By James D. Lakin PhD MD FACP
CFI,CFII,MEI,Airline Trans Pilot,FAA Sen. Aviation Medical Examiner 

Aeromedical Forum

Flying and Coronavirus

 


One thing about the aviation community, we get around. We are exposed to many different terrains, population, cultures and, unfortunately infections. If you’re flying under Part 121 or 135 you often cover a lot of territory and come into contact with a lot of people and a lot of viruses. Many General Aviation operations also fall into that category. Given all that, a lot of pilots have been wondering about the Coronavirus epidemic that started in China in January. It is spreading. The possibility of coming in contact with it is not as remote as it once seemed. As I am writing this column (February 5) it seems like we don’t know a lot about this disease but have a boat load of conjectures. I’ll try to share the hard facts and put the suppositions in perspective.

First of all, what is the coronavirus? Coronaviruses are named for the crown-like spikes on their surface. Human coronaviruses were first identified in the mid-1960s. There are seven coronaviruses that can infect people. Most cause a mild to moderate cold-like illness. They are common and usually no big deal. Sometimes however coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of these more severe infectious agents are the Severe Acute Respiratory Syndrome or SARS virus (SARS-CoV) which arose in China in 2003 with about 800 fatalities, Middle East Respiratory Syndrome or MERS virus (MERS-CoV) which popped up in Saudi Arabia 2012 and the current problem, Wuhan coronavirus (2019-nCoV). So, coronavirus epidemics are not new and in the other two recent instances they eventually died out.


So how is a coronavirus spread? With the Wuhan strain we are not completely sure. It seems to be pretty contagious. Coughing and sneezing spread most respiratory tract viruses. Thus, the importance of wearing a mask. A simple paper surgical mask may not prevent you from inhaling the coronavirus but it certainly will reduce spreading the virus if you’re infected. Many viruses can persist outside the body for short periods of time on surfaces that the infected individual has touched. Thus, the importance of frequent hand washing and use of hand sanitizers.

So, if I get it will I die? Probably not. Initial thinking among infectious disease doctors is that it is not as severe as the other coronavirus epidemics with SARS and MERS. Some estimates put it at a 2% mortality, that is of you get it there’s a 1 in 50 chance you’ll be a goner. That probably overestimates its lethality. Many cases in China are going undiagnosed. Test kits for diagnosing the infection are in short supply and hospitals are turning away many less severely ill people. Influenza or the common flu has about a 0.1% mortality. If Wuhan coronavirus is anything like influenza, the very young, the very old or folks with a chronic illness are probably more likely to have severe case and be at greater risk of death than an otherwise healthy person. The World Health Organization recently estimated that about 80% of Wuhan coronavirus infected people have a relatively mild illness, 20% coming down with severe problems including pneumonia and respiratory failure.


So, if I’m going to be in a place that has Wuhan coronavirus, what should I do? The governments of the world are making that more difficult each day as quarantine and travel bans pop up. However, we still don’t know how far the virus is going to spread. So, if things are getting out of hand and you’ve landed in the wrong place at the wrong time there are several things you can do to lessen the chance of infection.

• Avoid public places and crowds as much as possible.

• Wear a paper surgical mask when you are out. As we said it doesn’t help you too much but will reduce the chance of your spreading the virus.

• Frequently wash or apply sanitizer to your hands.

If you are feeling ill with chills, fever, cough and difficulty breathing of course you should seek medical attention. There is no known cure for Wuhan coronavirus beyond the action of your own immune system, so treatment is supportive. Severe cases are hospitalized for administration of oxygen, IV fluids and, if needed, respiratory support. Right now, there are only eleven documented cases in the United States so let’s hope for the best.

Fly wisely. See you next month.

 

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