CIRCULAR N° 0012

(Special Notice – 010 COVID-19)

In exercise of the powers conferred by Article 78, numeral 1 of the Decree with Rank, Value, and Force of Organic Law of Aquatic Spaces, in concordance with Articles: 73, numerals 1 and 2; and 74, numerals 3 and 4, ejusdem, and pursuant to the provisions of Article 17 of the Organic Law of Administrative Procedures.

CONSIDERING

• Whereas on March 12, 2020, the World Health Organization (WHO) declared the infectious disease caused by (COVID-19) a pandemic affecting all continents, the World Health Organization (WHO) declared a global Pandemic due to COVID-19, also known as CORONAVIRUS, all in accordance with the International Health Regulations, which allow the formulation of strict responses, actions, and indications from the WHO for the management of this disease.
• Whereas the WHO indicated that mass testing must be conducted to contain the spread of the disease, isolate cases of individuals with COVID-19, and prevent them from becoming community transmission clusters.
• Whereas health is a fundamental social right, subsidiary to the right to life enshrined in the Constitution of the Bolivarian Republic of Venezuela, the protection and guarantee of which falls upon the Venezuelan State to materialize through policies, plans, and strategies aimed at its maintenance, in order to preserve life and collective well-being.
• Whereas the National Executive, through Decree No. 4,160, declares a State of Alarm to attend to the health emergency of CORONAVIRUS (COVID-19) within the national geographical space, given the circumstances of a social order that gravely endanger public health and the safety of the citizens residing in the Bolivarian Republic, so that the National Executive may adopt urgent, effective, and necessary measures for the protection and preservation of the health of the Venezuelan population, in order to mitigate and eradicate epidemic risks related to the coronavirus (COVID-19) and its potential strains, guaranteeing timely, effective, and efficient medical care for cases that arise.
• Whereas it corresponds to the National Executive, through its organs and entities, to exercise the competencies assigned by law over aquatic and port spaces, in which sense the National Institute of Aquatic Spaces (INEA) shall act as the Aquatic Authority and enforce Executive guidelines and aquatic policies, including preserving and guaranteeing the best use of aquatic, insular, and port spaces, promoting the safety of seafarers as human capital, the safety of life, and the provision of assistance within aquatic spaces.
• Whereas a vessel is a particular means of transport where cohabitation is habitual, daily, and customary, and spaces are confined and in most cases shared, and taking into account the Joint Statement by the WHO and the International Maritime Organization (IMO) on the response to the COVID-19 outbreak, addressing the principles aimed at avoiding unnecessary restrictions or delays for the entry of ships, persons, and property into port as enshrined in Articles I and V, and in Chapter 6 of the Annex to the FAL Convention; nevertheless, by virtue of providing a public health response to the international spread of diseases that is “proportionate and restricted to public health risks.”

This Office, considering that the COVID-19 virus and its spread have demonstrated a dynamic character, and for the sake of protecting the aquatic sector:

DECIDES

Directs that after the free pratique procedure has commenced, the following protocol shall be executed:

1. The actions of the competent authorities for handling this type of event must be restricted to the provisions established in the “Handbook for the Management of Public Health Events on Board Ships” established by the World Health Organization (WHO), which is available at the following link: WHO Handbook. The first person authorized to board the vessel is the official from the Ministry of People’s Power for Health (MPPS), whose inspection of the crew shall be awaited for the granting of free pratique, after which other authorities may board.

   The requirements demanded by the medical officer on board are those established in the Health Free Pratique Form for vessels:

   Item	Requirement
   1)	History of the last ten (10) ports of call.
   2)	International Certificate of Vaccination or Prophylaxis.
   3)	Maritime Declaration of Health.
   4)	Ship Sanitation Exemption Certificate.
   5)	Ship Sanitation Control Certificate.

   If the procedure is standard and the free pratique form is granted, the other authorities shall proceed to board the vessel to conduct their respective inspections: ONA, INEA, SENIAT, NATIONAL GUARD, SAIME, and INSAI.

   In the event that the Health Free Pratique Form is not issued due to any circumstance, and it is recommended that the vessel drop anchor in the corresponding zone, a quarantine or fumigation order, or other applicable order, shall be issued.

   The Port Captain orders isolation, anchoring, or quarantine in accordance with the recommendation of the MPPS medical officer; and in the event that the detected anomaly is related to the COVID-19 disease—suspected or confirmed cases concurrently—the MPPS medical officer, in coordination with the maritime medical officer of the aquatic jurisdiction, shall manage actions regarding the crew members to provide the required care. The Port Captain shall officially notify the shipowner, through the Master of the Vessel and the Shipping Agent, of the measure taken.

2. INSTRUCTIONS FOR THE PILOTAGE SERVICE:
   

   1. Take into account the directives of the Aquatic Authority and other National Authorities within the framework of the declaration of alert.
   2. Prior to the embarkation of the pilot, the vessel must have free pratique granted by the MPPS authority.
   3. The Shipping Agent must verify that, on board the vessel, the Master and crew are complying with the respective precautionary measures to prevent the spread of the virus and that cleaning of common areas to be used during the pilot’s presence on board is being carried out. Hand hygiene is indispensable; the vessel must place alcohol-based hand sanitizer dispensers on the navigating bridge.
   4. The pilot must observe prevention recommendations, such as using appropriate Personal Protective Equipment (PPE): rubber gloves, face masks, protective goggles, etc., avoiding physical greetings, avoiding touching the mouth, eyes, and nose with their hands, and attempting to maintain a distance of at least one meter from other persons.
   5. The face mask must be replaced every 4 hours, or when it becomes damp or soiled.
   6. Pilots must wash their hands with water and soap frequently while on board the vessel and use alcohol-based hand sanitizer.
   7. When it is necessary to sleep or spend the night on board the vessel, pilots must be accommodated in an individual cabin, properly cleaned, and they must ensure that the bedding is clean and/or request fresh bedding.
   8. The vessel must provide two (2) clean towels and a sufficient quantity of soap and toilet paper according to the duration of the pilot’s stay on board.
   9. Pilots must take their meals in their cabins so they can safely remove their masks and maintain adequate hand hygiene.
   10. When consuming meals on board, they must verify that the food is well-cooked, fresh, and well-preserved; likewise, they must avoid consuming water that is not previously bottled.
   11. Pilots, in coordination with Masters / Agencies and Port Authorities, may take measures to embark directly through the Terminal if this promotes the protection, safety, and health of the pilot.
   12. In case of embarking using the pilot boat, they shall try to maintain a distance of at least one meter from other persons and verify that the crew of the pilot boat is complying with minimum sanitary measures: face masks and gloves.
   13. Masters and the Pilot must notify Port Captains and Port Authorities of any information or suggestions to improve these instructions in order to prevent the spread of COVID-19.
   14. The Master of the vessel shall assign a specific area of the navigating bridge, preferably on the starboard side, where a Marine VHF radio shall be placed for the exclusive use of the pilot, which shall have a clean protective cloth over the microphone/TX valve, preferably near a helm chair, with the minimum visibility established for the vessel.

3. MARITIME MEDICAL OFFICERS OF THE INEA AQUATIC JURISDICTION:
   

   1. For the duration of the national emergency, a duty Maritime Medical Officer shall be maintained for each Aquatic Jurisdiction, who were designated through CIRCULAR NO. 011 dated 20/03/2020, to coordinate prevention measures and, if necessary, the health recovery of any seafarer who might be affected, monitor the evolution of the crew’s health on board, and keep the Port Captain informed about the progress of the case(s); likewise, they shall channel cases of active port workers requiring medical attention due to suspected or confirmed Coronavirus, executing relevant arrangements together with physicians from the MPPS health system to coordinate necessary actions for the proper care of detected cases.
   2. Maritime Medical Officers must be provided with the safety kit for self-protection.

In this regard, the following terms are defined:

4. ISOLATION:
   

   A strategy used to separate people who have a contagious illness from those who are healthy. Isolation restricts the movement of ill persons to prevent the spread of the disease. Individuals in isolation may receive care in their homes, on board the vessel, in hospitals, or in designated healthcare facilities.

   The following recommendations must be taken into account:

   • Select a cabin with an en-suite bathroom.
   • Select one person in good health to assist the patient and another for daily cleaning and disinfection.
   • Clean the cabin and bathroom; for this purpose, surfaces may be cleaned with ordinary water and soap, and subsequently clean contact surfaces with bleach. Cleaning and disinfection shall be carried out with a standard-use disinfectant; viruses are inactivated after 5 minutes of contact with common disinfectants, such as bleach or a sodium hypochlorite solution containing 1000 ppm of chlorine. If there is no bathroom in the cabin, the common-use bathroom must be disinfected with ordinary water and soap and subsequently with bleach once the sick crew member has used it; used toilet paper must be placed in a completely sealed plastic bag, and then this bag placed into another bag to be handled as biological waste.
   • The person selected for cleaning and the one designated for patient care must have personal protective equipment: face mask, eye protection, gloves, and a disposable long-sleeve gown.
   • Keep the infected crew member in the cabin with the door closed, without contact with the rest of the crew.
   • The isolated crew member must have: a face mask, separate towels, utensils, separate cutlery, personal hygiene items (bath soap, toothpaste), toilet paper, napkins, and plastic bags for waste disposal.
   • The person in charge of monitoring the crew member shall be responsible for delivering food and medications, if necessary, and for the daily logging of clinical progress and vital signs.
   • The shipboard medical representative in charge of assisting the sick crew member must have a mask, gloves, and a long-sleeve gown when entering the room, avoiding close contact as much as possible.
   • The patient must wear a mask when receiving food, medications, and personal hygiene items.
   • The patient, the medical representative, and the person in charge of disinfection and cleaning must always wash their hands with water and soap before using masks; used masks shall be placed in double-sealed plastic bags, shall under no circumstances be reused, and shall be placed near the door for collection by the person in charge of cleaning.
   • The person responsible for healthcare and the person in charge of daily cleaning and disinfection must remove their personal protective equipment and place it in a sealed plastic bag once they have closed the room door, and proceed to wash their hands with water and soap.
   • Every person selected to care for the crew member undergoing isolation must sanitize their hands by rubbing them with an alcohol-based hand sanitizer for about 20 to 30 seconds, or washing with water and soap for at least 20 seconds, before putting on gloves, after any direct contact with the patient, their belongings, or any objects/surfaces that may have been contaminated with their blood or body fluids, and after removing personal protective equipment.
   • The patient’s clothing shall be placed in a closed double plastic bag and must be washed immediately with water and soap.
   • Wash clothing, sheets, towels, etc., of sick persons with ordinary water and soap, or in a washing machine at 60°-90°C with ordinary detergent, and allow them to dry thoroughly. Dirty laundry must be placed in a bag until the moment of washing. Do not shake dirty laundry; avoid direct contact of the skin and clothing with contaminated materials.
   • All waste generated in the cabin or isolation room must be handled in accordance with the vessel’s protocol for infectious clinical waste. If waste is to be discharged ashore, special precautions are necessary, and the port authority shall be informed before proceeding with its discharge.
   • The sick crew member suspected of COVID-19 virus infection shall be isolated until the corresponding evaluation by health authorities is performed.
   • The isolation of the crew member shall last until symptoms have disappeared. In general, isolation is recommended for 14 days counting from the first day of symptom onset, and it must be confirmed that the disease has been cured.
   • Immediately initiate contact tracing, always maintaining a separation distance of one meter. Determine which persons have maintained close contact with the sick individuals and evaluate them to ascertain if they present any symptoms according to their specific level of exposure. Based on the results of the interviews, crew members who meet the criteria to be considered contacts and who present symptoms must be isolated immediately.
   • Those who have maintained close contact with the affected individuals but do not present symptoms shall be placed in quarantine by decision of the competent health authority.

5. QUARANTINE:
   

   This is applied to separate and restrict the movement of persons who may have been exposed to a contagious disease but do not exhibit symptoms. The purpose is to observe the crew during a period in which, if a person has been infected by the virus, they are expected to manifest symptoms of the disease, in order to proceed consecutively with isolation and diagnostic evaluation through specific laboratory tests. It is recommended that the sample be taken by a Maritime Medical Officer authorized by INEA, in coordination with physicians from the MPPS health system.

   • The MPPS of the Bolivarian Republic of Venezuela is the competent entity to declare isolation or quarantine once a suspected case of coronavirus has been confirmed as positive.
   • Maritime Declaration of Health (Manifest presented by the Master regarding the health status of the vessel’s crew).
   • Article 37 of the General Law on Marinas and Connected Activities establishes that upon the arrival of a vessel in port and after the corresponding health inspection, it shall be visited by representatives of the aquatic authority to verify the effectiveness and validity of the vessel’s documentation (free pratique) in accordance with the Law.
   • The competent authority in the health area must communicate the result of its inspection to the Port Captain, the shipowner, or the shipping agent.

6. TRANSFER:
   

   • The transfer, through coordination by the Maritime Medical Officer, can be carried out, as appropriate, by vehicles, helicopter, and vessels depending on weather conditions.
   • A complete medical history must be compiled.
   • (No text specified in the document).
   • Ashore, an ambulance equipped for the transfer to the corresponding health provider center must be available. It is recommended to carry out the corresponding coordination with health provider centers at a national level.

7. HOW TO IDENTIFY THE SYMPTOMS OF A CREW MEMBER OR PERSON SUSPECTED OF COVID-19 DISEASE:

Crews must consider suspicion in a crew member who has been in contact with a person infected by the virus, who has returned from a risk country where the disease exists, and who has been in areas where confirmed cases have been detected within the last 14 days, if they present any of the following symptoms and signs:

• Acute respiratory symptoms of any degree of severity, including difficulty breathing or a cough with or without fever.
• Fever without other symptoms.
• Acute respiratory symptoms: understood as the unusual and unexpected presence of difficulty breathing, dry cough, and shortness of breath without fever.

8. WHOM WE CALL A CONTACT CASE AND WHAT CHARACTERISTICS DEFINE IT:

1. A contact is defined as a person who has been living in the same household as a person with a confirmed infection.
2. Having had direct contact with someone who has a confirmed infection, or their body fluids, without appropriate personal protective equipment.
3. Having face-to-face contact with a person with the confirmed infection for any period of time.
4. Being within less than two (2) meters of a person with a confirmed infection for more than 15 minutes.
5. Being informed by a public health agency that one has been accidentally exposed to a confirmed case.

9. CLASSIFICATION OF CASES BY COVID-19 DISEASE:

Cases are classified according to the presence of symptoms, contact with sick individuals, origin from areas where studied cases exist, and according to confirmation by specific laboratory tests, as follows:

• SUSPECTED CASE
• PROBABLE CASE
• CONFIRMED CASE
• DISCARDED CASE

10. SUSPECTED CASE ON BOARD A VESSEL:

Any crew member presenting fever and one or more respiratory symptoms, who within the last 14 days has been in contact with confirmed cases of COVID-19 or has a history of having been in areas with local transmission of the virus:

• Cough
• Sore throat
• Respiratory difficulty without another explanatory underlying issue

11. PROBABLE CASE:

A case under investigation whose laboratory results for SARS-CoV-2 are inconclusive or are only positive for one of the PCRs of the laboratory criteria. That is, cases under investigation in which other special tests are necessary to confirm infection.

12. CONFIRMED CASE:

Cases in which laboratory test criteria are positive for the COVID-19 disease.

13. DISCARDED CASE:

An investigated case in which laboratory criteria are negative.

The Maritime Authority, through the Institute’s General Management of Operations, shall ensure strict compliance with this Circular.

Please notify and disseminate the content of this Circular.

Issued in Caracas on the 26th day of the month of March, 2020.