s decision came days after its seafaring union, the Maritime Union of Australia (MUA), claimed on 29 January that there were inadequate checks on vessels arriving at Australian ports.

Merchant vessels are required to self-declare any quarantine or biosecurity threats before arrival at Australian ports and the union noted that many commercial ships were unlikely to have a doctor onboard.

MUA’s national secretary, Paddy Crumlin, said, “Australian workers are going out onto these vessels and have direct contact with foreign seafarers prior to them entering the port. It should not be left to these workers to provide Australia’s response to an international, viral threat.”

The Australian government released marine guidelines, saying that ships that left China on or after 1 February would not be accepted into the country’s ports.

However, Crumlin said that the government should have reacted earlier.

Singapore has attempted to keep cargo moving, despite COVID-19’s impact making authorities more cautious than previous outbreaks. During SARS, for example, Singapore had merely implemented temperature screening for all arriving and departing passengers. However, on 30 January this year, a Wuhan native working as a seafarer on a cargo ship that arrived in Singapore had tested positive for COVID-19, adding to fears that Chinese seafarers could carry the disease.

Cargo movements still had to continue, so Singapore and several countries gave no-disembarkation orders to seafarers on container vessels that had departed from any Chinese port in the last 14 days.

Caution was exercised even for other vessels, with port workers checking the temperature of disembarking crew members.

The Maritime and Port Authority (MPA) of Singapore’s chief executive, Quah Ley Hoon, said, “The general philosophy is that we take precautions for these crews, but goods and operations continue as usual.”

South Korea, meanwhile, repeated the measures taken during the SARS outbreak, such as measuring the temperature of seafarers and passengers and quarantining suspected cases.

While South Korea has only denied entry to Chinese nationals with passports issued in Hubei Province, it has stepped up checks on ferry services to and from China.

All 14 companies operating South Korea-China ferry services must monitor passengers and crew for pneumonia-like symptoms. Space on the vessels must be set aside to quarantine symptomatic passengers and crew.

Ferries should also have hand sanitisers on board, while crew members have been advised to wear face masks to minimise the risk of infection.

Cruise sector battered

SARS and COVID-19 have battered the cruise industry, especially in Asia.

During both outbreaks, cruise operators reacted in similar fashion, although COVID-19 had a greater impact in terms of infections.

During the SARS epidemic in 2003, major cruise lines screened passengers for fever before they boarded a ship and asked each guest to fill out a health questionnaire.

In instances where there was some risk, some passengers were medically screened before they were allowed to board the vessel.

Cruise operators turned away guests who came from SARS-affected areas such as mainland China, Hong Kong, and Taiwan. They also diverted ships from several Asian ports or cancelled calls to high-risk destinations, choosing to remain at sea instead.

While no cruise ship had any SARS cases, the current COVID-19 situation has turned out to be more serious.

Due to the COVID-19 coronavirus’ 14-day incubation period, infections had begun spreading by the time the 60-member Cruise Line Industry Association decided on 31 January 2020 to ban passengers who had been to China in the past two weeks.

Only a week before that, major cruise operators had called off sailings to and from Chinese ports, heeding China’s Ministry of Culture and Tourism’s directive to cease all tourism-related activities. The ministry’s move coincided with the lockdown on Wuhan and other Hubei cities to stem the outbreak.

Paranoia climbed with the infection rate and death toll. COVID-19 or not, unwell passengers or crew could stop any vessel in its tracks or warrant a quarantine.

One of Genting Cruise Lines’ ships, World Dream, carrying some 3,600 passengers and crew, was quarantined in Hong Kong on 5 February after three previous passengers caught COVID-19. Due to this, World Dream was asked to leave Kaohsiung port ahead of schedule on 4 February.

Everyone was allowed to disembark on 10 February after everyone tested negative for the coronavirus.

The worst-hit was Princess Cruises’ Diamond Princess, which was quarantined from 4 to 19 February in Japan’s Yokohama port, after a former passenger, a Hong Kong man, tested positive.

A passenger on a balcony of the Diamond Princess cruise ship, with about 3,600 people quarantined on board due to fears of COVID-19. Credit: CHARLY TRIBALLEAU/AFP via Getty Images

Princess Cruises and Holland America Line are part of British-American cruise group Carnival Corporation, whose chief medical officer, Dr Grant Tarling, said that the infected persons did not report any illness to the onboard medical staff.

By the time the quarantine ended, two passengers had died, and 619 other passengers and crew had been infected, forming the largest COVID-19 cluster outside China. As the quarantine dragged on, the mental pressure took its toll, and some passengers and crew took to social media to voice their fears. The Canadian, Italian, Israeli, US, and UK governments were among those which airlifted their nationals from Diamond Princess.

A spokesperson for Princess Cruises told SAS, “In order to assist our crew during this time, we have activated a wide variety of services including direct phone and video chat with counselors as well as spiritual and faith-based resources available 24 hours per day to provide comfort and support in seven languages.”

Harsher safeguards imposed  

Japan has adopted more stringent precautions than it did during the SARS outbreak, during which the government ordered that visa applicants in China and Taiwan be interviewed and, if necessary, that the applicant present a doctor’s certificate stating that they were SARS-free. Quarantine systems at ports were installed, including temperature checks on all passengers, regardless of their point of departure.

For the COVID-19 outbreak, however, Japan decided to deny entry to all persons arriving from China.

As for Westerdam, Cambodia allowed the ship to dock in Sihanoukville port on 13 February. However, after the aforementioned COVID-19 detection, governments scrambled to trace and quarantine the other Westerdam passengers who had dispersed around the globe.

The predicament of Diamond Princess and Westerdam sparked fears that cruise ships around Asia may be spreading the virus. Consequently, Tonga and Vietnam began turning away such vessels, even if they had not called at China.

Some cruise operators also shunned Singapore, which had 84 COVID-19 cases as of 19 February, one of the highest numbers outside China.

However, WHO executive director Michael Ryan said that cruise ship travel is a “manageable risk” and does not require a ban due to rising coronavirus fears, noting that many of the infections are in China.

Despite the risks from the COVID-19 outbreak, a measured approach has been urged for the shipping industry. Ryan asked, “If we are going to disrupt every cruise ship in the world on the off chance that there might be some potential contact with some potential pathogen, then where do we stop?”