FAI Update #3: Wuhan Coronavirus (2019-nCoV)

FAI is continuing to closely monitor the evolution of the Wuhan Coronavirus (2019-nCoV) outbreak since we provided our most recent summary of the situation 1 week ago in our Client Update #2.

Here is our third update together with our latest position on assisting you in the repatriation of your clients out of China.

Case volumes throughout China are escalating rapidly, the number of cases and their distribution within other countries around the world continue to grow more slowly.

Total confirmed cases @06.02.2020:

  • China: 28060 (new cases: 3697/24 hours)
  • Outside China (24 countries): 216 (new cases: 25/24 hours)
(https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200205-sitrep-16-ncov.pdf?sfvrsn=23af287f_4)

The most significant development since our last Update is that WHO has declared a PHEIC: Public Health Emergency of International Concern, and released Temporary Recommendations in this regard. WHO is working with the travel and tourism industries to discuss real and perceived risks particularly to the airline industry.

Of note is the WHO call for countries and agencies not to institute travel and trade restrictions, but to work within the ambit of the WHO Global Strategic Preparedness and Response Plan.

(https://www.who.int/docs/default-source/coronaviruse/srp-04022020.pdf)

From our perspective as an air ambulance operator, cumulative epidemiology experience to date:

  • The virus is highly contagious, spreading via aerosols, inhalation, and surface contact
  • There is clear evidence that human to human transmission readily occurs
  • Infected persons in their incubation period of 3-5 days can transmit the virus to others, even in the absence of fever or without respiratory symptoms
  • The duration of infectivity remains unknown. Viral shedding in the recovery phase may continue for long periods especially in severe cases
  • Viral mutation appears not to be occurring at this stage, based on evidence from virus sero-typing, although experts caution that this may change
  • Case fatality rates appear to be low to date, with deaths occurring mainly amongst patients with co-morbidities or other impaired immunity. This may change over time from what is currently being observed

FAI Operational Position Statement #3

Medical Transport Missions

FAI is pleased to announce that we have procured the latest version portable medical isolation unit PMIU solid-shell EpiShuttle manufactured in Norway by EpiGuard AS. *(refer attached specs)

After an induction and training period for our teams, FAI is now ready to commence dedicated PMIU missions as of 08 February 2020.

We have installed a customised stretcher configuration on a Challenger CL604 aircraft, with specific EpiShuttle equipment and accessory modules ready to deploy. We have deployed a dedicated team of 4 ICU Flight Doctors and 8 Flight Paramedics, now trained in accordance with the ECDC European Center for Disease Control Technical Directive: Infection Prevention and Control for the Care of Patients with 2019-nCoV in Healthcare Settings, February 2020

We have revised our Operational Transport Statement from previous Updates, and are pleased to announce our Transport Capabilities in the following patient categories:

a. Confirmed Cases of Wuhan Coronavirus (2019-nCoV)
Based on our current PMIU capability FAI will offer transportation of patients with confirmed “2019-nCoV“ infection on a case by case basis. All such flights will be operated in an EpiShuttle PMIU unit with dedicated trained medical teams and equipment.

b. Case Contacts with negative 2019-nCoV serology
Based on our current PMIU capability FAI will offer transportation of patients who are positive case contacts as defined, with negative “2019-nCoV“ serology test results, on a case by case basis. All such flights will be operated in an EpiShuttle PMIU unit with dedicated trained medical teams and equipment.

All cases will be reviewed under the following conditions, which will define our ability to perform any such mission:

  • The Health Authority Infectious Disease Notification processes relevant to all jurisdictions has been followed and approved prior to the mission
  • Receiving Care has been confirmed and the receiving hospital is fully informed and willing to accept the patient
  • The involved ground ambulance services are briefed accordingly and accept the patient
  • The patient and/or relevant family member/legal guardian gives consent to being transported in a PMIU after full disclosure of the risks and limitations involved
  • The transport is not in breach of aviation restrictions in place and subject to amendment from time to time as promulgated by international agencies eg: WHO/CDC/National authorities and aviation agencies

c. Patients with conditions unrelated to Wuhan Coronavirus (2019-nCoV)
Air ambulance transports for patients with unrelated diagnoses, from locations
where the outbreak is established, will similarly be reviewed on a case-by-case basis, subject to the following considerations, which will define our ability to perform any such mission:

  • 2019-nCoV case load of the patient’s hospital at the location concerned
  • The patient has a negative 2019-nCoV test by a methodology recognised by the WHO/CDC
  • The patient does not meet the criteria to be regarded as a de-facto Contact case as above

Please note:
All such flights will also be operated in an EpiShuttle PMIU unit with dedicated
trained medical teams and equipment. This will be discussed closely between FAI Medical Director/s and the Client.

d. Limitations for PMIU EpiShuttle missions

  • No relatives or other non-medical escorts allowed on board (exception: parents of small children subject to individual case by case decision)
  • Only hand-luggage is allowed, of a small enough size to be sealed in a red biohazard bag after disinfection
  • The viability of all missions is subject to many factors still evolving, and beyond the control of FAI: Port Health restrictions, overflight permissions and clearances, screening and quarantine regulations specific to individual locations
  • It is expected that obtaining many of these clearances and permits will be subject to unusual delays, outside of normal flight operations
  • Such delays may affect the patients’ overall Fitness to Fly if their condition has changed in the interim. This could lead to delayed or cancelled missions, in extreme cases

Multiple passenger air charter repatriation for normal healthy passengers

FAI is especially pleased to announce that after numerous client requests, and after alignment with multiple authorities, we have now commenced multiple passenger air transportation options for repatriation of unaffected, healthy adults and children from high risk locations to home country, on behalf of governments, international agencies and private clients.

These missions are offered on our Challenger CL604 and CL850, and Global Express aircraft, for up to 13 passengers. All missions are accompanied by a trained dedicated medical team, for pre-flight temperature screening, and the availability of medical/nursing care in flight should the need arise.
All passengers are required to wear surgical masks, and complete a pre-flight screening questionnaire, in addition to temperature screening.

All requests are evaluated on a case by case basis, subject to the following conditions:

  • The transport is not in breach of aviation restrictions in place and subject to amendment from time to time as promulgated by international agencies eg: WHO/CDC/National authorities and aviation agencies
  • Relevant Health Authority Infectious Disease processes relevant to all jurisdictions have been followed and approved prior to the mission

Appendix: EpiGuard EpiShuttle Patient Medical Isolation Unit

Dimensions
Outer dimensions: L=2285 mm W=640 mm H=695 mm
Weight: 58 kg on standard configuration
Patient weight: Max 150 kg / 330 lb
Patient Length: Max 198 cm / 6.5 feet
Operating temperature from: 0 to +40 °C (32 to +104 °F)

Air system
Blower unit: CleanAir® Chemical 2F
Power source: Rechargeable Li-ion battery 14,4V 2,6 Ah
Air exchange: More than 15 air exchanges per hour.
Operating negative pressure: Min 15 Pa relative to the environment
Operating positive pressure: Min 15 Pa relative to the environment

Access ports
Operator ports: 8 ports for gloves, waste bag, sluice bag configurations.
Wire port: Membrane inlet for IV lines, monitoring cables, similar equipment.
Ventilator port: Generic port for all types of mechanical ventilator circuits.

Download 2019-nCoV News Alert #3

Covid-19 News

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