David Powell, IATA Medical Advisor, notes that Wuhan is beginning to open up some two months after the initial lockdown. “But in other countries, some models suggest second or third waves of the virus are possible, so the best exit strategy from many current mitigation efforts is not clear.”
For aviation, a key challenge will be countries removing restrictions at a different pace according to national circumstances. That poses a question for establishing connectivity. It may have to be done on a case-by-case basis. Powell says that emerging economies may well be severely hit in the months ahead, for example.
And when international aviation does start up again, there will be a need to protect and reassure passengers. Hand sanitiser will likely need to be available throughout the airport, including at boarding gates. “And there is evidence that temperature control at airports reassures passengers, even though it is only a partial solution,” says Powell. “Likewise, routinely wearing masks is contrary to WHO advice but passengers may prefer cabin crew to wear them initially.”
On a positive note, the pace of understanding the virus is almost as fast as its spread. The novel coronavirus was only identified in late 2019 in China and came to the notice of much of the world in early January 2020. But already work is beginning on a vaccine, and antibody tests are becoming widely available. Though imperfect, they can immediately reveal when a person has had the virus, which indicates at least a temporary immunity. Airlines should be thinking of appropriate measures that harness the scientific developments.
In addition, some countries appear to be through the worst. China’s lockdown appears to have worked well, with imported cases now a bigger concern than the domestic transmission of the virus. South Korea, meanwhile, focused on extensive testing and contact tracing. Its only entry restriction was flights from Hubei province.
For now, though, the coronavirus outbreak continues to wreak havoc around the world. Only a small number of countries remain unaffected, usually small island nations and places where the testing capability is limited.
Most models suggest one person can infect about 2.5 people, which roughly matches the rise in numbers being reported around the world. About 85% of people will have mild symptoms easily treatable at home with up to 15% requiring oxygen at some stage. For a small percentage, variously estimated from 0.5% to 2.5%, the condition can prove fatal. The vast majority in this group are elderly or have underlying conditions.
“Most strategies to deal with the pandemic have moved from containment to mitigation, flattening out the peak of infection to enable health services to cope,” says Powell. “The essential ingredient in all efforts is limiting close contact as infection happens via droplets or touching a recently contaminated surface.”
Because the coronavirus is new, scientists are still determining when people are infectious. SARS was not contagious until the patient was quite ill but that does not appear to be the case with this strain of coronavirus, and infection can occur before symptoms show. It is why handwashing, self-isolation and social distancing are so important.
“The aim is to stop COVID-19 becoming established,” says Powell.
‘Herd immunity’ is a phrase that has cropped up often in COVID-19 articles and interviews.
It is important to note that most medical personnel only talk about this concept in connection with vaccines. If enough people are vaccinated, say 90%, then there will not be enough contact between unimmunized people to sustain the spread of a virus.