New COVID-19 recommendations for fully vaccinated crewmembers

(www.MaritimeCyprus.com) The US Center for Disease Control published new guidance to clarify its recommendations for crewmembers who are fully vaccinated. The guidance pertains to ships originating from or porting in the United States to help prevent, detect, report, and medically manage suspected or confirmed COVID-19 cases.

This document provides guidance for preventing the spread of COVID-19 during and after a voyage, including personal protective measures, management of sick or exposed persons on board, reporting suspected or confirmed cases, and cleaning and disinfection recommendations for common areas on the ship and areas previously occupied by individuals with suspected or confirmed COVID-19. CDC will update this interim guidance for ships as needed and as additional information becomes available.

Plans to Mitigate COVID-19 on Board Ships

Ship companies should develop, implement, and operationalize an appropriate, actionable, and robust plan to prevent, mitigate, and respond to the spread of COVID-19 on board ships. The Occupational Safety and Health Administration’s webpage, Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplaceexternal icon, provides ways to prevent workplace exposures to persons with COVID-19. Plans should include the following components:

• Training of all crew on COVID-19 prevention and mitigation
• On-board monitoring of crew and non-crew for signs and symptoms of COVID-19
• COVID-19 testing (onboard or onshore)
• On-board isolation, quarantine, and physical distancing (maintaining at least 6 feet [2 meters] from others)
• Adequate medical staffing (this can include telehealth or telemedicine providers)
• Maintaining sufficient quantities of Personal Protective Equipment (PPE), oxygen, and other supplies, and the ability to obtain additional resources, if needed
• COVID-19 outbreak management and response information
• Medical arrangements for onshore evaluation and hospitalization
• Screening of embarking or disembarking crew and non-crew
• A system to notify respective national, state, and local public health authorities

COVID-19 Vaccinations

In the U.S., people are considered fully vaccinated for COVID-19 ≥2 weeks after they have received the second dose in a 2-dose series Pfizer-BioNTech, Moderna), or ≥2 weeks after they have received a single-dose vaccine (e.g., Johnson & Johnson [J&J]/Janssen).^[1] There is currently no post-vaccination time limit on fully vaccinated status. People are considered not fully vaccinated if they have not completed a two-dose vaccination series or have not received a single-dose vaccine, regardless of age, including children under the age of 12. For the purposes of this guidance, those that are not fully vaccinated are referred to as unvaccinated.

As the majority of non-cruise ships are flagged in other countries, for the purposes of this guidance, maritime crew members on board a non-cruise ship are considered fully vaccinated if they have received the appropriate series of a vaccination authorized by a national government authority. If the maritime crew member disembarks the non-cruise ship at a U.S. port, CDC’s definition of fully vaccinated will apply.

[1] This applies to COVID-19 vaccines currently approved or authorized for emergency use by the U.S. Food and Drug Administration (e.g., Pfizer-BioNTech, Moderna, and Johnson & Johnson (J&J)/Janssen) COVID-19 vaccines. This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g., AstraZeneca/Oxford).

Pre-Boarding Procedures for Ships

Before anyone boards, conduct verbal or written screening in appropriate languages and in a private environment to determine whether persons have had signs or symptoms of COVID-19 or a known exposure (close contact) to a person with COVID-19 within the past 14 days. In addition, temperature checks should be used to identify any person with a temperature of 100.4°F (38°C) or greater.

Persons with signs or symptoms of COVID-19: Persons with signs or symptoms of COVID-19 who intend to board the ship should be denied boarding, regardless of vaccination status. These symptomatic persons should be assessed by medical personnel and either be determined not to have COVID-19 or complete isolation for COVID-19 before they are allowed to board.

Close Contacts: Unvaccinated persons who were exposed to a person with COVID-19 should be denied boarding until they complete a 14-day quarantine period.

Fully vaccinated persons who were exposed to a person with COVID-19 are not recommended to quarantine, but they should monitor their health until 14 days after their last exposure and follow guidance for testing and facemask wearing as detailed in CDC’s guidance for fully vaccinated persons. Allowing boarding is at the ship operator’s discretion but a negative test at 3-5 days after exposure is recommended before boarding.

People who recovered from COVID-19 in the past 3 months do not need to quarantine or be tested after an exposure but should take the following precautions:

• Wear a facemask indoors in public for 14 days after exposure.
• Monitor for COVID-19 symptoms and isolate immediately if symptoms develop.
• Consult with a healthcare provider for testing recommendations if new symptoms develop.

Anyone who develops symptoms of COVID-19 after an exposure should isolate until it is safe for them to be around others or they are determined by medical personnel to not have COVID-19.

Because SARS-CoV-2 the virus that causes COVID-19, can spread from persons without symptoms, ship operators should consider having embarking crew who are not fully vaccinated quarantine for 14 days immediately before or upon boarding the ship to prevent introduction of the virus on board. If testing is feasible, crew members should be tested using a viral COVID-19 test with a result available prior to boarding.

Preventive Measures for Ship Operators

Shipping involves the movement of people from different geographic areas in settings with inevitable close contact. Like other close-contact environments, ships may facilitate transmission of respiratory viruses from person to person through exposure to respiratory droplets or small particles that contain the virus or contact with contaminated surfaces.

To reduce spread of respiratory infections including COVID-19, CDC recommends that ship operators take the following actions:

• Explore options to vaccinate crew for COVID-19. This includes encouraging crew to get a COVID-19 vaccine and working with local authorities to make arrangements for crew to get vaccinated while the ship is at port. Ship operators should keep records of the vaccination status of all crew.
• Educate all persons on board about the signs and symptoms of COVID-19.
• Assign crew to single-occupancy cabins with private bathrooms, if possible.
• Implement physical distancing of persons when working or moving through the ship (maintaining at least 6 feet [2 meters] from others).
• Instruct persons to wear a facemask when outside of individual cabins (unless work duties prevent their safe use or necessitate personal protective equipment for hazardous reasons).
• Modify meal service to facilitate physical distancing (e.g., reconfigure dining room seating, stagger mealtimes, encourage in-cabin dining).
• Eliminate self-serve dining options at all meals.
• Minimize shore leave; if shore leave occurs, preventive measures are recommended.
• Discourage handshaking and instead encourage the use of non-contact methods of greeting.
• Promote hand hygiene and cough etiquette.
• Place hand sanitizer (containing at least 60% alcohol) in multiple locations and in sufficient quantities to encourage hand hygiene.
• Ensure handwashing facilities are well-stocked with soap, paper towels, and a waste receptacle or air dryer.
• Place posters that encourage hand hygiene and physical distancing to help stop the spread in high-trafficked areas.
• Educate workers that use of cigarettes, e-cigarettes, pipes, or smokeless tobacco can lead to increased contact between potentially contaminated hands and their mouths, and that avoiding these products may reduce their risk of infection.

Preventive Measures for Persons on Board the Ship

CDC recommends that all crew get a COVID-19 vaccine when one is available to them.

Persons who are fully vaccinated can follow CDC’s guidance for fully vaccinated people.

Persons who are not fully vaccinated (i.e., unvaccinated) should do the following to protect themselves and others:

• Avoid sharing personal items with other persons, such as blankets, laptops, video games, tablets and other hand-held devices.
• Wear a facemask indoors and when outside of individual cabins.
• Maintain a distance of at least 6 feet (2 meters) from others when working or moving through the ship. Note: If a 6-foot (2-meter) distance cannot be maintained in narrow corridors, then allow persons to pass completely before entering.
• Avoid physical contact with other people, including shaking hands, giving hugs, and cheek kissing.
• Avoid touching eyes, nose, and mouth with unwashed hands.
• Wash hands often with soap and water for at least 20 seconds.
• Use hand sanitizer (containing at least 60% alcohol) if soap and water are not available.

CDC has free, simple posters available to download and print, some of which are translated into different languages. The Stop the Spread of Germs poster pdf icon[PDF – 1 page] is also available in Spanish pdf icon[PDF – 1 page].

Symptomatic Persons on Board the Ship

Identifying and isolating persons with possible symptoms of COVID-19 as soon as possible is essential to minimize transmission of the virus. Educate crew to self-monitor for symptoms of COVID-19. Sick persons, regardless of vaccination status or previous recovery from COVID-19, should self-isolate immediately and inform the Captain or medical designee if they develop a fever (100.4°F / 38°C or higher), begin to feel feverish, or develop acute respiratory symptoms (cough or difficulty breathing) or other symptoms of COVID-19. All persons on board should be educated on, and aware of, the emergency warning signs for COVID-19.

Ship medical personnel and telemedicine providers should reference CDC’s COVID-19 website, Information for Healthcare Professionals, for the latest information on infection control, clinical management, collecting clinical specimens, evaluating patients who may be sick with or who have been exposed to COVID-19, and identifying close contacts. On non-cruise ships, all crew members are considered close contacts if a person with known or suspected COVID-19 is on board or disembarked within the past 14 days.

Isolation of Sick Persons or Confirmed Cases and Quarantine of Close Contacts

Persons with symptoms of COVID-19, regardless of vaccination status or previous recovery from COVID-19, should be isolated using the same procedures as a person with confirmed COVID-19 until testing can be conducted and results are available. Symptomatic persons who test positive or who are not tested should be isolated until they meet criteria to end isolation.

Quarantine of unvaccinated persons without symptoms who are identified as close contacts of sick persons (until COVID-19 test results are available) or confirmed cases is also needed to minimize on-board transmission. On non-cruise ships, all crew members are considered close contacts. Please see table below for quarantine options for crew on non-cruise ships.

• Isolate or quarantine persons in single-occupancy cabins, with private bathrooms, with the door closed, if possible. Persons should wear a facemask, i.e., facemask or surgical mask, any time they are outside of isolation or quarantine.
• Isolated or quarantined persons should have no direct contact with other persons except for medical designee.
• Designated ship medical personnel or other personnel should wear proper personal protective equipment (PPE) when in proximity to isolated or quarantined persons. Breaches in PPE or any potential exposures should be reported to the appropriate medical designee.
• Meals should be packaged in disposable dining ware with single-use cutlery and delivered to individual cabins with no face-to-face interaction during this service.
• To the extent possible, cabins housing isolated or quarantined persons should not be cleaned by other persons. Supplies such as paper towels, cleaners, disinfectantsexternal icon, and extra linens can be provided to isolated or quarantined persons so they can clean their own cabin as necessary.
• Food waste and other garbage should be collected and bagged by the isolated or quarantined person and placed outside the cabin during designated times for transport to the garbage/recycle room for incineration or offloading.
• Soiled linens and towels should be handled by the isolated or quarantined person and placed outside the cabin in labeled bags during designated times for transport to the laundry room.

Fully vaccinated persons who were exposed to a person with COVID-19 are not recommended to quarantine but they should monitor their health until 14 days after their last exposure and follow guidance for testing (if possible) and wear a facemask, as detailed in CDC’s guidance for fully vaccinated persons.

People who recovered from COVID-19 in the past 3 months do not need to quarantine or be tested after an exposure but should take the following precautions:

• Wear a facemask indoors in public for 14 days after exposure.
• Monitor for COVID-19 symptoms and isolate immediately if symptoms develop.
• Consult with a healthcare provider for testing recommendations if new symptoms develop.

Options for Managing Non-Cruise Ships with One or More Confirmed Cases of COVID-19

The following table provides management options for non-cruise ships and their crew after a confirmed case of COVID-19 is identified. Decisions regarding the best option for managing an individual ship and exposed crew on board should take into account various factors (e.g., the industry, seaport location, itinerary, and the availability of alternate crew).

Note: The ship should be allowed to come into port for all disembarkations, disinfection, and embarkations. There is an increased safety risk, to the crew and port partners, associated with embarking or disembarking a ship while at anchorage (i.e., keeping the ship at sea). In addition, quarantine of crew while the ship is at anchorage can be difficult due to the increased number of essential crew needed to safely maintain ship operations at anchor (i.e., operations are minimized on a ship while it is at a dock, which allows crew to quarantine more safely).

For more details, click below to download the full paper:

Source: CDC