Covid-19 and first class medical

[kly]

In March flight schools closed for several months allegedly because of Covid-19 pandemic. General data suggest that people who dying of Covid-19 tend to be very seriously ill with life-threatening diseases before getting the virus. In ATPL schools everybody, students and instructors have Class 1 Medical.

I wonder, does anybody know of anybody with Class 1 Medical who died of Covid-19?

[schweizer2]

What would make a class 1 holder immune to death from Covid-19?

I am sure Class 1 holders have died from undetected health issues in the past, which I suppose is why we train for incapacitation.
You can also have "controlled" health issues and hold a class 1 medical.

[double_barrel]

In March flight schools closed for several months allegedly because of Covid-19 pandemic. General data suggest that people who dying of Covid-19 tend to be very seriously ill with life-threatening diseases before getting the virus. In ATPL schools everybody, students and instructors have Class 1 Medical.

I wonder, does anybody know of anybody with Class 1 Medical who died of Covid-19?

Yes, I do.

[lederhosen]

A British pilot in Vietnam came very close to dying, in fact he is quoted as saying that he would probably have died had he been elsewhere. The worrying question is whether he and others who have been seriously ill will get their class 1 medicals back. There are reports of serious follow on consequences and as a class 1 medical holder these concern me. As far as actually dying there have been a number of cases reported in the media, a Kenya 787 captain, and an Air India pilot are two I remember.

[kly]

Can you give links to the original sources please.

[Gulf Julliet Papa]

https://lmgtfy.com/?q=british+pilot+vietnam (http://British Pilot Vietnam)

[swh]

Two very senior captains at Turkish Airlines Serdar Gündoğdu and Mehmet Ali Kılıç have died from Covid. Captain Daudi Kimuyu Kibati a senior Kenyan Airlines captain died after doing a Covid repatriation flight. Qatar has lost pilots, so too has Fedex.

Covid does not discriminate.

[infrequentflyer789]

General data suggest that people who dying of Covid-19 tend to be very seriously ill with life-threatening diseases before getting the virus.

That is a misconception or even misinformation. Around (depending on which study you read) 90% of Covid deaths are people with pre-existing conditions - this does not equate to "seriously ill with life-threatening diseases". Nor does it equate to "were going to die soon anyway" (as has been often said) - the excess deaths stats should be proof enough of that.

I have a couple of pre-existing conditions, some of which might in fact (I think) preclude Class 1 Medical (I have never tried to get one, was told years ago that my eyesight wasn't good enough to fly anyway), however I am not seriously ill, nor are the diseases life-threatening unless left unmanaged/untreated. According to the doctors most patients live with what I've got for more decades than I likely have left anyway, I am most likely to die with the diseases not of them. Those same doctors have also placed me in the highest risk "shielding" category when it comes to Covid.

More generally, you need to look at what is a "pre-existing condition", some commonly considered ones are:

* diabetes
* hypertension
* obesity
* asthma
* dementia and alzheimer's
* ischemic heart disease

Not all of those preclude a Class 1 (most of them don't, I think).

A quick look at population prevalence rates (looking at UK at least) tells you that most people (especially if you look at over 30 or over 40) actually have a "pre-existing condition", so it isn't surprising that most people dying of Covid also have a pre-existing condition. Age remains the biggest risk factor, but then it is surely also the biggest risk factor for dying anyway...

[ivor toolbox]

What would make a class 1 holder immune to death from Covid-19?

I am sure Class 1 holders have died from undetected health issues in the past, which I suppose is why we train for incapacitation.
You can also have "controlled" health issues and hold a class 1 medical.

Agreed.... having a class 1 doesn't mean you are invincible.


Ttfn

[kenparry]

Some decades ago a colleague died while operating as an airline captain - he had, of course, a current Class 1. It happened that he and I used the same AME. After the completion of my next Class 1 examination, I asked the AME about that incident. "How can someone with a current Class 1 die without showing problems?" His reply was that a Class 1 carries no warranty, and that I, having just passed, could easily expire in his car park before even driving away from his surgery. I felt somewhat chastened.

Later I discussed this with a fellow pilot who was also qualified as a doctor. Not only did he agree, he said that aeromedical examinations made a negligible contribution to aviation safety; and that view I have heard expressed by several who are professionally qualified to express an opinion.

That chimes with my experience in that of all the pilots I have known who have lost their Class 1, very few failed a routine renewal; the vast majority lost their medical category through events that happened at other times.

So, apart from being one of the many ticks that you need to practice your calling, a Class 1 counts for little.

[Max Angle]

Quite agree, for most of us it is as great a contribution to flight safety as watching the dangerous goods video for the 20th time.

[Livesinafield]

I don't think there is an assumption that a class 1 makes you immune to dying from covid.

Covid is killing people with underlying health issues and barely affecting people who do not have any, all I can see is that a class 1 is likely to identify those issues, pilots still fly with diabetes and heart conditions

[wiggy]

In March flight schools closed for several months allegedly because of Covid-19 pandemic.


Why the "allegedly"?

AFAIK they were closed for the same reason other educational institutions full of young, healthy individuals were shut down, e.g. schools and universities..-social distancing. It was done to stop Bloggs and his mates catching the disease in a class room or crew room from a fellow student and then going back out into the general community and spreading it to those more vulnerable such as perhaps their parents and grandparents.

( BTW I know of Class one medical holders who have been advised to "screen"/ treat themselves as vulnerable individuals and take suitable precautions because of their medical history - having a Class One doesn't mean you are a superman or a superwoman... )

[double_barrel]

Can you give links to the original sources please.

https://www.pprune.org/rumours-news/631248-kq-captain-evacuation-flight-dies-covid-19-a.html?highlight=kq#post10739012


General data suggest that people who dying of Covid-19 tend to be very seriously ill with life-threatening diseases before getting the virus.

"General data" ? There is plenty of hard information about the enhanced risk due to various factors, including age. I suggest you look it up. And, yes, there is a low but not negligible chance of a healthy 25 year-old dying of COVID-19.

[PilotLZ]

Anyone, young or old, can drop dead at any time. There wouldn't have been a huge number of sad stories involving pilots dying in uniform or in their sleep before/after duty if this could be ruled out by the Class I. Also, the fact that someone is "apparently" healthy does not mean that they don't have any underlying conditions - or just about enough contributing factors to make COVID-19 the straw which broke the camel's back. An individual who absolutely doesn't give the impression of being sick and infirm can still be affected by obesity, smoking, less-than-ideal heart condition, the wrong blood type and whatnot else - and COVID-19, in conjunction with all that, can make the scales tip.

[double_barrel]

On BBC today


42-year old Scottish pilot (https://www.bbc.com/news/world-asia-53196009)

Presumably therefore he had a class 1 medical

[zerograv]

On BBC today


42-year old Scottish pilot (https://www.bbc.com/news/world-asia-53196009)

Presumably therefore he had a class 1 medical

That is an amazing story !

Full marks for Vietnam !!!

[TyroPicard]

Kenparry
Later I discussed this with a fellow pilot who was also qualified as a doctor. Not only did he agree, he said that aeromedical examinations made a negligible contribution to aviation safety; and that view I have heard expressed by several who are professionally qualified to express an opinion.
I beg to disagree. In my mid-30’s the CAA queried my ECG trace. Investigation showed that everything became normal when exercising so I retained my Class 1. As a result I exercised regularly to stay fit, which I am sure made me a safer pilot, less prone to fatigue and better able to cope with jet-lag and long night duties. At the age of 72 I am still able to run, swim, hike for miles and play atrocious golf. Without that six-monthly Sword of Damocles hanging over me I would probably have been a bit of a slob...

[flash8]

Ah yes.

Initial FAA Class 1 took me an hour in London with an FAA approved Doc as I recall.... elderly Doctor gave me the once over, queried "if everything was OK down there" (I nodded and he didn't look!) and bobs your uncle, slip produced. CAA don't get me started, don't want to swear. One advantage of the CAA medical though is it is pretty thorough.

So "Class 1" is meaningless anyhow as standards vary hugely!

[Meester proach]

I believe a NAS SH 737 Capt in Spain died of it

[Joejosh999]

It’s the long term effects I wonder about.
In US the military has said that anyone who’s tested positive is permanently unfit and cannot join the armed forces. (No word on how they’ll deal with existing members who have had the virus - discharge? Change of duty?)
That does make me wonder if they know a bit more about this virus than they’re letting on. Permanent lung/organ damage maybe, such that high level fitness cannot be achieved. Worrisome.

[flash8]

In US the military has said that anyone who’s tested positive is permanently unfit and cannot join the armed forces. Is that so? Interesting to hear that.

[Check Airman]

https://www.stripes.com/news/us/contracting-coronavirus-won-t-disqualify-you-from-serving-in-the-military-but-a-hospital-stay-for-it-might-1.628995

[A0283]

It’s the long term effects I wonder about.
In US the military ... That does make me wonder if they know a bit more about this virus than they’re letting on. Permanent lung/organ damage maybe, such that high level fitness cannot be achieved. Worrisome.

Too early to say what long term effects will be... so it would surprise me that any organisation would take such a strong stand at this stage. What already is an issue to monitor though, is possible long term damage to parts of the nervous system and their effects. There have been studies published about that for at least two months. One example is persisting loss of smell and taste, even after mild cases. Such damage, if proven, will certainly set corona apart from the regular flu.
A more recent investigation wondered if neurological damage could explain loss of lung and organ functionality leading to deaths.
In line with this, an open question is if children and young people who get corona, but have no or mild symptoms, may still suffer neurological damage. They just dont know at this stage.
It is science.. science needs good data.. needs peer review .. and needs confirmation... this takes time...

[Joejosh999]

Check-Airman thanks for the updated report. I’d only sent the original in the Military Times.
i hope the desire to avoid hospitalization won’t cause Covid patients who want to preserve their eligibility to stay home when they should go into ED.

[janrein]

On BBC today


42-year old Scottish pilot (https://www.bbc.com/news/world-asia-53196009)

Presumably therefore he had a class 1 medical
That link wasn't readily accessible for me, however the following is:
https://www.reuters.com/article/us-health-coronavirus-vietnam-pilot/virus-stricken-uk-pilot-in-vietnam-may-be-discharged-from-hospital-soon-idUSKBN23O29W

[Fostex]

It’s the long term effects I wonder about.
In US the military has said that anyone who’s tested positive is permanently unfit and cannot join the armed forces. (No word on how they’ll deal with existing members who have had the virus - discharge? Change of duty?)
That does make me wonder if they know a bit more about this virus than they’re letting on. Permanent lung/organ damage maybe, such that high level fitness cannot be achieved. Worrisome.

Such a blanket ban based on a positive PCR at time of illness or subsequent antibody test is foolish. Covid-19 has proved itself to be a multi-phasic disease in which the outcome may range from a simple respiratory illness to an acute respiratory and vascular one involving MODS, CSS and prolonged periods ventilated in the ITU. Any repercussions for ongoing health and capabilities can only be carried out after a period of recovery and an assessment of fitness within the guidelines dictating the requirements of the role.

[Radgirl]

In US the military has said that anyone who’s tested positive is permanently unfit and cannot join the armed forces. (No word on how they’ll deal with existing members who have had the virus - discharge? Change of duty?)
That does make me wonder if they know a bit more about this virus than they’re letting on. Permanent lung/organ damage maybe, such that high level fitness cannot be achieved. Worrisome.
Joejosh999 is offline

No they dont know anymore than we do - there are literally dozens of papers coming out daily in the civilian world about a pandemic that is less than a year old.

I think there are some concerns for aviation. Certainly the immune mediated vasculitis (inflammation of small blood vessels) and thromboembolism (clot formation) which are the causes of serious illness and death may persist for some time but this can be managed, as with heart attacks, by a minimum time to return to flying after re examination. The stiff lung issue isnt really a problem for a sedentary pilot and any effect on oxygen absorption can be easily tested on the ground. Equally, long term damage to kidneys or liver can be tested with a blood test. I am more worried about issues with the brain. The virus can produce everything from necrosis (dead cells) to encephalitis (inflammation of the brain). Some consequences such as stokes can be easily checked by examination, but we are now hearing of dementia, mood changes and even psychoses. Although there have been improvements in aviation medicine since the German Wings accident, the incidence of mental health issues causing an accident has been so rare (7 in 20 years) as to be low down in terms of testing and management. The Authorities will undoubtedly consider this problem and regrettably may need to over restrict return to flying duties until the pathology and testing are better understood.

[PilotLZ]

On the subtopic of mental health, does one necessarily need to test positive for the dreaded lurgy to get serious mental health issues under the present circumstances? Many of our brethren are out of their jobs or waiting for the axe to fall. Most are on a severely reduced income. Confinement, lack of social interaction, uncertainty over the future, fear for the health of self and loved ones and all the other "joys" coming with this pandemic can lead to mental health problems even without actual infection. How's that going to be tackled? For now, there's nothing in place to mitigate the psychological impact. Airlines in their vast majority don't give two pence about the welfare of those who made the shareholders rich. AMEs don't perform any psychological screening other than casual chat; even if they did, it's questionable whether they will defer someone for counselling. To make matters even worse, after Germanwings and Lubitz many pilots simply fear to admit to having coping difficulties out of fear of being stigmatized (not that schizophrenia and coping difficulties are anywhere near the same, but the general public doesn't put too much thought into it). In all honesty, I find this sort of problems far more likely to cause long-term trouble with someone than a mild case of COVID-19.