Hello podcast listeners, and thanks for joining me. I will be talking about communicable diseases and some ATC Zero procedures that have come out recently. There seems to be an endless amount of information from regulators and associations regarding disease management and best practices. I’ll try to hit some of the highlights today with regards to infections that happen on the ground with ATC and in-flight in your cabin.
Recently a Qatari airliner landed in Athens with 12 COVID-19 cases on board. There were 91 total passengers aboard. The airline said they had screened everyone at the departure airport in Doha. There are many unknowns out there as the protocols are put in place and the virus mutates so one protocol used today may have to be modified the next time you fly. Keep educating yourself not just for your job, but also for your family. Pilots and cabin crew members are exempt from quarantine rules so this poses and extra risk to our families and friends. A medical source I speak to occasionally believes that COVID-19 is airborne which supports much new research, although the World Health Organization (WHO) has not gone ahead and said this formally-yet.
ATC Zero is new term to some so I will say that it is an FAA term and occurs when the FAA is unable to safely provide the published ATC services within the airspace managed by a specific facility. The term is defined in FAA Order JO 1900.47 – Air Traffic Control Operational Contingency Plans. It is one of three designations used by the FAA (ATC Alert, ATC Limited, and ATC Zero) to describe degraded operations and invoke operational contingency plans.
Cases of COVID-19 among ATC facility staff and technicians have led and will likely continue to lead to intermittent, total, or partial closures of ATC facilities. This could occur with little or no warning.
What Do You Do if ATC Goes off The Air in Oceanic Airspace?
The FAA recommends you review guidance material:
Aeronautical Information Publications (AIP) for the countries where you operate.
Regional operational air traffic management contingency plans, such as the Air Traffic Management Operational Contingency Plan for the North Atlantic Region (NAT) Doc 006.
Regional Supplements Doc 7030.
Here are the procedures as specified in the SAFO for aircraft in or planning to operate within oceanic airspace:
Continue as last cleared and contact the next ATC unit as soon as possible with a position report. Flights operating with an oceanic clearance are expected to continue in accordance with the last clearance issued.
Flight crews should use extreme caution and use all available means to detect any conflicting traffic.
Flights Approaching Any Oceanic Airspace when The Contingency Is Activated
If you don’t have an oceanic clearance, and you are approaching oceanic airspace where the contingency is activated…
Flights not in receipt of an oceanic clearance should land at an appropriate aerodrome or, if possible, request clearance to avoid the affected Oceanic Control Area (OCA).
If you have an oceanic clearance…
Aircraft operating with a received and acknowledged oceanic clearance can, at the flight crew’s discretion, continue, but should expect limited ATC service within the affected OCA. Due to the uncertainty surrounding the contingency situation, flight crews should, if possible, consider seeking a clearance to reroute around the affected OCA.
Flight crews are requested to broadcast traffic information in the blind to other flights/stations on 121.5 and on 123.45 (or 126.9 MHZ as appropriate in designated International Air Transport Association (IATA) broadcast areas), in order to exchange position information. A continuous listening watch and regular broadcasts must be maintained.
ATC may invoke the ICAO Traffic Information Broadcast by Aircraft or TIBA procedure.
TIBA is where flight crews broadcast in the following form:
ALL STATIONS (your call sign), FLIGHT LEVEL () (or CLIMBING/DESCENDING TO FLIGHT LEVEL (number)) (direction) (ATS route) (or DIRECT FROM (position) TO (position)) POSITION (position) AT (time) ESTIMATING (next reporting point, or the point of crossing or joining a designated ATS route) AT (time) (call sign) FLIGHT LEVEL (number) (direction).
Basically, it’s a normal radio call of who you are, where you are, and where you want to go.
TIBA calls should be provided at the following times:
10 minutes before entering the designated airspace or, for a flight crew member taking off from an aerodrome located within the lateral limits of the designated airspace, as soon as appropriate after takeoff.
10 minutes prior to crossing a reporting point.
10 minutes prior to crossing or joining an ATS route.
At 20-minute intervals between distant reporting points.
2 to 5 minutes, where possible, before a change in flight level.
At the time of a change in flight level.
At any other time considered necessary by flight crew.
Additional Remarks
The FAA adds the following comments:
You should complete a flight level change as soon as possible in accordance with the clearance.
Mandatory position reports should be accomplished via HF or SAT until directed by ATC.
Flights equipped with FANS 1/A or equivalent should communicate using HF or SAT while attempting to reestablish CPDLC
If you can communicate with your operation’s flight dispatch then they can forward position reports to the relevant OCA.
Standard Oceanic Checks
As always, following your oceanic SOPs is paramount. You should plan to experience a loss of ATC services at any point in the flight.
A heightened sense of awareness is required for all procedures including:
Plotting.
Adherence to the current clearance.
Mach number or airspeed which may need to be adjusted based on proximate traffic.
Conducting navigation accuracy checks.
Conducting waypoint and 10-minute post-position checks.
Using Strategic Lateral Offset Procedures (SLOP).
Additional Recommendations
Consistent with AIP recommendations, should flight crews encounter situations that are not covered by regulation, they are expected to exercise good judgment in whatever action they elect to take.
Additionally, flight crews should take the following actions:
Monitor for traffic visually and by using TCAS or ADS-B In.
Ensure all appropriate exterior lights are turned on.
Monitor and use relevant communication channels such as 21.5/123.45 or 126.9 MHz, HF, SATVOICE, and data link.
Refer to the SAFO itself for details.
Communicable Diseases
Let’s talk about communicable diseases and some procedures from your perspective.
There have been a number of pandemics since the beginning of the 20th century: the H1N1 pandemic of 2009, the Spanish flu of 1918/19, as well as flu pandemics in 1957 and 1968, and now the COVID-19 pandemic of 2019/20. Among the best-known pandemics is the Black Death, a plague which spread across Asia and Europe in the middle of the 14th century.
What Causes COVID-19?
COVID-19 is caused by a coronavirus called SARS-CoV-2. Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.
How Does COVID-19 Spread?
It is thought to spread mainly from person to person, mainly through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
Spread is more likely when people are within 6 feet of each other.
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but research continues.
Cleaning Procedures
Everything must be clean!
This is paramount. The airplanes I fly have never been cleaner, but all it takes is one infected passenger to get onboard. So what do we mean by “clean”?
Clean crew.
Clean aircraft.
Clean airport facilities.
Transporting clean passengers.
Clean hotels, rental cars, and ubers.
Countermeasures
So what are some thoughts on how to defend yourself and your passengers from disease?
Flight Planning
Is the destination safe? (Have there been reported exposures at the airport? Is the destination itself a “hot spot” experiencing large numbers of COVID-19 infections?
Does this trip need to be overnight (meaning additional opportunities for exposure at lodging)?
Do we have a plan in place if passengers or crewmembers show signs of exposure during the trip?
Does your operation use a or Flight Risk Assessment Tool (FRAT)?
Flight Risk Assessment Tool (FRAT)
A FRAT could bring your attention to:
A heath situation at location.
Number of passengers and physical distancing on the aircraft.
Length of mission.
Crew and passenger interactions with other people.
Need for ground transportation and overnight lodging.
If abroad, access to consular officials.
Personal Protective Equipment Kit
Personal Protective Equipment has never been more talked about. What is contained in your PPE kit? How much is in your PPE kit? Can you supply a few passengers with PPE if another passenger develops symptoms in flight? Business jets cabins can be small when you are trying to stay six feet apart from others onboard.
Some contents could include: hand sanitizer, N95 masks, a thermometer device, gloves, face shield, medical gowns.
Dry Powder that can covert small amounts of a liquid spill into a granular gel for pickup.
Germicidal disinfectant for surface cleaning.
Skin wipes.
Face or eye shield (separate or combined).
Disposable gloves.
Impermeable full-length sleeved gown that fastens in the back.
Large absorbent towels.
Pick-up scoop with scraper.
Bio-hazard disposal waste bags.
Instructions—there is a generic set of instructions for UPK, but they are usually specific to each kit.
Cleaning and disinfecting guidance from manufacturers of the UPK contents
Signs and Symptoms
A communicable disease is suspected when a person has a fever of 100 °F or 38 °C or greater and associated with one or more of the following signs or symptoms:
Cough.
Shortness of breath.
Fever.
Chills.
Repeated shaking with chills.
Muscle pain.
Headache.
Sore throat.
A new loss of taste or smell.
Diarrhea.
Keep in mind that symptoms have changed since the beginning of outbreak and may change again.
In-flight Situations
A difficult situation can occur when someone develops symptoms in-flight. Infections are much more easily dealt with on the ground, but in-flight has its complications.
Crew must:
Contact ATC immediately.
ATC will notify the FAA’s Domestic Events Network (DEN) of the report using the code “Request CDC consult.”
The DEN will in turn notify the CDC for Quarantine Station with jurisdiction for the arrival airport.
Pilot-in-command (PIC) must:
Report to flight department immediately (Prepare for all exposed to be quarantined upon return)
Consider a diversion. Is your destination equipped to handle this level of disease complexity?
Procedures to Follow while in Air
Ok, so have an infected person with some symptoms I referred to earlier. What are some procedures to follow while in air?
Place N95 on the individual and maybe on those surrounding the sick person.
Wash hands with soap and water for at least 20 seconds after tending the individual.
Equip any crewmember (if not already wearing a mask) in close proximity to the individual with an N95 mask.
Have all individuals on the flight fill out a public health passenger locator form www.who.int/ihr/ports_airports/locator_card/en/. This is to ensure contact tracing is performed if it is confirmed that the individual has COVID-19.
Ask the ill traveler where he/she has traveled in the last 21 days and if he/she has lived in the same household or has had contact with a person sick with a communicable exposure.
If medical support from the ground via SAT phone is available, such as medical service, contact them immediately or ask for medical assistance from any qualified individuals on board. Your company policy should be followed at all times.
Try to relocate the adjacent passengers leaving a space or two meters or six feet between the ill passenger and the other passengers. If no seats are available, consider giving PPE to the adjacent passengers such as a mask and face shield.
Designate one cabin crew member to look after the ill traveler, preferably the crew member that has already been dealing with this traveler.
If possible, designate a specific lavatory for the exclusive use of the ill traveler and use appropriate signage on the door.
Respiratory etiquette is required of the ill passenger:
Provide tissues and the advice to use the tissues to cover the mouth and nose when speaking, sneezing, or coughing.
Advise the ill traveler to practice proper hand hygiene. If the hands visibly soiled, they must be washed with soap and water.
Provide an air sickness bag to be used for the safe disposal of the tissues or bags from the Universal Precaution Kit.
If a face mask is available and the traveler is coughing or sneezing, the ill traveler should be asked to wear it. As soon as it becomes damp/humid it should be replaced by a new one. These masks should not be reused and must be disposed safely in a biohazard bag after use. After touching the used mask (i.e., for disposal), proper hand hygiene must be practiced immediately.
If the ill traveler cannot tolerate a mask or refuses it, the designated cabin crewmember or any person in close contact (less than one meter) with the ill person should wear a mask.
If touching the ill passenger is required, the designated cabin crewmember should wear the Personal Protective Equipment (PPE) found in the Universal Precaution Kit (UPK). UPKs are not intended to replace proper hand hygiene. The PPE in the UPK should be carefully removed as per training syllabus and discarded as per published procedures. Hands should be washed with soap and water. An alcohol-based hand rub can be used.
Store soiled items (used tissues, face masks, oxygen mask and tubing, linen, pillows, blankets, seat pocket items, etc.) in a biohazard bag if one is available. If not, place in an intact plastic bag, seal it, and label it “biohazard.”
Ask accompanying traveler(s) spouse, children, friends, etc. if they have any similar symptoms.
Reporting Procedures
The Captain is required by the International Civil Aviation Organization regulations (ICAO Annex 9, Chapter 8, and paragraph 8.15) and the World Health Organization International Health Regulations (WHOIHR 2005, Article 28(4) to report the suspected case(s) to air traffic control.
The captain must also advise the destination that specific cleaning and disinfection procedures may be required.
Unless stated otherwise by ground medical support or public health officials, ask all travellers to complete a passenger locator form if available on the aircraft or at the arrival station. This form tracks the passengers’ movement in previous days.
Upon landing, coordinate transportation and medical care with local health officials.
Post-flight Procedures
Operators must insist that both passengers and crewmembers report if they become ill within 14 days of the flight.
Designate a Human Resources point of contact for reporting to ensure passenger and crewmember confidentiality and that the appropriate parties are contacted.
Alert individuals who shared a flight with that individual or interacted with them at the workplace.
There’s lots of information out there. TrainingPort.net will have an online topic out soon. Have a plan before you fly. An effective Infectious Disease Control Plan could include any or all of the following:
Pre-flight assessment.
Crewmember assessment and monitoring.
Passenger screening procedures.
Baggage screening procedures.
Universal Precautions Kit (UPK).
Infectious disease precautions during flight.
Inflight sick passenger or crewmember procedures.
Post flight disinfecting procedures.
Travel and housing procedures.
Notification procedures for sick crewmembers or travellers.
Care plan for housing and travel for sick crewmembers.
Keep educating yourselves on communicable diseases. Thanks for listening.
