Aviation and the Ebola epidemic in West-Africa

[sn26567]

Ebola crisis: Nigeria declared free of virus

Nigeria has been declared officially free of Ebola after six weeks with no new cases, the World Health Organization (WHO) says. WHO representative Rui Gama Vaz, speaking in the capital Abuja, said it was a "spectacular success story".

Nigeria won praise for its swift response after a Liberian diplomat brought the disease there in July.

The WHO officially declared Senegal Ebola-free on Friday.

http://www.bbc.com/news/world-africa-29685127

[Passenger]

European Commission to audit exit screening in Ebola-affected countries

A high-level meeting of 21 European health ministers, co-organized by the Italian Presidency and the European Commission, has failed to reach common ground on the issue of entry screening at Europe’s airports for passengers arriving from Ebola-affected countries.

The UK, France and the Czech Republic are the only European Union (EU) states following the US lead in implementing entry screening at some airports. The rest of the region is following World Health Organization (WHO) and European Centre for Disease Prevention & Control (ECDC) guidance that entry screening will have only limited effectiveness and that exit screening from the Ebola-affected regions is a more effective route to follow.

To that end, the Commission has agreed with WHO to undertake an audit of exit screening systems in place in the affected countries to check their effectiveness and reinforce them as necessary.

http://atwonline.com/safety/european-co ... -countries

The European Commission has updated a previousd Memo on ebola through a very long press release. Seems they agree with two items, largely discussed here: "commercial flights are needed" and "quality screening is needed, also at arrival".

Link:
http://europa.eu/rapid/press-release_ME ... ?locale=en

Just a partial copy/paste:

The Ebola epidemic presents major challenges related to transport, coordination, equipment, availability of trained medical staff and behaviour of the population.

Air transport is extremely important, be it commercial air services, air ambulances, or even military airlift; it is indeed essential to maintain connections between the affected countries and the outside world to tackle the epidemic effectively, notably for the entry and free circulation of health workers, for general ingress and egress, or for medical evacuation.

However, the fear of spreading the disease and exacerbating the problem has led regional and global airlines to limit or even cancel their scheduled flights which means that transporting supplies and personnel is becoming increasingly challenging. Closure of borders, suspension of flights, absence of traffic rights granted for air ambulances for example, are all hampering efforts to solve the situation. Ensuring quality exit screening of air passengers coming for the affected countries is a priority.

Of course, competence in this area lies with the Member States and the role of the Commission is to encourage cooperation and better understanding of the issues at play. The Commission's services are working with NGOs, airline operators and air ambulance companies for that purpose. We note the WHO advice on the continuation of international trade and travel to the affected area.

Limited access to some areas in the affected countries also complicates the registration and isolation of patients. Lack of medical equipment to isolate patients and protect medical staff presents a further challenge. The disease has already claimed the lives of more than 120 health workers.

The immediate needs include tracing of people in contact with Ebola patients, changing behaviour to at least ensure safe burials, supplying treatment centres and equipment and also secure transport for medical staff and supplies. Additional trained medical staff is needed but this is made more difficult by the transport restrictions.

Additionally, there are large associated needs, such as social mobilisation, basic health care, and response to growing food insecurity, especially in the quarantined areas.

[sean1982]

I support Dr Beutler's analysis as a whole. So your last sentence makes no sense to me.

If you accept his analysis as a whole, that must include the following quote from him: "...It is hard to disagree with Dr. Anthony Fauci, the National Institutes of Health director of infectious diseases, and CDC Director Thomas Frieden when they point out the necessity of engaging the outbreak at its source, and being able to provide material support to the affected regions..."

How can one engage the outbreak at its source (cfr dr Beutler) without western volunteer doctors and nurses?

With drones perhaps? Or internet speedcourses Medecin for Monrovian citizens?

You see: if you accept dr. Beutler's analysis, you must accept that volunteers need to get there.

In the mean time you still haven given any valid argument why this should be provided by commercial air traffic. Nobody here is denying the fact that the region has a need for medical professionals and supplies, but they can be organised by a rescue airbridge. Joe Public has NO valid reason to go or leave the region as long as this is not under control!

Even that EU publication only mentiones travel of medical professionals which, again, can be safely provided by an organised rescue mission

[Passenger]

In the mean time you still haven given any valid argument why this should be provided by commercial air traffic. Nobody here is denying the fact that the region has a need for medical professionals and supplies, but they can be organised by a rescue airbridge. Joe Public has NO valid reason to go or leave the region as long as this is not under control! Even that EU publication only mentiones travel of medical professionals which, again, can be safely provided by an organised rescue mission

All rescue organizations like MSF/AZG (Doctors Without Borders) and the Red Cross have told already a zillion times that they need a constant flow of volunteers, and that this flow is only possible via commercial flights. And now you ask me to proof that this statement from MSF/AZG and the RC is correct? No sir, I suggest you give the proof that it can be done through chartered operations.

The volunteers are people working in a hospital somewhere in the (western) world: they're willing to take a few weeks off to execute their job for free because they know their experience can save lifes in Africa. You simply cannot tell them "departure day is the 15th or the 30th of each month". They're going to a battlefield where no rosters apply: every day there is a shortage of doctors, nurses and lab operators. Same applies for the constant supply of medical goods. Didn't someone posted here that Brussels Airlines offers AZG/MSF three pallets per flight, free of charge? MSF/AZG Doctors Without Borders cannot afford to charter a 737 for the forthcoming six months.

You referred to the EU, and you say “…Even that EU publication only mentions travel of medical professionals which, again, can be safely provided by an organised rescue mission”.

That is not what the EU says: the EU will only set up an air bridge for relief items, not for the transport of medical staff (my guess: they will pay for one of those WHO Kalitta flights out of AMS). I quote from their updated press release:

"...In October, the European Union set up a humanitarian air bridge to West Africa: the European Commission's Emergency Response Coordination Centre (ERCC) is facilitating the transportation of relief items to the affected countries. In addition, the EU will fund and coordinate if necessary the evacuation of international staff from Liberia, Guinea and Sierra Leone...

“...The immediate needs include tracing of people in contact with Ebola patients, changing behaviour to at least ensure safe burials, supplying treatment centres and equipment and also secure transport for medical staff and supplies. Additional trained medical staff is needed but this is made more difficult by the transport restrictions...”

[sean1982]

Who is talking about 2 flights a month? Im talking about an extensive coordinated rescue mission with daily (military or chartered) properly controlled flights into and out of the region to provide medical staff and supplies. This should not be paid for by any volunteer organisation but by all Western governments. Again, why does Joe public need a flight there when he has no business there and cannot be controlled properly if he/she takes proper measures against getting infected.

[airazurxtror]

"All rescue organizations like MSF/AZG (Doctors Without Borders) and the Red Cross have told already a zillion times that they need a constant flow of volunteers, and that this flow is only possible via commercial flights".

Sundry organizations have told what they want. They have no right to demand anything.
The Belgian government will make the needed decisions in the best interest of the Belgian people, as is its duty.

[sn26567]

If you think that Brussels Airlines is making money with Ebola, read this (the hysteria surrounding Ebola has compelled Brussels Airlines to repatriate an empty A330 from IAD to BRU and to rebook the passengers on other flights):

https://www.aviation24.be/forums/viewtopic ... 17#p307417

[sean1982]

Are you now claiming they are losing money on their ebola operation?? Get real please!

[sn-remember]

This is hysteria.. It is not an airborne virus. One has to physically touch an ill person to get infected. I have friends living in Freetown, and they say that as long as one does not touch other people one is not at risk.. they seem to have stopped shaking hands etc.. and always cleaning hands.. otherwise daily life is normal. Our western media is blowing things out of proportions, as usual. Like we assume that Damascus is like Berlin anno 1945..while life goes on,, people go to the movies and resto. etc in Damascus.

You are right. It's not considered an airborne virus ..
However, during the symptomatic phase, it seems demonstrated that big enough droplets of saliva expelled when sneezing for instance might be contagious ...
I was struck by the fact that the health workers are required to wear a mask.
If you want I can find the references of this debate among the medical community. The CDC had to backtrack at some point ...
..
Of course you can live in the EB-3 countries provided you scrupulously respect the prophylaxis measures.
I would do the cooking myself for instance and I would need no house maid (to stay on the safe side).
But it's just me ..

[White Light]

Who is talking about 2 flights a month? Im talking about an extensive coordinated rescue mission with daily (military or chartered) properly controlled flights into and out of the region to provide medical staff and supplies. This should not be paid for by any volunteer organisation but by all Western governments.

Paid by governments = paid by tax payers. Like the subsidised flights out of CRL and other regional airports.
MSF is an international organisation which can afford to pay for their air tickets thanks to their donors' generosity.

[airazurxtror]

(the hysteria surrounding Ebola has compelled Brussels Airlines to repatriate an empty A330 from IAD to BRU and to rebook the passengers on other flights):

https://www.aviation24.be/forums/viewtopic ... 17#p307417

I see no hysteria there - it's simple precaution.

[sean1982]

Who is talking about 2 flights a month? Im talking about an extensive coordinated rescue mission with daily (military or chartered) properly controlled flights into and out of the region to provide medical staff and supplies. This should not be paid for by any volunteer organisation but by all Western governments.

Paid by governments = paid by tax payers. Like the subsidised flights out of CRL and other regional airports.
MSF is an international organisation which can afford to pay for their air tickets thanks to their donors' generosity.

Off course paid by tax payers!! It's all in our best interest to get the situation sorted there asap, with as much money as needed. That regional airport comment is just .... Well ...

[FlightMate]

And our taxes would have been better spent if our governments had done something months ago.

If there is a hefty price to pay to get rid of this, so be it.

Now I wonder if SN will say it becomes too risky (read: expensive) to fly to ebola3, if they have to fly empty every now and then.
Surprising, though... couldn't they clean the plane in IAD?
Any idea of how many passengers had to be rebooked? I know IAD doesn't work very well anyway...

[sn-remember]

However, during the symptomatic phase, it seems demonstrated that big enough droplets of saliva expelled when sneezing for instance might be contagious ...
I was struck by the fact that the health workers are required to wear a mask.

Actually, the mask health workers wear is useful to prevent touching directly the face while attending the patients. Eyes, nose and mouth are entry points of the virus.

[MD-11forever]

According to a study published in "The Lancet", the risk of spreading the virus through travelling by air is rather limited. Also, a screening of the passengers at the place of departure is the most efficient way to detect persons who have symptoms.

http://www.standaard.be/cnt/dmf20141020_01332782

[sn-remember]

I would think that the SN operations to the EB-3 countries are in the scope of the Ebola coordinator mission.
On each aspects of the issue, some tentative guidelines should be enforced, of course updated according to the context.
The issues are :
0- Global policy enforcement regarding scheduled (AND NON-SCHEDULED !) air traffic to the EVD stricken countries (organization,costs)
1- scheduled operations continuation (Y/N)
IF YES
2- screening at departure supervision (constant supervision setup for monitoring purpose : Y/N)
3- decontamination of the a/c (when/what/how)
4- screening at arrival (objective, proceedings)
5- Quarantine measures (who, how)
IF NO
Exactly the same action points arise regarding the relief flights operation.
..
My humble VERY schematic views, at this point of the discussion, are :
0- Global actions should be engaged
1- scheduled operations may continue subject to correct implementation of the following points (-2 to -5)
2- A supervision team in all 3 concerned airports to monitor the professionalism of the screening process.
3- I am not an expert but I would say that decontamination of toilets at arrival + meal plates proper disposal should be ok
4- Screening at arrival : to confirm point -2, explain prophylaxis measures + emergency rules, unreliable profiles put in quarantine
5- Every single pax arriving from the EB-3 countries should be put in quarantine (thus abolishing the necessity of point-4)
..
I think that there is some consensus on the broad lines .. Or did I miss something ?

[sn26567]

With an ever worsening situation in West Africa as the Ebola virus continues its deadly expansion Ceva Logistics has airlifted more than 70 tonnes of urgent supplies to Monrovia, Liberia to help combat the spread of the outbreak. The airlift was chartered by the US Agency for International Development (USAID), the lead government agency coordinating the country’s efforts and which has been working to expand the pipeline of medical equipment and supplies to the region. Included in the shipment were infrared thermometers, disinfectant backpack sprayers, tents, and plastic fencing to be used in the construction of Ebola treatment units.

The supplies were sourced by USAID from multiple locations around the world and delivered to Ceva Charter Services at Liege Airport (LGG) in Belgium. There, Ceva loaded the cargo onto a Global Africa Cargo MD-11 freighter aircraft for a direct flight to the Liberian capital of Monrovia. Ceva Logistics Corporate Account Manager Marc Burgard, commented:

“This was a really important charter, and we were honoured to have been able to play a part in the Ebola response. There were several challenges along the way because of the diverse locations of the items involved, the urgency of the job and the number of time zones concerned, but the charter arrived safely in Liberia.”

http://www.handyshippingguide.com/shipp ... u0.twitter

[sn-remember]

According to a study published in "The Lancet", the risk of spreading the virus through travelling by air is rather limited. Also, a screening of the passengers at the place of departure is the most efficient way to detect persons who have symptoms.

http://www.standaard.be/cnt/dmf20141020_01332782

They say :
"Volgens de studie, die vandaag inThe Lancet verschijnt, stappen maandelijks gemiddeld nog geen drie ebolapatiënten op commerciële vluchten die de getroffen West-Afrikaanse landen met de rest van de wereld verbinden."
"Following the study published today in The Lancet, no more than 3 EVD patients/month in average would board a commercial aircraft outbound from EB-3 countries."
..
Given there are less than a handful of daily flights operated there, I would grossly extrapolate 1 Ebola patient/month at BRU ?
This is good news as we need not worry too much about the exportation of the virus (by air transport anyways), the rest (ships and roads-) is not studied yet ...but I'll not hold my breath.
All in all, A GOOD NEWS AT LAST on the Ebola front !!!
And they add :
"De meeste passagiers reizen overigens niet naar Europa, maar naar Ghana of Senegal."
'Most passengers don't fly to Europe but to Ghana and Senegal"
which could indicate that their statistics are ... hmm ... somehow "outdated" ... ?
AFAIK borders with both Ghana and Senegal have been closed since the EVD outbreak .. and no scheduled flights currently operate between these countries.

[sn26567]

AFAIK borders with both Ghana and Senegal have been closed since the EVD outbreak .. and no scheduled flights currently operate with these countries.

In the RTBF news yesterday night, there was a report showing regular flights between Dakar and Ebola countries. Not commercial flights, but commercial aircraft like B737 or A319.

[Passenger]

I think that there is some consensus on the broad lines

your statement reminds me to "and I am unanimous in that" from Mrs Slocombe (Are you Being Served?).

Or did I miss something ?

Actually, you are: the factual statements from medical ebola experts on websites like MSF.org (Medecins Sans Frontières), WHO.int (World Health Organization), ITG.be (Tropical Institute Antwerp) and others.

Just one example (medical fact): when a person has no fever on departure and no fever on arrival, it is impossible that this person has contanimated someone else in between. So why do you want Brussels Airlines to clean meal plates or decontaminate toilets then?

Although... perhaps... it would be a good idea afterall, such massive decontamination! The flu is an airborne virus that yearly kills more people in Europe then ebola does in Africa. So let's make those cleanings imperative. On all airports off course - to start with airports without jetway bridges. People have to do a long outside walk there from the airport terminal to the aircraft, and such walk in freezing temperatures is extremely dangerous to catch the flu!