As the covid-19 pandemic continues and the inevitable second waves engulf Europe, the USA and other nations, the demand and necessity for testing has become an even greater priority to help measure the infection rates and thus determine what sort of measures are put in place to reduce and control the spread of the virus.

There are a myriad of tests available and new ones being developed that report and measure different accuracy levels. The principle issue is the effectiveness of a test, the majority offer at best a 70% accuracy rate and false positives and negatives can be reported.

The following is a breakdown of the essential tests and what they do:

PCR Test

PCR testing is the gold-standard, in terms of detecting crew who may be infectious with Covid-19. This is primarily a laboratory-based test. Also, now available are PCR Analysers units which you can have onboard.

Antigen Test

Antigen testing claims to be very nearly as good as a PCR test, but take that with a pinch of salt. Antigen testing is still useful, as part of the overall clinical assessment of a crew member who is somewhat symptomatic.

Antibody Test

This is a test of antibodies present in the body.  Antibodies develop 2 to 3 weeks after having had a covid infection.  It’s uncertain how long the antibodies will remain in the system but current opinion is that it’s only a few months. There is no guarantee that you will develop an immunity in the future, only that you may be more resistant to getting infected again. An Antibody test does not really serve any purpose in the context of managing covid onboard, all it says is that someone has had covid after the fact.

Antigen/Antibody Combo Test

A combo test that indicates whether you are infected and whether you have antibodies from a previous infection.

PCR and antigen forms of testing are much more useful than antibody testing, which is of no use in an acute situation.

How testing works and is conducted:

Antigen Testing for SARS Covid-19 by Roche

Antigen testing is a pragmatic approach to testing or Covid-19. The Roche test offered is comparable to other rapid antigen testing kits, with between 95% and 98% sensitivity and specificity compared with the gold standard PCR test.

Some points regarding this test:

• It is based on analysis of nasopharyngeal swabs;
• It is a point-of-care test that can be performed on board, with no need to send samples anywhere else;
• Swabs should be taken by a medical ‘professional’  (a crew member with Proficiency in Medical Care who has some training in taking naso-pharyngeal swabs;

• It takes about 15-30 minutes to get a result
• The tests come in boxes of 25.

PCR Testing for SARS Covid-19 – point-of-care test Analyser – onboard testing option – Randox

In addition to the antigen testing kits described above, there are analysers for performing PCR tests for Covid-19 on board the vessel. For the PCR test, a nasopharyngeal swab is taken, and then dipped in some viral media, and then this fluid is put in to a testing cartridge, which is then inserted in to the machine. It takes about 45 minutes to do the test, after which the result is output as a downloadable pdf certificate. The manufacturers claim this will be acceptable with health authorities.

This is certainly an expensive option, but does have the advantage of performing the gold-standard test, so may help with operational problems. This analyser is used by various governments for national testing programs, so has a good track record.

At MSOS, we have rolled out an initiative to provide and economical and rapid test with the Roche Antigen Test and PCR Analyser option with the Randox unit to assist yachts in managing and mitigating covid-19 onboard.  This is in addition to maintaining a comprehensive hygiene protocol. We aim not to profit from this and as part of the initiative we are donating all profits to be equally distributed amongst the following charities.

Charities to which all proceeds will be equally donated:

• Yachting Gives Back  >  based in Mallorca – provides food etc for disadvantaged families www.yachtinggivesback.com
• Ellen MacArthur Cancer Trust  >  based in the UK – aimed at young people who have suffered from cancer rebuild their lives www.ellenmacarthurcancertrust.org

• Doctors without Borders (linked to Médecins Sans Frontières)  >  based in the US – with a broad base of providing medical care where it is most needed worldwide –www.doctorswithoutborders.org
• Save the Med  >  based in Mallorca – aimed at environmental rejuvenation of the Mediterranean in a sustainable way www.savethemed.org

In the first 2 weeks in November of starting this initiative we have been inundated with requests for the antigen test and have raised £20,000so far for charity. Many yachts will be adding Covid management protocols as standard procedures, one of which will be testing procedures. Why not contribute to our charitable cause as Christmas approaches while installing testing protocols onboard.

By Nick Stael von Holstein

Medical Support Offshore (MSOS)

www.msos.org.uk