ICAO and Public Health Emergencies Meetings Seminars...addresses public health emergencies of...

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7/4/2012 1 International Civil Aviation Organization ICAO and Public Health Emergencies Dr. Anthony Evans Chief, Aviation Medicine Section ICAO, Montreal Frankfurt, July 2012 Acknowledgement Mr Michiel Vreedenburgh ICAO Deputy Regional Director (Mexico Office) & CAPSCA project coordinator Provided some images for this presentation CAPSCAFrankfurt July 2012
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Transcript of ICAO and Public Health Emergencies Meetings Seminars...addresses public health emergencies of...

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    International Civil Aviation Organization

    ICAO and Public Health Emergencies

    Dr. Anthony EvansChief, Aviation Medicine Section

    ICAO, Montreal

    Frankfurt, July 2012

    Acknowledgement

    • Mr Michiel Vreedenburgh– ICAO Deputy Regional Director (Mexico Office) & CAPSCA project coordinator

    – Provided some images for this presentation

    CAPSCA‐Frankfurt July 2012

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    Plan

    • Background to ICAO• Aviation–related health issues• Multi‐sector preparedness• Way forward – high level• Way forward – technical level

    CAPSCA‐Frankfurt July 2012

    ICAO – UN specialized agency created in 1944. Strategic Objectives: 

    • Safety • Security • Environmental protection

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    Mexico

    Lima

    Dakar

    Paris

    Cairo

    NairobiBangkok

    ICAO HQMontreal

    International Civil Aviation Organization  ‐HQ and its seven Regional Offices

    Why worry about aviation?

    • Medical health– Spread of disease by travellers– Other issues:

    • Transport of samples – e.g. biological/radioactive

    • Transport of vectors• Transport of personnel to/from affected areas

    – Risk to individuals on aircraft

    • Economic health– Airlines– Supporting businesses– Governments

    CAPSCA‐Frankfurt July 2012

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    Some aviation health‐related issues

    Bennett, JS – NIOSH, 2009

    CAPSCA‐Frankfurt July 2012

    Some aviation economic‐related issues

    Passengers of Hong Kong International Airport, January to August 2003

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    Courtesy: Dr Henry Kong, past Chief Port Health Officer, Hong Kong

    12 March, WHO Atypical pneumonia alert

    2 AprilWHO traveladvisory

    23 MayTravel advisory lifted

    International arrivals, Mexico, 2008‐2010Courtesy: Dr Jose Valente Aguilar Zinser, Ministry of 

    Transport, Mexico

    CAPSCA‐Frankfurt July 2012

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    Challenges• Aviation is:

    – Focused primarily on prevention of accidents– Personnel not generally knowledgeable about public health

    • Public health is:– Focused primarily on non‐transport related health issues – Personnel not generally knowledgeable about aviation

    • And so…..

    • Preparedness planning in aviation can fall between two stools.   

    CAPSCA‐Frankfurt July 2012

    One answer:

    • Multi‐sector preparedness planning– WHO/public health  cannot alone provide necessary resources

    – Many sectors involved to varying degrees– Private industry involvement vital

    CAPSCA‐Frankfurt July 2012

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    Interlinking guidelines 

    WHO global Preparedness

    ICAOStandards & Guidelines

    for aviation

    Airports Council International:

    airport guidelines

    International Air Transport Association: 

    airline guidelines

    IHR 2005

    Guide to Hygiene and Sanitation in Aviation

    Case managementof Influenza A(H1N1) in air transport

    www.capsca.org

    Multi‐sector involvement:A challenge to achieve

    CAPSCA‐Frankfurt July 2012

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    Fukushima nuclear accident:ICAO Transport Task Force

    Weekly teleconference call

    ICAOIAEAWHOIMOWMOUNWTOILO

    IATAACI

    ICAO – International Civil Aviation OrganizationIAEA – International Atomic Energy AgencyWHO – World Health OrganizationIMO – International Maritime OrganizationWMO – World Meteorological OrganizationUNWTO – UN World Tourism OrganizationILO – International Labour Organization

    IATA – International Air Transport AssociationACI – Airports Council International

    Output ‐ Three News releases during the initial weeks

    CAPSCA‐Frankfurt July 2012

    Way forward – high level

    • High level management buy‐in– Role of UN

    • Resources allocated to multi‐sector collaboration

    • Combined agendas• Public and private involvement

    CAPSCA‐Frankfurt July 2012

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    Way forward – technical level: CAPSCA(Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel)

    CAPSCA‐Frankfurt July 2012

    CAPSCA‐Frankfurt July 2012

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    CAPSCA programme implementation

    • Meetings– Annual regionalmeeting e.g. this meeting in Frankfurt

    • Update in preparedness planning in the aviation sector • Multi‐sector communication/networking platform

    – Annual globalmeeting, regional meeting is designated ‘global’  • On rotation: 2010, Asia Pacific; 2011, Africa; 2012, Americas; 2013, Middle East; 2014, Europe

    • Assistance Visits– To individual States/airports– Assist with implementation of 

    • ICAO health‐related Standards and Recommended Practices (SARPs) • WHO International Health Regulations 

    CAPSCA‐Frankfurt July 2012

    CAPSCA‐Frankfurt July 2012

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    CAPSCA Resources

    • Donors – UN Central Fund for Influenza Action ($1.3 m for all five projects – Asia Pacific; Africa; Americas; Europe; Middle East)– CAA Singapore (Dr Jarnail Singh, technical advisor)

    • Partners: Principal International Organization partner – WHO

    • Member States’ Technical Advisors• Meeting Hosts (ICAO Regional Offices and States)

    CAPSCA‐Frankfurt July 2012

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    Asia‐Pacific Africa Americas Europe Middle East

    Year of Establishment 2006 2007 2009 Sept. 2011 Dec. 2011

    No. MemberStates 17 17 30 6 7

    State  Technical Advisors Trained by ICAO (OJT completed)

    1 4 12 0 2

    State & Airport AssistanceVisits Completed

    9 5 22 0 2

    CAPSCA‐Frankfurt July 2012

    CAPSCA‐Frankfurt July 2012

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    Aims of this meeting

    • Update on preparedness planning in aviation• Networking ‐multi‐sector, public and private• Select a CAPSCA‐Europe chair (normally three year term)• Encourage more States to join CAPSCA

    – No cost• Identify States/Airports for Assistant Visits

    – Intention, no cost: may not be possible (CFIA grant ends December 2012, & funds are low)

    • Identify CAPSCA‐Europe Technical Advisors (TAs)• Commence TA training (presentation from Frankfurt Airport 

    and walkthrough/debrief)• Identify host for 2013 CAPSCA‐Europe meeting

    CAPSCA‐Frankfurt July 2012

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    ICAO and Public Health Emergencies

    Dr. Anthony [email protected]

    Chief, Aviation Medicine SectionInternational Civil Aviation Organization

    Frankfurt, Germany, July 2012

    Fukushima Daiichi Nuclear Power Plant11 March 2011

    CAPSCA‐Frankfurt July 2012

    What if:•An aircraft flies through the plume?•An aircraft is parked overnight downwind?•An exposed individual wants to fly for treatment?

    Screening:•Should Japan be screening departures?

    Cargo?People?

    •Should other countries be screening for arrivals?Cargo?People?

    •What levels are acceptable?•What equipment/training/PPE is needed?•Etc….

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    ICAO Transport Task ForceWeekly teleconference call

    ICAOIAEAWHOIMOWMOUNWTOILO

    IATAACI

    ICAO – International Civil Aviation OrganizationIAEA – International Atomic Energy AgencyWHO – World Health OrganizationIMO – International Maritime OrganizationWMO – World Meteorological OrganizationUNWTO – UN World Tourism OrganizationILO – International Labour Organization

    IATA – International Air Transport AssociationACI – Airports Council International

    Output ‐ Three News releases during the initial weeks

    CAPSCA‐Frankfurt July 2012

    Plan

    • ICAO – International Civil Aviation Organization • Convention on International Civil Aviation  ‐(‘Chicago Convention’) and its Annexes 

    • Standards and Recommended Practices• ICAO Guidelines on Public Health Emergencies• ICAO Assembly Resolutions• ICAO Audits• UN crisis management

    CAPSCA‐Frankfurt July 2012

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    ICAO HQ – Montreal, Canada

    18 Annexes to the Convention ‐‘Standards and Recommended Practices’  SARPs

    •Governments 

    Regulatory Aviation Authorities

    e.g. 

    •Federal Aviation

    Administration (US)

    •Transport Canada

    •UK CAA

    96 Articles

    ‘Chicago’ Convention (1944) – 191 signatories

    CAPSCA‐Frankfurt July 2012

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    Basis for Action ‐ healthArticle 14, Convention on International Civil Aviation:

    ‘Each contracting State agrees to take effective measures to prevent the spread by means of air navigation of cholera, typhus (epidemic), smallpox, yellow fever, plague, and such other communicable diseases as the contracting States shall from time to time decide to designate….

    CAPSCA‐Frankfurt July 2012

    Basis for Action ‐ healthArticle 14, International Convention on Civil Aviation:

    ….and to that end contracting States will keep in close consultation with the agencies concerned with international regulations relating to sanitary measures applicable to aircraft.’

    CAPSCA‐Frankfurt July 2012

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    18 ICAO Annexes to the Convention‐ contain ‘SARPs’• Annex 1 Personnel Licensing• Annex 2 Rules of the Air• Annex 3 Meteorological Service for International Air Navigation• Annex 4 Aeronautical Charts• Annex 5 Units of Measurement to be Used in Air and Ground Operations• Annex 6 Operation of Aircraft • Annex 7 Aircraft Nationality and Registration Marks• Annex 8 Airworthiness of Aircraft• Annex 9 Facilitation • Annex 10 Aeronautical Telecommunications• Annex 11 Air Traffic Services

    – Procedures for Air Navigation Services – Air Traffic Management  (PANS‐ATM)• Annex 12 Search and Rescue• Annex 13 Aircraft Accident and Incident Investigation• Annex 14 Aerodromes• Annex 15 Aeronautical Information Services• Annex 16 Environmental Protection• Annex 17 Security: Safeguarding International Civil Aviation Against Acts of Unlawful• Interference• Annex 18 The Safe Transport of Dangerous Goods by Air

    CAPSCA‐Frankfurt July 2012

    ICAO Standards are audited:Results posted on ICAO public website

    CAPSCA‐Frankfurt July 2012

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    International Passengers to Mexico, 2009‐2011 (25 April WHO announced PHEIC)

    CAPSCA‐Frankfurt July 2012

    International Arrivals

    Passengers of Hong Kong International Airport, January to August 2003

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    Courtesy: Dr Henry Kong, past Chief Port Health Officer, Hong Kong

    12 March, WHO Atypical pneumonia alert

    2 AprilWHO traveladvisory

    23 MayTravel advisory lifted

    CAPSCA‐Frankfurt July 2012

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    Fukushima nuclear powerplantaccident – 11 March 2011

    CAPSCA‐Frankfurt July 2012

    Fukushima Daiichi Nuclear Power Plant11 March 2011

    CAPSCA‐Frankfurt July 2012

    What if:•An aircraft flies through the plume?•An aircraft is parked overnight downwind?•An exposed individual wants to fly for treatment?

    Screening:•Should Japan be screening departures?

    Cargo?People?

    •Should other countries be screening for arrivals?Cargo?People?

    •What levels are acceptable?•What equipment/training/PPE is needed?•Etc….

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    How does it work in practice?

    • An example –– determination of a case of communicable disease on board an aircraft in flight

    – notification to the public health authority at destination

    – further communication with the aircraft– how to manage the aircraft’s arrival  at destination

    CAPSCA‐Frankfurt July 2012

    PHA

    AIRPORTOPERATOR OTHER 

    AGENCY

    NOTIFICATION OF EVENT TO DESTINATION AIRPORT

    Air traffic controller

    AIRLINE OPERATING AGENCY

    Destination aerodrome tower

    A/C IDDep.Dest.ETAPOBNo. casesNature of risk

    Aircraft gen. declaration –Health Part (WHO & ICAO docs)

    CAPSCA‐Frankfurt July 2012

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    GUIDELINES ‐ assist with interpretation of ICAO SARPs 

    and the IHR (2005)

    To help States develop and implement national 

    preparedness plans we have “CAPSCA”

    Cooperative Arrangement for the Prevention of Spread of 

    Communicable Disease through Air Travel

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    ICAO Assembly ResolutionsSeptember/October 2010

    CAPSCA‐Frankfurt July 2012

    And nowCAPSCA!

    CAPSCA WP ResolutionThe Assembly:

    1. Urges Contracting States and Regional Safety Oversight Organizations to ensure that the public health sector and the aviation sector collaborate to develop a national preparedness plan for aviation which addresses public health emergencies of international concern and which is integrated with the general national preparedness plan;

    2. Urges Contracting States to develop a national preparedness plan for aviation that is in compliance with the World Health Organization International Health Regulations (2005) and which are based on scientific principles and on the guidelines from ICAO and the World Health Organization;

    3. Urges Contracting States, and Regional Safety Oversight Organizations as appropriate, to establish requirements for the involvement of stakeholders such as airport operators, aircraft operators and air navigation service providers in the development of a national preparedness plan for aviation; and,

    4. Urges Contracting States to join and participate in the Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA) project, where available, to ensure that its goals are achieved, unless equivalent measures are already in place.

    CAPSCA‐Frankfurt July 2012

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    To ensure States implement the ICAO SARPs ICAO auditscivil aviation regulatory 

    authorities

    UN Humanitarian Response to crises

    • The Cluster System– Camp Coordination– Early Recovery– Education– Emergency Telecommunications– Food Security– Health– Logistics – transport cell proposed– Nutrition– Protection– Water and Sanitation

    CAPSCA‐Frankfurt July 2012

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    Summary

    • ICAO and Convention on International Civil Aviation  ‐ (‘Chicago Convention’) and its Annexes 

    • Standards and Recommended Practices within the Annexes

    • Guidelines on Public Health Emergencies• CAPSCA – implementing project• ICAO Assembly Resolution• ICAO Audits• UN crisis management ICAO

    CAPSCA‐Frankfurt July 2012

    ICAO and Public Health Emergencies

    Dr. Anthony EvansChief, Aviation Medicine Section

    International Civil Aviation Organization

    Cairo, December 2011

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    CAPSCA: A37‐WP/58 Technical Commission 

    Agenda Item 42: (Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA))

    WP/58 Title:Improved management of communicable disease in the aviation sector through multi‐sector collaboration

    Result: Resolution 42/1: Prevention of spread of communicable disease through air travel

    CAPSCA‐Frankfurt July 2012

    CAPSCA Resolution

    Resolution 42/1:  Prevention of spread of communicable disease through air travel

    Whereas Article 14 of the Convention on International Civil Aviation states that ‘Each contracting State agrees to take effective measures to prevent the spread by means of air navigation of cholera, typhus (epidemic), smallpox, yellow fever, plague, and such other communicable diseases as the contracting States shall from time to time decide to designate, and to that end contracting States will keep in close consultation with the agencies concerned with international regulations relating to sanitary measures applicable to aircraft’;

    Whereas Article 14(1) of the World Health Organization International Health Regulations (2005) states that ‘WHO shall cooperate and coordinate its activities, as appropriate, with other competent intergovernmental organizations or international bodies in the implementation of these Regulations, including through the conclusion of agreements and other similar arrangements’;

    Whereas ICAO Resolution A35‐12 states that ‘the protection of the health of passengers and crews on international flights is an integral element of safe air travel and that conditions should be in place to ensure its preservation in a timely and cost‐effective manner’;

    Whereas Article 44 of the Convention on International Civil Aviation states that ‘The aims and objectives of the Organization are to develop the principles and techniques of international air navigation and to foster the planning and development of international air transport so as to ...[m]eet the needs of the peoples of the world for safe, regular, efficient and economical air transport’;

    Whereas Annex 6 – Operation of Aircraft, Annex 9 – Facilitation, Annex 11 – Air Traffic Services, Annex 14 – Aerodromes, Volume I — Aerodrome Design and Operations to the Convention on International Civil Aviation and the Procedures for Air Navigation Service – Air Traffic Management (Doc 4444) contain several Standards and Recommended Practices and Procedures relating to health measures that should be taken by Contracting States to manage public health emergencies of international concern and to prevent the spread of communicable disease by air travel;

    Whereas the ICAO Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA) project is an appropriate measure to improve and harmonize preparedness plans;

    CAPSCA‐Frankfurt July 2012

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    Other ongoing work with WHO/other stakeholders

    • Aircraft disinsection• Aircraft disinfection

    CAPSCA‐Frankfurt July 2012

    International Civil Aviation Organization

    ICAO SARPs

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    Relevant ICAO SARPs/Guidelines ‐ see“Health Related Documents” on CASPCA website

    • Annex 6 ‐ Operation of Aircraft • Annex 9 ‐ Facilitation • Annex 11 ‐ Air Traffic Services

    – Procedures for Air Navigation Services – Air Traffic Management  (PANS‐ATM)  

    • Annex 14 ‐ Aerodromes 

    • ICAO Guidelines for States

    CAPSCA‐Frankfurt July 2012

    ICAO Standards and recommended Practices

    CAPSCA‐Frankfurt July 2012

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    Other potential crises

    CAPSCA‐Frankfurt July 2012

    International Civil Aviation Organization

    Questionnaire on preparedness

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    Communicable Disease Questionnaire

    • State letter (EC 6/22‐10/51, 22 June 2010) –“National Aviation Plan: Communicable Diseases”

    Responses from Americas = 13• North Am. – 5• South Am. ‐ 8• Deadline for replies: 30th

    June 2011 (extended from October)

    CAPSCA‐Frankfurt July 2012

    State letter

    CAPSCA‐Frankfurt July 2012

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    Funding

    • UN Central Fund for Influenza Action– Primary funding

    • States (countries)

    CAPSCA‐Frankfurt July 2012

    Audit protocol questions

    CAPSCA‐Frankfurt July 2012

    CMA SAAQ

    SAAQ

    REF.

    SAAQ QUESTION INFORMATION PROVIDED BY STATE

    COMMENTS

    ORG Has the State identified a clear contact point at

    national aviation level, with identified

    individual(s), for policy formulation, operational

    organization of preparedness and coordination of

    a national plan in order to respond to a

    communicable disease with the potential to pose

    a serious public health risk?

    Yes No

    If yes, provide name and contact

    details

    New question

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    Audit protocol questions

    CAPSCA‐Frankfurt July 2012

    A9 8.15PANS

    ATM Doc 4444 16.6.1

    Does the aircraft operations organization ensure that the air operator has established procedures for the pilot in command to report promptly to ATC a suspected communicable disease?

    □ Yes□ No

    Review operations inspectors procedures to ensure they check air operators related procedures

    Sample an air operator procedure in operations manual

    Ensure, in the procedure, that the following information is transmitted by the crew:

    a) aircraft identification;b) departure aerodrome;c) destinationaerodrome;d) estimated time ofarrival;e) number of persons onboard;f) number of suspectedcase(s) on board; andg) nature of the publichealth risk, if known.

    □ Satisfactory□ Not satisfactory

    6

    Audit protocol questions

    CAPSCA‐Frankfurt July 2012

    ICAO ref. Protocol question Reply Guidance for review of protocol question

    Status of implementation Evidence/Notes/CommentsCE

    A9 8.15 Note 1

    A9 2.10 & App1

    A6 6.2 and AttB

    Does the aircraft operations organization ensure that the air operator has established a procedure for the crew to evaluate a traveller with a suspected communicable disease, based on the presence of a fever and certain other signs or symptoms?

    □ Yes□ No

    Review operations inspectors procedures to ensure they check air operators related procedures

    Sample an air operator procedure in operations manual or cabin crew manual

    Check the procedure includes the transmission, as required, of a General Declaration form to the State authorities.

    □ Satisfactory□ Not satisfactory

    6

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    CAPSCA‐Frankfurt July 2012

    Does the aircraft operations organization ensure that the air operator has established a procedure for the crew to evaluate a traveller with a suspected communicable disease, based on the presence of a fever and certain other signs or symptoms?

    ICAO Standards and Recommended Practices + Guidelines for States

    CAPSCA‐Frankfurt July 2012

    www.CAPSCA.org

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    Audit Protocols

    • Questions on preparedness planning will be included in ICAO Universal Safety Oversight Audit Programme questions:– “Protocol questions”

    • Undergoing testing in selected States• To be introduced from 2013

    CAPSCA‐Frankfurt July 2012

    Audit Example 1

    “Has the State identified a clear contact point at national aviation level, with identified individual(s), for policy formulation, operational organization of preparedness and coordination of a national plan in order to respond to a communicable disease with the potential to pose a serious public health risk?” 

    CAPSCA‐Frankfurt July 2012

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    Audit Example 2

    “Does the aircraft operations organization ensure that the air operator has established a procedure for the crew to evaluate a traveller with a suspected communicable disease, based on the presence of a fever and certain other signs or symptoms?”

    CAPSCA‐Frankfurt July 2012

    Audit Example 3

    “Does the aircraft operations organization ensure that the air operator has established procedures for the pilot in command to report promptly to ATC a suspected communicable disease?” 

    CAPSCA‐Frankfurt July 2012