Safety of Air Medical Transport of Patients With COVID-19 by Personnel Utilizing Routine Personal Protective Equipment

BACKGROUND: Air medical transport of patients with known or suspected COVID-19 likely represents a high-risk exposure to crewmembers as aircraft cabins are quite small resulting in very close personal contact. The actual risk to medical crewmembers is not known. METHODS: We conducted an IRB-exempt, retrospective study of air medical transport of patients with known or suspected COVID-19 by eight programs in the Four Corners Region to determine the number of symptomatic COVID-19 among air medical crew members compared to total exposure time. All programs utilized similar routine PPE including N-95 masks and eye protection. Total exposure time was considered from time of first patient contact until hand-off at a receiving hospital. RESULTS: There were 616 air transports: 62% by fixed-wing and 38% by rotor-wing aircraft between March 15(th) and September 6(th) 2020. 407 patients (66%) were confirmed COVID+ and 209 (34%) were under investigation. Patient contact time ranged from 38 to 432 minutes with an average of 140 minutes. The total exposure time for medical crew was 2,924 hours; exposure time to confirmed COVID+ patients was 2008 hours. Only 30% of patients were intubated, the remainder had no oxygen (8%), low flow nasal cannula (42%), mask (11%), high-flow nasal cannula (4.5%) and CPAP or BPAP (3.5%). Two flight crew out of 108 developed COVID that was presumed related to work. CONCLUSIONS: Air Medical Transport of patients with known or suspected COVID-19 utilizing routine PPE is remarkably safe for medical crew members, even when patients are not intubated. This has implications for healthcare personnel in any setting that involves care of patients with COVID-19 in similarly confined spaces.