Photo: AirlineGeeks | Fabian Behr

Air Transport of Highly Contagious Patients: How It Works

The recent outbreak of the novel coronavirus 2019 has resulted in many evacuation flights coordinated by various governments and China to quickly remove the respective country’s citizens from China. The U.S. Government along with many European and Asian governments have led rescue flights to bring back citizens to their homelands. It isn’t an easy endeavor.

Doctors and researchers believe that the virus could potentially spread even if a patient is not experiencing symptoms which has led to quarantines for up to three weeks upon landing in home countries. This also complicates how the flight is operated since it has to be assumed anyone could potentially be infected. Unfortunately, the exact details of how these flights are adapted to protect crew are not very clear beyond just the use of personal protective equipment (PPE).

However, there is one recent air transport of highly contagious patients that has been well documented. The transport of Ebola patients.

Phoenix Air

This operation started in 2005 and continues to this day whenever a new Ebola epidemic arises such as the one currently impacting people in the Democratic Republic of Congo.

Phoenix Air is an air ambulatory service and is a well-known organization for moving extremely contagious people around the globe. A service that isn’t flush with options.  

Phoenix Air uses modified Gulfstream aircraft to safely transport highly contagious patients and has become the go-to operation for governments and organizations needing to transport their people.

The fleet of Gulfstreams Phoenix Air uses are highly modified aircraft that are flying containment chambers. It’s called the Aeromedical Biological Containment System (ABCS).

ABCS Design

It’s a large metal framed structure covered in a specialized plastic liner that creates a large chamber for the patient to reside in along with monitoring equipment and a chemical toilet.

The system maintains a negative pressure environment inside the liner to prevent any air leaks into the aircraft’s cabin. One air pump brings in cabin air into the chamber through two high-efficiency Hepa filters. Air is pumped out of the chamber through a similar process and out into the sky through a valve in the fuselage to prevent any mixing with cabin air.

Limitations to Use

This is effective, however, there is a huge limiting factor. It can only transport one patient at a time and the plane needs a day afterward to be decontaminated. There are other portable isolation units such as a system that could be loaded onto Boeing 747 freighter aircraft but quantities are limited still. The U.S. Air Force is developing units that can hold up to 12 patients.

These units are aiming to be portable so only the unit needs to be decontaminated instead of the whole plane as is with Phoenix Air. Their aircraft fly to a highly secure hangar where they undergo a decontamination process that can take up to a day. Everything inside the liner has to be sterilized multiple times then everything is removed and put in special boxes to be incinerated.

Other Options

Another option is the Containerized Biocontainment System (CBCS) which was developed by Phoenix Air, the State Department and Paul Allen of Microsoft. This system is a literal lifesaver to patients. Since Phoenix Air’s Gulfstream jets can only pick up one patient at a time every three days, the CBCS can transport four extremely sick/contagious people along with six medical staff.

While these options are used in extreme cases and are highly unlikely to be used for patients suffering from the novel coronavirus, it is interesting to see how aviation plays a role in moving extremely sick patients around the globe safely.

Hemal Gosai
Hemal Gosai
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