Covid-19 infection on a liveaboard at the Maldives

[Altamira]

I agree - but, unfortunately, the US (and The WHO as well) messaging/guidance has been poorly managed and inconsistent (CDC, Surgeon General, Fauci, etc.,) so it’s planted seeds of doubt that conspiracy theorists and others have seized on. I certainly respect and listen to Dr. Fauci - but don’t take his opinions as absolute gospel - he’s one input among many to consider in figuring how to best protect myself and my family.

I agree it is a good idea to consider many inputs when making any decision, especially one involving travel and precautions in this Covid environment. Unfortunately, what many people fail to consider is the fact that all opinions and inputs are not equally valid. I have many neighbors that, despite the availability of world wide evidence, still think the pandemic is a hoax, and using masks, social distancing, avoiding crowds and indoor functions are ridiculous. These folks are listening to people that are giving them inputs which are not based on fact, science, medical data, and expertise. Consequently, they continue to put themselves and everyone else at increased risk. Personally, I trust and follow what Fauci and the other medical and science experts are telling us to do at this stage of the pandemic, and have come to the conclusion many of my neighbors have lost their ability for critical thinking.

 

[chillyinCanada]

Colliam7 raises a number of good points, which lead me to a frustrating conclusion; an informed decision relies on knowing the situation, including 'what if' scenarios, and at this point, those are often unknowable these days. We could look at the original report as authoritative on how the Maldives handles COVID+ tourists detected at the end of their trip, but...the surprisingly poor execution suggests to me that 'plan' wasn't thoroughly thought out, the different parts weren't well coordinated (i.e.: the right hand didn't know what the left hand was doing), and it sounds like they hadn't run many people through this, as I take it some of those involved in dealing with the quarantined folks were surprised by some of what happened.

So, the Maldives might be handling things differently a month from now. Or two months. And even if a given dive destination knew it was going to use such a pitiful system, they would not publicize it! So we still wouldn't know (except by further reports).



You brought to mind a follow up question; wonder what live-aboards do to clean up after they get a COVID+ cases? They don't have a lot of unused rooms like some hotels. Respiratory transmission is more a danger than via touching contaminated objects, but still... Plus you've got staff who were in theory exposed.

Speaking of which, and apologies if I forgot this (we're on page 16), what happened to the live-aboard staff? Did they get quarantined and replaced (and if quarantined, were they kept in the same place as the tourists?)? Did the next group arriving to board proceed with their trip? Did that group facing quarantine get an opportunity to speak to the incoming group?

What happens if you arrive for your live-aboard trip, and find out via your smart phone that the boat you're about to get on had a COVID outbreak this past week?

I was once upon a time aboard a "sick" boat in the Red Sea. Despite the fact that many of their crew had had to take time off due to the illness, despite knowing that they'd had sick divers for weeks, with some becoming so ill, that they left for home early, I didn't notice any effort at all, to sanitize the boat.

I fell sick after dive 4 and that was the end of enjoyment for me. I was not entirely well for a couple of months following that trip. In fairness, I believe that my infection was from exposure to the severely sick man sitting near me on the way there. He never covered his sneezes or coughs. Regardless, of where I got mine, I then isolated myself as best possible. My roommate has an amazing system and didn't fall ill other than the tummy aspect, which I maintain, was from the sick boat. Many of the others also fell victim to this and eventually some of our other divers fell to the "Egyptian flu virus" or whatever it was. One of them will never be able to dive again, having damaged his ears.

It was already known to the staff and repeating divers aboard, a
as a sick boat when we came aboard.

Though I had isolated myself to my room, the staff were still aware that I was sick, yet they didn't clean the boat. They'd had sick staff and divers for weeks before we showed up and they didn't sanitize the boat.

Though some of the crew took good care of me from the perspective of bringing me meals and such, I will never board that boat again.

Erm, though it should probably be noted that it burned down, and one diver died. That was last year, iirc.

 

[scubadada]

I was once upon a time aboard a "sick" boat in the Red Sea. Despite the fact that many of their crew had had to take time off due to the illness, despite knowing that they'd had sick divers for weeks, with some becoming so ill, that they left for home early, I didn't notice any effort at all, to sanitize the boat.

I fell sick after dive 4 and that was the end of enjoyment for me. I was not entirely well for a couple of .oaths following that trip. In fairness, I believe that my infection was from exposure to the severely sick man sitting near me on the way there. He never covered his sneezes or coughs. Regardless, of where I got mine, I then isolated myself as best possible. My roommate has an amazing system and didn't fall ill other than the tummy aspect, which I maintain, was from the sick boat. Many of the others also fell victim to this and eventually some of our other divers fell to the "Egyptian flu virus" or whatever it was. One of them will never be able to dive again, having damaged his ears.

It was already known to the staff and repeating divers aboard, a
as a sick boat when we came aboard.

Though I had isolated myself to my room, the staff were still aware that I was sick, yet they didn't clean the boat. They'd had sick staff and divers for weeks before we showed up a d they didn't sanitize the boat.

Though some of the crew took good care of me from the perspective of bringing me meals and such, I will never board that boat again.

Erm, though it should probably be noted that it burned down, and one diver died. That was last year, iirc.

Strange how things work out. I had two really great weeks on the Red Sea Aggressor I in 2016. Personally, I was really surprised to hear about the fire and sinking in 2019, only 2 months after the Conception tragedy

 

[Kimela]

Though I had isolated myself to my room, the staff were still aware that I was sick, yet they didn't clean the boat. They'd had sick staff and divers for weeks before we showed up a d they didn't sanitize the boat.

That is incredibly disappointing - and a bit 'middle ages', to be honest. I don't believe we'll EVER see that sort of cavalier attitude again (so sorry that was the boat that burned too). We were on a bus tour of Europe last year and someone, of course, had a cold. By the end of the trip absolutely everyone got it. My husband missed the day in Seville (probably my favorite day) and I missed the day they visited a Berber village in Morocco (didn't sound like I missed a lot!). One of the things they could have done to prevent the spread was have us keep the same seats every day - but we rotated every day so every person would get their chance at the gorgeous panoramic view from the front seats. I'd bet/hope that's a discontinued practice going forward. We're certainly learning how to minimize transmission of all illnesses!

 

[chillyinCanada]

That is incredibly disappointing - and a bit 'middle ages', to be honest. I don't believe we'll EVER see that sort of cavalier attitude again (so sorry that was the boat that burned too). We were on a bus tour of Europe last year and someone, of course, had a cold. By the end of the trip absolutely everyone got it. My husband missed the day in Seville (probably my favorite day) and I missed the day they visited a Berber village in Morocco (didn't sound like I missed a lot!). One of the things they could have done to prevent the spread was have us keep the same seats every day - but we rotated every day so every person would get their chance at the gorgeous panoramic view from the front seats. I'd bet/hope that's a discontinued practice going forward. We're certainly learning how to minimize transmission of all illnesses!

At a minimum, everyone should have been disinfecting their own area and masks will remain a thing, at least for the sick one. Fingers crossed

 

[Dan]

I was once upon a time aboard a "sick" boat in the Red Sea. Despite the fact that many of their crew had had to take time off due to the illness, despite knowing that they'd had sick divers for weeks, with some becoming so ill, that they left for home early, I didn't notice any effort at all, to sanitize the boat.

I fell sick after dive 4 and that was the end of enjoyment for me. I was not entirely well for a couple of months following that trip. In fairness, I believe that my infection was from exposure to the severely sick man sitting near me on the way there. He never covered his sneezes or coughs. Regardless, of where I got mine, I then isolated myself as best possible. My roommate has an amazing system and didn't fall ill other than the tummy aspect, which I maintain, was from the sick boat. Many of the others also fell victim to this and eventually some of our other divers fell to the "Egyptian flu virus" or whatever it was. One of them will never be able to dive again, having damaged his ears.

It was already known to the staff and repeating divers aboard, a
as a sick boat when we came aboard.

Though I had isolated myself to my room, the staff were still aware that I was sick, yet they didn't clean the boat. They'd had sick staff and divers for weeks before we showed up and they didn't sanitize the boat.

Though some of the crew took good care of me from the perspective of bringing me meals and such, I will never board that boat again.

Erm, though it should probably be noted that it burned down, and one diver died. That was last year, iirc.

I was supposed to be on RSA1 in December 2019. Since it burned down, Aggressor used Scuba Scene liveaboard as a temporary replacement. The trip came out alright, see my trip report: BDE Trip Report, 21-28 December, 2019.

Speaking of contracting a flu while on the boat, I got it too while on Palau Aggressor 2, December 24-31, 2017 Palau Trip Report. Luckily it was towards the end of the trip. I was still able to make all the dive & to get the “Iron Diver” medal LOL. The unlucky part was the fever hit me when I was on the flight home. I collapsed & fell on the floor of the plane when waiting in-line to go to the lavatory during the flight from Koror to Honolulu. A medical doctor on the flight woke me up. They put me on the stretcher when we landed in Honolulu. Honolulu airport EMS nurse said that my body temperature was over 101F and took me to the hospital emergency.

I spent overnight in Honolulu hospital emergency room with saline IV, given a doze of Tamiflu & other stuff that I don’t remember any more. What I remember was I celebrated the New Year twice (in Koror & in Honolulu) as we pass an international dateline when flying from Koror to Honolulu. By morning my body temperature went back to normal and they let me continue my journey home.

I was glad that I had DAN travel insurance then. My health insurance paid for the $8000 medical expenses minus the deductible of $1500, which was paid by DAN. So, nothing came out of my pocket.

The lesson I learned from this is to keep the social distancing from the sick people or wear mask if the distancing is not possible.

 

[Altamira]

That is incredibly disappointing - and a bit 'middle ages', to be honest. I don't believe we'll EVER see that sort of cavalier attitude again (so sorry that was the boat that burned too). We were on a bus tour of Europe last year and someone, of course, had a cold. By the end of the trip absolutely everyone got it. My husband missed the day in Seville (probably my favorite day) and I missed the day they visited a Berber village in Morocco (didn't sound like I missed a lot!). One of the things they could have done to prevent the spread was have us keep the same seats every day - but we rotated every day so every person would get their chance at the gorgeous panoramic view from the front seats. I'd bet/hope that's a discontinued practice going forward. We're certainly learning how to minimize transmission of all illnesses!

I sincerely wish I could find my way to your optimistic view of human behavior. In my experience, it is a rare person that does not quickly revert to previous attitudes and performance once the original/immediate crisis is in the rear view mirror. I think this is especially true in those who are overworked and underpaid. A cavalier attitude about work ethic and professionalism appear to be the rule rather than the exception. That is why the same human errors keep cropping up in decades of accident reports that I have plowed through since 1969.

 

[drrich2]

Since Dr. Fauci's credibility has a bearing on informing dive tourist decisions, whether to the Maldives or elsewhere, I did a little Googling and turned up a CNN article that set out to fact check whether he lied about some things. It seems mostly 'no,' though he did slowly and deliberately raise his estimates for the vaccination rate needed to get herd immunity. Even here, it's not clear he outright lied.

Whether you give major public figures a little room to 'spin' in the pursuit of accomplishing well-intentioned agendas is up to you.

The pandemic situation and knowledge about it have evolved so fast that of course various leaders have had to change course occasionally as more information came in. So while advisories on some issues (e.g.: recommendation to wear masks) has indeed changed over time, so has the information base driving the advisories.

 

[drrich2]

Follow up hypothetical example. I figure people hitting an airport to catch a flight are less likely than the general population to have the coronavirus. Let's say...1% do. And let's say our test is 99% sensitive and 99% specific. A thousand asymptomatic travelers hit the airport one day. What will our results be?

990 Travelers are healthy and 10 have coronavirus. Everybody gets tested.

1.) Of the 10 who have coronavirus, the 99% sensitive test catches...9.9 - it rounds to 10. Really good! We need a few thousand travelers to reliably let one slip through.

2.) Of the 990 who don't have the virus...the test gives a false positive on 1%, which is 9.9...rounds to 10. So 10 false positives.

So, we've got 20 passengers out of a thousand (2%) who tested positive, and only half of them (1%) actually have the virus.

The disease prevalence rate and sensitivity and specificity rates are key issues. If your test specificity is less, you can get a lot more false positives.

The CDC has an article,
Performance of an Antigen-Based Test for Asymptomatic and Symptomatic SARS-CoV-2 Testing at Two University Campuses — Wisconsin, September–October 2020 - with some useful numbers for an example. From that:

"Antigen tests for SARS-CoV-2 are inexpensive and can return results within 15 minutes, but test performance data in asymptomatic and symptomatic persons are limited."
"Compared with real-time reverse transcription–polymerase chain reaction (RT-PCR) testing, the Sofia antigen test had a sensitivity of 80.0% and specificity of 98.9% among symptomatic persons; accuracy was lower (sensitivity 41.2% and specificity 98.4%) when used for screening of asymptomatic persons."

The important thing to note is that screening asymptomatic people gave specificity of 98.4%. Sounds good, but in my hypothetical example, we'd have 16 false positives instead of 10. And it missed most asymptomatic infected people! Nearly 6 would get through! Wonder if they'll spread it on the plane?

 

[Blackcrusader]

NO government was adequately prepared for a global pandemic such as COVID-19. NO government was fully prepared to deal with such a rapidly evolving situation. And, NO country had, or has, a health care infrastructure in place to address the sudden burden of large numbers of people who need / want to be tested for something for which there wasn’t even a test available a little over a year ago, or who need to be treated for an infection that was unknown a little over a year ago, or who need to be quarantined. )

Actually one country since Sars implemented procedures for a future pandemic since China lied even about the outbreak of Sars. It put in place thermal imaging at all ports and airports 17 years ago and anyone with a temperature was referred to see a doctor. In December 2019 it put into place quarantine and tests for any person with a high temperature or cough or runny nose and then contact traced all the people they had come into contact with. Masks become the norm and was mandatory for those in many public places or using public transport. This country has had one of the best responses worldwide and has avoided the lockdowns and surges that have occurred in other countries. Nearly all the cases were people entering through airports and were traced. Anyone entering the country had to have a sim card and location tracking and had to do quarantine. The police would call a few times a day and if you didn't answer they were at your registered address within 20 minutes. Some people broke quarantine and fines of up to US$35,750 were issued to serious offenders, one quarantine violator a few days ago is being fined US$17,800 for violating his quarantine. Testing is free for anyone referred to for the test.