2020 will be remembered as a year like no other, when the Coronavirus forced everyone to find new ways to live and work. For European Air Ambulance (EAA), this meant adapting quickly but safely - using their knowledge and experience to not only navigate 2020 but also to inform the way ahead into 2021 and beyond.

Covid-secure transport

The most immediate challenge was developing Covid-secure transport methods - an absolutely crucial requirement to be able to operate safely in the new reality of life in the pandemic.

EAA already had experience of transporting patients with infectious diseases, most notably Ebola – and this gave a vital head-start in the race to find ways to deal with Covid while keeping patients and staff safe. New and streamlined procedures were put in place, and new protocols for all staff to follow at every stage of a mission, depending on whether patients had a positive, negative or unconfirmed Covid status, to ensure the safety of patients and the medical and flight crews treating and transporting them.

In many cases EAA’s Infectious Disease Unit was used. This tent-like module was originally designed for the safe transport of Ebola patients, but was adapted and is now being used solely for Covid missions. It ensures the patient and their belongings remain completely isolated physically from the aircraft and crew, but allows the medical teams to administer all the necessary treatment – even intensive care – through specially designed pockets in the enclosure.

Smaller isolation systems such as the ISO-Pod or EPI-Shuttle are also available for transports where appropriate, underlining the safety-first approach and commitment to patient and staff care that underpins every mission flown by EAA.

Thanks to the experience gained during the Ebola crisis, and as the only service worldwide to equip its fleet with such specific risk-reducing equipment, EAA was able to transport large numbers of Covid patients both domestically and abroad.

Everyone is used now to seeing medical teams in full protective equipment, and familiar with the need for extra precautions in all walks of life - but these measures in a medical setting are physically demanding and time-consuming for staff. However, right from the early days of the pandemic, thanks to their experience, EAA’s teams were able to quickly adapt to the new measures.  

EAA staff were already used to the disinfection protocol of the aircraft and equipment, where all equipment and the aircraft have always been fully disinfected after every mission. But Covid means even greater precautions are required to prevent the spread of the virus, and provide a safe working environment for staff alongside safety and quality of care for patients.

These include not only the PPE that is now such a familiar sight, but additional measures – including airlock entry to and exit from the IDU, bagging of possessions in sealed and disinfected containers, staff disinfecting their colleagues, and the secure bagging and incineration of all PPE used and the IDU itself at the end of every mission.

At the height of the first pandemic peak last summer – and at the request of the Luxembourg government - EAA and parent company Luxembourg Air Rescue (LAR) transported Covid-19 patients between hospitals in France where health services were overstretched, and medical facilities in neighbouring countries.

Showing cross-border cohesion and solidarity with European neighbours, ministers in Luxembourg agreed with French health authorities to help ease the pressure by transferring and treating patients, providing targeted relief to hospitals in the worst affected areas.

One of the first such missions involved a 57-year-old who was on life support battling the virus in hospital in Metz. The Grand Est region was in the grip of Covid, and medical teams were struggling with the sheer number of patients.EAA flew him to Luxembourg, where despite his initially poor condition he improved, and some weeks later was eventually able to be flown home – an early success story that brought real hope to all involved, and a life-saving mission that was repeated many times.

This cross-border Covid collaboration saw EAA’s mother company Luxembourg Air Rescue (LAR) honoured for outstanding work during the pandemic – as a joint recipient of the prestigious Adenauer-De Gaulle Prize for 2020. The prize, created by the French and German Governments in 1988, is awarded to individuals, initiatives or institutions that, through their work, have made an outstanding contribution to the consolidation of Franco-German friendship.

Disaster zone response service extended

There was more good news for the wider EAA family when the contract for a rapid response service providing life-saving humanitarian assistance in disaster zones worldwide was extended for six years.

Luxembourg Air Ambulance (LAA), the aircraft operator of the EAA brand, is one of the founding partners of emergency.lu – a mobile, satellite-based telecommunications platform providing internet and phone connections to support humanitarian organisations in the field.

Funded by the Luxembourg government and available at no cost to the international aid community, emergency.lu allows equipment and personnel to be deployed to affected areas within 12 hours – a life-saving service that all at EAA are proud to contribute to.

Staying flexible

The slowdown and in some areas the complete hold on international air travel did of course lead to uncertainty for EAA. After an initial rush of repatriations, when people who had become ill while on holiday raced to get home, much of the day-to-day business came to a halt.

Maintenance teams kept the aircraft ready and on standby for missions, but EAA were able to take advantage of the Luxembourg government’s support for businesses, which allowed them to be flexible with staff, giving leave when required but still able to call them in at short notice.

EAA has always run a programme of regular training and ongoing professional development for staff – but fitting this around the usual busy schedules can be challenging. One of the unforeseen consequences of being in a series of global lockdowns was that team members could spend more time in the unique training facility at EAA’s headquarters. Equipped with state-of-the-art simulators, staff can rehearse adult, paediatric and neonatal medical situations as well as mass casualty incidents – ensuring they are ready for any medical situation and severity.

Taking stock

EAA is always looking for ways to streamline and enhance its services, and prior to the pandemic was already considering how to adapt its fleet of Learjet 45XRs to provide the best options for clients. But the situation worldwide brought into focus the importance of fighting the spread of all viruses and infectious diseases, and showed that an increasing number of patients will need to travel in isolation units.

These take up space in the aircraft, leaving less for patients and medical teams, so EAA is considering  the addition of larger aircraft to the fleet which would provide more internal room - but would also add efficiency through being able to fly longer-range missions, with fewer fuel stops and stopovers.

Two of the existing fleet of Learjets have therefore been sold, and decisions will be made on future additions when the global health situation allows.

Making plans

While everyone at EAA is optimistic about the coming year and beyond, so much depends on the Coronavirus situation – how vaccination programmes will help, and whether life can return to anything close to ‘normal’. Simple arrangements are no longer straightforward, and commonplace missions are now complex. With so many asymptomatic Covid sufferers, more tests need to be carried out, and patients can rapidly deteriorate mid-flight.

On top of the medical concerns, there are huge logistical complications - every country has its own rules and restrictions, and things can change on a daily or even hourly basis, which has a huge impact for air ambulance services where permits, fuel stops and layovers are necessities.

The whole team at EAA are determined to rise to the challenge though – and just as their earlier experiences helped them in 2020, so the lessons learned from the pandemic will help them going forward.