During the NBAA virtual Flight Operations Conference on February 23, flight department managers and medical experts shared useful information for operating safely during the Covid-19 pandemic and how vaccines may help towards a return to normal operations. The “Post Covid-19: Best Practices for Crewmembers” webinar featured Brian Abrahamson, supervisor of operations and scheduling for Merck’s flight department; Jared Taylor, fixed-wing pilot and safety manager, Johnson & Johnson; Alexander Smith, MedAire director of nursing and health screening products; and Dr. Paulo Alves, MedAire global medical director.
The key piece of advice from the experts is that with proper risk-mitigation, flying can continue during a pandemic, but planning is essential and even with regular testing, it is still necessary to adopt best practices for mask-wearing, social distancing, hand-washing, and cleaning.
For the Johnson & Johnson flight department, which operates three fleet types (Gulfstream G550s and G650s and a Leonardo AW139 helicopter), an initial step was to consult with the company’s own medical experts and peers in other flight departments. One of the first issues was deciding whether pilots should wear masks on the flight deck. Although Taylor found in looking at other flight departments that most pilots were not wearing masks, his company’s risk-assessment found that wearing masks should be done. The principal safety risk is the additional time needed to remove a medical mask and put on an oxygen mask in case of a rapid decompression, he explained. However, he added, “Our medical department told us we were at much greater risk by not wearing a mask. We decided that a mask was the best solution.”
MedAire’s Dr. Alves underscored that risk-assessment, based on his own research into the rarity of rapid decompression events. “I’m not downplaying the potential threat,” he said. But the risk is low compared to the more immediate threat of Covid-19 infection. “If at all possible, wearing a mask is not a bad idea,” he said.
MedAire’s Smith said that “Education is the key.” Helping everyone involved understand the issues increases the buy-in by each team member and it shows that the company encourages a safety culture and wants individuals to take personal responsibility. “It’s only effective when you approach it collectively,” he said.
“It all comes from the top,” said Taylor. “Johnson & Johnson is extremely safety-based, everything we do is rooted in safety. Implementing the guidance and protocols was not an issue.”
What this meant for the company flight department was building a plan to keep team members safe from Covid-19 while also enabling them to maintain currency and prepare to fly during a time when Johnson & Johnson executives needed to travel.
Maintaining proficiency proved to be a challenge, and this was also the case for Merck’s flight department, which also operates a mixed fleet. “We had trouble with maintaining pilot proficiency,” said Abrahamson. “We weren’t [traveling] anywhere.”
Taylor worked with the company’s training manager, assistant chief pilot, and standards manager to tackle the myriad problems caused by the pandemic. To start, crews were created for each airplane, and pilots were assigned to one type only. This minimized cross-contamination between pilots but also simplified the currency issues because pilots had to remain current in just one aircraft type.
At first, because not much company flying was happening, the Johnson & Johnson plan was to conduct a regular series of round-robin flights at night so pilots could stay current. “It was a great idea in theory,” said Taylor, “but there were complications.” The flight department has long used a flight risk assessment tool (FRAT) before each flight, and night flying adds to the threat level. Because the flights were short-range, they were not at very high altitudes, and these both added risk. It turned out that every FRAT for these flights required major mitigation. At the same time, pilots flying these round robins submitted a relatively high number of forms reporting safety of flight issues. “We thought we had a great plan,” he said, “and thought we were reducing the level of risk by [staying current]. We realized we were doing the opposite.” It turned out to be much safer to move proficiency flying into simulators.
Flying did eventually pick back up, much of it related to Johnson & Johnson’s work on a Covid-19 vaccine, so that helped improve the currency situation for pilots. But this also meant the department had to develop other risk-mitigation strategies for crew and passengers and, of course, it helped that Johnson & Johnson is a medically focused company.
The first step was to create an active Covid-19 testing program, as well as protocols for when testing isn’t available. Luckily most of the international flying is cargo, without passengers, so that helped simplify the process.
The flight department worked with the medical department and put in place a process that applies to all crew, flight department employees, and passengers. The day before, everyone must take their temperature and if they have no Covid-19 symptoms, they can go to the airport. They must use a return-to-work app created by Johnson & Johnson for initial screening, and if the app gives them a green light, then they can enter the flight department facility, have their temperature taken, then get the Covid-19 test. Results are available in 22 minutes and this provides certainty about whether or not the candidate is shedding virus particles. “We can be certain of that [not shedding] for 24 hours,” Taylor said.
Each flight is assigned a primary and backup crew in case a primary member tests positive. But no one interacts until they all test negative. Everyone assigned to the flight must continue wearing a mask until they climb aboard and shut the door. Because the testing has determined that no viral shedding is happening for the next 24 hours, the pilots can then remove their masks and keep them off until reaching the 24-hour mark (although they may need to don masks when stopping for fuel at an FBO). For international trips, the flight carries a third pilot and a flight engineer. The aircraft are all regularly sanitized, including the application of an anti-microbial compound.
Generally, international trips can be flown within the 24-hour window by avoiding spending any extra time at the destination. But if it is impossible to obtain testing or the trip lasts longer than 24 hours, the pilots switch to wearing masks all the time.
Taylor understands that not all flight departments can afford such extensive Covid-19 surveillance protocols. But handling companies such as Universal Weather & Aviation and World Fuel can help, and his flight department does work with them. “They provide a lot of resources for us determining what we can do and can’t [for where they can travel],” he said. “But everything is constantly changing. You’ve got to be Googling and using every resource available.” Johnson & Johnson also uses MedAire to help with medical and security logistics.
“Rely on the basics,” he said. “Do your best to maintain social distance, wear a mask, and wipe things down. In the event we can’t get tested prior to departing, we can go to a local facility for an instant test. We still have to wear a mask in the cockpit if we do that.”
“The capricious nature of travel restrictions makes this a challenge for everyone,” said MedAire’s Smith. It’s important to know ahead of time about restrictions at the planned destination, including crew protocols and testing requirements, but more importantly what to do in case of an emergency. “What if you have a positive case in Asia?” This could mean having to quarantine for weeks before being allowed to travel again or having to arrange for an air ambulance.
Smith recommends additional information resources such as the International Air Transport Association, government agencies, travel website Kayak, OpsGroup, and even China Airlines. “The most important thing is to have a plan before you go,” he said.
The Johnson & Johnson flight department employs an emergency response plan developed by Fireside Partners. If someone on a flight is displaying Covid symptoms, that person is isolated and masked and then placed in a closed-off area with no further contact with the crew. Passenger loads are limited to six on its large-cabin Gulfstreams, and plans are in place for where passengers can be isolated in case this happens.
MedAire can also help flight operations set up testing programs. According to Smith, a regular surveillance program remains the best way to resume flying, “as often as you can with the best test possible. We sit down with operators and consult about what resources do you have, what is your risk profile, what can you feasibly do?”
Ultimately, he added, “The basics still apply. You’re trying to prevent onward transmission. How can I prevent moving this virus particle from A to B? The expectation is that you act like you’re infectious all the time. Getting access to testing so you can make [smart] decisions is empowering. As we get vaccinated, there is a lot of good opinion that vaccines will help prevent some onward transmission. There will be better tools in the toolbox.” Meanwhile, people will still need to wear masks, wash their hands frequently, and employ social distancing.
“We’ve been extremely successful in preventing the spread of Covid in our department,” said Taylor. “We haven’t seen any issue of Covid in our 35-member department. Some of the mitigation strategies have helped us not to have it spread.”
On the vaccine front, these are already helping lower case numbers, but Smith doesn’t expect something like a “vaccine passport” to enable widespread travel. “We’ll see indirect effects of lower transmission numbers, hospitalizations, and lower death [numbers]. We’re seeing a significant decrease of cases in the U.S.
“There is evidence of both of the vaccines in the U.S. being equally efficacious,” he said. “For the two vaccines, there is a 99.5 percent chance you won’t get Covid-19 after 14 days with no symptoms. Even [the soon-to-be-approved] Johnson & Johnson vaccine is 100 percent effective at preventing hospitalization. Our message is, if you have the ability to get access to any vaccine, you should take it.”