Impact of communicable diseases on the economy and what this means for the aviation industry

Transcription

1 Impact of communicable diseases on the economy and what this means for the aviation industry Dr. Lesego Bogatsu: SM Aviation Medicine SA Civil Aviation Authority & ICAO-CAPSCA Deputy Technical Advisor

2 Introduction The International Civil Aviation Organisation (ICAO), the International Air Transport Association (IATA) and Airports Council International (ACI) estimates that there are more than 3 billion passengers travelling Ultra-Long Range. Passengers & flights are able to circumnavigate the globe in less than 24 hours. Passengers can carry a communicable disease to the opposite end of the world in less than 24 hours. In the past, commercial air carriers suffered from low passenger numbers over terrorist attacks such as the 9/11 in 2001; Natural Disasters like the Iceland Volcanic eruptions in The global aviation industry could once more be under siege as the Ebola virus crisis expands via commercial flight.

3 2003: SARS In 2003, the rapid spread of Severe Acute Respiratory Syndrome (SARS) caught many states by surprise. A primary casualty was the aviation sector, resulting in major reduction in air travel. Economic Impact during the SARS Outbreak - <1000 dead, $50 billion estimates.

4 ISSUES: Panic reactions No preparedness plans Knee jerk responses No Harmonization of stakeholders

5 No. of passengers (' 000) 3500 Passengers of Hong Kong International Airport, January to August March, WHO Atypical pneumonia alert 2 April WHO travel advisory Jan Feb Mar Apr May Jun Jul Aug Month 23 May Travel advisory lifted Courtesy: Dr Henry Kong, Chief Port Officer, Hong Kong

6 Full Flights Evacuations of Foreign Nationals Reduction of Travel especially for leisure Absenteeism and attempts to avoid infection will have economic consequences aviation staff Low turn out of passengers as /Flights cancellation is the major effect on the sector Travel Bans,Airlines Suspending Travel Absence of safety critical personnel (during a public health emergency) increases flight safety risk 6

7 Impact of communicable diseases on the economy and what this means for the aviation industry Diversion of Aircrafts to suitable Airports Aviation Fuel Partial or full closure of businesses Early forecast on the economic impact of Guinea, Liberia & Sierra Leone suggests cuts of 0.5 to 2% points in growth in 2014 Agriculture & Mining being areas that may be affected. 7

8 Rush out of an affected area

9 Empty Aircraft

10 .and then 10

11 Start of Pandemic H1N1 Spread to rest of world Swine flu There is no evidence of increased illness in the pig population

12 Economic-Related issues International Arrivals, Mexico, Courtesy: Dr Jose Valente Aguilar Zinser, Ministry of Transport, Mexico

13 ICAO World Health Org. UN Specialized Agencies

14 Basis for Action - Health Article 14, International Convention on Civil Aviation Each contracting State agrees to take effective measures to prevent the spread by means of air navigation of cholera, typhus (epidemic), smallpox, yellow fever, plague, and such other communicable diseases as the contracting States shall from time to time decide to designate.

15 Basis for Action - health Article 14, International Convention on Civil Aviation And to that end contracting States will keep in close consultation with the agencies concerned with international regulations relating to sanitary measures applicable to aircraft.

16 ICAO Amendment Annex 6,9,11, 14, & 18 - Aircraft Callsign (ID) - Dep. Aerodrome - Dest. Aerodrome - Est. Time Arrival - Number of persons on board - Number of suspect cases - Nature of public health risk Airport Operator Public Health Authority Other agency(ies) ICAO Aircraft General Declaration - Declaration of Health (signs/symptoms) (ICAO Annex 9, Appendix 1 & IHR (2005) Annex 9) Aircraft Operator (or handling agency) at destination aerodrome incl. ground-based medical services provider (if available) Airport Operator Public Health Authority Other agency(ies) Via local procedure (Aerodrome Emergency Plan) Via local procedure (Aerodrome Emergency Plan) Departure Aerodrome Air Traffic Services Air Traffic Controller Voice or data link e.g. AFTN* Destination Aerodrome Air Traffic Services *AFTN = Aeronautical Fixed Telecommunication Network

17 International Health Regulations (2005) A global legal framework for public health security IHR (2005) came into force on 15 June 2007* Legally binding for the world s countries that have agreed to follow the same rules to secure international health.

18 CAPSCA - AIM Populations Mitigate the risk from pandemic Travelers (passengers and crew) Reduce risk of spread on board aircraft Commerce Mitigate the financial impact from an outbreak or pandemic, business continuity models.

19 Early Recognition & Containment

20 Hand Washing Remove all jewelry and wet hands with warm water Apply soap to hands Cover all surfaces of the hands and fingers Clean knuckles, back of hands and fingers Rub hands together Clean the space between the thumb and the index finger Use soap: Using water alone does not remove soil and grease which can trap unseen germs and viruses. Wash your hands for at least seconds using the following steps. Total duration of the entire procedure is seconds Cover the fingernails by working the fingertips into the palm Rinse well under warm running water Dry with a disposable paper towel, then use the towel to turn off the tap 20

21 Early Recognition & Intervention

22 Early Recognition & Intervention

23 Early Recognition and Containment Thermal scanners at airports

24 Core capacity requirements at all times (routine) (a) Assessment and Medical care, staff & equipment (b) Equipment & personnel for transport (e) Trained staff and programme for vector control (c) Trained personnel for inspection of conveyances (d) ensure save environment: water, food, waste, wash rooms & other potential risk areas - inspection programmes

25 Comparative risk of outbreaks Transmissibility Severity of Disease (Morbidity & Mortality) High Low H5N1 SARS High 1918 Pandemic Low Pandemic (H1N1) 2009 Seasonal Flu

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27 Ebola: Johannesburg 1996 SA 1996 (Crit Care Med, 2000;28(1): y old anesthetic assistant nurse (Index case) significantly exposed to imported Gabonese primary/source & atypical case: 29/10/96 Acute febrile illness 02/11/96 Series of events: delays in both diagnosis and judgments definitive diagnosis of Ebola v: 15/11/96 Primary/source case traced to convalescent home on 16/11/06 & confirmed to have had Ebola Fever Cascades of actions and reactions, including patient transfers & resulting in >1000 exposures Death of patient on 24/11/96 from intracranial hemorrhage & nosocomial infectious complications

28 Lusaka September 2008 Index patient: fever, rash, sore throat, convulsions T/F to RSA? Tick bite fever Johannesburg

29 Recent West Africa Ebola Outbreak

30 Symptoms and signs of EVD 30

31 Assumptions all patients present with symptoms & signs

32 Ebola Virus Disease Incubation period: 2-21 days. WHO has indicated that there is no risk during the incubation period & low risk in the early phase of symptomatic patients Airborne transmission has not been documented. No known specific treatment or preventative vaccine Fatality Rates can reach 90%, and the current outbreak have fatality rates of % of infected cases estimated. Treatment - supportive care.

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34 EBOLA VIRUS DISEASE - GUINEA (02): BAT EATING BANNED Date: Tue 25 Mar 2014 Guinea has banned the sale and consumption of bats to prevent the spread of the deadly [ebolavirus], its health minister has said. Bats, a local delicacy, appeared to be the "main agents" for the Ebola [virus disease] outbreak in the south, Rene Lamah said...

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36 The Exit Screening

37 Where are we now Globally Ebola? State of Pandemic Readiness A. Very few: Comprehensive Whole-of-Society Planning B. FEW: Essential Infrastructure interdependencies and the role of other sectors of society is identified but critical sectors not fully involved in planning, lack concrete operational plans C. MAJORITY :Pandemic Preparedness limited mainly to the Ministry of Health and Agriculture with some involvement of the disaster management structures D. ICAO SAPRS & WHO not implemented

38 Key Considerations International border health measures should be implemented under the framework of the new International Health Regulations; Decision on public health measures based on assessed risks; Public health measures should be evidence-based whenever possible; Countries should balance the benefits against the costs and potential consequences; Desirability of harmonization of interventions at international POE; Planning, coordination and communication is essential.

39 Business Continuity for Airlines/Airports For public health emergencies, the decision to activate the BCP should be based on a number of factors including: WHO assessment of the public health emergency; National public health authority assessment; Community Impact & Response Internal company assessment (based on location and number of online stations affected, number of affected staff or family members, etc.) All of the above should be monitored and tracked continuously throughout the outbreak in order to evaluate the severity and its potential impact on operations.

40 Adapted Response Response depends on the nature of public health risks and events occurring New IHR emphasize the need of risk assessment to inform appropriate public health actions. International public health security is based on strong national public health response capacity connected to a global alert and response system (e.g. GOARN). Need flexibility for POE public health measures.

41 Early Containment at Source IHR emphasize the importance of the IHR core capacity requirement for surveillance and response at national and local levels Rapid response and containment at the source is: the most effective way to secure maximum protection against international spread of diseases key to limiting unnecessary health-based restrictions on trade and travel

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43 ? Causative organism H?N?, Variant?,? Others? When? How widespread? Where will it start Aviation sector may again be hit badly Preparedness planning is our only protection A harmonized preparedness plan will inspire confidence in the travelling public

44 THANK YOU