7 April 2020

Updated 30 April 2020

COVID-19 mechanism of transmission and the clinical signs of the disease

Cases of pneumonia caused by a new coronavirus (SARS-CoV-2) were detected in China in December 2019. The disease is often referred to as the COVID-19 infection.

The new coronavirus is mainly spread as a droplet infection when an infected person coughs or sneezes. The virus does not stay in the air. It is possible for the virus to be transmitted via direct and indirect contact such as touching a surface that has droplets on it from sneezing, coughing or the direct touch of an infected person. However, coronaviruses do not stay on surfaces for several days in varying temperatures. There are no known cases of infection via items.

The incubation period of the disease is estimated at 2–14 days, with an average of about 4–5 days. According to current knowledge, most f the infected people have had mild symptoms, but there have also been patients with severe symptoms. Severely ill people have usually been elderly (over 70 years of age), and many of them have also had underlying illnesses. See risk groups listed on THL’s (Finnish Institute for Health and Welfare) website.

Mild symptoms – do as follows

If the symptoms of the disease are mild and the person does not belong to any risk group, a diagnosis made by a doctor is generally not required, and the person can recover on board. Mild symptoms include runny nose, cough, sore throat, muscle aches or fever. However, the patient’s condition should be monitored and certain symptoms require immediate treatment.

Serious symptoms – do as follows

If the patient develops severe symptoms, such as shortness of breath, or trouble breathing, and if their general condition weakens, ask for guidelines through the TMAS system (link to guidelines on when to seek treatment THL)

Many other microbes can also cause respiratory track infections with symptoms similar to those caused by the new coronavirus, meaning they cannot be distinguished on the basis of clinical symptoms alone.
See THL’s home care guidelines).

Risk groups

If people belonging to the risk groups (THL) work on board, it is recommended that, where possible, they would be moved to ships sailing near the coasts to ensure access to medical care as soon as possible.

Due to the current COVID-19 pandemic, when sailing on European waters, we must also bear in mind that country-specific medical care resources have changed dramatically, concerning the seriously ill.

General protection measures on ships

  • No-one should to work when sick. Adherence to general hygiene guidelines on board ships is particularly important because the staff spend long periods of time in the same premises, both at work and in their free time, which increases the risk of spreading infectious diseases.
  • Close contact should be avoided in dining and relaxations areas, and breaks should be scheduled in such a way that as few people as possible occupy the areas at the same time.

Respiratory track infections are best avoided by adhering to hygiene guidelines regarding hand washing and coughing and sneezing. It is important to thoroughly clean hands with soap and/or disinfectant.

Guidelines in case of illness on board

Measures in the event of a crew member suffering from a mild respiratory infection on board. The infection may be COVID-19 or another respiratory tract infection.

  • The patient should avoid close contact with others. They must stay in their cabin for at least seven days. If the patient still has symptoms after the 7-day period, they should remain in the cabin until they have had no symptoms for at least 24 hours. A respiratory tract infection usually clears up by resting for about one week.
  • When you are sick, it is important to rest and drink adequate amounts of water. Fever and pain can be relieved with medicine available from the ship’s pharmacy.
  • hygiene guidelines regarding hand washing and coughing and sneezing.
  • If it is necessary for the sick person to move outside their cabin on board, they should use a mouth and nose mask (whenever possible).
  • The patient’s condition should be monitored and, if necessary, a doctor should be consulted.
  • When visiting the patient’s cabin, try to maintain a distance (of more than 1 metre) and ensure good hand hygiene.
  • Protective equipment such as that used for protecting the mouth and the nose, or FFP2/3 respirators, should be reserved for those caring for a sick crew member and for those who have been instructed in the use of protective equipment.
  • A maritime declaration of health must be submitted before entering port in accordance with the requirements of the port or country concerned.

When should a doctor be consulted?

A doctor should be consulted if the sick person belongs to a risk group (THL) or if they develops severe symptoms, such as shortness of breath and/or their general condition weakens. Please note that microbes other than the coronavirus can also cause serious infections. The doctor will make a risk assessment and decide whether the sick person should be evacuated from the ship.

Cleaning, laundry and housekeeping

Cleaning guidelines are available on FIOH’s website.

Measures to be taken when a respiratory tract infection is confirmed as a case of COVID-19

If a respiratory tract infection is confirmed while a member of the crew affected by COVID-19 is on board, proceed in the same manner as described above under “Guidelines in Case of Illness on Board”.

A maritime declaration of health must be submitted for the case in accordance with the requirements of the port or country concerned before entering the port. Local health authorities will decide on further action.

If the respiratory tract infection is confirmed as a case of COVID-19 after the sick crew member has been evacuated from the ship, a maritime declaration of health must be submitted before entering the port in accordance with the requirements of the port/country.

Local health authorities will decide on further action.. The cabin used by the sick crew member must be cleaned in accordance with FIOH’s cleaning guidelines.

Further information: viestinta@ttl.fi.

The guidelines of the Finnish Institute of Occupational Health (FIOH) are drawn up together with the Ministry of Social Affairs and Health (SMAH) and the Finnish Institute for Health and Welfare. We also follow the publications of the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO).

European Centre for Disease Prevention and Control (ECDC), COVID-19

World Health Organization (WHO), coronavirus