AFW Suggestions and Criteria for Safely Transporting Patients during COVID-19

Suggestions and Criteria for Safely Transporting Patients by Air or Ground Rich Pickett – Angel Flight West Safety Officer - Updated May 2021

There are various methods to reduce the chance of virus transmission between pilots and passengers. The suggestions and criteria listed below provide a framework for Command Pilots and Earth Angels. Our thanks again to Dr. Hunter Handsfield who provided the basis for this list.

  • Exclusion of persons with symptoms consistent with COVID-19 (including but not limited to: cough, sneezing, chest congestion, shortness of breath, fever, or loss of taste or smell). 
  • Consider temperature screening of vehicle occupants. Non-contact thermometers are recommended for safe measurement. Due to the dynamic nature of this disease, the CDC symptoms website should be consulted for the current list of symptoms. NOTE: According to the CDC, individuals may be asymptomatic, and infectious, a number of days before any symptoms appear. 
  • Exclusion of persons with known exposure to another COVID-19-infected person within the preceding two weeks, including persons who have been notified of possible exposure through contact tracing. 
  • Exclusion of persons who have traveled recently to geographic areas with high infection rates. 
  • Excluding others potentially at high risk as defined by the CDC High Risk Website. 
  • Consider limiting the number of travelers, as each additional person on board in principle raises the risk for all occupants. 
  • Masks are optional ONLY if all passengers and volunteers are vaccinated and are comfortable taking off their masks.
  • Masks are required (1) if any passenger or volunteer is not vaccinated, or (2) if any passenger or volunteer requests that masks be worn during the transportation.
  • If masks are worn, they should be surgical type masks or other suitable face covering. Ensure that they are properly used with minimal gaps around edges. Angel Flight West will supply facemasks upon request. 
  • Avoid seating any patients, companions, or their family members in the front seat in order to increase social distancing from the pilot, whenever possible. 
  • Avoidance of direct personal contact between vehicle occupants, such as hand shaking or other direct contact.
  • Avoid the consumption of any liquid or food during the flight, unless medically necessary, to avoid the removal of the mask. Using a straw is one way to drink and still use the mask and offer some protection to occupants. 
  • Hand washing or hand sanitizer by all occupants immediately before and after transportation. 
  • Optionally wear protective (e.g. nitrile) gloves when handling other persons’ luggage or other personal equipment; or wash hands or apply sanitizer after such contact and prior to boarding. 
  • Increase air flow as much as possible in the cabin, consistent with temperature control and patient comfort, to reduce rebreathing of potential virus-containing aerosols. In cars, avoid use of recirculation mode to enhance air movement. 
  • Consider local or regional COVID-19 frequency, to the extent accurate information is available from local health authorities. For example, Command Pilots and Earth Angels may have different standards for passengers from communities with especially high rates versus those from communities with few known cases. 
  • Disinfect interior aircraft surfaces, both before and after mission flights, with particular attention to frequently manipulated or contacted components such as headsets, seat belt buckles, and arm rests. 
  • If headsets are provided to passengers, microphone muffs should be used by only one person and discarded following a single use. 
  • If flight conditions require oxygen, consider disposable cannulas for passengers. 


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