HOW HEALTHY ARE YOUR GUESTS?
2021
EXECUTIVE SUMMARY MedAire continues to see high case volumes from owners/guests and this figure may, in fact, be higher, as often owners/ guests do not wish to identify as such. The health-related cases reported by guests on board are diverse and not as easy to define as may be perceived, as observed in the data for cases of heart attacks on board. Security and health are closely linked; keeping the guests healthy and safe requires interpretation of complex geopolitical, population health and environmental considerations. Plan B must be well defined and well thought out; there is no guarantee of a safe evacuation or repatriation, even in traditional yachting destinations such as the Mediterranean.
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INTRODUCTION Maintaining the guests’ experience safely and healthily presents a multifaceted challenge for safe superyacht operations. MedAire has worked extensively with their clients to develop systems for both the aviation and maritime sector that mitigate the risks.
constant basis. As the fleet expands to more diverse global regions, it’s more important than ever that superyachts have access to upto-date information about anything that could affect guest health.
In looking after guests, Crew need to be able to: discern what a serious medical event looks like, have the proper tools to handle the situation and be able to provide the guest with peace of mind. Some vessels might do this by employing an onboard doctor, but for many it’s through regular onboard training, and having access to telemedical support and the latest technologies.
“ There is a fine line to walk between guests and crew in terms of the way we approach health on board, you can’t consider one without the other; there is very little point trying to separate them.”
The security landscape that the superyacht industry now operates in has also changed; the overarching effects of COVID, climate change and geopolitical instability create a fluid system that needs to be evaluated on a
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CAPTAIN MIKE K. DOUGLAS, M.Y. SECRET, 83M
GUEST RELATED HEALTH EVENTS The MedAire case volume relating to owners and guests were much higher than average in 2019-2020. This figure is likely higher still, as owners and guests often do not wish to identify as such. So, a portion of that, at least half of the other/non-reported category, is most likely owners/guests also. In every aspect of the superyacht experience, crew are expected to provide high quality service to their guests and a medical event is no exception. There remain many misconceptions about what will lead to a medical event onboard a superyacht and this is exemplified by the fact that only a tiny percentage of calls to MedAire, 203 in the last five years, were cardiovascular. Of these cases, one in five were attributed to chest pain. T he first assumption when treating chest pain is often heart attack - but that is not necessarily true. Acute myocardial infarction, the medical name for a heart attack, accounts for only a tiny part of ‘cardiovascular’ cases. MedAire has had very, very few cardiac arrests on vessels.
MEDAIRE CASE CALLS FROM SUPERYACHTS 2015-2020
6%
3%
7%
25%
7%
9% 16% 14% 15%
Steward(ess) Deckhand / ABS Not Reported / Other Guest / Owner Officer
Despite this, captains and medical officers must be aware that health issues are multifaceted and chest pain may belie various other conditions. Preconceptions can be misleading, and consultation with experts is paramount.
Engineer Chef Captain / Master Boson
GUEST CASES BY CATEGORY 2015-2020
Without a medical professional onboard full time, one of the most effective ways of ascertaining the true source of chest pain is a Tempus IC2 unit.
3%
3%
3% 3%
14%
5%
The device allows non-medical experts to monitor vital signs, and sends live data to a doctor, who can make correct decisions on the rescuer’s behalf. It is invaluable in case of chest pain, as highlighted, but is used across the full range of potential medical events on board, from diving emergencies, to fevers or dizziness. The Tempus ensures that guests receive the high standard of medical care and peace of mind that they would expect to receive shoreside and in turn reduces the risk of disrupting a charter for a situation that could be managed onboard.
5%
13%
5% 7% 11% 8% 9%
Injury/External Ears, Nose and Throat
Urologic/Renal
Dermatological
Other Neurological
Gastrointestinal Musculo-skeletal General Respiratory
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11%
Ophthalmological
Cardiovascular Infectious/Communicable Allergy/Immunology
SECURITY AND THE IMPORTANCE OF ‘PLAN B.’ Security and health considerations are directly linked, - From a Mediterranean perspective, countries with and the Pandemic has exacerbated this. The traditional the highest GDP dependency on tourism have reliance on the stability of the nations that superyachts also had the most adverse economic impact from are visiting has been degraded. The assumption that the Pandemic, Turkey, Greece and the Adriatic, for a yacht may evacuate its guests, even via helicopter, example, and related increased risk of guests and cannot be taken for granted. crew being targeted. 4. Natural disasters: This consideration can supersede all others. The key observation from MedAire’s security analysis is that; when there is a natural disaster, security, and therefore health is detrimentally affected. - The Pandemic has provided an example of how an overarching situation can have a cascading effect through a region. Whenever there is a significant world event, MedAire will send out an incident management The critical security considerations for safe team to go on-site, help coordinate any evacuations and make a full assessment of the risk, like the recent superyacht operations are: eruptions of La Soufrière volcano in popular yachting 1. Entry restrictions: Especially in a region such as the destination St Vincent. Mediterranean, where this has not been a factor in the past, it is an increasingly complex issue that requires 5. Supply chain disruption: The breakdown of local infrastructure, again highlighted by COVID, has a close consultation. detrimental effect on a vessel’s security. 2. Social unrest: The pressure applied by COVID has - Medical supplies, evacuation protocols, food and exacerbated this further, with every country increasingly water; the Pandemic has given us the chance to needing to be treated individually and evaluated on an re-evaluate how we take these things for granted. ongoing basis. - A clear contemporary example being Barcelona in 6. Increased migrant numbers in the Mediterranean: 2021 and the elevated risk associated with the release There has been a significant increase in migrant of political prisoners. A complex and volatile issue, but crossings, especially in southern Spain and Gibraltar, one that is tracked and observed on an hourly basis by higher than the perceived peak of 2013/14. But the risk MedAire and their security consultants. to yachts remains low. This highlights the critical consideration that; just - 3. Petty Crime: COVID has exacerbated this issue; because something has dropped out of the media increased unemployment rates and the economic spotlight does not imply that it has disappeared. crunch have increased petty crime rates across Equally, the intrinsic risk assessment to yachts and guests is quantified through in-depth analysis and the board. requires expert consultation.
Put simply, once a guest leaves the vessel, they are a tourist. The complexity of the surrounding geopolitical, medical and environmental conditions combine to dictate the security consideration in a given region. Having experts on-hand to provide a concise overview of the relevant information for specific countries and regions is more important than ever.
12,000 security alerts per year
26 assistance centres
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5200 medical professionals
2300 security professionals
1,000 medical services sites
85,000 accredited providers.
CONCLUSIONS Each vessel must build upon a foundation of up to date equipment and training onboard, implementing effective health care protocols. The use of the more advanced technology available, such as the TEMPUS unit, can significantly mitigate the risk to the health of the guests and limit the disruption to the successful operations of a superyacht. The guest experience is intrinsically linked to the health of the crew and the strength of the protocols on board. The complexity of health-related issues requires communication and consultation with health professionals. There is a vast amount of information disseminating at all times about health issues; deciding who and what to trust is vital for both guests and crew. The security landscape is constantly evolving, and the health considerations of the guests are directly tied to this inherent instability. MedAire security experts are always in the field, evaluating the risk and providing actionable mitigation plans. There are many more considerations related to guests health in the COVID landscape, and MedAire has the expertise to guide a captain and crew through a safe season.
“ When guests are off the boat, we encourage and hope that they will wear masks. However, this is their choice, and therefore we have to assume that each time they return to the boat this season, the guests will be bringing a potential contagion on board.” CAPTAIN MIKE K. DOUGLAS, M.Y. SECRET, 83M
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ABOUT MEDAIRE MedAire, an International SOS Company, is the world’s leading medical assistance and travel safety service, used by over 50% of the world’s superyachts. For over 35 years we have been ensuring that owners, captains, crew and guests are prepared, capable and confident during medical and travel safety incidents, 24/7/365. This expertise goes into everything we do, from: telemedical support, medical kits, training and emotional support. Find out more at www.medaire.com/yachts
For more information on our products and services contact MedAire: INFO@MEDAIRE.COM NORTH & SOUTH AMERICA +1 480 333 3700 EUROPE +44 1252 517 951 ASIA PACIFIC +65 6330 9534 MIDDLE EAST & AFRICA +97142536020
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