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FAI Air Ambulance Update #2: Wuhan Coronavirus (2019-nCoV) Featured

FAI Air Ambulance Update #2: Wuhan Coronavirus (2019-nCoV)

FAI Air Ambulance has been closely monitoring the evolution of the novel coronavirus outbreak since we provided our first summary of the situation.

Here is our 2nd update on the now officially named Wuhan Coronavirus (2019-nCoV) together with our latest position on assisting you in the repatriation of your clients out of China. As anticipated, case volumes throughout China continue to grow, as well as the number of cases and their distribution within other countries around the world. Clinical evidence and epidemiological information regarding the behaviour of the virus is accumulating rapidly, and is being circulated widely both through global official channels, and through the media.

From our perspective as an air ambulance operator, the most important findings of the last days are:

  • There is clear evidence now that human to human transmission is readily occurring;
  • 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;
  • Virus transmission does not require very close or intimate contact;
  • The contagious nature of the virus is expected to change, depending on the rate of viral mutation, based on evidence from previous novel coronavirus outbreaks;
  • Likewise the severity of infection, and case fatality rates, will remain difficult to predict, and subject to change from what is currently being observed.

FAI Operational Position Statement #2

1. Confirmed cases of Wuhan Coronavirus (2019-nCoV)

Based on the current situation FAI will for the time being adhere to our previous position, and will currently not consider transporting patients with confirmed “2019-nCoV“ infection.

  • This position will be reviewed after a definitive response has been received from a submission FAI has made to the German Federal Ministry of Health;
  • FAI is mobilising our PMIU capability meanwhile and a further update will follow in the coming days.

2. Case contacts

Contact-only cases will be reviewed on a case-by-case basis, under the following circumstances, which will define our ability to perform any such mission:

  • Health authorities of all involved countries do not decline the transport;
  • The receiving hospital is fully informed and willing to accept the patient;
  • The involved ground ambulance services are briefed accordingly and accept the patient;
  • FAI flight crew and medical crew retain their personal right to decline the mission;
  • The patient has a negative 2019-nCoV test by a methodology recognised by the WHO/CDC.

Please note: Such patients will require to be transported via a PMIU, depending on our case risk assessment. This will be discussed closely between FAI Medical Director/s and the Client.

3. 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: Such patients will require to be transported via a PMIU, depending on our case risk assessment. This will be discussed closely between FAI Medical Director/s and the Client.

4. General Principles

In ALL accepted cases, FAI will apply strict hygiene measures, including, but not limited to:

  • FAI Medical Crew will wear FFP3/N95 masks, disposable protective gowns and gloves at all times;
  • Flight Crew will do so only when assisting in patient loading / unloading or other close contact;
  • Patients will wear surgical face mask or FFP3 mask subject to individual case by case decision;
  • Strict adherence to hand hygiene;
  • For intubated/ventilated patients: closed suctioning system; double filters at the ET/trach tube, and at the ventilator; very restrictive use of aerosol / droplet generating procedures;
  • No relatives or other non-medical escorts allowed on board (exception: parents of small children subject to individual case by case decision);
  • Meticulous attention to medical waste management sealed in biohazard – proof plastic bags;
  • Meticulous aircraft post-mission disinfection according to FAI advanced hygiene plan.

5. Limitations

Please note the following limitations:

  • FAI reserves the right to modify all items listed above on a case by case base, including the possibility that individual cases might be declined;
  • All cases will be discussed closely between FAI Medical Director/s and the Client, and close liaison will be maintained throughout the progress of any case;
  • 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 should be assumed that obtaining many of these clearances and permits will be subject to unusual delays, outside of normal flight operations per location;
  • 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.
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