2 MARCH 2020


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Article from BTNews 2 MARCH 2020

ON THE SOAPBOX: Dr Paulo Alves & John Strickland and COVID-19

With the ever-evolving COVID-19 crisis, BTN for the first time ever has two contributors to ON THE SOAPBOX, both experts, one in the aviation medical area, and the other a leading consultant to airlines and airports in the strategy and commercial fields.

Both are well-known speakers in their particular areas. BTN is privileged to publish their thoughts in what is an evolving situation. See also ITB axed in virus clampdown.

Dr Alves is a member of the MedAire Medical Advisory Board, part of International SOS. John Strickland created JLS Consulting in 2003 after a career that included British Caledonian, British Airways, KLMuk and Buzz. 

Paulo Alves leads off. Later this week he will join IATA’s Aviation Resilience Health workshop in Singapore to address the overall impact of COVID-19 to the aviation industry.    

"MedAire is working with the airline industry to address COVID-19.  The objective is to have one coordinated approach to alleviate the public health concerns, looking at pre-flight and in-flight prevention, containment and response.

As an IATA Strategic Partner, we participate in key aviation medical associations, putting us in the unique position to help airline operators by sharing best practices. We consult with airline clients to provide actionable advice on day to day operations.  

As in other cases defined as a PHEIC (Public Health Event of International Concern), the World Health Organisation (WHO) has provided outbreak-specific definitions of what qualifies as a COVID-19 case. We have incorporated that definition into how our medical team classifies and manages any suspected cases identified pre-fight or in-flight.

Currently, given all the containment efforts in place, we are not seeing any increase in suspected airline cases of infectious disease vs. the same period last year.

During the boarding process, if a situation is brought to us by the airline or ground staff that suggests any communicable disease, our long-established procedure is always to recommend against flying. 

Furthermore, during an outbreak, the heightened attentions of gate agents enhance the efficacy of the system – helping prevent exportation of cases via air travel to other countries. This process aligns with the exit-screening initiatives already implemented by the health authorities around the world. These public health measures are well proven to limit the international spread of an infectious disease.

If a passenger is suspected to meet the criteria for COVID-19 – or any contagious disease for that matter – while in flight, we provide recommendations aligned with IATA, ICAO and WHO. In addition, there are best practices that can be enacted to mitigate the risk to other crew and passengers onboard. The airport and authorities at the destination country will also be notified there is a person onboard presenting symptoms of a contagious disease.

Constant monitoring of the situation is crucial. The outbreak is evolving rapidly, and is a matter of significant public health and international interest. 

For example, there has been a rise in cases in South Korea and Italy, while cases have declined in Japan. The situation will continue to evolve and ramifications for events such as the Olympics are unknown. It would be premature to forecast the behaviour of this new virus, but hopefully COVID-19 would behave as SARS in 2002, which declined its activity progressively from April. That could have been associated with seasonal environmental conditions unfavourable to virus spread.

To avoid the spread of COVID-19, a state of permanent vigilance should be practised. Contact tracing and evaluation are paramount, along with good quarantine and case isolation practices. While not completely unavoidable, delaying international spread is crucial to allow time for vaccine and treatment development and additional studies of the virus. 

Sad to say this is not our first medical crisis for the airlines.  Over the years, MedAire has advised the industry during outbreaks such as SARS, H1N1, MERS, Ebola and Zika. All were serious at the time but eventually constricted."


“COVID-19 is a challenge for airlines”, says John Strickland.

“Coronavirus is yet another challenge that airlines have to take in their stride. Not all will make it. A lot depends on cost management but it’s also about agility and flexibility of response.

The virus will subside in the months ahead, but we can’t yet calculate the final scale of damage it will wreak for airlines. IATA puts the revenue losses in multi-billion dollars and rising. At first it seemed that the impact might be similar to SARS and that it might be relatively geographically contained. It was clear home carriers and those with significant exposure to the Chinese market would be hit hardest. 

However, the Chinese market has become so much more globally linked with people travelling and transferring on a larger and more interconnected worldwide airline network. Consequently, the ripples have extended into wider Asia and we now see, more unexpectedly, that they have reached other directly unrelated markets such as Iran and Italy. Britain too is now affected and the US. It is worldwide.

While airlines are led by health and travel advice from global agencies such as the WHO, their immediate internal challenge is monitoring booking trends and revenue management teams will be poring over the data. As we’ve witnessed in parts of Asia, bookings melted away at an incredible pace and a similar pattern has now been seen in Italy and some surrounding markets. Airlines have to react quickly to stem the blood loss of operating empty flights or surplus capacity. A delicate question too, how much flexibility should be offered to worried customers to change or cancel bookings, without unnecessarily adding to mounting revenue losses? Another concern, particularly for network airlines and others focused on higher margin business travel, is the disproportionate hit to revenues as companies put in place travel bans and many corporate events are cancelled.

Equally sensitive and of critical importance is concern for the wellbeing of airline crews. Where operations are maintained, airlines have to be confident this can be done without jeopardising the health of their own staff. The complication of any quarantine risk could also eat into crew availability, which would cause further disruption to operations.

As significant numbers of flights are cancelled at slot coordinated airports, airlines will look for some relief on the “use it or lose it” regulation, by which 80% of slots must be used in a given season to protect grandfather rights. This is a major point of discussion in the aftermath of the COVID-19 crisis. It is, in any case, expensive to leave aircraft and crew idle, so where possible some airlines are moving to add extra capacity to other unaffected routes and markets. This will go some way toward mitigating revenue losses and to circumventing the potential slot challenge.

For carriers operating in EU markets, there’s the thorny question of EU261 compensation in the event of flight cancellations which, I would argue, should not apply for such a force majeure situation. 

Airlines have plenty on their plates right now to tackle the challenging and unpredictable trajectory of this virus. An understatement! History tells us traffic will recover, but currently we cannot predict the time frame. The impact on important premium yields is another current unknown factor. I hope in a few months we will see a return of normality to operations and be able to look back and reflect on the lessons learned, but there is certain to be some carnage for the industry in the wake of this health crisis.”


The British Business General Aviation Association (BBGA) is tackling how coronavirus is affecting the business aviation sector at its 2020 annual conference this week, Thursday 5 March, at Luton Hoo with speakers MedAire Europe medical director Dr Michael Braida and Gama Aviation risk management and assurance director Hannah Smith. https://bbga.aero

Paulo M. Alves, MD, MSc, provides technical guidance and analysis for MedAire’s MedLink medical advisory service and is a member of the MedAire Medical Advisory Board. A popular presenter and requested speaker, Dr Alves also authors papers and articles on medical topics affecting remote medicine based on trends in medicine and technology. A cardiologist, Dr Alves previously was the medical director for Varig Brazilian Airlines and was a member of the IATA Medical Advisory Group from 2002 to 2006. MedAire, part of International SOS, the world's largest medical and travel security services firm, provides aviation-specific travel risk-management solutions for more than 150 airlines, charter companies and thousands of private jets worldwide.  www.medaire.com

John Strickland is a graduate of the University of York and has held senior positions including network planning and revenue management with a number of airlines. JLS Consulting was established in 2003, providing strategic insight, guidance and advisory services concerning the air transport industry for a wide range of clients including airports, airlines and investors. Strickland provides expert independent business and financial commentary on the sector for leading media, including the BBC, Sky, Bloomberg, CNN and the Financial Times. He is also a regular conference chair and moderator at industry events, frequently interviewing leading senior executives. www.jlsconsulting.co.uk

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