AXA Partners US
Author: Cai Glushak, MD FACEP, International Medical Director
Approximately 1 year since the World Health Organization announced a pandemic related to the SARS-2 coronavirus, the presence of the virus and infections are still a very real problem. In recent weeks, though variable in different parts of the world, the rate of new infections has increased, despite expanding vaccination campaigns and social distancing efforts.
AXA Partners went into action weeks before the pandemic was declared, being highly practiced at early recognition of global threats, and has maintained its expertise in bringing the best available solutions to its customers and clients in the context of COVID.
Nonetheless, it is still essential that travelers and expatriates prepare carefully for presence abroad and accept the realities of challenges they will face if needing emergency medical care or evacuation.
✓ Most countries still impose some level of border restrictions, making emergency travel difficult to plan and slowing down emergency medical evacuations. For air ambulances, obtaining permissions may involve multiple governmental agencies including immigration, health and aviation entities.
✓ Not all air ambulance providers are able to transport COVID patients, narrowing the number of qualified providers available for these missions.
✓ Hospitals in the desired destination may be saturated and obtaining a hospital bed for transfer may take time.
✓ No airline will accept a COVID positive passenger, even if asymptomatic; the only option for such patients for repatriation would be private aircraft.
✓ Countries wiling to receive non-resident COVID patients from abroad are very few. Though most countries are willing to accept their own residents, even if COVID positive, the patient may not be stable enough to tolerate an evacuation of extreme distance, such as trans-oceanic.
✓ Current countries to be avoided due to major surges and critical shortages of hospital beds include:
Brazil
India
Lebanon
Philippines
✓ Due to airline reductions of service, options for rebooking for missed flights and medical repatriation are limited and may delay travel plans.
AXA Partners has taken key measures to specifically address the challenges of medical transportation during COVID:
We have identified key points of evacuation and best medical care for all regions. These include:
1. Home country if within reasonable distance
2. Africa: South Africa and Kenya now accept foreign COVID patients; Nairobi providers are generally qualified to manage seriously ill COVID cases.
3. Central Asia: Istanbul, Turkey - major medical centers will accept COVID patients on a case-to-case basis
4. Europe will accept some non-resident COVID patients on a case-by-base basis
5. All intended destinations may be limited by bed-capacity and rapidly changing country policy
✓AXA Partners maintains an up-to-date inventory of “COVID-capable” air ambulance providers.
✓AXA maintains up-to-date information on airline requirements and border restrictions, including quarantine and testing requirements
✓AXA has a corps of fully vaccinated medical staff as well as an extended network of prepared escort providers
✓AXA Partners actively monitors the evolving COVID situation covering case rates, hospital bed occupancy, viral variants and vaccine progress.
Although AXA Partners has acquired unsurpassed expertise in navigating these obstacles, it is important to have realistic expectations about the challenges and delays that may be encountered bringing international patients the support they need.
For this reason, it is essential that travelers and expatriates carefully prepare for their stay abroad.
Be fully prepared to avoid non-COVID illness. Especially take measures to avoid febrile and foodborne illness that may cause symptoms that mimic COVID. Be careful about consuming unsafe beverages and foods, exposure to mosquito borne infections and avoid traumatic injuries.
1. Carry plenty of masks and hand sanitizer
2. Be up-to-date on travel-recommended vaccinations
3. Keep your travel documents close at hand; do not surrender them to a hospital or 3rd party or ensure a trusted companion keeps them secure. These will be required prior to transport.
4. Hospitals may not permit visitors. Keep your mobile phone handy with a charger.
5. Make sure you can be reached by mobile phone and e-mail and designate a reliable companion who can also be reached.
If planning a long stay, register with your local embassy or consulate. They may be helpful in overcoming transportation and border restrictions. Employers of expatriates should do the same and be prepared to use diplomatic influence when available to facilitate transport.
Expect to need a COVID PCR test no more than 72 hours prior to travel, whether traveling by commercial airline or by air ambulance.
While vaccine availability holds out hope for the end of the COVID pandemic, it is expected the outbreak will be with us for many months and may never completely disappear.
This means that vigilance is key and adapting to new conditions for travel and stay abroad will be the new reality, at least for some the foreseeable future.
AXA Partners will continue to update its clients and customers on all important developments.
References:
https://covid19.who.int/
https://www.cdc.gov/coronavirus/2019-nCoV/index.html