FAI Client Update #5: Novel Coronavirus COVID-19 / SARS-CoV-2

Dear clients and partners,

The global Covid-19 Pandemic is having a rapidly increasing impact on our own aviation business operation as well as that of our Clients.

Here is our fifth Covid-19 Client Update together with our latest Operations Position Statement.


The Coronavirus Covid-19 Pandemic is now irrevocably established globally. The effects on the wider global community and the global economy as a whole have been immense, in a matter of weeks.

The last 7 days has seen a dramatic and unprecedented escalation in global public health response. The situation in most countries is now in full crisis mode. States of emergency and disaster proclamations have been declared in many countries. Cities and communities are in full lockdown. Land borders have been closed across neighbouring regions, notably between many EU countries.

The epicentre has moved unequivocally to Europe, with significant daily increases in new case detection – notably Italy, Spain, Germany and France. No EU country is spared. Iran is the focus in the Middle East. New case notifications in Asia (China, South Korea) are in a downward trend, although it remains to be seen whether this will be sustained. This has been attributed to aggressive local containment measures, which are now being replicated to varying degrees elsewhere.

Public health measures globally have abandoned a strategy of “containment” and moved to one of “delay” aimed at slowing down the spread of the virus to allow health care systems to adapt and ramp up. Countries have implemented varying approaches to self-isolation, quarantine, and restrictions on personal freedoms for their own citizens.

International commercial air travel is at a virtual standstill due to severe in-bound and outbound restrictions in virtually all countries. The precise details are available in real time via this link: https://www.iatatravelcentre.com/international-travel-document-news/1580226297.htm

FAI Operations Position Statement

At FAI, as a global aviation operator, we have adopted a strong and consistent policy for management of these aeromedical patient transport cases.

Our first priority is to protect our own crews, both flight crews and medical teams.

This is in the interests of their own health and safety, and in our own integrity as a business which has to keep operating globally to serve our clients despite this uncertainty and the changing restrictions.

We published our Covid-19 Aeromedical Transport Policy in our previous Client Updates 1 – 4.

We would now like to provide a New Update to Clients on our experiences to date, and our Current Approach in the light of the dramatic developments over the last 7 days.

Latest Developments as at 20 March 2020

  1. FAI Aviation Operations update
  2. FAI Client Obligations
  3. FAI policy on Covid-19 PCR testing
  4. FAI policy on Companions on air ambulance flights
  5. FAI EpiShuttle PMIU update

1. FAI Aviation Operations Update

As is widely known to this audience, over the last 7 days dramatic and unprecedented restrictions have been imposed on air traffic between countries across the globe. This includes most countries within the EU, the UK, USA, South Africa, and other African countries. GCC countries have implemented various regional restrictions by country. The original “legacy” restrictions on China, South Korea and Thailand remain in place.

FAI is pleased to announce that our aviation operations continue to most destinations globally through exemptions we have secured in place, however the situation remains in flux, and we are conducting daily Risk Assessments in this regard.

Where necessary, we have had to amend our logistical planning to include more tarmac transfers at certain destinations to overcome local entry restrictions. We will work closely with Clients on a case by case basis to ensure patient safety and optimal patient care at all times, to the highest standards.

Our flight crews and medical teams face onerous conditions: temperature screening, health questionnaires, Covid-19 PCR testing, sometimes on more than one occasion in any given 24 -hour period, at points of origin and destination, and tech stops in between. They face quarantine in hotel rooms, during overnight stops, restricted access to food, rest and recreation. We salute our teams, we all owe them a great debt of gratitude for their professionalism, their dedication and loyalty so that we can continue to serve you, our Clients.

2. Clients are reminded of the following Obligations

We announced previously in Update 4, of our reliance on the close collaboration of our clients to provide us with case-critical information for ALL aeromedical transport requests.

  • Medical report in full detail
    • history of presenting illness
    • working diagnosis
    • current clinical status in all parameters
    • all available diagnostic test results
  • Travel and contact history for the past 14 days
  • Covid-19 PCR test result (patient)
  • Exposure of treating facility to patients with Covid-19
  • Confirmation of acceptance by national health authorities at destination
  • Confirmation by receiving care of case and necessary isolation measures
  • Confirmation by ground ambulance providers at both ends (where arranged by client)
  • Confirmed consent by the patient and/or next of kin for transfer in a PMIU

We have found considerable gaps in the implementation of these requests over the last 14 days, and we wish to remind our Clients that this information is case critical.

We appeal once again to Clients to pay closest attention to providing FAI with their support in this matter.

3. FAI Policy on Covid-19 PCR Testing

Covid-19 PCR test result is mandatory to accept any person onto an FAI air ambulance flight.

We still receive questions every day from clients whether these tests are really necessary, or various explanations why they cannot be done or are refused to be done. The aviation sector is unique and specific. These PCR test
results are added to the official documents which FAI uses to obtain overflight and landing clearances, and must be produced to port health authorities and hospital facilities in any jurisdiction. Where the test is positive, we are obligated to use a Portable Isolation Unit/EpiShuttle to transport the patient.

We really need strong support from our clients to make extra efforts to push for these tests despite limitations in local public health screening policy.

By exception on a case by case basis, where all measures have been actively applied at local level, and no Covid-19 PCR test result can be obtained, we may conditionally accept a Hospital Certificate stating that “the patient does not have Covid-19 Infection”.

*Clients should note that this certificate must be formatted as an official document which can be used as stated above.*

Where no Covid-19 PCR test result or Hospital Certificate is available, FAI will still be able to assist, however the mission will be performed using an EpiShuttle PMIU on a CL604 aircraft. This is still a workable solution, albeit at higher cost.

4. FAI Companion Policy

FAI announces a temporary suspension on the carriage of companions on any FAI air ambulance aircraft, whether with or without EpiShuttle.

As explained above, Covid-19 PCR test result is mandatory to accept any person, whether patient or companion onto a FAI air ambulance flight. We are facing unsurmountable difficulties in obtaining Covid-19 PCR test results for companions. They are not patients, and under no duty of care obligation through a healthcare facility in having testing carried out.

We also are not able to find a way to facilitate companions under the new immigration exit/entry and health screening restrictions we are now encountering since the last 7 days. Authorities are allowing exceptions only for our crews and our patients. This has been further aggravated by the restrictions imposed through tarmac transfer to and from our aircrafts now in place on many missions.

Accordingly with great regret, we now announce an immediate temporary suspension on the carriage of companions on any FAI air ambulance aircraft, whether with or without EpiShuttle.

Please note:
*Exceptions will be made in the case of transportation of children and other dependents, subject to approval on a case by case basis. *
*Where a companion is indeed able to produce a negative Covid-19 PCR test result, we will of course also assess such companion/s on case by case basis, subject to the entry/exit health screening restrictions in place, and tarmac transfer limitations, as outlined above.

Close collaboration with Clients will be maintained in all such cases.

5. FAI EpiShuttle PMIU Update

Our Covid-19 Standard Operating Policy announced previously using our EpiShuttle PMIU on CL604 aircraft remains strictly enforced as follows for the following categories:

  1. Confirmed Cases of Coronavirus Covid-19
  2. Case Contacts with negative Covid-19 PCR
  3. Patients with conditions unrelated to Covid-19 from locations where the outbreak is especially established, or have been “blacklisted”

The following changes are announced

We have reviewed our list of Red Zone/Blacklisted countries to include the following:

  • China
  • South Korea
  • Iran
  • Italy
  • Spain
  • Regional outbreaks in Austria, Germany, France and USA on case by case basis

Transport cases from these countries are to be performed in an EpiShuttle PMIU irrespective of Covid-19 PCR test result in the patient. The list of these countries is reviewed daily as part of our Risk Assessment procedure. Clients will be kept closely updated of new changes and amendments.

*All other Conditions and Limitations relating to EpiShuttle cases remain in place as per previous editions of our Updates*

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