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COVID-19

Like with everything else, COVID-19 has created real challenges and uncertainty on flight instruction. Below is my perspective on and policy for giving flight instruction in the era of COVID-19. I will change this policy as circumstances change and based on new experience and insights.

Summary of changes on May 29, 2020, after a Angel Flight West sponsored pilot briefing by infectious disease expert and pilot Dr. Hunter Handsfield and AFW safety officer and recovered COVID-19 patient Rich Pickett.

  • We have to assume we will be living with the COVID-19 related challenges for a while, with infections prevalence getting worse before it gets better in our region (also: detection rate in Pacer has risen since re-opening).
  • Based on the Angel Flight session, it appears reducing the probability of infection during prolonged close proximity in the cockpit is both possible and necessary to keep overall risks acceptable.
  • Changed my view on wearing face masks – Dr. Handsfield and Mr. Pickett were united in their view that face mask use is a must in this environment. They said they are using it and only regret not having done it sooner
  • Refined screening and hygiene procedures based on Dr. Hunter’s white paper.

Summary

It is becoming increasingly clear that COVID-19 will not go away quickly, and we will need to find ways to live with it for the time being. Flight instruction (and any type of GA flying) requires special attention as social distancing norms cannot be maintained and equipment is generally shared. As best as possible, pilots need to follow cockpit hygiene and personal hygiene best practices as they are being developed and increasingly implemented across industries and throughout society. This includes, among other things:

  • Mutual screening of pilots and passengers
  • Disinfecting aircraft and equipment
  • Frequently washing hands and use hand sanitizer frequently
  • Avoid touching ones face
  • Consider using gloves when touching bags
  • Wear face masks when inside the airplane

1. This Is Serious

The combination of high mortality and incredible ease of transmission, which is still only partially understood, makes COVID-19 a dangerous threat that justifies extreme caution and restraint. We need to consider not just the risk to ourselves and our loved ones, but also the possible explosive public health impact our individual and collective actions can have. In that way, the hazard is much bigger than an engine failure over inhospitable terrain: though we may have a similar 9 our of 10 chance of survival, the engine failure will probably only impacts ourselves and our passengers, while each inadvertent COVID-19 transmission could impact hundreds or thousands of people through downstream infections.

2. Managing The Risk

As pilots, we are expected to be experts at Risk Management. We may also be more used to accepting risks we understand and are managing than people immediately around us. This is another reason to be extremely clear and transparent in what we are doing and why. In this document, I will follow a Aeronautical Decision Making approach to risk management. First, let’s recognize the hazard, then understand the impact and analyze the probability. Using the TEAM acronym, I will review options to Transfer, Eliminate, Accept and/or Mitigate the risk.

The COVID-19 Hazard

COVID-19 is the most devastating pathogen the world has seen in a century. More than a million people in the United States have been infected as I write this, and 25,000 new known cases are added every day. As of now, more than 1 in every ~25 people with known infections dies as a result of the infection. Getting the daily infection rate to stabilize has come at a huge effort of collective restraint with an immense economic impact to millions of individuals and businesses.

Stay at home recommendations, orders and directives have been given by local, state and federal authorities to reduce the spread. As of May, 2020, most counties have started to carefully open businesses, but there are several indicators that COVID-19 is far from over. Since reopening started in Placer County, a pattern of increased hospitalizations and positive tests has been established. If growth in infections is back to being exponential, even small changes can spin out of control very quickly.

The related hazard with flight instruction, or any situation where two pilots are flying together, is that (1) one becomes ill because the other is infected and (2) each become a vector in the further transmission of the disease.

The Impact

Risks are defined by an uncertain event (COVID-19 transmission due to flight instruction), which has an impact and a probability of happening.

Let’s say Pilot 1 and Pilot 2 are flying together. It turns out that Pilot 1 carries COVID-19 and transmits it to Pilot 2. The impacts are:

  • Pilot 2 gets sick, possibly very much so, with a uncomfortably high probability (1 in ~25, it seems) to die.
  • Pilot 2 may make his loved ones sick.
  • If Pilot 2 flies with other pilots (like me as a CFI), Pilot 2 may transmit the disease to other pilots, who may then get sick and die.
  • Anyone who has gotten sick may go on and infect others in their normal activities.

As I said before, I believe the hazard is very serious.

The Probability

Can we reduce the probability of transmission?

Obviously, it is impossible to do flight instruction and maintain the recommended 6 feet distance. The same is true for several other situations, like hair dressers, dentistry, etc.

According to Dr. Hunter Handsfield, a pilot and infectious disease expert, the risk of transmission in the cockpit can be reduced to what he would consider acceptable levels when following some specific guidelines, which he has outlined in a paper for the University of Washington.

So how can we impact the probability? I believe there are four factors:

  1. Monitor and evaluate infection rates in the region. If prevalence becomes very high, this may drive risks up to unacceptable levels.
  2. Mutual screening of the person you fly with. There appears to be gravitation in other industries around a set of standard questions that, if all are negative, provides an effective screening method.
  3. Add Cockpit hygiene procedures to pre- and post flight procedures and check lists.
  4. Personal hygiene and protective equipment are critical: frequent hand washing, frequent use of hand sanitizer, use of disposable gloves when using baggage, and, yes, use of the controversial face masks while in the airplane.

3. Risk Mitigation Measures

The FAA recommended approach for risk management is using the TEAM acronym: Transfer, Eliminate, Accept and/or Mitigate.

The risk with COVID-19 is, in my view, too personal to Transfer and I can’t think of a way to do so.

Eliminating the risk is of course an option, and each pilot needs to make a determine whether the risk is justified given the benefits of their flight (as with all types of risks in flying).

If we do determine we want to fly, we will need an approach to Mitigate until the risk becomes Acceptable.

My Personal Risk Mitigation Requirements

With lowish infection rates in Placer County and using some measures as outlined below, I believe risks can be mitigated to levels that are acceptable to me. You will need to make your own determination.

To protect myself, my other students and my family, I believe some measures are in order. Some are already part of the ‘new normal’, and some may be considered extraordinary.

Personal and Airplane Hygiene (The New Normal)

  • Disinfect your airplane’s high touch surfaces. Some recommendations here.
  • Wash hands according to CDC guidelines before we meet. I will do the same.
  • Stay 6 feet apart during pre-flight discussion / ground training.
  • Cancel the flight with any illness symptoms.
  • Wear face masks (procedure masks / surgical masks) when in the airplane.

Mutual Screening

When two pilots fly, both are at risk of getting infected by the other. Mutual screening can give both pilots a level of risk mitigation. Here are the screening questions:

  • Are you, or is anyone in your household sick with COVID-19 symptoms, including: cough, sneezing, chest congestion, shortness of breath, fever, loss of taste or smell?
  • Do you, or does anyone in your household have a fever?
  • Have you, or has anyone in your family been notified of possible exposure through contact tracing?
  • Have you traveled recently to areas with high infection rates?
  • Do you or anyone in your household work in health care caring for COVID-19 patients?
  • Do you or anyone in your household work in a a skilled nursing facility, food processing, prison or other workplace associated with COVID-19 hot spots?
  • Anything else I should know about you or that you would want to know about me related to COVID-19 risk?

4. Conclusion

We live in unprecedented times with real new hazards to ourselves, our loved ones and society. COVID-19 appears here to stay for a while and we need some high impact procedures to manage the new risk associated with our flying.