Covid-19 infection on a liveaboard at the Maldives

[Dan]

Here are some Q&A between our trip leader & Emperor after the incident:

1. “Q: Were your staff from that boat also required to quarantine for 14 days - and were they subject to the same conditions?
   A: Yes all staff were/are required to isolate for a minimum of 14 days. – staff were sent to a different facility much the same as the one where the guests were taken. Isolation/quarantine onboard is not allowed at present based on the rules from the ministry of health in the Maldives.
2. Q: How often is your staff tested for COVID and if one of your staff does test positive, what is your procedure for sanitizing the boat and removing and quarantining the rest of the staff from that particular boat?
   A: The crew stay on board therefore only have contact with other crew members and the guests each week. If one staff were to test positive, all crew and guests if onboard are required to isolate for 14 days, we fumigate the boat over 24 hours and then can have another crew join as per the HPA regulations. We have been testing staff only when we have had positive cases or close contact cases
3. Q: I know you said that the group from Australia cancelled, but will there be others not from our group on the boat? We all see each other regularly here at home and know that our friends practice safe distancing and wear masks, but we cannot know if strangers from other countries practice the same standards.
   A: We do have a further 12 guests booked on board, a variety of nationalities, one small group of 4 from Spain, the rest are solo travellers or travelling as part as a couple. All guests are of course required to present a negative PCR test on arrival into the Maldives, this should help reduce the risk of anyone onboard having covid.
4. Q: Is wearing masks mandatory on the boat in the salons, dining room and at the dive briefings where people are in close quarters?
   A: Once guests are onboard the team explain to them that the boat is now a bubble and request that all guests wear masks in the inside communal areas and follow the sanitising recommendations and social distancing while onboard. We have santiser stations around the boat. We explain it’s the guest responsibility to follow the rules.

It may help to put a bit of perspective on the article you have read, we have been running between 1– 4 boats weekly in the Maldives since September 2020 and this is the first case of covid we have had on board and the first time we have had guests need to quarantine in the Maldives.

I hope this helps, please let me know if there any further questions or concerns and I will be happy to help answer them.”

 

[wedivebc]

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?

Your hypothosis seems flawed since people who are travelling are more likely not less to have the virus. Those of us who are rigidly following guidelines are less likely to be infected than those travelling. I have missed out on 3 trips to Cozumel and one to Scotland that I had already paid for since the covid outbreak.

 

[drrich2]

Your hypothosis seems flawed since people who are travelling are more likely not less to have the virus. Those of us who are rigidly following guidelines are less likely to be infected than those travelling.

Counter-argument:

1.) Many people who aren't traveling don't rigidly follow the guidelines.
2.) Many people who do travel get tested in preparation for travel, and some learn they're positive and cancel or reschedule their trips. Most in the general population don't get tested unless symptomatic (and often not then).

People who travel may be higher risk to contract the virus than the general population, during their travel period, but how much higher a risk, and whether that elevation is unacceptable, aren't so clear. And the people one is amongst at an airport have hopefully largely screened negative recently.

Even so, yes, I admit people who rigidly adhere to guidelines can bring their risk even lower than that. But I suspect only a minority of non-travelers fit that description.

 

[chillyinCanada]

Here are some Q&A between our trip leader & Emperor after the incident:

1. “Q: Were your staff from that boat also required to quarantine for 14 days - and were they subject to the same conditions?
   A: Yes all staff were/are required to isolate for a minimum of 14 days. – staff were sent to a different facility much the same as the one where the guests were taken. Isolation/quarantine onboard is not allowed at present based on the rules from the ministry of health in the Maldives.
2. Q: How often is your staff tested for COVID and if one of your staff does test positive, what is your procedure for sanitizing the boat and removing and quarantining the rest of the staff from that particular boat?
   A: The crew stay on board therefore only have contact with other crew members and the guests each week. If one staff were to test positive, all crew and guests if onboard are required to isolate for 14 days, we fumigate the boat over 24 hours and then can have another crew join as per the HPA regulations. We have been testing staff only when we have had positive cases or close contact cases
3. Q: I know you said that the group from Australia cancelled, but will there be others not from our group on the boat? We all see each other regularly here at home and know that our friends practice safe distancing and wear masks, but we cannot know if strangers from other countries practice the same standards.
   A: We do have a further 12 guests booked on board, a variety of nationalities, one small group of 4 from Spain, the rest are solo travellers or travelling as part as a couple. All guests are of course required to present a negative PCR test on arrival into the Maldives, this should help reduce the risk of anyone onboard having covid.
4. Q: Is wearing masks mandatory on the boat in the salons, dining room and at the dive briefings where people are in close quarters?
   A: Once guests are onboard the team explain to them that the boat is now a bubble and request that all guests wear masks in the inside communal areas and follow the sanitising recommendations and social distancing while onboard. We have santiser stations around the boat. We explain it’s the guest responsibility to follow the rules.

It may help to put a bit of perspective on the article you have read, we have been running between 1– 4 boats weekly in the Maldives since September 2020 and this is the first case of covid we have had on board and the first time we have had guests need to quarantine in the Maldives.

I hope this helps, please let me know if there any further questions or concerns and I will be happy to help answer them.”

I noticed that they left out the part about the booze coming aboard out at sea. Heehee

 

[uncfnp]

Your hypothosis seems flawed since people who are travelling are more likely not less to have the virus. Those of us who are rigidly following guidelines are less likely to be infected than those travelling. I have missed out on 3 trips to Cozumel and one to Scotland that I had already paid for since the covid outbreak.

Drrich2’s hypothesis is valid. He is referring to disease prevalence within a given population and is one of the considerations when evaluating how accurate a test is. It has nothing to do with who is more likely to get infected.

 

[wedivebc]

Counter-argument:

1.) Many people who aren't traveling don't rigidly follow the guidelines.
2.) Many people who do travel get tested in preparation for travel, and some learn they're positive and cancel or reschedule their trips. Most in the general population don't get tested unless symptomatic (and often not then).

People who travel may be higher risk to contract the virus than the general population, during their travel period, but how much higher a risk, and whether that elevation is unacceptable, aren't so clear. And the people one is amongst at an airport have hopefully largely screened negative recently.

Even so, yes, I admit people who rigidly adhere to guidelines can bring their risk even lower than that. But I suspect only a minority of non-travelers fit that description.

My experience is that most of the divers in my circle of friends are not travelling right now. In Canada we seem to be taking covid more seriously from what I perceive based on posts made on social media.

 

[Dan]

My experience is that most of the divers in my circle of friends are not travelling right now. In Canada we seem to be taking covid more seriously from what I perceive based on posts made on social media.

Different place has different attitude towards the pandemic situation. Air travel from Houston to Belize is about the same period as from Houston to Miami, guess where I would rather go during this pandemic situation?

A trip to Miami doesn’t require the negative PCR test while a trip to Belize does. So I would not know whether the person, whom would be sitting next to me for 2 hour flight to Miami, would carry the virus or not, while the one, that would be flying to Belize, at least has the negative PCR test within 72 hours of the flight. Also I saw more mask deniers in Houston than in Belize. I’ll be going to a safer environment.

 

[Joneill]

Counter-argument:

1.) Many people who aren't traveling don't rigidly follow the guidelines.
2.) Many people who do travel get tested in preparation for travel, and some learn they're positive and cancel or reschedule their trips. Most in the general population don't get tested unless symptomatic (and often not then).

People who travel may be higher risk to contract the virus than the general population, during their travel period, but how much higher a risk, and whether that elevation is unacceptable, aren't so clear. And the people one is amongst at an airport have hopefully largely screened negative recently.

Even so, yes, I admit people who rigidly adhere to guidelines can bring their risk even lower than that. But I suspect only a minority of non-travelers fit that description.

Agreed - I have not travelled and follow CDC guidelines on masking and social distancing, don't eat out, etc., - but that is no guarantee that I won't get infected. I have never been tested so, for all I know, I may have already had it. I know many people who have tested positive for antibodies but never had been sick, including my parents and sister - all of whom strictly followed CDC guidelines and were not travelling. So, I don't think folks can say that people that are travelling are more likely to have the virus. From what I've seen, it seems that most spread is from larger indoor gatherings where people are not being careful.

 

[tridacna]

Different place has different attitude towards the pandemic situation. Air travel from Houston to Belize is about the same period as from Houston to Miami, guess where I would rather go during this pandemic situation?

A trip to Miami doesn’t require the negative PCR test while a trip to Belize does. So I would not know whether the person, whom would be sitting next to me for 2 hour flight to Miami, would carry the virus or not, while the one, that would be flying to Belize, at least has the negative PCR test within 72 hours of the flight. Also I saw more mask deniers in Houston than in Belize. I’ll be going to a safer environment.

Dan, it's not about YOU traveling to a safer environment. It's about what YOU and OTHERS are bringing with them to that environment. This argument should not be about I or ME. It's about keeping others safe by not introducing them to the virus.

 

[Centrals]

We in HK is still picking up infected person from aboard regularly at our airport even they have possessed -ve test report.
All arrival will be required to book in designated hotels for 14-21 days and will be monitored regularly.
It is NOT just about individual.
The test result is only valid(?) up to the time of the testing ie you can get infected afterward or even recently infected but the number of the antibody was beyond detection. the incubation period of this virus is incredibly long.

Coronavirus Update (Live): 114,977,663 Cases and 2,549,506 Deaths from COVID-19 Virus Pandemic - Worldometer

2.5M did not survive and the number is still rising.
Nearly 50,000 new cases in USA alone.