High infectious diseases at an int. Airport (lessons learnt...)

Transcription

1 High infectious diseases at an int. Airport (lessons learnt...) W.Gaber MD, Vice President Human Resources Medical Director Fraport,FRA

2 Walter Gaber MD Vice President Human Resources since 1996 Medical Director, Public Health Officer Consultant für national/international Airports Occupational physician, Emergency medicine Environmental medicine, Sports medicine Acupuncture, Chirotherapy Qualification as fire service physician Qualification as organizing manager for rescue operations Qualification as safety expert Medical Consultant for WHO, ACI,EAGOSH, national and international Organisations International Trainer for Crisis Intervention since 2006 AWARDS 2017 Certificate of Appreciation, US Consulate 2013 Certificate of Appreciation, US Consulate for outstanding medical support 2011 Certificaton of Appreciation ; Mark A,**** General USAF for medical support at the tragic event in March Certificaton of Appreciation, State Department USA for continued support of medical operations for United States Government personnel through the Frankfurt Airport Certificate of Achievement Department of the Air Force (USA) for 20 years of outstanding support and unending cooperation 2004 Certificate of Appreciation Delta Airlines, Atlanta, USA, for 15 years of medical support 1995 Silver Pin award of "Arbeitsgemeinschaft gesunder Rücken"(AGS) for committed work on a national level in various member associations.

3 Goal of Airports.Keep the Airport running. Goal of Public Health Services...Keep the Pandemic outside.

4 Source: Brockmann et al 2004, Göttingen Frankfurt

5 BCM?

6 The complete Air Traffic is still shut down 3 h 118= 130= 13 long-haul aircrafts could not start 80 medium-haul aircrafts could not start 25 short-haul aircrafts could not start 44 long-haul aircrafts could not land 62 medium-haul aircrafts could not land 24 short-haul aircrafts could not land passengers are at FRA passengers are not at their destination Px = 83 ICE s to = 159 trucks tons of freight are not at their destination 248 aircrafts are not available at their scheduled intermediate airports Source: Kühn The effects are noticeable worldwide

7 Why do people travel when they are sick? They want to get home... The importance of the journey: Business Sick or dying relatives abroad Returning to birthplace to die Migrants Believe that they only have a minor illness Asymptomatic carriers Asymptomatic incubating disease Travelling to OWN health care

8 Questions to be answered... Are you a designated Airport? Do you know the IHR? Do you know the Core Capacity Tool? Did you talk to your PHA? Do you know your all local laws for public health? Do you know all your keyplayers? 24/7? Safe communication required! Do you have procedures coordinated with PHA in case of an event? Are you prepared? Logistic,facility,medical staff,training,...at all time?

9 Flughafen Frankfurt Medizinische Dienste

10 Scenario: 36 x 250 Pax = 9000 Pax/day* *Frankfurt Airport 2017

11 Obligation of the aircraft s captain According to international regulations WHO (23rd May 2005) and ICAO (Annex 9, Chapter 8, as well as attachment to State letter AN Guidlines for Air Traffic Services Units and Public Health Authorities when notified of a suspected case of communicable disease on board in inbound aircraft The aircraft s capitain should radio ahead to the ATC so that health and airport authorities are alerted by ATC to the arrival of a suspected case of any infect. disease

12 Management of on-board-cases A/C ID DEP DEST ETA No. Cases Nature of Risk { Airport Operator PHA Other Agencies Airline Operating Agency Destination Aerodrome Tower Air Traffic Controller

13 SARS 2003 FRA Seite 13 Source: PHA Ffm

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15 Swine Flue: incoming Aircraft (LH)

16 Procedures at Frankfurt Airport: (Swine Flue) All direct flights from Mexico Screening No gate position 2 physicians (generally 1x Airport and 1x Public Health Authority) Announcement by physicians in German and English First Visual Medical Screening (public health officer)

17 Swine Flue Announcement and information by public health officer before deboarding

18 Lufthansa: LH 499 Announcement for the medical screening Handouts for passengers at the gate after arrival

19 COLOR CODING

20 Procedure with 4 color coding in Hong Kong (SARS) Four busses for the different categories Red orange Yellow green

21 Modified 3 color coding FRA Green Bus Yellow Bus Red Bus

22 Color coding through Fraport s or Public Health Department s physician on duty Red: Index patient Yellow: Passengers or contact persons sitting within a radius of 2 meters* from the sick passenger as well as family or travel group members and flight attendants (serving this area) not showing disease s symptons Green: Passengers and crew members without close contact to the index patient *not two rows ahead and behind (wide body aircrafts?)

23 No Signs of symptoms Signs of symptoms Information leaflets from the Public Health Authority are distributed to all passengers 1. Index patient Protective mask Transport through FPA University Hospital 2. Prevention measures EMS 3. PLC is distributed to all passengers 4. HA s information leaflet is distributed to all passengers Key: FPA = Fire Protection Authority Frankfurt EMS = Emergency Medical Services

24 Thermoscan Bangkok Airport (RAMT Meeting,BKK) passengers have been screened with thermo scan; 2 (!) have been tested /confirmed positiv (in the first month) (Source: T. Evans, ICAO, 1st May 2009 ) Source: Gaber

25 HKG Excersice: Areas are separated Medical Post and paramedics are Available. CX employees will support passengers if there are any questions.

26 After filling out the public health declaration (PHD) the passengers will see the public health officer. Passengers do get informed by a medical expert and (!) a PowerPoint presentation with information runs always in the background.

27 Passenger Listing Source: Gottschalk,Ffm Seite 27

28 BCMS : Structured Planning BCP for each business process and operational system Pre-failure Plans Post-failure Plans System Fallback Plans Preventive & Maintenance Plans IT Recovery Plans Operational Continuity Plans Business Recovery Plans Failure Event TIME Business Continuity Management System An integrated, multi-layered, business-driven, process-based approach to plan for and manage business disruptions and crises.

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30 30 Dr. Gaber after 25 minutes on the scene

31 everything is ok, dont be Scared; we will take care Of you... 31

32 Patient sick and (!) vomating What should I do? With that kind of PPE? 32

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34 Lessons learnt... Never alone as a doc on the aircraft At least 2 paramedics and 1 expert for communication Suit (orange) is scary...or? Orange suit is not good for doc wearing glasses After 80 minutes without using a toilet and liquid the doc is exhausted Resumee: Immediately 3 Persons have to be dressed (safing time) Yellow PPE: is the correct dressing Do not use ORANGE suits Eye contact via yellow PPE is possible Communication has to be organized all the time 34

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36 Airport clinic: Incoming patient via Terminal

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39 Gloves have to Be modified Does not work that way... 39

40 Does it work in real? 40

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42 Overview Disinfectants versus scope of application Scope of application Disinfectant Source: DLH FRA *) for small areas [< 1m²] due to possible flammability

43 Standard operating procedures Fig. 1 Standard operating procedures from Lufthansa Technik to be used in aircrafts for disinfection in the presence of high infectious diseases Source: Lufthansa Group,Klaus Joachim 2018

44 Link for HID-Form Fig. 2: Link for the complete set of High Infectious Diseases Forms (HID Forms) on Lufthansa aircraft from Lufthansa Technik AG. The forms may be used for your own purposes. Lufthansa would appreciate a short feedback ( FRAPZO@DLH.DE) if you use the SOPs Source: Lufthansa Group, Klaus Joachim 2018

45 Recommodations Be aware of the upcoming event Be trained Know the keyplayer Have checklists prepared Cross check SOPs from different Airports, Airlines,Countries Act as experts stay away from politics... Satisfy the media Be careful with your human resources Check COLOR Coding Implement BCP and BCM KEEP THE AIRPORT RUNNUNG

46 Seite 48 Any Questions?