Red Alert: This is No Drill

June 12, 2006
Airports might want to consider instituting a plan in case some infectious scenario drops out of the sky.

There’s a lot of discussion regarding airports and how potential aircraft infectious disease situations could mandate that airports maintain sufficient areas to quarantine passengers. Although the discussion appears to be more focused on the large U.S. international gateway airports, other airports might want to consider instituting a plan in case some infectious scenario drops out of the sky. Such a situation occurred at Wichita Mid-Continent Airport (ICT) in 2003, when SARS (Severe Acute Respiratory Syndrome) had the world on edge.

Located in Wichita, KS (just about dead center of the U.S.), Mid-Continent Airport handles some 1.5 million passengers annually with direct non-stop airline service to about a dozen major cities, all of which provide international connections. Due to its prime mid-US location, ICT has for years been a convenient diversion point for just about every type of aircraft. Most diversions typically involved circumstances related to aircraft mechanical problems and in-flight passenger medical emergencies.

Our experience, much to our surprise, was not a diverted flight but instead a daily scheduled domestic air carrier flight from a city within 500 miles of Wichita. Fortunately it was mid-week when management and other supervisory personnel were all on hand. That was very relevant because the cumulative experience of all the airport’s management team included aircraft accidents and crashes, fires and electrical outages, bomb threats and security incidents, picketing and parking overflow, crippling winter storms and natural disasters — you name it — but never a situation where infectious disease was the center of attention.

Warning Signs

On that day, the scheduled commercial CRJ captain discovered, halfway into the hour-long flight, three passengers of Asian descent exhibiting signs of the then-popular SARS. The captain subsequently radioed his corporate operations center to report the situation (consistent with the airline’s newly established procedures); then someone from airline operations called our airport’s safety division to advise us of the situation and need for attention. It was this phone call from the airline that officially handed the baton to the airport. We then knew it was going to be our event to manage, regardless of whether or not we were prepared.

Faced with the reality that we had an inbound aircraft containing a suspect infectious disease situation, the ICT team assembled to formulate the best plan of attack. We had experience handling serious life-threatening medical diversions; however, not being an international gateway airport, we had never had any reason to have specific procedures for infectious disease situations. We’d provided staff with appropriate training and procedures for handling of materials and patients related to the control of bloodborne pathogens, but it’s not the same animal — SARS could be transmitted via airborne particles.

With only minutes to make key decisions and formulate a plan, all kinds of questions popped up. Where is the best place to stage the aircraft? What to do with the other passengers once the suspect SARS individuals were isolated? What about the crew, the aircraft, the terminal? Should we allow any passengers to enter the building? If we do, should we shut the ventilation down to minimize the circulation of airborne particles? If we have no choice but to deplane in the terminal, do we have to drench the building in bleach and antibacterial spray to try and make the interior air safe once more once the passengers leave? What about all the other people in the building? How do we address the liability issues? Will we be forced to shut down the terminal for days and essentially put ourselves and airline tenants out of business?

Once the aircraft landed and we made the (correct) decision to keep the local airline management involved, station personnel instructed them to direct the captain that he is not to taxi the aircraft up to the passenger boarding bridge, and that there wasn’t going to be any deplaning of passengers into the terminal. We asked FAA/ATC to advise the pilot this same directive, knowing the conversation would be on a recorded frequency. The captain was instructed not to open the door of the aircraft or to allow anyone to deplane, not even on the ramp, until authorization was given from airport management. The captain complied and parked the aircraft some 100 feet short of the passenger boarding bridge.

Local Involvement

Our local EMS and County Health Department officials were notified sometime shortly after we first learned of the in-flight situation. Officials who never really had reason in the past to rush to the airport took some time to arrive. (They were probably as surprised as we were.)

With county health officials on hand, we knew we had the right decisionmakers within our midst regarding the disposition of the passengers, crew, and three suspected SARS carriers. After being briefed, the officials boarded the aircraft to gain some information from the three individuals; they then authorized the deplaning of passengers. They commended the decision to not allow the captain to deplane anyone. Yet, at this point we still needed somewhere to put the passengers and crew for further attention by health officials.

In order to find a space to “quarantine” the 40 or so individuals, we decided the terminal was off limits, and we were not about to start asking tenants to empty hangars and cease conducting their business. The best solution was to bring the space to the passengers, accomplished by using the airport bus.

The non-SARS suspect passengers were transferred to the bus where the health department officials checked every passenger. Information gathered from the three suspect SARS passengers indicated that SARS was not the likely culprit. As a precaution, they were isolated in a different vehicle for questioning and then transported by EMS to the local hospital for examination.

Other Considerations

As another precaution, the baggage was not unloaded onto the normal baggage handling system; instead, passengers were escorted to the front curb and bags were delivered to them. To shield the terminal from any type of airborne contamination, all passengers were asked to not enter the terminal. If they had any airline or rental car issues, personnel from those agencies were brought to the outside. Pages were also made to any meeters and greeters to direct them to the front terminal curb or in the lot. As expected, the media converged on this event, and we kept them informed during the entire situation.

We conducted a post-incident review that included the health department, the airport, and other emergency response personnel. It allowed us to immediately identify some of issues we confronted. During ensuing months, we held similar meetings to develop an actual response plan. The airport safety division developed an Operating Instruction, an internal written procedure for handling aircraft (scheduled or diverted) with infectious disease passengers (suspected or verified).

It was written into our plan that suspect aircraft would never be allowed to deplane into the passenger terminal, or any building for that matter. Aircraft and passengers will be staged on the cargo apron, well away from the terminal, to allow easy staging of personnel and equipment. It was also decided that if local or federal health officials mandated a quarantine on-airport, then either the aircraft itself or buses would be utilized.