Due to the rapid changes that Covid-19 has inﬂicted upon the assistance and medical repatriation industry, the need to adapt to the current times is clear. Leading medical personnel in Israel have joined in a roundtable discussion regarding proper measures to ensure the return of safe travel. Understanding the complexity of this matter, the leading assistance and repatriation company in Israel, MedAssis Ltd, was invited to present the cutting-edge isolation technology that it has implemented successfully in several international missions when repatriating a Covid-19 patient.
Executing a medical repatriation mission, which was a complex task pre Covid-19, has become an enormous operational eﬀort. Maneuvering through dynamic and everchanging restrictions, pushing through the barrier of endless bureaucracy and utilising existing partnerships for optimal coordination – MedAssis has implemented extreme measures to ensure the smooth execution of medical repatriation ﬂights during these times. Utilising the advanced technology of the leading player within the isolation rooms and chambers space, MedAssis has integrated an isolation chamber within its services to provide safe repatriation ﬂights for patients who have tested positive for Covid-19.
MedAssis is the leading assistance and medical repatriation ﬂight provider in Israel, with thousands of complex missions completed successfully. They provide leading medical escorts on air ambulances as well as on commercial ﬂights. MedAssis provides its services to over 70% of the outbound travel industry in Israel and is an up and coming dominant player in the inbound travel marketplace as well. Ariel Mauer, MedAssis’s Chief Paramedic, has explained further how the isolation technology works, and how it has already been proven in the ﬁeld in various missions.
Why is repatriating a Covid-19 patient a better medical and ethical practice than allowing recovery and then returning them home?
There are three main reasons why, in many cases, a medical repatriation ﬂight for a Covid-19 patient outweighs the alternative of continuous hospitalisation in the patient’s destination.
First, many patients do not want to spend their sickness experience in a foreign land. They want to be close to friends and family and want to return eagerly to where they feel most comfortable.
Another issue, which cannot be overlooked even in Western countries these days, is medical care capabilities. Due to the enormous number of patients flooding healthcare systems worldwide, levels of care have substantially decreased in some destinations.
Once a country is close to capacity in their healthcare system, the need for competent care becomes acute. We had a patient in Nigeria who was positive for Covid-19, and it was clear that if he stayed at the medical facility there, he would probably not survive.
Finally, for those who utilise this service through an insurance agency, their policy might be disrupted or cancelled if they chose to stay hospitalised at their destination. The costs of hospitalisation abroad could accumulate to enormous figures, which could be cut drastically by this type of flight. MedAssis was asked to repatriate a Covid-19 patient from New York. The cost of a ventilated Covid-19 patient exceeded US$15,000 per day. The insurance company has avoided an astronomical cost by the repatriation.
How does the isolation chamber avoid contamination within the cabin of an aircraft?
Our highly trained medical personnel rendezvous with an ambulance at the airspace while fully protected, and the chamber open, ready for the patient. Once the patient is securely fastened within the sealed chamber, it is completely sterilised with chlorine on the exterior. Once evaporated and completely dry, the patient is moved into the air ambulance.
The chamber itself could run on power or on a 10-hour long battery [MedAssis owns a few, which allows us to operate a transatlantic flight without any need for external power]. The chamber has a blower connected to a HEPA filter. The blower causes negative pressure within the chamber, causing air to enter from the filter at the rear of the chamber, and exit the chamber through the HEPA filter ensuring the safety of the medical personnel, passengers, and crew. This also allows the medical team to treat the patient without the restrictions of protective equipment.
Does the isolation chamber provide an adequate treating environment?
In short, yes. The chamber is completely transparent, allowing the medical team to keep an eye on the patient at all times. Due to the constant negative pressure, there are designated openings that do not aﬀect the isolation, allowing connection to the monitor cables, ventilator etc. As part of the procedures that were implemented, we have a list of medical equipment that is enclosed with the patient to assure that there is no need to break the isolation or the duration of the ﬂight. In addition, the patient, medical providers, and crew are all synched with proprietary headsets to provide ideal communication. Finally, the chamber is equipped with four glove-like openings on each side, where the medical provider can reach every part of the isolation chamber.
What training do you provide for a smooth execution of such a mission?
We pride ourselves on the professional competence of our medical providers. Each provider is an active medical professional respectively in their ﬁ eld. All our Critical Care Paramedics work on an ICU, all nurses are intensive care nurses and all our doctors are specialists who are tailored to the mission dependent on the medical condition. Our Medical Director, Dr Ami Mayo, is actively the head of the emergency department of a leading hospital in Israel.
Every medical provider must undergo a theory course and exam regarding the technical aspects of the isolation chamber, as well as a drill in the air space with one of our jets from our ﬂeet. MedAssis has heavily invested to guarantee extreme health and safety measures for such complex missions.
Will we be seeing isolated patients on commercial flights as well anytime soon?
This is a realistic possibility. The isolation chamber ﬁts on a stretcher in a commercial aircraft.
We have done drills to ensure compatibility with the commercial setting and it works.
We are looking forward to cooperating with commercial airlines in the future as well in order
to assist more of those who are in need.
Ariel Mauer - Business Development Manager
4 Ha’Nechoshet St., Tel Aviv, 6971069, Israel