U.S. explores cross-border air transport of critically ill patients
Xinhua News Agency, Washington, April 18 Overview: The United States explores cross-border air transport of critically ill patients
Xinhua News Agency reporter Lin Xiaochun
On April 11, two Boeing 747s and three Gulfstream III passenger planes departed from Atlanta, the United States, and flew to Sierra Leone, once the hardest hit area of Ebola, after a short stop in Senegal. After picking up 11 patients, they immediately flew back to Dulles International Airport in Washington, the capital of the United States. After customs clearance, the five planes flew to five Ebola treatment centers in New York, Baltimore, Minneapolis, Denver and Omaha...
This is the largest overseas medical evacuation exercise held by the US government in recent years. Six US federal agencies, mainly the US State Department and the Department of Health and Human Services, participated in the exercise, which was code-named "Quiet Transfer". William Walters, director of operations medicine at the U.S. State Department's Medical Services Bureau, said: "The scale of this exercise is unprecedented and verifies the lessons learned and changes made after the Ebola epidemic."
In the past 10 years, from SARS to Middle East Respiratory Syndrome to Ebola, serious local public health crises have emerged from time to time. How to deal with these epidemics, especially the cross-border transportation of critically ill patients, has become an imminent and thorny challenge. The U.S. State Department and the Department of Health and Human Services held a telephone press conference on the 18th to introduce the U.S. government's practices and relevant lessons learned in this regard.
Walters said at the press conference that when the Ebola epidemic broke out in 2014, the U.S. government was "largely unprepared", but under the coordination of the U.S. State Department, 46 medical workers who had been exposed to or infected with the Ebola virus were taken to the United States for treatment, changing the view of some people in the U.S. government that patients with Class A pathogens cannot be transported by air. Class A pathogens refer to pathogens that are easily spread and highly lethal, including anthrax, dengue virus and Ebola virus.
These more than 40 patients were mainly transported by the Phoenix Airlines medical plane. The "Aeromedical Biocontainment System" on the special plane is a soft plastic tent built with steel frames that can isolate patients, but can only transport one person at a time. In order to obtain greater patient transportation capacity, the US State Department cooperated with a foundation to develop a "Containerized Biocontainment System" with US$5 million.
According to Walters, the new system is equivalent to a 40-foot (about 12 meters) standard container, with 3 rooms inside. One of the large rooms is similar to an intensive care unit and can accommodate 4 patients at a time. The middle room is for medical staff to put on and take off protective clothing, and a small room is for medical staff to take shifts and rest. Unlike the "Aeromedical Biocontainment System", the new system does not require a special plane and can be installed on Boeing 747-400 passenger planes, Il-76 transport planes, Antonov transport planes, C-17 or C-5 transport planes.
"The Containerized Biocontainment System represents a revolutionary step toward meeting biosafety needs and will ensure that the United States has strategic options when leading or supporting a response to the next global epidemic," Walters said.
Since August last year, the U.S. government has conducted three overseas medical evacuation exercises using the Containerized Biocontainment System, with the April 11-14 exercise being the most recent. Joseph Ramana, director of operations for the Office of Emergency Management of the U.S. Department of Health and Human Services, said there are a total of 10 Ebola medical centers in the United States and China, five of which were mobilized this time. The U.S. Department of Health and Human Services has provided partial funding to these medical centers to support them in preparing biocontainment wards, training staff and developing necessary patient reception plans.
Ramana said that in the past, it was relatively easy to manage with only one plane at a time to transport one patient, but now that 11 patients can be transported at a time, the logistical difficulty has increased, "It's not easy to do this."
As for the lessons learned from the three exercises, Walters said that overseas medical evacuation involves many details and is a "complex aviation operation", including mechanical failures of the aircraft, and consultations with the governments of Senegal and Sierra Leone. They had estimated that the aircraft would encounter problems in transit through Senegal, so they sent a large group of ground personnel to Dakar, the capital of Senegal, to provide assistance.
Walters emphasized that infectious epidemics have been emerging. In addition to Ebola, there is also the recent Middle East Respiratory Syndrome outbreak in Qatar, the Lassa fever outbreak in West African countries Benin, Togo and Burkina Faso since February this year, and the plague in Madagascar last December. "What I want to say is that in the end, whether the epidemic occurs in (the American city) Paducah or (South Africa) Pretoria, patients need to be safely and effectively transported to receive appropriate treatment. It is impossible for every American hospital to have a biocontainment ward, so admitting this, having a safe transportation mechanism is crucial now and in the future."