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High infectious diseases at an
int. Airport 2003-2018(lessons learnt...)
W.Gaber MD,
Vice President Human Resources
Medical Director Fraport ,FRA
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 2011
2008 Certificaton of Appreciation, State Department USA for continued
support of medical operations for United States Government personnel
through the Frankfurt Airport.
2005 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.
Goal of Airports
….Keep the Airport running….
Goal of Public Health Services
.....Keep the Pandemic outside….
Source: Brockmann et al 2004, Göttingen
Frankfurt
BCM ?
The complete Air Traffic is still shut down
58.086 Px = 83 ICE‘s
4.139 to = 159 trucks
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
31.596 passengers are at FRA
26.490 passengers are not at their destination
4.139 tons of freight are not at their destination248 aircrafts are not available at their scheduled
intermediate airports
3 h
The effects are noticeable worldwide
118=
130=
Source: Kühn
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
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 ?
Scenario:
36 x 250 Pax = 9000
Pax/day*
*Frankfurt Airport 2017
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 522-0755 „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
Management of on-board-cases
A/C ID
DEP
DEST
ETA
No. Cases
Nature of Risk
Airline Operating
Agency
PHAAirport Operator Other Agencies{
Destination Aerodrome Tower
Air Traffic Controller
Source: PHA FfmSeite 13
SARS 2003 FRA
Swine Flue: incoming Aircraft (LH)
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)
Announcement and information by public health officer before deboarding
Swine Flue
Lufthansa: LH 499
Announcement for the medical screening
Handouts for passengers at
the gate after arrival
COLOR CODING
Four busses for the different categories
Red
orange
Yellow
green
Procedure with 4 color coding
in Hong Kong (SARS)
Green Bus
Yellow Bus
Red Bus
Modified 3 color coding FRA
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?)
No Signs of
symptoms
Information leaflets
from the Public
Health Authority are
distributed to all
passengers
1. Index patientProtective maskTransport through FPAUniversity Hospital
2. Prevention measures EMS 3. PLC is distributed to all passengers4. HA‘s information leaflet is distributed
to all passengers
Key: FPA = Fire Protection Authority Frankfurt EMS = Emergency Medical
Services
HA = Health Authorities PLC = Passengers locator card
Signs of
symptoms
Thermoscan
(Source: T. Evans, ICAO, 1st May 2009 )
Bangkok Airport
02.09.2009 (RAMT Meeting ,BKK)
1.600.000 passengers have been screened with thermo scan;
2 (!) have
been tested /confirmed positiv (in the first month)
Source: Gaber
HKG Excersice:
Areas are separated
Medical Post and paramedics are
Available.
CX employees will support passengers
if there are any questions.
Passengers do get informed by a
medical expert and (!) a PowerPoint
presentation with information runs always
in the background.
After filling out the public health
declaration (PHD) the passengers
will see the public health officer.
Passenger Listing
Seite 27Source: Gottschalk ,Ffm
TIME
Preventive & Maintenance
Plans
IT Recovery PlansSystem Fallback
PlansOperational Continuity
Plans
BCP for each business process
and operational system
Pre-failure Plans Post-failure Plans
Business Recovery PlansFailure Event
BCMS : Structured Planning
Business Continuity Management SystemAn integrated, multi-layered, business-driven, process-based approach to
plan for and manage business disruptions and crises.
29
30
Dr. Gaber after
25 minutes on the scene
31
everything is ok, dont be
Scared; we will take care
Of you.........
32
Patient sick and (!) vomating
What should I do ? With that
kind of PPE?
33
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
Airport clinic:
Incoming patient via Terminal
39
Gloves have to
Be modified
Does not work
that way.....
40
Does it work
in real ?
41
Overview Disinfectants versus scope of application
Scope of
application
Disinfectant
*) for small areas [< 1m²] due
to possible flammability
05.11.2014
Source: DLH FRA
Standard operating procedures
Source: Lufthansa Group,Klaus Joachim 2018
Fig. 1 Standard operating procedures
from Lufthansa Technik to be used in
aircrafts for disinfection in the presence
of high infectious diseases
Link for HID-Form
Source: Lufthansa Group, Klaus Joachim 2018
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 (e-mail
[email protected]) if you use the SOPs
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
Seite
48
Any Questions ?
