Vol 71, No 4 (2020)
Original article
Published online: 2020-12-30

open access

Page views 5445
Article views/downloads 1281
Get Citation

Connect on Social Media

Connect on Social Media

Telemedical assistance at sea in the time of COVID-19 pandemic

Getu Gamo Sagaro1, Gopi Battineni1, Nalini Chintalapudi1, Marzio Di Canio2, Francesco Amenta12
Pubmed: 33394487
IMH 2020;71(4):229-236.


Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aetiological factor of COVID-19 infection, poses problems in providing medical assistance at sea. Ships are in an isolated environment, and most of the merchant ships do not carry medical personnel or medical supplies. Telemedicine offers a real possibility to provide reasonable quality medical assistance to seagoing vessels. The fact that ships may touch ports in affected areas, the difficulties for seafarers to be assisted ashore due to quarantine measures and the crews’ lack of turnover make medical assistance at sea difficult. This study has compared maritime telemedical assistance data before and during the COVID-19 pandemic to propose prevention measures.

Materials and methods: The study was based on the data from medical records of Centro Internazionale Radio Medico (C.I.R.M.) database of seafarers assisted from January 1 to June 30, in the years 2017–2020. The data were collected separately for each year. Age, sex, rank, and pathologies affecting the assisted seafarers were considered. Common signs of COVID-19 infection such as fever, cough, sore throat, shortness of breath, and other respiratory symptoms were analysed. Results: From January 1, 2017, to December 31, 2019, C.I.R.M. assisted 15,888 patients on board ships. During the first 6 months of the years under evaluation, C.I.R.M. assisted 2,419 patients in 2017, 2,444 patients in 2018, 2,694 patients in 2019, and 3,924 in 2020. The number of assisted cases almost doubled in the first 6 months (from January to June) of 2020 compared to the same period of the previous years. Gastrointestinal disorders, injuries/traumas, and dermatological pathologies were the first, second, and third most often reported causes of illness on board over the 4-year study period. A higher number of seafarers with fever, cough, sore throat, and shortness of breath were assisted during the COVID-19 pandemic than before the coronavirus outbreak. Medical requests for fever increased significantly during the COVID-19 pandemic compared to the same period from 2017 to 2019. Conclusions: The requests for medical advice for fever, sore throat, and shortness of breath were significantly more common during the coronavirus epidemic. Close follow-up, regular health education on preventing coronavirus transmission, personal protective equipment, adequate environmental hygiene, and applying other standard precautions could help minimise the risk factors for the spread of COVID-19.

Article available in PDF format

View PDF Download PDF file


  1. de Wit E, van Doremalen N, Falzarano D, et al. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016; 14(8): 523–534.
  2. Mizumoto K, Chowell G. Transmission potential of the novel coronavirus (COVID-19) onboard the diamond Princess Cruises Ship, 2020. Infect Dis Model. 2020; 5: 264–270.
  3. Glass C, Cash J, Mullen J. Coronavirus Disease (COVID-19). Family Practice Guidelines. 2020.
  4. ILO. ILO Sectoral Brief: COVID-19 and maritime shipping and fishing, 2020; No. March, pp. 1–8.
  5. Takeuchi I. COVID-19 first stage in Japan - how we treat 'Diamond Princess Cruise Ship' with 3700 passengers? Acute Med Surg. 2020; 7(1): e506.
  6. Rocklöv J, Sjödin H, Wilder-Smith A. COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures. J Travel Med. 2020; 27(3).
  7. Sagaro GG, Amenta F. Past, present, and future perspectives of telemedical assistance at sea: a systematic review. Int Marit Health. 2020; 71(2): 97–104.
  8. Amenta DTF, Tveito A., TELEMEDICINE AT SEA: COMMUNICATIONAL CHALLENGES, ISfTeH e-Journal, 2007; pp. 219–222 [Online]. https://www.isfteh.org/media/med_e_tel_2007.
  9. Mahdi SS, Amenta F. Eighty years of CIRM. A journey of commitment and dedication in providing maritime medical assistance. Int Marit Health. 2016; 67(4): 187–195.
  10. WHO. International statistical classification of diseases and related health problems:10th revision. 2016; vol. 1, no. Fifth edition 2016 [Online]. . www.who.int/about/licensing/copyright_form/en/index.html.
  11. Szafran-Dobrowolska J, Renke M, Wołyniec W. Telemedical Maritime Assistance Service at the University Center of Maritime and Tropical Medicine in Gdynia. The analysis of 6 years of activity. Med Pr. 2020; 71(2): 121–125.
  12. Amenta F, Dauri A, Rizzo N. Organization and activities of the International Radio Medical Centre (CIRM). J Telemed Telecare. 1996; 2(3): 125–131.
  13. Westlund K, Attvall S, Nilsson R, et al. Telemedical Maritime Assistance Service (TMAS) to Swedish merchant and passengers ships 1997-2012. Int Marit Health. 2016; 67(1): 24–30.
  14. Kakimoto K, Kamiya H, Yamagishi T, et al. Initial Investigation of Transmission of COVID-19 Among Crew Members During Quarantine of a Cruise Ship — Yokohama , Japan , February 2020, 69, 11, 312–313.
  15. Guo Y, et al. The origin , transmission and clinical therapies on coronavirus disease 2019 ( COVID-19 ) outbreak – an update on the status. 2020: 1–10.
  16. CDC. People Who Are at Higher Risk for Severe Illness | CDC. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fpeople-at-higher-risk.html (accessed Apr. 09, 2020).
  17. Rashid H, Haworth E, Shafi S, et al. Pandemic influenza: mass gatherings and mass infection. Lancet Infectious Diseases. 2008; 8(9): 526–527.