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Operational challenges during the COVID-19 Pandemic

By Joe Gleason, AHT Director, Risk Management Services


As the impact of the COVID-19 Pandemic evolves, organizations are increasingly asking: What happens if someone needs to be evacuated? For many operating globally – and especially NGOs and others working in more challenging developing world environments – being able to evacuate international personnel for medical or security issues is an essential link in the duty of care chain.

So, can people be evacuated during the COVID-19 pandemic? The answer: Maybe…depending on the situation. While that may be an unsatisfying answer, those operating internationally should understand the challenges and limitations on evacuations during this unprecedented global crisis:

1) Medical evacuation (for COVID-19 and otherwise)
Both travel restrictions, as well as medical considerations, potentially complicate medical evacuations. The travel restrictions imposed by governments vary considerably, with some countries limiting who can enter and depart while other countries closing airports and sealing borders entirely. Medical evacuations providers are limited by these restrictions which, depending on the details, may delay or even prevent evacuation: even medical evacuation flights may not be able to operate if borders are sealed. And even where the restrictions are less onerous, it may take longer than usual to get necessary flight clearances. These challenges may impact medical evacuations of those with COVID-19, as well as those with other medical conditions.

Potential medical challenges related to COVID-19 include:

  • Restrictions by countries on the movement of those with, or suspected of having, COVID-19 (departure, overflight or interchange/layover)
  • Restrictions by countries on the arrival of those with the disease to nationals only – i.e. US nationals can only be admitted to the US, Canadian nationals to Canada, etc.
  • Limits on air ambulances: only a limited number can be “fully sealed” to prevent exposure to the aircrew and any aircrews exposed to COVID-19 may be quarantined
  • Need to have a confirmed destination for COVID-19 patients – that is a bed in a hospital in their destination – which may be limited based on available space

As is always the case, any medical evacuation must be determined to be “medically necessary” by the assistance provider and the underlying insurance carrier. That’s not a new condition, but worth remembering.

2) Pre-emptive “Security” Evacuation (ie. Non-medical departure)
With the US State Department raising their global advisory level to “Do Not Travel”, there is an increase in interest by people – US nationals & otherwise – in returning to their home countries. However, departing a country pro-actively to return “home” – wherever that home is – is complicated by all the travel restrictions noted above, including (and especially) closed borders and airports. Additionally, many countries are imposing restrictions on travelers coming from international locations – typically only allowing nationals of their country to enter (US citizens/residents to the US, etc.), screening on arrival and quarantine for 14 days.

Should security conditions deteriorate considerably in countries and the need for a true security evacuation occurs, it’s likely that travel restrictions would be modified to allow governments and assistance providers to coordinate departures.

Insurance coverage for medical and security evacuations, and how it may apply during this pandemic, varies based on specific policy details, so it’s essential to confirm specific organizational coverage with your broker.

What can organizations do to mitigate these risks?

  • Have clear procedures for seeking medical care and engage medical assistance providers early in an illness or injury situation to, hopefully, reduce the need for a medical evacuation.
  • Monitor travel restrictions in program countries with assistance providers and other sources to understand the potential impact on evacuations; “ground truth” travel restrictions with trusted local sources wherever possible.
  • Proactively draw down the number of international assignees and dependents – and especially any with underlying health conditions – in a country to reduce those who may need medical or security evacuation. Of course, this may be a moot point in locations that have sealed their borders.
  • Prepare to shelter in place for an extended period, especially in locations prone to instability. This is always important, but it’s even more crucial now as travel restrictions may limit evacuation options and timing.

Though hopefully used sparingly, evacuations are a necessary capability for organizations operating globally. But evacuations are always dependent on a host of local conditions and during the ongoing COVID-19 Pandemic those conditions are more challenging than usual… and subject to constant change.

For additional information and resources, please visit AHT’s dedicated COVID-19 page.