Due to the recent Coronavirus (COVID-19) pandemic, operators should be examining the policies and procedures they have in place surrounding travel health.
There are many informational resources available that provide solid information on preparing for and responding to travel health concerns; however, piecing the information together and writing a procedure can be a challenge.
We have a few recommendations on where to get started…
For your Flight Operations Manual (FOM) / General Operations Manual (GOM)
We recommend including proactive policies into your FOM or GOM to address these concerns. A good place to start is the preflight planning phase, as the design of your flight may drastically change as you research travel health concerns. Some topics to include are:
Researching travel health concerns at the departure location, destination, and any territories you plan to overfly.
- There are several resources that can be used to identify health concerns. Some examples are the United States’ Center for Disease Control (CDC), the World Health Organization (WHO), and the International Air Transport Association (IATA). Additionally, if contracted, utilize your inflight medical service provider as they should have much of this information readily available.
- Read through this guidance and begin compiling information that may affect your flight. Some specific information to watch out for includes best practices to protect passengers and crew, travel restrictions, vaccination requirements and recommendations, screening and quarantine procedures, and any recommended medical support equipment.
Reviewing customs and governmental publications for any travel restrictions pertinent to your departure, destination, and any planned alternates. As seen with the COVID-19 and Ebola outbreaks, there may be restrictions on entry, requirements to arrive at particular airports, and additional information or Form requirements.
Planning potential medical diversion alternates. When the topic of alternate airports is brought up, most think of departure and destination alternates in case of bad weather; however, it is important to consider where crewmembers can land in the event of a medical emergency during the flight, particularly when operating internationally. Some items to consider are:
- What medical services are available? A hospital may not be located near the airport and, in some cases, it may be faster to continue the flight to a different location. Additionally, not all hospitals are equipped to handle all types of emergencies.
- Will the security situation at the diversion airport endanger crewmembers or passengers? Research local security issues and the political climate in advance.
- Will there be a language barrier? It is beneficial to research potential interpreter services at each medical alternate in case they are needed.
Checking First Aid Kits (FAKs) / Emergency Medical Kits (EMKs) to make sure supplies are appropriate to the health situation.
- Include a policy to check the FAKs / EMKs on your aircraft to make sure equipment and medications have not expired.
- Outline policies for acquiring additional medical support equipment (universal precaution kits, medical face masks, hand sanitizers, and other suggestions based on your research).
It is also important to include procedures for crewmembers and passengers to follow during the trip. Some topics to explore are:
- Personal hygiene: Encouraging frequent hand washing, avoiding touching the mouth / eyes / nose with unwashed or un-gloved hands, providing guidance on safe food / catering handling, and including procedures for aircraft cleaning / disinfection. Reinforce that any bodily fluids be treated as they are infectious.
- Considerations for crewmembers while on the ground: Limiting movement and avoiding public transportation when in areas that have been identified to have a heightened risk of infectious disease.
- Outlining procedures for crewmembers to identify a crewmember or passenger with a potentially communicable illness and report it to Air Traffic Control (ATC). The United States’ CDC has a webpage that lists symptoms and signs to be alert for.
For your Safety Management System (SMS)
An SMS lends itself well to evaluating travel health concerns, since an SMS is all about assessing and managing risk. Since the risk mitigation process will be similar to assessing a risk of a different nature, you may not have to adjust your SMS procedures; however, there are a few things to keep in mind:
First, perform a risk assessment. Will the risk level be too high? What mitigations can be put in place to lower the risk? Are there adequate resources available to execute these mitigations? Use the information you are gathering in the preflight planning process to support this risk assessment. You may also want to involve corporate / company resources and your Accountable Executive in these discussions.
If a location you frequently operate to is affected by a longer-term travel health concern, you should update your company’s Safety Risk Profile. Ensure the additional risk is captured and record any mitigations that can be used for future trips.
Lastly, if a travel health issue does arise during the trip, make sure it is reported per your incident and hazard reporting process. Perform a root cause analysis to discover why mitigations were ineffective and make modifications to them for the future. This is crucial to preclude a recurrence.
For your Emergency Response Plan (ERP)
The ERP will be key in responding to a travel health or medical emergency. These procedures will make sure everyone is aware of what needs to be done for a successful response.
A good place to start is to verify that any contact information in your ERP is up-to-date. This will benefit you not only in the event of a travel health emergency, but for any emergency type.
Specific to travel health emergencies, it may be easier to create procedures by breaking up the response into what crewmembers should do inflight and what personnel should do on the ground.
For an inflight medical emergency, evaluate your procedures to make sure personnel are well aware of:
- The resources at their disposal. This can include training in First Aid, aircraft equipment that can be used while diverting (the FAK / EMK, therapeutic oxygen / walk-around bottle, and universal precaution kits), contacting an inflight medical service provider (if contracted), medical diversion alternate options and considerations, and coordinating with ATC for the ground response upon landing.
- Who will be doing what. This will vary based on your aircraft crewmember composition (particularly if Flight Attendants are carried) and is critical to define. Consider who is trained and authorized to perform first aid, who will be communicating with an inflight medical service provider, who will be discussing options with ATC, and what to do if a crewmember is incapacitated.
- What the crewmembers should do if a communicable illness is identified onboard. Reinforce discussing the concern with ATC as they can coordinate with the appropriate resources to ensure an appropriate response when you land.
Make sure you have policies for ground-based medical emergencies. This should not be limited to crewmembers on a trip – these emergencies can also occur at home base.
- Similar to the inflight procedures, make sure personnel are aware of resources at their disposal (FAK locations, AED locations, etc.).
- Make sure emergency services contact information is widely known. This is particularly important for crewmembers when on an international trip, as the emergency services phone number may not be the same as it is back home.
- Outline who will accompany an injured or ill individual to the hospital.
- Review emergency contact information with your team to make sure it is still accurate. Additionally, make sure your ERP is clear on who is authorized to contact and provide support to emergency contacts and families of affected individuals.
- If a required crewmember is injured or ill while on a trip, make sure you have considerations on how to move the passengers, other crewmembers, and relocate the aircraft. This may involve flying in an additional supporting crewmember, coordinating with an airline, or utilizing a contract crewmember.
If your flight department is designed to support a corporate backing, make sure you develop these policies and procedures in conjunction with the parent company. The corporate side will most likely have established policies and procedures and/or a business continuity plan, and it is important that your procedures do not conflict. The coordination will also serve to reassure the corporate side that you have been researching and have a plan of action in place just in case an emergency occurs.
Lastly, plan a drill to practice these procedures and identify weak-points. Involve as many resources as you can, including your whole flight department, corporate personnel (if applicable), medical services, airport authorities, and emergency responders. This not only helps strengthen your plan, but also provides reassurance to your team as they have been trained to respond.
Need help with any of the above? We would be happy to support you. Contact us today.