The COVID-19 pandemic and maritime telemedicine: 18-month report.

BACKGROUND: The onset of the coronavirus disease 2019 (COVID-19) pandemic has greatly impacted maritime telemedicine services. The aim of this study is to describe the impact of the pandemic, both quantitatively and qualitatively, by analysing the teleconsultations by doctors from the French Tele-Medical Assistance Service (TMAS). MATERIALS AND METHODS: We carried out a descriptive observational study of retrospective data from the TMAS files. The main inclusion criterion for the files was a diagnosis of "influenza due to an unidentified virus". We extracted the following data: type of ship, gender, age, nationality, role on board, reason for the call and symptoms, number of calls, navigation zone, severity, medical decision, whether or not a COVID-19 test had been carried out, and treatments prescribed on board. RESULTS: One hundred and ninety-nine files were included of which 39 (20%) were clusters. We were able to analyse data from 384 patients. The study population comprised 376 suspected COVID-19 patients, of whom 334 (87%) were symptomatic and 42 (10.9%) asymptomatic. Eight (2.1%) patients were not thought to have COVID-19 but their call was related to the pandemic. Of the symptoms presented by the patients, fever was the most frequent (n = 196; 59%), while 129 (39%) presented a cough, 60 (18%) a headache, 41 (12%) non-specific ear, nose, throat signs, and 40 (12%) dyspnoea. Two hundred fifty-two (75%) patients stayed on board, 55 (17%) were disembarked, for 14 (4%) a ship diversion was arranged, and 13 were evacuated including 4 medical evacuations. CONCLUSIONS: The most important problem encountered related to managing asymptomatic or pauci-symptomatic patients at sea, which was the subject of the majority of calls. The TMAS doctors played an important role in managing the pandemic by emphasising the need for social distancing and quarantine procedures at sea to limit the spread of the virus, while adapting to the sometimes difficult implementation conditions and logistics for medical decision and quarantine.

COVID-19 and French Medical Maritime Teleconsultation.

Introduction: The coronavirus disease 2019 (COVID-19) epidemic has impacted both land and maritime health services. The purpose of this study is to describe the calls received by the Tele-Medical Assistance Service (TMAS) in relation to this epidemic. Methods: From March 1 to 30 April 30, 2020, all records coded by TMAS doctors as "influenza due to an unidentified virus" were extracted. The following data were collected: patients' age, gender, nationality, role on board, type of ship, area of navigation, reason for the teleconsultation, patient's symptoms, whether or not a COVID test had been carried out, and treatment given. The data were analyzed in two groups, depending on the reason for the consultation: teleconsultation for suspected COVID patients and teleconsultation for non-COVID patients for whom the call was nevertheless related to the COVID pandemic. Results: Sixty-one records were included-51 for suspected COVID patients and 10 records for COVID-related problems (six patients whose treatment had stopped due to shortage of medication/one patient reporting a psychiatric problem associated with isolation, three patients followed up as contact cases). Forty-five patients presented with fever when the first call was made (88%) and 39 had a cough (76%). On closure of the medical records, 33 were receiving treatment on board (65%), 10 had disembarked (20%), 1 had been rerouted (2%), and 7 had been evacuated (13%). Discussion: TMAS was able to aid professional sailors as well as passengers/recreational sailors in terms of telemedicine (diagnosis and monitoring), logistics (barrier actions and isolation), and operations (evacuation and repatriation).