Aeromedical Forum

A couple of months ago we talked about the then looming pandemic. Well here it is and it looks like it's going to be around for a while. The good news is that Minnesota has done an effective job of slowing the rate of viral transmission of SARS Cov 2 (Serious Acute Respiratory Syndrome Coronavirus 2) and reducing the rate of development of clinical Covid 19 (Coronavirus 2019) illness. The bad news is that the duration of the epidemic may be prolonged, albeit at a lower intensity. So assuming that you're not going to spend the next two years living in the attic waiting for a vaccine to be invented, what's an airman going to do to reduce the likelihood of his catching it?

First, you should assess your risk of serious infection or death if you get Covid 19. Several points seem to be emerging from the data from China, Europe and the US. The very young -- infants and preschoolers seem to have a moderately increased risk for serious complications of Covid 19. The older population, defined as being over 60, definitely does. A third group is that with preexistent health problems: diabetes, hypertension, heart or kidney disease, cancer or other immunosuppressive disorders seem to top the list. Since many elderly folks have these conditions they have been very hard hit by the disease. So if you are young and healthy your risk of getting into trouble with Covid 19 is low.

Indeed many infections are sub-clinical. In other words you feel a little crummy for a few days or maybe not even that but your system responds to the infection and you become immune. How do you know if you've had it and are immune? You'll need a test for antibodies to the virus. Mayo is working on one anti-Covid 19 antibody test. If it does become available in your neck of the woods, it would be a good idea to get it if you fly commercially coming into contact with a lot of passengers. A word of caution though. We do not know how effective the immunity conferred by these antibodies is or how long it lasts.

The second thing to consider is your exposure to fellow crew and passengers. Social distancing-staying at least six feet apart-seems to be a pretty effective means of preventing Covid infection. However that's pretty hard to do even in an Airbus cockpit. In a C172 you can smell what your right seat passenger had for breakfast! So obviously you have to try to choose with whom you climb into the cockpit (if you can). If your first officer, student or passenger has had a fever, cough, sore throat, loss of taste or smell I would advise passing up that relationship if you can.

Another nifty way of picking up early Covid 19 infections is with a pulse oximeter. Those of you who operate a non-pressurized aircraft over 10,000 MSL probably have one. You can pick an oximeter up for $40 or $50. It's been found that even before a patient with Covid pneumonia begins to feel short of breath, his arterial oxygen saturation (pO2) starts to drop off. At sea level your pO2 should run from 94% to 100%. If it is significantly lower than that you should be asking questions.

Also don't forget hand hygiene. Washing your hands with soap and water for 20 seconds or using a hand sanitizer with at least 70 percent alcohol will kill the bugs before your touch your face. Remember that the mode of entry of SARS Cov 2 is through the membranes of the eyes, nose or mouth. One study found residual virus particles on hard surfaces, like most of your cockpit instruments, for as long as 72 hours. The critters lasted 24 hours on paper. How infectious were these particles? We don't know. However a wash down of the equipment with a 10 percent bleach or 70 percent alcohol solution might be a good idea if you are sharing cockpits.

One final point: the FAA announced on 4/10 that the use of chloroquine or hydroxychloroquine to prevent coronavirus infection is disqualifying. They have nasty side-effects such as low blood sugar and heart rhythm disturbance. Also there is no satisfactory evidence they work. An April study of severely ill VA patients showed an increased rate of death for those treated with the drugs.

Fly wisely. See you next month.