AIRLINE EMERGENCY REPONSE PUBLIC HEALTH PLAN DAICY DEMAS

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AIRLINE EMERGENCY REPONSE PUBLIC HEALTH PLAN DAICY DEMAS

o South African Airways (SAA) Airport Operations has established a clear procedure in response to a suspected communicable disease or passengers with ill health with the potential to pose a serious public health risk. o The procedure is documented in the Customer Procedures Manual: Section 2 Chapter 39 as well as in the 14 CFR Part 382 learner guide. o SAA procedure adheres to IATA Communicable Disease recommended guidelines in collaboration with the WHO.

Ground Staff Screening Process o A communicable disease is suspected by ground staff, when a customer : Has a visible skin rash Has a severe cough Is obviously unwell Has a high fever and complains of the following :

Severe cough Fever Bruising or bleeding without previous injury Persistent diarrhoea A non-visible skin rash Persistent Vomiting

o When ground staff suspect that a customer displays these signs or symptoms, they : Call their Team Leader / Supervisor immediately If Team Leader / Supervisor shares the same concern, contact the SAA Medical Department / External Physician / Airport Medical Facility / Port Health If medical support is not immediately available, customer will be denied boarding and customer asked to consult a physician and request a medical clearance before travel is accepted

Procedure if a communicable disease is suspected and a customer is denied boarding o Customer s baggage will be offloaded. Recommended that ground staff wash their hands with soap and water after handling the baggage. o Assistance will be provided if customer requires to be escorted. Masks to be worn / Tissues used to cover both the customers / airline staff s mouth.

o In terms of Article 32 of the WHO International Health Regulation, SAA will treat customers with dignity and try to minimise discomfort. If a translator/interpreter is needed, we will try our best to arrange one. o In some countries (eg: USA), the Customer Complaint Resolution Official (CCRO) must be involved. o Ground Staff / Airport will inform Customer Care of decision take and provide additional information.

Procedure if a communicable disease is suspected and a customer is allowed to board o This should not happen as staff are aware of the problems associated if this is allowed. o Seek guidance from SAA Medical department. o Airline staff to note on General Declaration and advise Cabin Crew. o Destination airport to be advised.

What SAA has Implemented Training Course that is mandatory for all ground staff to attend within 36 months (every 36 months). The training course explains important and essential aspects of communicable diseases. This will equip ground staff to effectively screen customers and forms part of the US DOT Part 382 training. Training records are available at the training section. Regular audits are carried out to ensure that ground staff know procedure to follow.

Communicable Disease flashcards available at all check-in and ticketing counters, for staff to refer to Masks, gloves and hand sanitizers readily available. Communiques distributed by Medical Department to all SAA employees when faced with a suspected case of a communicable disease, so that all are informed of WHO updates. Briefing reminders.

General Declaration ICAO made changes to the General Declaration Declaration of Health. SAA requested these changes in 2014 from Amadeus. They have lodged a service request and all carriers had to approve this. The final approval was obtained and the changes will be reflected by end of 2015. Ground staff will print a gen dec for each flight and hand over to the crew. The crew will update any incidents on board and on arrival hand the gen dec to Port Health.

Changes Made to Gen Dec NAME AND SEAT NUMBER OR FUNCTIONS OF PERSONS ON BOARD WITH ILLNESSES OTHER THAN AIRSICKNESS OR THE EFFECTS OF ACCIDENTS, WHO MAY BE SUFFERING FROM A COMMUNICABLE DISEASE (A FEVER, TEMPERATURE 38ºC/100.F OR GREATER, ASSOCIATED WITH ONE OR MORE OF THE FOLLOWING SIGNS OR SYMPTOMS: E.G. APPEARING OBVIOUSLY UNWELL; PERSISTENT COUGHING; IMPAIRED BREATHING; PERSISTENT DIARRHEA; PERSISTENT VOMITING; SKIN RASH; BRUISING OR BLEEDING WITHOUT PREVIOUS INJURY; OR CONFUSION OF RESENT ONSET, INCREASES THE LIKELIHOOD THAT THE PERSON IS SUFFERING A COMMUNICABLE DISEASE) AS WELL AS SUCH CASES OF ILLNESS DISEMBARKED DURING A PREVIOUS STOP.

THANK YOU

SUSPECTED COMMUNICABLE DISEASE GUIDELINES FOR CABIN CREW

SUSPECTED COMMUNICABLE DISEASE ON BOARD Guidelines for Cabin Crew A temperature above 38 degrees Celsius Associated with one or more of the following Appearing obviously unwell Persistent coughing Persistent diarrhoea Impaired breathing Persistent vomiting Skin rash Bruising or bleeding without previous injury Confusion of recent onset History of travel in last 21 days Ask Accompanying Pax of any similar symptoms Note : If the temperature of the affected person is normal but several travellers have similar symptoms think of other public health issues such as chemical exposure

NOTIFICATION ON BOARD Report suspected case COMMANDER OCC ATC INTERNAL PROCESS ACTIVATED ERP / MEDICAL SERVICES

On Board Action Plan Suspected Communicable disease Relocate adjacent passengers 2meters between ill pax/other Designate one crewmember No seats available offer masks adjacent pax

Passenger Care Respiratory Etiquette Block Off Toilet for specific Pax/If no extra toilet available crew to educate pax on UPK- Washing hands/wiping toilet seat tap handles/door handles with antiseptic provided or soap and water

CABIN CREW CONCERNS-EXPOSURE When Exposed to Body Fluids TRAINING FROM MNORT Inception of High Level PPE Identifying the GAPS Hot/Uncomfortable/ Pretty Scary for crew Crew much more Relaxed REMOVAL suit even More important INTENSIFIED TRAINING PRIOR TO FLIGHT AND IN RECURRENT TRAINING Proper Donning and Removal Key Aspect of Training

Flight Operations OM Part 1 Chapter 9 Rev 15 Cabin Crew to inform the Captain of the passenger with suspected communicable disease Captain to notify ATC (to allow for notification of Port Health Captain to notify the SAA GOCC (request disinfection of a/c) Captain to complete the Communicable Disease GENDEC Trained by Sr. Linda annually during recurrent training

FOLLOW UP/TRACING PASSENGER LOCATOR FORMS GENERAL DECLARATION FORMS TO BE COMPLETED BY CABIN CREW FOR PAX ROWS FORWARD/AFT/SAME HANDED TO PORT HEALTH ON ARRIVAL

THANK YOU

DR NONHLANHLA SISHABA

Suspected Communicable Disease on Board A SENIOR AVIATION DOCTOR, /A NURSE IS ON STAND BY 24/7 FOR All EMERGENCIES. NOTIFICATION COMES THROUGH FROM THE AIRCRAFT VIA OCC SICK PAX ON BOARD

COMMUNICATION BETWEEN SAA DR/NURSE OCC AND COMMANDER VIA SATCOM DECISION IS MADE ON HISTORY RECEIVED FROM THE CABIN CREW A temperature above 38 degrees Celsius Appearing obviously unwell Persistent coughing Persistent diarrhoea Impaired breathing Persistent vomiting Skin rash Bruising or bleeding without previous injury Confusion of recent onset History of travel in last 21 days If Suspicion is confirmed ERP is activated via OCC

1. AVIATION EMERGENCY RESPONSE PLAN ACTIVATED R 2. MNORT Instructions Followed if Pax/Crew Hospitalized

CREWMEMBER MANAGEMENT POST INCIDENT A GROUP DEBRIEFING GROUP POST COUNSELLING INDIVIDUALISED PROFESSIONAL POST COUNSELLING PRN CREWMEMBER MEDICAL FILE DOCUMENTED CONTINUED MONITORING/WELLNESS MANAGED FITNESS TO RETURN ESTABLISHED

AIRLINE EMERGENCY RESPONSE PUBLIC HEALTH PLAN (OUTSTANDING SUBMITT SUNDAY) ZAMA NGUBANE

THANK YOU