February 18, 2020
Coronavirus Information for Flight Crews
This situation is evolving, and updates will be provided on this page as news becomes available.
FAA: Screening Protocols for Flight and Cabin Crews at U.S. Ports of Entry (February 18, 2020)
This Page Contains:
- Air Safety Organization Coronavirus Updates
- Background and Timeline
- U.S. Government Answers to ALPA Concerns
- Resources for Flight Crews
- Reporting Deaths or Illness in Flight
- Nonalcohol-Based Sanitizers
- World Health Organization Recommendations to Avoid Transmission
Air Safety Organization Coronavirus Updates
ALPA’s Air Safety Organization (ASO) is closely monitoring the 2019 Novel Coronavirus (COVID-19) outbreak and will hold weekly conference calls until the emergency is resolved. Call notes will be posted in this section.
Aeromedical Conference Call—February 14, 2020
Hosted by ASO Aeromedical Chair Ellen Brinks (DAL)
- As of February 13, CDC reported that the coronavirus outbreak, which WHO and CDC now call COVID-19, continues to affect thousands, the vast majority of which are in China. Globally, there have been about 47,000 cases reported, with all but about 450 of those within mainland China. The mortality rate is approximately 2 percent for all cases, but this is subject to change as time passes and we learn more.
- Since airport screening began in mid-January, CDC and its government partners have screened more than 30,000 passengers arriving from China. With the temporary restrictions on travel, CDC is seeing fewer and fewer travelers from China, especially from Hubei province. As stated last week, passengers coming into the United States are being funneled through 11 airports. Most of these travelers are coming from parts of mainland China outside of Hubei and show no symptoms, nor are they assessed as high risk. Those who pass the screening continue to their destination where they self-monitor their health for 14 days in cooperation with their state and local health departments.
- Last week, several asymptomatic pilots reported being held with symptomatic passengers at three airport locations: ORD, EWR, and SFO. After numerous tries, ALPA was successful in reaching CDC to report these anomalies, and we believe that the agency has resolved the screening issues with CBP.
- ALPA Pilot Assistance Chair John Taylor spoke with the FAA chief of staff, Angela Stubblefield, yesterday (February 13) to request emergency contact information for CDC to avoid a repeat, which she has provided. We also requested that DOT hold another conference call with government and industry as they did on February 4, and she agreed to pursue that with DOT for a call perhaps weekly.
- CDC has confirmed another person in the United States who has been infected with COVID-19, which brings the total to 15; there have been no U.S. fatalities from it to date.
- On last week’s call, it was noted that Hong Kong authorities had announced a mandatory quarantine for individuals entering the country who had been in mainland China within the previous 14 days beginning February 8. On February 7, the Hong Kong government issued guidance on the quarantine that exempts airline pilots but requires them to wear masks and have their temperatures taken while in HKG. This guidance was posted to the ALPA coronavirus webpage last week.
- There is a new e-mail address for those who have a question or concern about the outbreak: Coronavirus@alpa.org. Several ASO reps are monitoring this account and will reply to inquiries as they arrive.
- We are presently hearing very few questions or concerns from members about airline operations as related to COVID-19, which we take as good news.
- As a reminder, ALPA is continually updating information on the COVID-19 outbreak on this page, which should be the first source of information for ALPA members.
Background and Timeline
The 2019 Novel Coronavirus (2019-nCoV) is the most recent infectious agent that represents the seventh strain of the coronavirus. Its symptoms include fever, body aches, cough, trouble breathing, sore throat, vomiting, and diarrhea. Many people have been infected with a form of common human coronavirus without realizing it, resulting in mild to moderate upper-respiratory tract illnesses similar to the common cold, but other coronavirus strains, including 2019-nCoV, can be deadly.
On January 22, ALPA Air Safety Organization Pilot Assistance leaders and ALPA Engineering and Air Safety Department representatives participated in a government-industry conference call (sponsored by the Federal Aviation Administration) aimed at sharing the latest information about the outbreak of a new strain of coronavirus.
According to the U.S. Department of Health and Human Services (HHS), severe illness from the virus has affected thousands of individuals in China and dozens of individuals in other countries. The agency has identified 11 individuals with the virus so far in the United States, none of which have proven fatal to date (February 4, 2020). The outbreak has resulted in about 425 fatalities, nearly all of which have occurred in China involving mostly older persons and those with diabetes or other diseases.
On January 27, U.S. Centers for Disease Control (CDC) and Customs and Border Protection (CBP) agents expanded monitoring for the illness to 20 U.S. airports. At the time, HHS determined that the risk to anyone in the United States is low; however, the situation is evolving, and the ultimate outcome of the crisis is still unknown. The State Department raised the Hubei province to a Level 4 travel notice-meaning Americans are not to travel to the Hubei province. To reduce the risk of contracting the illness, CDC issued a Level 3 travel notice, Avoid Nonessential Travel to China.
Canadian officials are tracking the situation, providing advice for travelers and making arrangements for repatriating Canadians from China.
Following a teleconference of the International Health Regulations Emergency Committee on January 30, WHO declared the outbreak to be a Public Health Emergency of International Concern, stating that it is expected that cases may appear in any country. Following WHO's announcement, the U.S. State Department issued a Level 4 travel notice: "Do Not Travel" to China.
The White House on January 31 declared a public health emergency concerning the outbreak and a temporary ban on entry of foreign nationals who have been in China within the last 14 days. American citizens returning from China may be quarantined for up to 14 days. As of February 2, all flights from China to the United States are required to land at 11 airports with enhanced screening. The White House said that the risk to U.S. citizens is still low, and they want to maintain that status with these provisions. Later that same day, the White House suspended entry into the United States "as immigrants or nonimmigrants, of all aliens who were physically present within the People’s Republic of China, excluding the Special Administrative Regions of Hong Kong and Macau, during the 14-day period preceding their entry or attempted entry."
On February 2, the FAA issued interim health guidance for air carriers and flight crews.
On February 6, ALPA Air Safety Organization Aeromedical chair F/O Ellen Brinks (DAL) briefed dozens of ALPA MEC, Aeromedical, and Safety chairs on the latest developments related to the coronavirus outbreak. Meeting notes are provided in the section "Air Safety Organization Coronavirus Updates" above.
U.S. Government Answers to ALPA Concerns
On February 4, ALPA participated in a call with the U.S. government (USG) to address members' immediate concerns. ALPA asked the following questions:
Q1. Is the CDC guidance concerning cleaning of commercial passenger aircraft for the ebola virus also being used for the coronavirus, or is there other guidance on this specific outbreak? If other guidance is being used, please identify it.
A1. CDC is updating the ebola guidance for use with the nCoV. There are no special recommendations in this regard at present.
Q2. Is FAA or any other government agency monitoring and overseeing the sanitizing of aircraft? Are all-cargo aircraft operating in China required to be sanitized? If yes, what guidance is to be followed for doing so? Is FAA or another agency monitoring/overseeing this activity?
A2. Sanitization is an airline responsibility, and FAA doesn’t monitor this activity. The Occupational Safety and Health Administration (OSHA) plans to update its website with info regarding aircraft cleaning, aviation workers, and jurisdiction of this responsibility. (Note: The OSHA rep stated that nCoV isn’t a bloodborne pathogen, so it will be interesting to see what they say about jurisdiction over infectious diseases, over which they do not have authority on aircraft.)
Q3. Are pilots, whether as part of an operating crew or in some other status, required to undergo health screening if they develop flu-like symptoms while traveling into the U.S. from origins other than China?
A3. During check-in/boarding process, airline reps may deny boarding to anyone who appears to be sick. A medical certificate is required to board, if one is denied, per 14 CFR 382.21.
Q4. Who is responsible and how are pilots being updated as countries change guidelines and acceptance of aircraft operations?
A4. It’s up to the airlines to provide this information to employees.
Q5. Is there a single point of contact for updated information concerning aviation and the outbreak?
A5. Not addressed on the call, but we are using our USG contacts on this issue, with DOT and others.
Q6. Has the USG determined definitively how long the nCoV will live on hard surfaces? Can you verify that the virus will live outside a host for 2 to 12 hours?
A6. CDC doesn’t know the lifespan of nCoV on hard surfaces yet, but they believe it is of short duration. There is a low probability of transmission of the virus except by person-to-person (i.e., sneezing, coughing, etc.)
Q7. Has the USG undertaken a review of the liability issues regarding the requirement for pilots employed by Part 121 airlines to continue operations into China?
A7. The USG hasn’t reviewed liability for pilots operating in China. The USG isn’t requiring airlines to operate there, so the liability issue would be one for the airlines.
Q8. Could you verify that asymptomatic persons are still considered noncontagious?
A7. The degree of contagion is linked to demonstrated symptoms. The speed of the virus’s spread indicates that it could be transferred by mildly sick people through coughing and sneezing.
Q9. With multiple countries closing their borders to passengers who have been to China, is the DOT working to get an exception for airline crewmembers?
A9. The USG isn’t tracking or involved in country closures to passengers or crews coming from China.
Resources for Flight Crews
- Hong Kong Government: Quarantine Guidance
- DHS: Instructions on Screening of Individuals Who Have Been to China
- White House: Suspension of Entry of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus
- U.S. State Department: Level 4 Travel Advisory—Do Not Travel to China
- Government of Canada:
- OSHA: 2019 Novel Coronavirus
Reporting Deaths or Illness in Flight
42 CFR 71.21 requires the pilots of international flights to the United States to report before arrival any deaths or illnesses (as defined in the regulations) among passengers or crew to CDC’s quarantine station at or nearest to the airport of arrival. This may be done by a report to ATC or the company using established means for that purpose.
Pilots who are concerned about the potential for testing positive for alcohol consumption through skin absorption may question whether it is safe to use alcohol-based hand sanitizers and surface disinfectants for the novel coronoavirus (nCoV) and whether there are suitable alternatives. According to ALPA’s aeromedical advisor, Dr. Quay Snyder, alcohol-based disinfectants could, in theory, be absorbed through the skin and create a positive alcohol urine test, but other forms of testing for alcohol abstinence (i.e., breath and blood) would not test positive. Daily physical contact with a significant amount of alcohol-based disinfectant or sanitizer could potentially result in a positive test. Nonpermeable gloves provide adequate protection for a pilot who wishes to sanitize surfaces with an alcohol-based disinfectant. And nonalcohol-based sanitizers, such as those that are hexachlorophene-based (used in surgical scrub), followed by a 20-second wash with soap and hot water, is a good, alternative sanitizing method.
World Health Organization Recommendations to Avoid Transmission
- Avoid close contact with people suffering from acute respiratory infections.
- Frequently wash hands, especially after direct contact with ill people or their environment.
- Avoid close contact with live or dead farm or wild animals.
- Practice cough etiquette if you have symptoms of acute respiratory infection (i.e., maintain distance and cover coughs and sneezes with disposable tissues or clothing).
Questions? Contact ALPA
U.S.-based pilots should contact the Aviation Medicine Advisory Service, ALPA’s Aeromedical Office, at 303-341-4435, Monday through Friday, 8:30 a.m. to 4:00 p.m. mountain time.
Canadian ALPA members can call David Noble, the Association’s pilot health consultant, in the Association’s Toronto, Ont., office toll-free at 1-800-561-9576 to be referred to a physician.
For additional information, contact ALPA’s Engineering and Air Safety Department at EAS@alpa.org or 1-800-424-2470.