This space is created to compile comments, observations, or concerns from 395P staff on the content and implementation of the COVID Mitigation Protocols Established for Safe JR Operations (COPE) established by the JRSO.

Precruise

Communication

Comment 1: 

Comment 2:

Travel

Comment 1: I'm not sure if this is feasible, but would be possible to avoid stamping out of the country until closer to when the ship sets sail, in situations where we spend an extended port-call before the expedition? I'm not sure of the logistics/legality but it seems like it would be easier in case of seeking medical attention or returning to the hotel is necessary, in the event of a major outbreak.

Comment 2: Stamping out of country is controlled by the country

Comment 3: In COPE point 2.3: COVID-19 RT-PCR testing is strongly recommended prior to departure. This test should be mandatory and no more than 72 hours before departure, or following the rules of the country of destination. There should be an open space for options when doing so is not possible due to the regulations of the country of origin.

Comment 4: In COPE point 2.2 says 'Shipboard participants will shelter at home 14 days prior to departure from home'. 

In COPE point 6 says 'Everyone onboard will follow Siem Offshore's procedures'

In COPE point 7.6 says 'If the laboratory examination of the suspect case is positive for COVID-19 then all close contacts are likely to be quarantined for 14 days according to instructions from the competent authorities'.

After reviewing these three points and taking into account that the Captain decided, as a precaution and to keep all personal onboard safe, not to allow anyone to board the ship without going through the 14 days quarantine. Could be safer that also the personal returning home wait 14 days before do it, because: There is a probability of having been in contact with a positive case, PCR reach its highest effectivity on day 8, during the trip exists the possibility to spread it to the people that is around and arriving home could be spread into each ones family. Also, by doing the 14 days quarantine before traveling home, the three points mentioned above will be followed and the same safety policy will be apply before and after an expedition.

Hotel

Comment 1: Hotel did not seem as well-equipped to handle us as the one in Norway. Next time it would be great if it was clearly communicated that we were not to have contact with hotel employees, e.g. food left at door instead of waiting for us to get the door, no refreshments served at check-in. Also would it be good for us to get into our "pods" earlier on? We could get staggered hotel test times based on our pods, seating within our pods on the bus, etc. This would help with contact tracing, in the event that someone tests positive. As noted below, hotel testing this time was somewhat disorganized and IODP employees were neither isolated from each other, nor from Siem employees.

Comment 2: The check in process was somewhat clustered. 

Comment 3: Checking in was a complete cluster.

Comment 4: Hotel with Balconies should be a priority. Online info says that no matter what the air filtration systems are at a hotel, the number one thing is fresh air to help prevent the spread. My room had one window that could open about 8 inches. Not good enough for days in a hotel. The mental health of the employees should also be a priority, having a balcony could ease any stress a staff member has of being locked inside. A balcony during isolation should be consider a necessity.

Comment 5: A balcony in every room has to become a requirement for any length of quarantine. Being able to have access to fresh air cannot only be made available for smokers. A window that you can crack is not sufficient and cannot under any circumstances be interpreted as "fresh air". Access to direct sunlight is essential in the times of the current pandemic. Our skin generates vitamin D from sunlight, as shown in the following Dermato-Endocrinology article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897598/  Our immune systems's ability to fight Covid-19 greatly depends on sufficient levels of vitamin D in our system. https://www.nature.com/articles/s41598-020-77093-z  

Comment 6: Following comments 4 and 5. Fresh air and sun light are extremely important, both for physical and mental health during several days of quarantine. In that order having rooms with balcony were the sun arrives at least for a couple hours each day becomes one of the important determinants when electing a hotel.

Even thinking about the possibility of renting vacation apartments instead of hotel rooms to pass the quarantines may be more advisable in these cases. A vacation apartment (of course with a balcony) offers the individual, not only more living space, but more isolation and the possibility of expanding and organizing their way of eating in a healthier and more convenient way according to their diet, which would help to keep the immune system strong. The departments not only have the possibility of home delivery but also provide the possibility of cooking if the person feels safer in this way. Another attraction of this type of apartment is that they are usually cheaper than hotels.

Testing

Comment 1: We were all scheduled for the same time for the two tests done in the hotel, so we were all waiting in the hallway and the common room for long periods of time. We were in a hot, narrow hallway with limited to no ventilation, not able to space out 6 feet in some cases. Some of us were waiting in line upwards to 30 minutes. In the common room for the first test (the size of a hotel living room suite), 4 Siem personnel were in the room the entire time talking, some eating or drinking, while we rotated in as one person left after testing, where 4 of us would sit on couches and chairs next to each other also in the suite (so at all times for the first test, there were 8 people in that room). This whole structure should be overhauled, as there was no reason this many people had to be gathered in small spaces at any given time during "quarantine". There needs to always be a spaced out testing structure.

Comment 2: We got tested almost immediately upon landing, then 48 hours later, and moved to the ship less than 72 hours after landing. According to the CDC website after traveling internationally: "Get tested 3-5 days after travel AND stay home and self-quarantine for 7 days after travel". Even if we can't quarantine in the hotel for 7 days, the testing schedule should be re-evaluated to at least have 72 hours between landing and getting tested one of the two times. We ended up getting tested again after moving to the ship because someone tested positive in the hotel, which we knew before moving to the ship. This third test wasn't originally planned, but it needs to be!

Comment 3: Addition to Comment 2. If any CSS does test positive twice at the hotel, every CSS onboard should be tested again 48 to 72 hours after boarding the vessel. At this point only IODP were retested, along with a few Siem personnel. This is insufficient, as we ALL had used the same testing location at the same time at the hotel, had touched the same pen to sign the testing form and had been unmasked for the duration of the test, breathing in the same air that the positive CSS had been breathing out only moments before. Testing every CSS one more time after boarding the vessel is an inexpensive measure to mitigate the risk of a Covid-19 outbreak onboard.  

Comment 4: I am concerned that the spacing of the tests was inadequate to minimize the chances of false negative results. It's been widely reported in the media that PCR tests have a false negative rate that goes down with time since exposure (https://www.acpjournals.org/doi/10.7326/M20-1495 article stating that the probability of a false-negative result in an infected person is around 67% on day 4 (AKA 96 hours)). Our hotel tests were at 1 and 48 hours after potential exposure during travel, while our first ship COVID test was 72 hours after our potential exposure to infected crew member. For reference, typical time of symptom onset is on day 5. In the future, perhaps we should do no less than 5 days in the hotel, with the two tests occurring as late as possible within that time period.

Comment 5: The COPE protocol does not take into account the incubation period of the virus. As test results are becoming available faster, the protocol must include a statement on respecting the incubation period with a minimum 5-day hotel quarantine. Our quarantine was cut short this time, and a virus that had been picked up either traveling or upon arrival at the hotel did not have sufficient time during the shortened quarantine to produce a positive test result. 

Comment 6: The COPE protocol should make three tests for every CSS during the hotel quarantine the new standard. This is an insignificant expense compared to allowing the virus aboard the vessel. The last one of the three tests should be arranged as late into the hotel stay as possible. 

Comment 7: The COPE protocol should state the standard protocol only to be followed in case no CSS test positive. In case of two positive test results for any CSS or a positive result in the last of the three tests, the protocol should specify a different procedure to be followed. Nearly all CSS will have some contact with other CSS during travel, upon arrival and/or during testing. In case of two positive test results or a positive result in the last of the three tests, all CSS having arrived or tested together with the positive CSS should remain in the hotel for a minimum of two extra days on top of the 5-day standard. This will allow for the incubation period of the virus. The amount of additional days will depend on when the potential exposure to the positive CSS had occurred. During this extra time at the hotel, all CSS in question will undergo an additional PCR test. 

Comment 8: Every positive result should be treated as a true positive until a negative result is obtained. There has been a lot of assuming that a positive result must be a false positive. Any CSS that have tested positive should not be allowed out into the test waiting room with others. They should be tested last after all other CSS have exited the testing area. 

Comment 9: We should be called to the testing room one at a time, we had phones in our room and this could have easily been done. For future tests I recommend one person at a time in the testing room.

Comment 10: I did appreciate having the room set up with coffee and water, there is never enough water provided and to be able to get new bottles and coffee helped with the quarantine. But the testing should not have taken place in the same room, and there should be a '1 person only' policy. No chatting, or drinking the provided beverages in there. In reality a 'common room' is a direct contradiction of quarantine or isolation.

Comment 11: Testing was too soon after arrival into Cape Town, if the virus was caught on the plane we were in the pre-symptomatic stage. I agree with comment 4 and state again we should do no less than 5 days isolation with a test as late as possible on day 4.  Link to the paper is posted again here (same paper as in comment 4)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240870/  Results copied from that paper: "Over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21". Further questions may be answered here https://www.aamc.org/news-insights/your-covid-19-testing-questions-answered.

Comment 12: New Nature Communications article that looked at quarantine effectiveness in offshore oil and gas industry sites and recommends a seven day quarantine with testing 24 hours before release from quarantine. Figure 1 is especially informative. https://www.nature.com/articles/s41467-020-20742-8

Comment 13: First test should be done 72 hours after arrival and start quarantine, follow by 2nd test 48 hours after the 1st. As we start to see the 5 day pattern currently. 

Comment 14: Testing each CSS in their own hotel room should be made a new policy standard. This will be a significant safety improvement as all will no longer be sharing the air in the common (sometimes very small) testing room. We must not ignore the fact that masks do come off for the duration of the testing. 

Comment 15: Once onboard, frequent testing of all personnel should continue for as long as the vessel remains in port. Even in the case of a short port call, at least one vessel wide test should be performed - one person at a time, in open air on the dock. A canopy tent can be used for this purpose.

Comment 16: The quarantine period in the hotel changed from five days to three days. This surprised me and others – we were booked into the hotel from 2 to 7 February. The Cope document says five days for the quarantine period, but also time enough for two Covid tests – it can be read both ways. We now know that three days is not enough, and it was questioned at the time. What was the discussion and decision-making process for going from five to three days quarantine at the hotel? It was not clear who is in charge. 

Comment 17: JRSO staff and ship crew lined up in a windowless corridor for the two Covid tests at the hotel. This was risky, as recognized by those of us in the line. It is not covered specifically in the Cope document, but it shouldn’t need to be – it should be a basic quarantine practice. We don’t know whether the JRSO staff member caught the virus during travel or in the Covid testing line at the hotel. This is an easy one to fix for future port-calls.

Comment 18: In COPE point 4.2.3 says 'The shipboard complement will moved onboard after been screened on the dock...If not, then the individual returns to the hotel for two days to see if symptoms resolve, and possibly test again for COVID-19'. An option to avoid that personal that matches this last point get in contact to other members of the crew could be to perform this check at the hotel, before leaving the room.

Comment 19: Although a PCR test is the most effective method to detect COVID-19, maybe a combination of antigen and PCR during the quarantine days, could be useful to detect positives early. The effectivity of the antigen test depends on the manufacturing laboratory, so it depends on the country which ones are available. According to WHO their sensibility should be greater than or equal to 80% and their specificity greater than or equal to 97%. Antigen tests are recommended to be done before day 5 or 7.

Shipboard Protocol

Mask Use

Comment 1: Not everyone was mask compliant. There were many instances within the first few days alone when people were seen without masks in common areas, and many people were wearing masks underneath their noses.

Comment 2: RE problems with masks slipping under noses, IODP/ODL etc could agree on a regulation mask, which they would provide or at least have more abundantly accessible to all crew members (including Siem and Entier). Some types of masks seem less likely to slip than others (especially certain kinds of fabric masks).

Comment 3: Face to Face crossovers should be discouraged. We do not need to meet face to face for handing over. As we see from this expedition the person(s) crossing over with someone(s) infected may have spent a couple hours with an infected individual.

Comment 4: One option for daily onboard crossovers, if they are needed, is to perform them in open spaces.

Comment 5: In COPE point 4.2.3 says: 'Off-going CSS will depart the vessel prior to the oncoming CSS arriving, except for essential personnel for which in-person crossover are required'. I really encourage to strictly follow this point.

Meals/Mess Hall.

Comment 1: I appreciated that once there was a positive case onboard, Entier started providing pre-wrapped sets of silverware, to minimize people rummaging around in the bin. Perhaps next time we should start this earlier.

Comment 2: I feel safer as a whole that basically all food items have been removed from the eating area after someone tested positive. At the same time, maybe there will be a safe, standard way in the future that we can obtain snacks outside meal times, as we're all used to cookie breaks out here!

Gym

Comment 1: It is nice to have the movie room as a workout space for one person at a time during the mitigation period, with plenty of isopropyl and hand sanitizer available.

Housekeeping

Comment 1: No cleaning of state rooms for first 5 days of boarding vessel. We requested that Entier NOT clean our state rooms for the first 5 days from boarding to prevent cross contamination if someone is actually carrying the virus. This obviously helped as it did not put any Entier staff at risk of entering an infected state room.

Other observations

Comment 1: By nature of their jobs, certain employees have a wider potential degree of exposure and have to interact with a larger number of crewmembers or contractors (COVID testers, hotel, agent). Do these individuals to undergo a more rigourous regimen of testing and if not, can they?

Comment 2: There should be more transparency with positive Covid cases. How can we conduct contact tracing if no one is informed of who and when?  Supervisors (IODP and ODL) need to be informed to ensure they can properly access their staff's potential contact and keep everyone as safe as possible. Notification of individuals with covid did improve as more and more cases occured onboard, but the initial case at the hotel was kept a secret until we were onboard.

Comment 3: The notification process is not transparent. LO/OPS/EPM were not notified with the first positive test result. It was only verbally communicated. This should all under the right-to-know working environment, as as long as someone is tested positive, we have an hazardous working environment

Comment 4: The ship’s doctor was recommending hydroxychloroquine as a remedy for Covid, as he told two staff at ship's safety briefing. I like Dr Jean, but this was surprising and made me wonder about his Covid advice in general. We can all look at the CDC guidelines and UNOLS portcall protocols, but in the end we’re not medical professionals, and probably there should be someone medically qualified (beyond the ship’s doctor) to check over the next version of the Cope document. 

Comment 5: The cohort concept is a good one (interacting only within a small group), but it could be applied more rigorously. It worked for mealtimes on the JR. But it could also be applied to testing at the hotel, transport from the hotel to the ship, sharing fridges on the JR, etc. 

Comment 6: I believe that a good habit could be to make the staff aware, before boarding the ship, of the importance of the security measures that must be followed. Also reminding us that not having symptoms or having a negative PCR result does not mean that we are not carriers of the virus.

Comment 7: We were very lucky this time that South Africa and the hotel allowed us off the ship once the onboard outbreak was confirmed. Quarantining the exposed and the positive asymptomatic CSS in the hotel worked very well as all further cases occurred in the hotel. We must not forget that this will not always be an option. Evacuating anyone from a "positive" vessel could prove very difficult.