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

Abstract

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.