It’s hard to believe it’s been over a year and half since Covid sent shockwaves across the world. Throughout this time, we have spent a significant amount of time talking about the challenges we have faced with patient care and how we can safely transport those affected by Covid home. What we really haven’t spoken much about are all the challenges that we are faced with surrounding the transport itself.
In 2020, when we realised that there was going to be a screeching halt to travel, transportation and tourism around the globe, as a company we knew we were going to need to make some changes. Here at REVA Inc., the bulk of our business revolves around travel and tourism. Some of these changes for us included reducing our staffing numbers across the board – in aviation, medical, and our corporate headquarters, along with office space. This was an extremely difficult decision, but as a company we understood that our flight volume was going to be substantially less than what we are used to, and what we budgeted for, with a subsequent and obvious impact on revenue. The other piece of the puzzle is that we didn’t know for how long everything would be locked down, or for how long Covid would prevent people from travelling.
Fast forward to July 2021, there remain many places where travel restrictions either limit numbers of inbound residents and tourists, or where citizens from other countries are not welcome at all. Even with the increase in travel and tourism and flight volume over the past seven months, our staffing numbers are still lower than they were during normal times.
One very positive thing that came out of this, however, was how efficient we have become, with fewer resources available at any given time. Along with becoming more efficient, we have also worked with many other companies to assist in any way we can, because during these tough times we all had – and still have – the same common goal of delivering the highest level of care to each patient.
Medical staffing levels affected by Covid-19
Although we are all working together as efficiently as possible, in the US, we have seen evidence of severe burnout in medical personnel. This includes physicians, registered nurses, respiratory therapists and paramedics. For us at REVA, we have many per-diem medical staff, so in addition to their responsibilities with us, they have full-time commitments elsewhere. During the height of Covid, a lot of these staff members were mandated to do even more at their full-time jobs than normal, with the addition of working in full PPE for 12- to 24-hour shifts. These shifts have been extremely tough, especially facing an increase in the number of deaths, and a decrease in available critical care beds because of the high-acuity Covid patients that were being treated. This burnout in the hospital and increase in hours resulted in a decrease in staff availability for us. The decrease in staffing availability from the per-diem personnel then placed pressure on the workload for our full-time flight staff, resulting in burnout and agitation because the crews were ‘turning and burning’. It was at this point that we realised we had to reevaluate our rest times and slotting of our staff members. On a weekly basis, we consistently look at the hours flown for all staff members and make sure that we are taking care of our own and are always in constant communication with them.
Having one patient for a 12-hour duty day is much more appealing than running around for a 12-hour shift in a stressful environment inside the hospital
Currently, we are seeing evidence of some very lucrative contracts for medical personnel across the US. Some of these contracts are paying in one week what most medical personnel are seeing in an entire month. It is very hard for us to compete with something like that, but we also understand that these contracts will not go on forever. As we begin to increase our staffing levels commensurate to an increase in flight volume, we are experiencing a bit of a struggle that we wouldn’t normally see because of these high-dollar-sign contracts, and sign-on bonuses at the hospital. One of the best benefits of flying in the air ambulance industry is that it is one patient at a time, versus countless patients in a 12-hour shift in the hospital. Having one patient for a 12-hour duty day is much more appealing than running around for a 12-hour shift in a stressful environment inside the hospital. This recruitment tactic has been very appealing to candidates that we have interviewed in the past couple of months.
Navigating the travel rules and restrictions for medical escorts
Aside from the staffing and budgeting concerns, one of the biggest hurdles for the past year has been all the different rules and regulations for each country and state in which we are transporting patients to or from. It is no longer just a simple ‘wheels up in two hours’ for a mission. Now, we have an entire checklist for each country. Whether it be special permits, visas, new travel documents, or Covid testing, each country is different and is constantly changing. One way we have made a lot of this easier is by having our own Covid testing available in-house 24/7. We can complete RT-PCR testing that gives results in 30 minutes, and rapid antigen testing that gives results in 10 minutes. By having this capability, it has allowed us to be wheels up much faster because we do not have to rely on a third party to complete the testing for us.
The Covid pandemic has really forced everyone in the industry to be much more thorough when launching a flight. Communication and checklists have been the key to successful missions during these times. The pandemic has also really forced everyone to evaluate every dollar spent, and make sure we are working as efficiently as possible company wide. Collectively, as an industry, we have all worked together to help get through these times. One thing I think we as an industry can acknowledge is that if we can make it through this pandemic, we can make it through anything.