Protective suits for cabin crew and protection for flight crew
 

For the few flights that have not been cancelled.
What level of protection is right? for Cabin Crew and flight crew
Which level of masks should flight crew wear?
Are gloves and hand sanitiser,etc enough ? Goggles, when in close contact with passengers(?)
As Ukrainian cabin crew wear full protective suits, is this correct?


Air Canada's main flight attendant union says some of the supplies being provided don't fit properly and that it is time crews be provided with full-length protective gowns."We need the equipment; we need it yesterday," said Wesley Lesosky, president of the Air Canada component of CUPE.

"We don't have properly fitted N95 masks, we don't have properly fitted gloves and we don't have things such as disposable long-sleeve isolation gowns that should be made available to our crews."

He said the union looked into the feasibility of hazmat suits but concluded disposable gowns would be easier for crews in tight quarters and pose less risk for contamination and spreading the virus.

¨Protective suits and goggles are now required equipment for crew on Ukraine International Airlines, a measure of how far some in the airline industry are going to protect workers during the global emergency.¨ Source CBC News



https://www.cbc.ca/news/health/fligh...uits-1.5513439

It that sort of equipment is needed, the flight shouldn't be operated except in special circumstances such as evacuation flights. But for regular commercial service, no. Just no.

Please simply read the relevant advice from acknowledged sources such as WHO. https://apps.who.int/iris/bitstream/...2020.2-eng.pdf

If you try to apply those ludicrous requirements you quote, and are somehow able to get supplies, all you will do is deprive clinicians of PPE they desperately need.

Just be properly informed, please.

There is indeed a worldwide shortage of PPE - totally avoidable, but another discussion

The main risk of transmission is aerosol. The HEPA filters on the AC should provide protection so the risk is to CC within 2M of passengers. ie uncirculated air. The number of asymptomatic patients (those infected but not ill but shedding virus) has been low but is now 2-5% in the UK possibly reaching 10% next week. This is no longer negligible and at long last most healthcare systems are starting universal precautions ie assuming everyone is positive

NO flights should still be happening but there are repatriation flights and if it was up to me I would recommend coveralls, FFP3 masks and goggles and gloves. There is no evidence the risk to cc is that much less than to healthcare workers......However they need to be trained and it will not be easy to doff on board so long haul flights will be difficult

The one thing that is clear is that ordinary surgical masks are effectively useless unless a passenger actually sneezes in your face.

Aircrew are only at risk from each other plus the difficulty of getting airside - airports have some of the highest risk of all. But no PPE is sensible on the flightdeck

Radgirl, would you be kind enough to quote some science or published guidance behind those opinions please? This is, literally, life and death. Perhaps, just to reassure us, you could state a published definition of ‘aerosol’, in this context. The available science says that ‘droplet’ is the usual mechanism and there is little evidence that ‘aerosol’ is a mechanism.

https://www.nejm.org/doi/full/10.105...=featured_home

Social distance and flights
 

I do not understand how governments can mandate social distance in the open air spaces and then allow pax on a plane or even two pilots in the cockpit. The risk in between the two pilots is possibly statistically negligible however in the pax cabin I see, personally, extremely high risk of contagion. I would also include airports, airport lifts, airport lounges and toilets, boarding gates, etc Maybe we should allow only emergency flights or scheduled with cargo only without pax and no cabin crew for a few weeks. I would be terrified if I was cabin crew these days. They even found traces of polonium a few years ago on a BA flight after a well known incident with Russia. This explains how easy is to spread anything on an aircraft by touching, by sitting, by any contact really + the air obviously. Covid19 is clearly highly contagious, it is everywhere and in small confined places it must really be everywhere on seats, handles, tables, etc. Basically impossible to 100% disinfect the entire cabin after each flight. It would be interesting to see some stats re. Cabin crew rate of Covid19 infections and deaths but probably there is no data and each carrier would not divulge anyway.

It’s hard to know where to start with that post, so I’ll be blunt: it’s uninformed trash.

There is a plethora of reliable information, very little of which is reflected in this site.

Please, close this browser window, open a new one, and do some proper research, for everyone’s sake.

Air China
 

Air China is taking Covid19 very seriously.
"On board, all the Air China cabin crew were in full PPE too, their names written on the back of their suits and cartoons they had drawn. During the short flight, they took our temperature again." Source Sky News UK journalist today.
Considering that China is coping well with the virus and they are left with only 2.5k active cases, the rest of the world is struggling instead and in fact there are many more active cases in the US and most European countries... it is either that Air China is over-reacting or the rest of the world is taking risks and soon will have to catch up. 133,000 active cases in the US, or 58,000 in Spain and exponentially growing by the day. These are only confirmed cases, real numbers are much higher. We will see. I hope you are right but I doubt + I do not trust greedy airline senior managers during this phase as I found it hard to trust them on the previous debate on fume events, Covid19 is much bigger than anything else we have seen before. Even in highly specialized departments in Hospitals the virus is spreading quickly and Doctors and nurses are infected in large numbers despite all precautions. This has already happened in Italy, Spain, USA, UK, etc Consultants are dying.We will see where we are in a few weeks with flights and cabin crew in Europe and the US. Hope you are right however I predict much stricter measures on board all flights in the weeks ahead.
The sad truth is that whilst in the past only flights from/to China were classified as high risk re. Covid19, now all flights should be considered high risk because of the global spread of the virus, it is a pandemic... definitely all flights from/to any country in Europe or from/to any airport in the US are very high risk these days.

No, Air China is needlessly depriving clinicians of PPE. There is no scientific reason for what they are doing at all. READ THE SCIENCE.

Thank you Kit Sandbumps KG

The difference between droplet and aerosol is basically size. An aerosol is iso or hypobaric and floats. An analogy is air freshener which stays in the air, but with expired breath we are talking even smaller particles. CDS in the US suggest an aerosol can remain in still air for 3 hours, but obviously not in an aircraft cabin. A droplet is a much larger particle - for example a visible lump of sputum so more relevant if a person coughs at you and the droplet falls on your face. Otherwise it falls on the floor.

The best place to go is CDC who estimate 80% of spread is aerosol, and 20% from touching surfaces - the virus will live 72 hours on stainless steel, a little less on plastics, and 24 hours on cardboard. If you touch the virus it is quite safe until you touch your face. It is only spread from airway to airway. Hence dont touch your face and wash your hands as often as possible.

Obviously you can be infected via a droplet but you have to be face to face and the other person has to produce a droplet eg cough. an aerosol has a longer range, Stays in the air and merely needs the other person to exhale.

Sadly airports ARE high risk. Most airlines were removing seatback magazines and cleaning with disinfectant. The virus has a lipid coat which is destroyed very easily so it is possible to clean cabins but the risk then depends upon both the load factor and the behavior of the passengers plus the ability of cc to stick to the protocol.

Radgirl, from the CDC as you suggest:

DROPLETS. Not aerosol. You could at least have read your own references before you quoted them. I’ll say it again, DROPLETS.

The CDC says nothing that I can find about the 80% figure you mention, but it does confirm that it’s not aerosol.

AS I didnt give references I dont see how you know I misquoted

Have a look at https://www.nih.gov/news-events/news...hours-surfaces

If it is ONLY droplets, then there is no transmission unless someone coughs and sneezes and you are within about 2 feet, possibly less, and the snot hits your face. People who are shedding dont cough or sneeze - that is the problem - they are asymptomatic. Yet we are seeing the incidence double every 2-3 days in many countries. Nobody is arguing droplets dont transmit covid19, we are just saying that it is neither safe nor correct to assume this is the only vector.

Actually, no. Speaking, laughing and crying can also generate droplets - though not as copiously violent or far-flung as coughing or sneezing. Nonetheless it definitely happens, and can have a range greater than two feet - though mostly not, thank goodness.

In other words, you can still have transmission in close contact to people who don't seem ill, without going so far as to say "it's aerosol transmission". This is one of the reasons why a surgical mask (or even a home-made unit) is still better than no mask at all. Even in the presence of asymptomatic carriers, it will help defend against this kind of droplet, whereas it would be all but useless against an aerosolized virus.

Hence the two metre rule for those of us able to follow it, and (hopefully) a sensible level of masking and other protection those who cannot. Such as cabin crew.

The ill-est I've ever been was from my mate on the right.


At last, the dangers of the mist is coming to the fore. Weeks of screaming into science forums bought little but the occasional s.t.f.u won't you, kind of comments. Great science.

Even Bill Bryson derided Hoyle on his off the wall theories - it was funny when he said it. Not now.

I speculate that the Italians are dying because of their happy, loving and effusive nature. And their singing from verandas. Their can be no question something is different there.

Again and again talking heads are breathing in droplets, or is it aerosols. I'll go with that name. I see the point. Covid-19 goes deep into the gas-exchange mechanisms of the lungs. It infects unprecedented areas. Well, unprecedented since 1918.

I don't know why Kate Ogg's image affects me the way it does. I wonder, if when the heat is off a little, she could be remembered as an icon of brave dedication to nursing. She died of pneumonia less than a year before my granddad.


https://heatonhistorygroup.org/2016/...gg-remembered/

Hello posters,

This is a worthwhile topic for discussion, and obviously a part of our reality for some time to come. Despite concerns expressed, I have not deleted posts, and don't want to stop the discussion. However, would posters please assure that information which is presented as authoritative is based upon factual information, which is referenced. We pilots are not the best to be generating opinions about health issues, so please let's leave that to the experts. However, quoting experts and broadening knowledge is obviously helpful to all of our learning.

The problem with that is having a highly qualified talking head on TV and in moments realise that he's talking Bo-lox. "Leave masks in the operating theatres." Film of surgeons wearing masks. Why does this doctor of medicine think they wear masks? Let me guess. It is primarily protection for the patient. I wear a double mask, not for me, but to protect the young lady at the local Coop checkout that is bewilderingly vulnerable. Only now are some stores fitting plastic screens at the checkouts.

Boris shaking hands with patients. Well, he's not qualified, but Matt Handcock?! At home taking Ibuprofen. Matthew John David Hancock is a senior British politician serving as Secretary of State for Health and Social Care. What is it that he doesn't understand about Immunosuppressants?

This is a good post. It's as I understood Viral Load, but comes with the empiricism. Patricia Tung on Quora.

https://www.quora.com/Why-do-some-pe...om-coronavirus

Slightly off this topic, however related to protection on board:
As i am retired i have no more access to bulletins etc.. Therefore my question:
Is there any recommendation as to operating the air systems on airliners? Specifically i am curious if airlines recommend switching off the recirculation fans.
It might be good practice to increase new inflow / outflow and reduce recirculation in these times.

I had a group email from MIAT Mongolian yesterday they mentioned the they are changing the cabin recirc filters after every flight but then go onto say every flight(International) has been cancelled until April 30th.

There is no doubt in my mind that Covid 19 spreads between people In the same air space, we now have 3 government officials infected, they were probably not infected by aerosol and they would have been infecting others before they had symptoms. Social distancing helps slow spread but we are all going to get infected, how much virus we come into contact with will affect our immune reaction, many will have mild symptoms or none at all and some will be infectious carriers. Aircraft should not be recirculating air at all removing most of the risk, but it’s very difficult to achieve the same risk limitation in terminal buildings and transit systems.

If the lockdown lasts 6 months that is now being projected there are going to be a lot of bankruptcies, not only in the airline industry, lack of cash flow is a killer, bills are not being paid now, most of the government help is loans. There will be no cash to repay them, in any case there is no collateral to secure them in many cases - this is going to get very messy for everyone. How much collateral has a company like BA actually got, most assets are leased or rented, what do they own outright?.

As always pilot DAR you make a good point and I appreciate pilots need hard facts. However, the medicine is fast moving, and the time taken to publish facts means references wont appear for months.

My posts are based on my conversations with colleagues in China and Europe treating patients on ITU and my planning to keep my own doctors and nurses safe. I will provide peer reviewed publications where I can. In the case of droplets vs aerosols CDC has changed some positions in the last 5 days. I stand by what I posted based on the above plus my knowledge of the airway and many decades in ITU. However we should be looking at the bigger picture of what to do to keep cc safe. If someone gets infected they dont really care if it was a droplet or an aerosol. I am not here to win arguments but to offer advice. Can we agree that CC in a highly loaded commercial aircraft are at risk and that normal surgical masks do not provide full protection, certainly if not properly donned and doffed and if working for a protracted time

Stay safe

Security & Check-in Staff too...I have a p/t ground job at a regional airport and there are “Lifeline flights” going twice a day.

As well as Medical, Cargo or Mail.

Totally agree. CC are at very high risk.

Amen to that and thank you.

Flying 2 sectors after the 1st flight
 

Below is from the CDC.

The problem with the CDC and WHO recommendations is that passengers who have not been symptomatic have been spreading the virus, on flights. That is a fact, look at the articles about cruise ship passengers being brought home. The CDC/WHO recommendations have changed as the virus evolves and clearly there are many things the experts do not know, so better to be on the side of prevention, with common sense. Here the recommendation from the CDC, recommends wearing a PPE for cleaning, for flight attendants or cleaning personnel, certain airlines are still asked to do cleaning after the 1st sector.

See the difference between the procedures between symptomatic passengers and non symptomatic passengers.

We do agree that PPEs should go to doctors and nurses, etc first,
Interesting to note with the shortages that PPEs can still be purchased on Amazon

https://www.cdc.gov/quarantine/air/m...-airlines.html

• ¨¨ If no symptomatic passengers were identified during or immediately after the flight:
  • Follow routine operating procedures for cleaning aircraft, managing solid waste, and wearing PPE.¨
• If symptomatic passenger(s) are identified during or immediately after the flight, routine cleaning procedures should be followed, and enhanced cleaning procedures should also be used as follows:
  • Clean porous (soft) surfaces (e.g., cloth seats, cloth seat belts) at the seat of the symptomatic passenger(s) and within 6 feet (2 meters) of the symptomatic passenger(s) in all directions.
    • Clean porous (soft) surfaces (e.g. seat covers and carpet) by removing visible contamination if present and using appropriate cleaners that are compatible with aircraft surfaces and components in accordance with the manufacturer’s instructions. For items that can be laundered, use the warm setting and dry items completely on high heat.
  • Clean non-porous (hard) surfaces (e.g., leather or vinyl seats) at the seat of the symptomatic passenger(s) and within 6 feet (2 meters) of the symptomatic passenger(s) in all directions, including: armrests, plastic and metal parts of the seats and seatbacks, tray tables, seat belt latches, light and air controls, cabin crew call button, overhead compartment handles, adjacent walls, bulkheads, windows and window shades, and individual video monitors.
    • Clean non-porous (hard) surfaces with disinfectant products with EPA-approved emerging viral pathogens claims that are expected to be effective against the virus that causes COVID-19 (SARS-CoV-2) and ensure these products are compatible with aircraft surfaces and components. All products should be used according to label instructions (e.g., concentration, application method and contact time, PPE).
  • Clean lavatories used by the symptomatic passenger(s), including: door handle, locking device, toilet seat, faucet, washbasin, adjacent walls, and counter.
  • Properly dispose of any items that cannot be cleaned (e.g., pillows, passenger safety placards, and other similar items as described below).
• Recommended Personal Protective Equipment (PPE) during Enhanced Cleaning:
  
• Disposable gloves that are recommended by the manufacturer of the disinfectant should be worn.
• Disposable gowns should be worn while cleaning the cabin and lavatories.
• If splashing is possible, eye protection, such as a faceshield or goggles and facemask may be required according to the manufacture’s label.
• General Recommendations during the Enhanced Cleaning Process:
  
• Ground and cleaning crews should not board the plane until all travelers have disembarked.
• Ventilation systems should be kept running while cleaning crews are working aboard the airplane.
• If visible contamination (e.g., a body substance such as blood or body fluids) is present, routine airline cleaning procedures should be followed based on blood or body substance spill management according to , 29 CFR 1910.1030.OSHA’s Bloodborne Pathogen Standard, 29 CFR 1910.1030external icon.
• Airlines should ensure workers are trained on the hazards of the cleaning chemicals used in the workplace in accordance with OSHA’s Hazard Communication Standard, 29 CFR 1910.1200external icon.
• Airlines should train ground and cleaning crews on and require that crew members demonstrate an understanding of when to use PPE, what PPE is necessary, how to properly don (put on), use, and doff (take off) PPE.
• After doffing (taking off) PPE, cleaning staff should immediately clean hands with soap and water for at least 20 seconds. If soap and water not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.
  • Airlines should consider providing alcohol-based hand sanitizer to cleaning staff for their personal use.
• Cleaning staff should immediately report breaches in PPE (e.g., tear in gloves) or any potential exposures (e.g., contact with blood or body fluids without wearing appropriate PPE) to their supervisor.
• Cleaning staff should dispose of PPE and other disposable items used in cleaning following the airline’s routine procedures. Note that all waste from international flights will also fall under jurisdiction of the U.S. Department of Agriculture/Animal and Plant Health Inspection Service (APHIS).
• Ground crews assigned to wastewater management operations should follow routine procedures.
• Employers should educate workers to recognize the symptoms of COVID-19 and provide instructions on what to do if they develop symptoms.
  • Cleaning staff should immediately notify their supervisor if they develop symptoms of COVID-19.¨

In response to the request for publications, this paper is doing the rounds of my colleagues

https://doi.org/10.1101/2020.03.23.20039446

Please click on the link at the top right to view the paper itself

I am posting this to help readers to form their own opinion, not to nit pick. I and many other hospitals in the UK are moving to universal precautions ie we are assuming every patient and every colleague is infected and contagious. We may be wrong, we may be over reacting, but I would rather be wrong than feel responsible for anyone being infected

Stay safe