Covid-19 Forcing New Approaches to Fitness for Duty

 - April 15, 2020, 4:50 PM

This story is part of AIN's continuing coverage of the impact of the coronavirus on aviation.

The outbreak of Covid-19 is changing the way pilots need to assess their fitness for duty because now they are now not only responsible for determining their own situation, but how their health might affect others, according to Dr. Paulo Alves, global director of aviation health for MedAire.

Alves participated Wednesday in a webinar hosted by NBAA, “Keeping Your Crew Fit for Duty in the Downtime,” alongside Dr. Quay Snyder, president, CEO, and co-founder of Aviation Medicine Advisory Services; Matt McNeil, a licensed professional counselor and founder of LiftAffect; and Greg Farley, manager of aviation safety and security for John Deere Global Aviation.

Along with the virus has come a “wave of information [that is] not always well aligned,” Alves said, noting that strategies are changing as the outbreak enters new phases. But what is becoming clear, he said, is that pilots need to rethink their approach to fitness for duty.

Alves cited an example of a pilot who got tested after experiencing early Covid-19 symptoms but continued to fly because they felt well. Five days later the test came back positive, but the pilot already had been exposed to other pilots, flight attendants, and passengers. Subsequently, another pilot ended up with Covid-19 symptoms. This was not an isolated case, he said.

“This is a totally new perspective where you personally need to change your strategy in your assessment of fitness for duty in this period of uncertainty because you are responsible not only for yourself but sometimes for the whole flight department.”

MedAire is finding different operators are approaching this with different strategies, Alves said, citing the example of companies who are sticking with set crew pairings to avoid extended contact.

Meanwhile, countries on the way to recovery are grappling with how to accept crews, he added. Different nations are questioning the use of quarantines. At the moment, Hong Kong is testing everyone and quarantining them until results are available, which could take three days. Discussions are being raised about whether crewmembers should carry certificates that they are virus-free. “Those are new challenges,” he said, adding focus is on the “broadening of fitness for duty to how your fitness could threaten others around you.”

Snyder also pointed to international challenges, particularly as renewing medicals and keeping up with the appropriate paperwork becomes extremely difficult. While the FAA is providing latitude by withholding enforcement through June 30, nations internationally have taken varied approaches. Some have provided no extra latitude, while others are providing one-month to six-month extensions. To fly internationally, employers must petition for exemptions for each pilot facing medical deadlines. Aviation officials have been working with the International Civil Aviation Organization to ease this process and are hoping for relief in the coming days.

The issue of medicals is particularly pressing because the average age of an aviation medical examiner (AME) is 62 and the average for senior AMEs is 68, falling within the high-risk category should they encounter Covid-19. “As a result, most AMEs temporarily closed their practices and some even announcing permanently,” Snyder said. Others practice at healthcare facilities where they would not want to put pilots at risk for exposure. “Therefore, it’s become very difficult to get a new medical exam.”

However, he still recommends that pilots undergo such exams when possible and said aviation officials are surveying to see which AMEs are still available. He warned that those who push such exams off until June 30 will see “a bow wave” of pilots doing the same and might experience a paucity of appointments.

Snyder further warned about looking for changes in drugs disallowed for use, pointing to the FAA move this week to prohibit flying while a pilot is taking medications such as chloroquine or hydroxychloroquine for Covid-19. While permitted for malaria, the dosage can be much higher when prescribed for Covid-19 and is not fully tested, he noted.

Mental health is another important factor that must be considered for fitness for duty, added LiftAffect’s McNeil, who noted the stress and anxiety that has come with the Covid-19 pandemic. Many pilots may experience fear, sadness, or even grief when they know of others affected by the virus, which are normal and adaptive feelings, he said.

The concern for fitness for duty comes when these feelings “slide” into other states, such as depression, increased anxiety, substance abuse, or even suicidal thoughts. Loss of sleep is another concern, he pointed out. Pilots must be aware of the risks associated with these periods and recognize that flying is not advisable. He encouraged pilots to reach out to others to discuss these issues.

John Deere’s Farley provided insight into his flight department’s approach during the pandemic. Early on, the flight department had already installed measures such as cleaning workstations, strategic crew pairing, and quarantines because the regular flu was becoming problematic. John Deere was able to retain these procedures for its approach to Covid-19, he said. But as guidelines changed rapidly – sometimes even on the same day – so too did the department’s procedures.

As an example, he cited rotating pilots flying aircraft for currency purposes. But now, unless it is a required trip, pilots are staying home. Key to this is checking in regularly with each other through videoconferencing or other means, Farley said. He also stressed that with an overwhelming amount of information flowing, it is important to make decisions based on what has proven to be factual.