Amós García Rojas
Former head of the Epidemiology and Prevention Service of the General Directorate of Public Health of the Canary Islands Health Service, former president of the Spanish Vaccination Association (AEV) and until his retirement in 2024 a member of the WHO Standing Group for Europe
I believe that, fundamentally, the option of allowing the ship to dock in the Canary Islands – which is not yet clear – is being considered to safeguard the health of some passengers who may be ill or in case others develop symptoms. Logically, the Canary Islands have a hospital infrastructure capable of handling patients of this kind, and I believe this is the key issue: ensuring care for these people who are currently in a vulnerable state and, above all, being able to gain a comprehensive overview of the outbreak’s status.
In a context such as this, it is vital to convey a message of reassurance to a population that is already sufficiently distressed and for whom the memory of that terrible health crisis—the pandemic—is still all too fresh. And, furthermore, because this situation is being exploited for social media to spread an absolutely terrifying message about the risks we might face if the ship docks in the Canary Islands—a message which, without a doubt, is intended to terrify the population.
This has absolutely nothing to do with Covid. I’ll highlight two key differences: when Covid emerged, we had no information about what this new microorganism was. The hantavirus has been with us for many decades; we know enough about these viruses and their epidemiology. Furthermore, COVID-19 is transmitted through the air, whereas this virus is not. This explains the low risk to the population in an environment such as ours. The hantavirus is transmitted primarily either through direct contact or inhalation of microscopic particles from rodent faeces, urine or saliva; or through the consumption of food contaminated by these rodent residues. Person-to-person transmission is very rare. There is only one American variant, known as Andes, in which some cases of human-to-human transmission have been reported, but these are few and far between and require direct, close and very intense contact in enclosed, poorly ventilated spaces.
Therefore, the likelihood of a public health risk is low, as the WHO has stated, if not non-existent.
It is reasonable to wait for the epidemiological data from the cruise ship to get a rough idea of how the problem arose on board. As we do not yet know, it is reasonable to be cautious. The hantavirus on that ship may have been transmitted in three ways. The first: the ship was coming from Argentina, it visited adventure tourism areas where hantavirus is endemic, and infection may have occurred there in some of those patients; as the American variant of hantavirus has an incubation period of around seven weeks, they may have been infected there and the clinical symptoms may have manifested here. The second: through direct contact with or inhalation of rodent faeces, urine or saliva. The third: because a person who had been infected in Argentina with the Andes variant lives in close contact with another person, for example, a partner, and person-to-person transmission has occurred.
These are the variables on the table. Logically, we need to have a rough idea of how the outbreak occurred in order to make a decision, although the risk to the general population is frankly low.