Dear Reader:

Thorax is one of the world’s leading respiratory medicine journals, publishing clinical and experimental research articles on respiratory medicine and more. Here is a recent article from three days ago (thorax. bjj. com/ content/ early/ 2020/05/27), all that follow is quotes:

“We describe what we believe is the first instance of complete Covid-19 testing of all passengers and crew on an isolated cruise ship during the current Covid-19 pandemic. Of the 217 passengers and crew on board, 128 tested positive for Covid-19 on reverse transcription-PCR (59%). Of the Covid-19 positive patients, 19% (24) were asymptomatic; 6.2% (8) required medical evacuation; 3.1% (4) were intubated and ventilated; and the mortality was 0.8% (1). The majority of Covid-19-positive patients were asymptomatic (81%, 104 patients)…

The expedition cruise ship departed from Ushuaia, Argentina, for a planned 21-day cruise of the Antarctic Peninsula, including Elephant Island.. The ship departed mid- March 2020, after the global Covid-19 pandemic was declared by the WHO, with all 128 passengers and 95 crew screened for Covid-19 symptoms, and body temperatures were taken before boarding. No passengers or crew that had transit through China, Macau, Hong Kong, Taiwan, Japan, South Korea or Iran in the previous 3 weeks were permitted to board, given that these countries were where Covid-19 infection was most prevalent at the time. Multiple hand hygiene stations were positioned throughout the ship and especially in the dining area… all passengers and crew had regular body temperature reviews performed by the ship’s two physicians.

The first recorded fever on board the ship was a febrile passenger on day 8. Isolation protocols were immediately commenced, with all passengers confined to cabins and surgical masks issued to all. Full personal protective equipment was used for any contact with any febrile patients, and N95 masks were worn for any contact with passengers in their cabins.  The crew still performed duties, including meal services to the cabin doors three times a day, but rooms were not serviced…

Further fevers were detected in three crew on day 10, two passengers and one crew on day 11, and three passengers on day 12.. The majority of febrile patients had improved with symptomatic treatment and were afebrile on arriving at Montevideo. Rapid testing kits for Covid-19 were delivered on board and performed on six passengers and crew, who had initial fevers. All returned negative results on day 14… Three additional passengers and crew developed fever on day 14, but with mild cough and lethargy only. One of these passengers, a 68 year old man who was a lifelong non-smoker with no comorbidities, deteriorated and required urgent medical evacuation to a hospital in Montevideo on day 17. He was intubated and ventilated and tested positive for Covid-19.

A total of eight passengers and crew were medically evacuated from the ship to hospitals in Montevideo, all for impending respiratory failure, including a 70 year old woman with chronic obstructive pulmonary disease (evacuate day 20), a 65 year old woman with no comorbidities (evacuated day 21), and two crew and one passenger evacuated on day 22. A seventh passenger, a 68 year old man, developed fever on day 23 and was evacuated for hypoxaemia on day 24. One of the two ship physicians required medical evacuation on day 27 also for hypoxaemia. All evacuated patients subsequently tested positive..

Of the 217 passengers and crew on board, 128 tested positive for Covid-19 (59%)… There were 10 instances where two passengers sharing a cabin recorded positive and negative results.

Despite 128 (59%) of the population testing positive, fever and mild symptoms were present in only 16 of 128 Covid-19 positive patients (12.5%), with another 8 medically evacuated (6.2%) and 4 requiring intubation and ventilation (3.1%). There has unfortunately been one death to date (0.8%). There were therefore a total of 24 Covid-19 positive patients who were symptomatic (19%), with the majority being asymptomatic (104 patients or 81%).

From the departure date in mid-March 2020 and for the next 28 days, the expedition cruise ship had no outside human contact and was thus a totally isolated environment in this sense.

We conclude from this observational study that.. The majority of Covid-19 positive patients were asymptomatic (81%).. there may be a significant false-negative rate with RT-PCR testing. Follow-up testing is being performed to determine this… The timing of symptoms in some passengers (day 24) suggests that there may have been cross contamination after cabin isolation”-

– more about this article, later.

anita

• This reply was modified 4 years, 6 months ago by .