Introduction to the

AVIATION PANDEMIC
PREPAREDNESS PLAN
CONTENTS
1. RECORDS AMENDMENTS............................................................................................... iv
2. INTRODUCTION TO AVIATION PANDEMIC PREPAREDNESS PLAN............................ iv
3. REFFERENCES................................................................................................................ v
4. DEFINITIONS..................................................................................................................... v
5. BACKGROUND................................................................................................................. 1
6. OBJECTIVE OF THE NATIONAL AVIATION PANDEMIC PREPAREDNESS PLAN......... 2
7. MODE OF DISEASE TRANSMISSION.............................................................................. 3
8. IMPACT OF PUBLIC HEALTH ON MENTAL HEALTH ISSUES IN AVIATION................... 5
9. LEGISLATIVE AND RELATED ASPECTS......................................................................... 7
10. ARTICLE 14 OF THE CONVENTION ON INTERNATIONAL CIVIL AVIATION................ 8
11. ICAO ANNEX – 9 FACILITATIONS.................................................................................... 8
12. ICAO ANNEX 6 OPERATION OF AIRCRAFT (RECOMMENDATION).............................. 9
13. ICAO ANNEX 11: AIR TRAFFIC SERVICES AND PLANS ATM........................................ 9
14. ANNEX 18 (“SAFE TRANSPORT OF DANGEROUS GOODS BY AIR”............................ 9
15. CLASSIFICATION OF INFECTIOUS DISEASE AND CLASSIFICATION OF
INFECTIOUS SUBSTANCES............................................................................................ 10
16. ICAO COVID-19 GUIDELINES AND BULLETINS............................................................ 11
17. WORLD HEALTH ORGANIZATION AND THE INTERNATIONAL HEALTH
REGULATIONS (2005)...................................................................................................... 11
18. NATIONAL LEGAL INSTRUMENTS: AVIATION PUBLIC HEALTH PLAN......................... 13
19. THE CIVIL AVIATION REGULATIONS (CARS), AND ASSOCIATED TECHNICAL
STANDARDS..................................................................................................................... 13
20. OTHER APPLICABLE NATIONAL LEGISLATION............................................................. 22
21. RISK MANAGEMENT MODEL FOR DOCUMENT............................................................ 22
22. GENERAL RISK MANAGEMENT PRINCIPLES APPLIED TO AIR TRANSPORT............ 23
23. BUSINESS CONTINUITY PLANS FOR PUBLIC HEALTH EMERGENCIES
IN AVIATION....................................................................................................................... 25
24. VARIOUS STAKEHOLDERS IN THE MANAGEMENT OF PUBLIC HEALTH EVENTS.... 26
25. ROLE OF THE NATIONAL DEPARTMENT OF TRANSPORT.......................................... 27
26. NATIONAL AIR TRANSPORT FACILITATION COMMITTEE............................................. 27
27. ROLE AND RESPONSIBILITY NATIONAL DEPARTMENT OF DIRECTOR
GENERAL HEALTH AND TRANSORT............................................................................. 28
28. FUNCTIONS OF A PORT HEALTH OFFICER (COMPETENT AUTHORITY)
IN AVIATION (check with DOH)......................................................................................... 29
29. THE ROLE OF THE CIVIL AVIATION AUTHORITY........................................................... 30
30. THE ROLE AND RESPONSIBILITY OF A DESIGNATED AIRPORT................................ 31
31. THE ROLE OF THE EMERGENCY OPERATION CENTRE............................................. 33
32. ROLES AND RESPONSIBILITIES OF BAGGAGE AND CARGO HANDLING
DURING PUBLIC HEALTH EMERGENCIES..................................................................... 33

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33. ROLES AND RESPONSIBILITIES OF THE SECURITY SCREENING DURING
PUBLIC HEALTH EVENTS................................................................................................ 34
34. ROLES AND RESPONSIBILITIES OF CATERING SERVICES DURING PUBLIC
HEALTH EMERGENCIES.................................................................................................. 40
35. ROLES AND RESPONSIBILITIES OF THE AIR TRAFFIC AND NAVIGATION
SERVICES (ATNS)............................................................................................................ 41
36. ROLES AND RESPONSIBILITIES OF IMMIGRATION OFFICERS DURING PUBLIC
HEALTH EMERGENCIES.................................................................................................. 43
37. ROLES AND RESPONSIBILITIES IN THE MANAGEMENT OF MEDICAL WASTE
AND DISPOSAL BY AIRLINES AND AIRPORTS.............................................................. 44
38. MANAGEMENT OF MEDIA AND PUBLIC EDUCATION DURING PUBLIC
HEALTH EVENTS.............................................................................................................. 45
39. COMMUNICATION AND COLLABORATION WITH ICAO................................................. 45
40. INTERNATIONAL COOPERATION.................................................................................... 46
41. RESPONSIBILITY MEDIA AVIATION AND PUBLIC HEALTH EDUCATION DURING
PUBLIC HEALTH EMERGENCIES.................................................................................... 47
42. ROLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN POLICE SERVICE
(SAPS)............................................................................................................................... 47
43. ROLES AND RESPONSIBILITIES OF THE RESCUE AND FIRE FIGHTING (RFF)
SERVICES AT AIRPORTS................................................................................................. 48
44. ROLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN REVENUE
SERVICES (SARS)............................................................................................................ 48
45. CORPORATE GOVERNANCE AND TRADITIONAL AFFAIRS......................................... 48
46. ROLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN NATIONAL DEFENCE
FORCE (SAMHS)............................................................................................................... 49
47. ROLES AND RESPONSIBILITIES OF THE DEPARTMENT OF INTERNATIONAL
RELATIONS AND CO-OPERATION (DIRCO)................................................................... 49
48. ROLES AND RESPONSIBILIITES GENERAL AVIATION CONSIDERATIONS IN
PLANNING THE AVIATION INDUSTRY’S RECOVERY PUBLICH HEALTH
EMERGENCY.................................................................................................................... 49
49. ROLES AND RESPONSIBILITIES OF CARGO REGULATED AGENTS.......................... 51
50. REGIONAL COLLABORATIVE ARRANGEMENT IN PUBLIC HEALTH CORRIDOR....... 51
51. COMMUNICATION AND CO-OPERATION WITH OTHER STATES................................. 52
52. COMMUNICATION WITH ICAO........................................................................................ 52
53. FOREIGN STATE AND AIR CARRIER AUDIT PUBLIC HEALTH PROTOCOLS............. 52
54. ROLES AND RESPONSIBILITIES GENERAL AVIATION CONSIDERATIONS IN
PLANNING THE AVIATION INDUSTRY’S RECOVERY PUBLIC HEALTH
EMERGENCY.................................................................................................................... 54
55. RESPONSIBILITIES OF INCIDENT AND ACCIDENT INVESTIGATORS DURING PUBLIC
HEALTH EMERGENCIES.................................................................................................. 55
CONCLUSION................................................................................................................... 58

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1 RECORDS AMENDMENTS

This document will be subject to amendment from time to time. Such amendments are to be controlled
through the Record of Amendments included in this document. The coordinating body for amendments
is the Department of Transport and the Civil Aviation Authority

Amendment No. Effective Date Date Entered Entered by

1 07 April 2017 Dr.Bogatsu

2 29 March 2022 Dr.Bogatsu

2 INTRODUCTION

PLAN
TO AVIATION PANDEMIC PREPAREDNESS

With the increase in global transport of passengers and cargo, the potential transmission of communicable
disease or exposure to other agents of public health significance has increased substantially. A public
health emergency of international concern (PHEIC) may be declared by the World Health Organization
when a State’s health authority is satisfied that there is an outbreak or imminent outbreak of a
communicable disease that poses a substantial risk to the population of the country OR upon activation
by WHO (according to Annex 2 of the IHR (2005) .The roles of the aviation authority during a PHEIC are
to ensure the availability, continuity and sustainability of critical air transport services and coordinate
and facilitate the implementation of health and non-health measures to protect the health and welfare
of travellers, staff and the general public as well as to minimize / mitigate the spread of communicable
disease through air travel.

This Aviation Pandemic Preparedness Plan describes measures that should be adopted during a
PHEIC in compliance with the relevant articles in the IHR 2005 and the ICAO Annexes 6, 9,11, 14, 18
and 19 .This will ensure a coordinated and timely response implementation of health measures by
multi-agency effort and will not be the sole responsibility of the aviation and health authority. As such,
the measures implemented by the respective agencies should be well coordinated to avoid confusion,
inconsistencies and duplication of resources.

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3 REFFERENCES


■ WHO: International Health Regulations (2005)

■ WHO: Chemicals of Major Public Health Concern
■ WHO: Disinfection
■ WHO: Sanitary Measures in Aviation
■ WHO: Handbook for the Management of Public Health Events in Air Transport
■ WHO: Updates on Emergency Preparedness and Response
■ WHO: Vector Surveillance and Control at Ports, Airports, and Ground Crossings
■ ICAO: Aviation Pandemic Preparedness Plan
■ ICAO CART 3
■ IATA Guidelines
■ Airports Council International
■ Centre for Disease Control
■ Frankfort
■ EURAMI
■ ICAO Council Aviation Recovery Task Force (CART 1,2,3 )
■ ICAO Handbook for Cabin Crew Recurrent Training during COVID-19-Doc 10148-
■ ICAO Handbook for CAAs on the Management of Aviation Safety Risks related to COVID-19- 10144
■ ICAO Manual on Testing and Cross-border Risk Management Measures- 10152
■ ICAO Bulletin - Promoting, Maintaining and Supporting Mental Well-Being in Aviation during the
covid-19 pandemic
■ Others, refer to ICAO and the SACAA Website

4 DEFINITIONS


“Authority” means the South African Civil Aviation Authority

“Committee” means the Aviation Pandemic Committee

“Director” means the Director for Civil Aviation or his /her successor in title.

“Affected” means persons, baggage, cargo, containers, conveyances, goods,

postal parcels or human remains that are infected or contaminated, or
carry sources of infection or contamination, so as to constitute a public
health risk;

“Affected area” means a geographical location specifically for which health measures
have been recommended by WHO under these Regulations;

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“Agreement” means the agreement as set out in this document and all annexures
hereto;

“Aircraft” means an aircraft making an international voyage;

“Airport” means any airport where international flights arrive or depart;

“Biohazard bag” Bag used to secure biohazard waste that requires microbiological
inactivation in an approved manner for final disposal and such bags must
be disposable and impervious to moisture and have sufficient strength
to preclude tearing or bursting under normal conditions of usage and
handling.

“Crisis” A sudden, unplanned calamitous event resulting in significant business

disruption that adversely impacts the overall reputation, profitability, or
viability of an organization;

“Competent authority” means an authority responsible for the implementation and application
of health measures under these Regulations;

“Contamination” means the presence of an infectious or toxic agent or matter on a human

or animal body surface, in or on a product prepared for consumption or
on other inanimate objects, including conveyances, that may constitute
a public health risk;

“Conveyance” means an aircraft, ship, train, road vehicle or other means of transport
on an international voyage;

“Decontamination” means a procedure whereby health measures are taken to eliminate an

infectious or toxic agent or matter on a human or animal body surface, in
or on a product prepared for consumption or on other inanimate objects,
including conveyances, that may constitute a public health risk

“Departure” means, for persons, baggage, cargo, conveyances or goods, the act of
leaving a territory;

“Disease” means an illness or medical condition, irrespective of origin or source,

that presents or could present significant harm to humans;

“Disinfection” means the procedure whereby health measures are taken to control
or kill infectious agents on a human or animal body surface or in or on
baggage, cargo, containers, conveyances, goods and postal parcels by
direct exposure to chemical or physical agents;

‘’Disinfection” means the procedure whereby measures are taken to control or kill
the insect vectors of human diseases present in or on baggage, cargo,
containers, conveyances, goods and postal parcels by direct exposure
to chemical or physical agents

“DOH” means the Department of Health;

“DOT” means the Department of Transport;

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“Environmental control System that provides air supply, thermal control and pressurization
system” for the passengers and crew travelling on an aircraft used for airline
operations

“event” means a manifestation of disease or an occurrence that creates a

potential for disease;

“free pratique” means permission for a ship to enter a port, embark or disembark,
discharge or load cargo or stores; permission for an aircraft, after
landing, to embark or disembark, discharge or load cargo or stores; and
permission for a ground transport vehicle, upon arrival, to embark or
disembark, discharge or load cargo or stores; health measure does not
include law enforcement or security measures;

“ill person” means an individual suffering from or affected with a physical ailment
that may pose a public health risk;

“infection” means the entry and development or multiplication of an infectious

agent in the body of humans and animals that may constitute a public
health risk;

“inspection” means the examination, by the competent authority or under its

supervision, of areas, baggage, containers, conveyances, facilities,
goods or postal parcels, including relevant data and documentation, to
determine if a public health risk exists;

“isolation” means separation of ill or contaminated persons or affected baggage,

containers, conveyances, goods or postal parcels from others in such a
manner as to prevent the spread of infection or contamination;

“medical examination” means the preliminary assessment of a person by an authorized health

worker or by a person under the direct supervision of the competent
authority, to determine the person’s health status and potential public
health risk to others, and may include the scrutiny of health documents
and a physical examination when justified by the circumstances of the
individual case;

“National IHR Focal means the national centre, designated by each State Party, which shall
Point” be accessible at all times for communications with WHO IHR Contact
Points under these Regulations;

“Personal protective Equipment and materials used to create a protective barrier between
equipment” a worker and the hazards in the workplace.

“point of entry” means a passage for international entry or exit of travellers, baggage,
cargo, containers, conveyances, goods and postal parcels as well as
agencies and areas providing services to them on entry or exit;

“Pandemic” A worldwide spread of an infection or a disease.

“Public health authority” Government agency or designee responsible for the protection and
improvement of the health of entire populations through community-
wide action;

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“Public health The ongoing, systematic collection, analysis and interpretation of data
surveillance” about specific environmental hazards, exposure to environmental
hazards and health effects potentially related to exposure to
environmental hazards, for use in the planning, implementation and
evaluation of public health programs;

“Public health means an extraordinary event which is determined, as provided in

emergency of these Regulations: (i) to constitute a public health risk to other States
international concern” through the international spread of disease and (ii) to potentially require
(PHEIC) a coordinated international response

“public health means the monitoring of the health status of travellers over time for
observation” determining the risk of disease transmission;

‘’Event” means a manifestation of disease or an occurrence that creates a

potential for disease;

“Free pratique” means permission for a ship to enter a port, embark or disembark,
discharge or load cargo or stores; permission for an aircraft, after
landing, to embark or disembark, discharge or load cargo or stores; and
permission for a ground transport vehicle, upon arrival, to embark or
disembark, discharge or load cargo;

“ICAO” means the International Civil Aviation Organisation;

“Ill person” means an individual suffering from or affected with a physical ailment
that may pose a

“Infection” means the entry and development or multiplication of an infectious

agent in the body of humans and animals that may constitute a public
health risk;

“IHR” means the International Health Regulations, 2005;

“Inspection” means the examination, by the competent authority or under its

supervision, of areas, baggage, containers, conveyances, facilities,
goods or postal parcels, including relevant data and documentation, to
determine if a public health risk exists;

“Isolation” means separation of ill or contaminated persons or affected baggage,

containers, conveyances, goods or postal parcels from others in such a
manner as to prevent the spread of infection or contamination;

“Medical examination” means the preliminary assessment of a person by an authorized health

worker or by a person under the direct supervision of the competent
authority, to determine the person’s health status and potential public
health risk to others, and may include the scrutiny of health documents
and a physical examination when justified by the circumstances of the
individual case;

“National IHR Focal means the national centre, designated by each State Party, which shall
Point” be accessible always for communications with WHO IHR Contact Points
under these Regulations;

viii
“Point of entry” means a passage for international entry or exit of travellers, baggage,
cargo, containers, conveyances, goods and postal parcels as well as
agencies and areas providing services to them on entry or exit;

“Public health means an extraordinary event which is determined, as provided in these

emergency of Regulations: (a) to constitute a public health risk to other States through
international concern” the international spread of disease; and (b) to potentially require a
(PHEIC) coordinated international response;

“Public health means the monitoring of the health status of travellers over time for
observation” determining the risk of disease transmission;

“Public health risk” means a likelihood of an event that may affect adversely the health
of human populations, with an emphasis on one which may spread
internationally or may present a serious and direct danger;

“Quarantine” means the restriction of activities and/or separation of other suspected

persons who are not ill or suspected baggage, containers, conveyances
or goods in such a manner as to prevent the possible spread of infection
or contamination;

“Scientific evidence” means information furnishing a level of proof based on the established
and accepted methods of science;

“Reservoir” means an animal, plant or substance in which an infectious agent

normally lives and whose presence may constitute a public health risk;
and

“Surveillance” means the systematic ongoing collection, collation and analysis of data
for public health purposes and the timely dissemination of public health
information for assessment and public health response as necessary;

“Suspect” means those persons, baggage, cargo, containers, conveyances, goods

or postal parcels considered by a State Party as having been exposed,
or possibly exposed, to a public health risk and that could be a possible
source of spread of disease;

“Vector” means an insect or other animal which normally transports an infectious

agent that constitutes a public health risk;

“WHO” means the World Health Organisation;

“WHO IHR Contact means the unit within WHO which shall be accessible always for
Point” communications with the National IHR Focal Point.

“Business Continuity An ongoing management process to ensure continuity of core business

Management” processes in the event of a crisis to minimize interruption and adverse
impact to the organization. It has two components: an Emergency
Response Plan, and Business Continuity Plan.

ix
“Business Continuity Plan or a set of plans developed to ensure continuity of business
Plan” processes in the event of crisis. The identification and protection
of business processes required to maintain an acceptable level of
operations in the event of sudden, unexpected, or not so unexpected,
interruption of these processes and their supporting resources i.e.,
keeping the critical business running – no matter what.

“departure” means, for persons, baggage, cargo, conveyances or goods, the act of
leaving a territory;

‘’disease” means an illness or medical condition, irrespective of origin or source,

that presents or could present significant harm to humans;

“disinfection” means the procedure whereby health measures are taken to control
or kill infectious agents on a human or animal body surface or in or on
baggage, cargo, containers, conveyances, goods and postal parcels by
direct exposure to chemical or physical agents;

“dis-insection” means the procedure whereby health measures are taken to control or
kill the insect vectors of human diseases present in baggage, cargo,
containers, conveyances, goods and postal parcels;

“public health risk” Means a likelihood of an event that may affect adversely the health
of human populations, with an emphasis on one which may spread
internationally or may present a serious and direct danger;

“quarantine” means the restriction of activities and/or separation from others of

suspect persons who are not ill or of suspect baggage, containers,
conveyances or goods in such a manner as to prevent the possible
spread of infection or contamination;

“reservoir” means an animal, plant or substance in which an infectious agent

normally lives and whose presence may constitute a public health risk;

“scientific evidence” means information furnishing a level of proof based on the established
and accepted methods of science;

“surveillance” means the systematic ongoing collection, collation and analysis of data
for public health purposes and the timely dissemination of public health
information for assessment and public health response as necessary;

“suspect” means those persons, baggage, cargo, containers, conveyances, goods

or postal parcels considered by a State Party as having been exposed,
or possibly exposed, to a public health risk and that could be a possible
source of spread of disease;

“vector” means an insect or other animal which normally transports an infectious

agent that constitutes a public health risk;

“WHO IHR Contact means the unit within WHO which shall be accessible at all times for
Point” communications with the National IHR Focal Point.

“signature date” means the date on which this agreement is signed by the last party;

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5 BACKGROUND

According to the World Health Organization’s (WHO) International Travel and Health, “more than 900
million international journeys are undertaken every year”. Global travel on this scale exposes many
people to a range of health risks. Itineraries, the environment at departure, conditions during flight and
passenger volumes all contribute to the challenge of managing public health events during air transport.
Airports are places where travellers, the public and airport workers may interact in close surroundings,
particularly when embarking or disembarking.

Passengers arrive from international or domestic destinations with their baggage, and air cargo may
originate from different parts of the world to be loaded or offloaded on aircraft for transport. Passengers
and cargo may be in-transit to be transported from airports to other destinations, frequently connecting
with other airlines or other international or domestic conveyances. All these activities provide
opportunities for interactions among persons and their environment, with the potential for exposure to
and/or transmission of disease. The need to prepare and maintain the capacity to respond to public
health events in this complex air travel environment has been highlighted by recent public health events,
including the outbreak of severe acute respiratory syndrome (SARS) (2003), the H1N1 in 2009, Ebola,
Zika, Plague, Middle East Respiratory Syndrome and the recent Covid-19 pandemic. The knowledge
and experience gained during these events has resulted in best practices developed by both public
health and aviation sectors to mitigate the risk to the public, staff, passengers on board an aircraft and
crew.

The WHO IHR (2005) are a binding legal agreement signed by 194 WHO Member States. These
regulations set out the requirements to develop core capacities for prevention, detection and response
at designated points of entry (PoE), both for routine operations and public health emergency response,
aimed at enabling a rapid and harmonized response to public health events globally. With the adoption
of an all-hazard approach to public health risk, management of public health in air transport requires
a multidisciplinary, multi-sector approach and must be implemented in the context of IHR and other
intergovernmental agreements and national/ regional rules and regulations.

This framework of regulations, agreements, plans and protocols informs the roles and responsibilities
of the involved parties, including aircraft operators, airport operators, aviation regulatory authorities,
supporting industry to the aviation sector, public health authorities and other stakeholders. In the aviation
sector, the Convention on International Civil Aviation is the legally binding document that underpins all
civil aviation activities related to safety, security and efficiency. Article 14 of the Convention requires
countries to prevent the spread of communicable diseases, in collaboration with other agencies. The
International Civil Aviation Organization (ICAO), a specialized agency of the United Nations (UN), is
responsible for developing international Standards and Recommended Practices (SARPs) which
countries use to form national legislation. Because of the disparate nature of the public health and aviation
sectors, it is essential that efficient and effective lines of communication, collaboration and coordination
be established between stakeholders to ensure a harmonized approach in the management of public
health emergencies.

Pandemics are unpredictable and may recur in the near future resulting in severe impact on human health
and economic wellbeing worldwide. Environmental change, international travel, microbial evolution and
the breakdown of public health facilities have all contributed to the changing spectrum of infectious
diseases with which the global community is challenged. Furthermore, the current trend in international
civil aviation is towards aircraft of larger passenger-carrying capacity and greater range. This means
that passengers and flights are able to circumnavigate the globe in less than 24 hours and passengers
can carry communicable diseases or public health events of international concern to opposite ends of
the world in less than 24 hours.

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It is important to note that the Aviation Public Health Preparedness Plan may not completely prevent
the spread of an evolving pandemic, but, with the appropriate measures, it may be possible to delay
and mitigate the effects of such an emerging pandemic. Advance planning and preparedness are critical
to help mitigate the impact of a global pandemic. It is imperative that the Aviation Sector’s response to
the threat of a possible pandemic be timely, robust, coordinated and harmonized. The production of the
relevant vaccine remains the best chance to mitigate the high morbidity and mortality usually associated
with a pandemic. In 2003, the rapid spread of severe acute respiratory syndrome (SARS) caught many
states by surprise. A primary casualty was the aviation sector, resulting in major reduction in air travel.
The emerging threat of Avian Influenza raised fear of a human influenza pandemic in 2005.

The aviation sector has been impacted economically by Covid-19. Preparedness and harmonized
planning is our only protection that will inspire confidence in the travelling public based on the ICAO
Council Aviation Recovery Task Force (CART). The ICAO CART was established as guidance for Air
Travel through the COVID-19 Public Health Crisis to facilitate recovery.

The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the
mental health and well-being of both passengers and aviation personnel, which could impact operational
safety. It is the responsibility of all aviation stakeholders to play a proactive role in maintaining aviation
safety while preventing the transmission of communicable disease and safeguarding the health and
safety of aviation personnel and passengers. In the context of providing a psycho-socially safe and
supportive aviation environment for aviation personnel and passengers, “aviation personnel” refers
to personnel such as pilots, cabin crew, air traffic controllers, technical operations personnel, ground
service personnel, aerodrome personnel and aviation medical examiners (AMEs).

Aviation stakeholders are required to encourage the application of the principles to support aviation
personnel and passengers and consider peer support guidance. Peer support plays a critical role
throughout every stage of the spectrum to guide the person in need and facilitate early access to the
appropriate level of support and intervention. It is also important in recovery and return to work processes.

NOTE: A
 detailed guideline for the management of respiratory communicable disease is attached in
Annexure A

6 OBJECTIVE
 OF THE NATIONAL AVIATION PANDEMIC
PREPAREDNESS PLAN

a) The aim of the aviation pandemic preparedness plan is to mitigate the spread of
communicable disease through air travel by preventing the spread at a population level
to reduce mortality and morbidity, on board an aircraft (passengers and crew) and ensure
business continuity;

b) The Authority shall implement and maintain a national civil aviation public health plan,
ensure training for all personnel involved with or responsible for the implementation of
various aspects of the public health programme;

c) This training policy shall be designed to ensure that the importance of the public aviation
health measures is understood by all stakeholders involved;

d) The Authority shall approve procedures of all aviation and other intergovernmental
organizations based at the designated airports and from airlines/charter and air navigation
operators to ensure compliance with the national civil aviation public health programme;

2
 e) The priorities and frequency of oversight activities shall be determined on the basis of risk
assessments carried out by the relevant authorities, and include public aviation health
audits, inspections and tests to provide for the rapid, harmonized and effective response to
a public health emergency;

f) The Authority shall conduct aviation public health audits, tests, inspections and approve
risk assessments conducted by operators as a means of establishing compliance with the
national requirement and evaluating the effectiveness of aviation public health measures;

g) The Authority shall make available to a designated airport operator, air carrier, air traffic
service providers, security services providers, health and other organisations contributing
to the programme a written version of the appropriate part or parts of the Aviation Public
Health Plan and relevant information or guidelines to enable them to meet the requirements
of the Preparedness Plan;

h) The Director may make and issue orders, circulars and directives prescribing an aviation
public health measure to an operator or entity for the purpose of implementation of
regulations, including additional aviation public health measures and procedures;

i) The Authority shall develop and implement a process to identify differences between
Article 14 of ICAO Convention, Annex 6,9,11(PANS),14 and 18, Standards, The Aviation
Pandemic Plan and the CAR 2011, SA-CATS Documents, and the Department shall notify
ICAO of such differences.

Reference: ICAO Template Preparedness Plan

7 MODE
 OF DISEASE TRANSMISSION

When developing procedures for public health events of international concerns, it is important to
understand how infectious diseases are transmitted from an infected individual to an uninfected one.
This understanding is needed to develop strategies to prevent transmission and manage the public
health events. While infectious organisms can be spread through many routes, including via insects
and sexual contact, the focus of this project is on infectious organisms that are spread by three general
routes of transmission:

■ Aerosols that remain airborne and can be inhaled.

■ Large droplets that settle on surfaces.
■ Direct contact with secretions, bodily fluids, or contaminated surfaces.

AEROSOL AND DROPLET MODE OF TRANSMISSION

Infectious diseases spread by the aerosol route are transmitted by particles most often generated by
coughing and sneezing. However, these particles may also be generated by other common activities,
such as talking or breathing. These particles are very small (around 10 micrometres); can remain airborne
for hours at a time; and can even be transported to other areas of a building by heating, ventilation, and
air conditioning systems. Tuberculosis represents the prototypical airborne transmission disease, as the
organism, Mycobacterium tuberculosis, is small enough to remain suspended in air for long periods of
time (Mycobacterium tuberculosis must not only be inhaled but must reach deep into the lung to start an

3
infection). For other diseases, like influenza, aerosols play a role in transmission, but other routes can
contribute to the spread of disease as well.

The physical acts of sneezing and coughing can generate large droplets in addition to the aerosols
described herein. These large droplets cannot remain airborne for more than a minute or so and fall
to surfaces and the ground within several feet of their release location. These large droplets can be
transmitted directly to susceptible individuals that were near the infectious individual during the act of
sneezing or coughing or can contaminate inanimate objects that can then be contacted by susceptible
individuals. Many infectious diseases (e.g., influenza) that can be transmitted by aerosols can also be
transmitted by large droplets. Infectious diseases transmitted by direct contact can be spread when a
person comes in contact with contaminated surfaces or bodily fluids (e.g., vomit, blood, faeces). For
these infectious organisms, surfaces become contaminated through the spread of contaminated large
droplets, nasal secretions, faeces, vomit, or other means. These organisms, if they survive and remain
infectious, may then infect susceptible individuals, through contact with these surfaces.

Following contact, the susceptible individuals typically infect themselves by touching their mouth,
eyes or nose with their contaminated hands. Studies have shown that individuals whose hands are
contaminated with a live virus may contaminate up to seven additional clean surfaces. Studies have
shown that the majority of commonly touched surfaces, such as faucets, ATM screens, and escalator
railings are contaminated with microorganisms. Surfaces can remain contaminated and infectious for
a long time if adequate disinfection is not performed, as evidenced by a norovirus outbreak on an
airplane where flight crew from different shifts became ill up to five days after an infectious passenger
vomited on the airplane. Transmission by direct contact can be mitigated with barrier precautions, such
as gloving, thorough washing of the hands, and effective cleaning of contaminated surfaces. Examples
of microorganisms that can be spread through direct contact include the common cold virus (rhinovirus)
and influenza.

How contact transmission occurs: Contact transmission can occur in two ways

■ Direct Contact Transmission

■ Indirect Contact Transmission

Contact precautions are required to protect against either direct or indirect transmission. Contact
precautions are indicated for persons with gastrointestinal (diarrheal).

DIRECT CONTACT TRANSMISSION

■ Involves body-surface to body-surface contact and physical transfer of microorganisms between a

susceptible person (host) and an infected or colonized person. 
■ More often occurs between a healthcare worker and a patient than between patients.

INDIRECT CONTACT TRANSMISSION

■ Involves contact of susceptible person (host) with a contaminated intermediate object such as
needles, dressings, gloves or contaminated (unwashed) hands. 
■ Disease is more likely to develop following direct or indirect contact transmission when the pathogen is
highly virulent or has a low infectious dose or the patient or healthcare worker is immunocompromised. 
■ Poor hand hygiene is most often cited as a cause of contact transmission.

Reference: WHO Handbook for the Management of Public Health Events in Air Transport

4
Refer detailed Doc Transmission of Disease

8 IMPACT
 OF PUBLIC HEALTH ON MENTAL HEALTH ISSUES
IN AVIATION

Public health emergencies have had a significant impact on the mental health and well-being of both
passengers and aviation personnel, which could impact operational safety. It is the responsibility of all
aviation stakeholders to play a proactive role in maintaining aviation safety by preventing the transmission
of communicable disease and safeguarding the health and safety of aviation personnel and passengers.

a) In the context of providing a psycho-socially safe and supportive aviation environment for
aviation personnel and passengers, “aviation personnel” refers to personnel such as pilots,
cabin crew, air traffic controllers, technical operations personnel, ground service personnel
and aerodrome personnel;

b) The Authority must ensure collaboration between aviation medical examiners, aviation
medical assessors, other healthcare professionals, peer support groups and aviation
personnel to support the mental health and well-being for all aviation personnel;

c) Provide appropriate guidance and support to aviation medical examiners to manage the
impact of public health events on mental health and well-being in a consistent manner;

d) Aviation stakeholders are required to encourage the application of the principles to support
aviation personnel and passengers and consider the peer support guidance described in
the attached enclosures;

e) Self-care is a critical component of maintaining mental health and a sense of well-being

at all points on the spectrum. Peer support can play a role in the early identification of a
deterioration in mental health or well-being;

f) Peer support plays a critical role throughout every stage of the spectrum to guide the person
in need and facilitate early access to the appropriate level of support and intervention. It is
also important in recovery and return to work processes;

g) Professional and Industry Associations, will provide access to appropriate services to

support health and well-being and will make peer support programmes available to all
aviation personnel;

h) Industry Service Providers (e.g. aircraft operators, airports, air traffic control organizations,
training organizations, etc.), awareness among leadership and management to support
well-being among aviation personnel and continue to offer existing resources to support
aviation personnel including peer support, employee assistance programmes (EAP) or
other programme; and

i) Provide a supportive environment for aviation personnel to address their well-being and
proactively discuss work-related challenges during medical certification examination.

5
 Medical
Certification Critical
Concerns Incident Response
Liaise with AME and Mitigating the effects
Regulator of trauma

Peers
Professional Wellbeing &
Standards
• Actively Listen
Life Crises
• Build Trust
Facilitate conflict Assist to structure
• Offer Support
resolution dilemmas and
(pilots only) • Refer, if needed identify solutions

Substance
Addiction Training Issues
Triage with Regulator, Collaborate with
Management and Training to identify
AME over recovery feasible solution
process

Diagram 1: The different dimensions of Peer Support: Detailed guidelines are attached

Reference: ICAO Electronic Bulletin: Promoting, Maintaining and Supporting Mental Wellbeing
in Aviation During the Covid-19 pandemic

PROGRAM APPLICABILITY

The Aviation Pandemic Preparedness Plan shall apply to:

a) An operator of a designated airport;

b) A foreign and domestic commercial air carrier operating at designated airports;
c) Air cargo, mail and catering;
d) An approved aviation security training organisation;
e) An air Traffic and Navigations Services provider;
f) Aviation Training Organization;
g) Customs;
h) Immigration;
i) Police;
j) Baggage Handlers;
k) Any other aviation participant determined by the Minister from time in the Government Gazette;
l) Relevant government departments and security agencies;
m) Other airport community members.

6
9 LEGISLATIVE AND RELATED ASPECTS

International Legal and Ethical Dimensions of International Public Health Response

The increase in global travel and recent public health events has triggered a corresponding increased
interest in international health law, including the development and implementation of the WHO
IHR(2005). As part of public health planning and response, countries must consider both legal and
ethical dimensions, and for the purposes of this plan, only the primary legal authorities based on WHO,
IHR and are included ICAO Annexes. Other govemental and non-govemental organizations must refer
to national and international legal authorities not covered in this plan.

INTERNATIONAL LEGAL INSTRUMENTS

The International Civil Aviation Organization (ICAO) is a specialized agency of the United Nations. It
was created with the signing, in Chicago, on 7 December 1944, of the Convention on International Civil
Aviation. The ICAO is the permanent body charged with the administration of the principles laid out in
the convention. The Convention establishes the privileges and restrictions of all Contracting States and
provides for the adoption of International Standards and Recommended Practices (SARPs) regulating
international air transport. The Convention on International Civil Aviation includes several articles which
call for adoption of international regulations in all fields where uniformity facilitates and improves air
navigation.

These regulations, known as Standards and Recommended Practices (SARPs), have been promulgated
in ICAO Annexes to the Convention which are amended from time to time when necessary. Their purpose
is to promote the safe and orderly development of international civil aviation throughout the world. The
ICAO sets standards and regulations necessary for aviation safety, security, efficiency and regularity,
as well as aviation environmental protection. The organization serves as the forum for cooperation in
all fields of civil aviation among its 193 Member States. Its work is underpinned by the Convention on
International Civil Aviation, the “Chicago Convention”, which is legally binding. Compliance by each State
within the Convention with the Standards and Recommended Practices in its 19 annexes is audited by
ICAO and the results posted on ICAO’s public website. Article 14 of the Convention is titled Prevention
of Spread of Disease, and it encourages contracting States to take “effective measures to prevent
the spread of communicable diseases” and to collaborate with other relevant agencies to this end.
Following SARS in Hong Kong in 2003, ICAO and WHO established the Collaborative Arrangement
for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA) to mitigate a
potential spread of communicable diseases through air travel. ICAO public health Annexes form part of
the USOAP audit.Relevant ICAO Annexes applicable to public health events of international concerns
include but are not limited to the following:
Annex 6 International Commercial Air Transport Aeroplanes
Annex 9 – Facilitation
Annex 11 – Air Traffic Services
Procedures for Air Navigation Services – Air Traffic Management
Annex 14 – Aerodrome Design and Operations
Annex 14 – Heliports
ACI, Airport Operational Practice Examples for Managing COVID-19
Annex 18 (Doc 9284) - Technical Instructions for the Safe Transport of Dangerous Goods
by Air (7)

PLEASE NOTE: Other, ICAO is currently amending Annexes might be applicable in the future.

7
10 ARTICLE
 14 OF THE CONVENTION ON INTERNATIONAL
CIVIL AVIATION

Article 14 requires each Contracting State to agree 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.

Following a meeting between ICAO and WHO, ICAO strengthened its support for Article 14 of the
Convention on International Civil Aviation and amended Annexes 6,9,11 (PANS ATM),14,18 and
following Covid-19, a number of Annexes may be amended to incorporate public health measures such
as Annex 19.

11 ICAO ANNEX – 9 FACILITATIONS

The ICAO Annex 9 (8.19) stipulates that each Contracting State shall establish a National Facilitation
Committee and Airports Facilitation Committee as required, or similar coordinating bodies, for the
purpose of coordinating facilitation between departments. The Contracting States shall ensure that
the objective of the National Air Transport Facilitation Programme shall be to adopt all practicable
measures to facilitate the movement of aircraft, crews, passengers, cargo, mail and stores by removing
unnecessary obstacles or delays. The latest health-related changes to ICAO Annex 9, were developed
and associated procedures came into force in Nov 2009. ICAO Annex 9, (paragraph 8.16, Standard)
states that: ‘Contracting State shall establish a National Aviation Plan in Preparation for an Outbreak of a
Communicable disease posing a public health risk or public health emergency of international concern’.
ICAO Annex 9, (paragraph 8.15-Standard) stipulates that: ‘The pilot in command shall ensure that the
suspected communicable disease is reported promptly to air traffic control, in order to facilitate provision
for the presence of any special medical personnel and equipment necessary for the management of
public health risk on arrival’. ICAO Annex 9, paragraph 8.15.1(RP) stipulates that: “the Contracting State
should accept the Public Health Passenger form reproduced in appendix 13 as the sole document for
this purpose. ‘The aircraft general declaration’’ was amended to assist the crew in identifying possible
symptoms of communicable disease, such as: - Fever (38°C/100°F or greater), plus one or more of the
following signs or symptoms:

■ Appearing obviously unwell

■ Persistent coughing
■ Impaired breathing
■ Persistent diarrhea
■ Persistent vomiting
■ Skin rash
■ Bruising

Reference: Annex 9 Facilitation Document

8
12 ICAO
 ANNEX 6 OPERATION OF AIRCRAFT
(RECOMMENDATION)

Annex 6 of ICAO stipulates that an aircraft shall be equipped with accessible and adequate medical
supplies, which should comprise of Universal Precaution Kit (1 per aircraft if cabin crew is required,
and 2 if >250 passengers) for airplanes required to carry cabin crew as part of the operating crew, for
the use by cabin crew members in managing incidents of ill health associated with a case of suspected
communicable disease, or in the case of illness involving contact with body fluids. It is important to note
that, during an outbreak of a specific communicable disease, the World Health Organization (WHO) or
member states, in collaboration with IATA, may modify or add further procedures to these guidelines.

Annex 6 also makes reference to the First Aid Kits and Doctor’s Bag on board an aircraft. Contents of the
Universal Precaution Kits. The content of the Universal Precaution Kids are reviewed regularly based of
the mode of transmission and operators should keep themselves abreast of this information:

■ Dry powder that can convert small liquid spill into a sterile granulated gel.
■ Germicidal disinfectant for surface cleaning.
■ Skin wipes.
■ Face /eye mask (separate or combined).
■ Gloves(disposable).
■ Non-Mercury Thermometer.

13 ICAO ANNEX 11: AIR TRAFFIC SERVICES AND PLANS ATM

Air Traffic Service Authorities shall develop and promulgate a contingency plan (Public Health) regarding
the assessment of risk to civil air traffic due to military conflict or acts of unlawful interference with civil
aviation as well as a review of the likelihood and possible consequences of natural disasters or public
health emergencies. The Notification of suspected communicable disease, or public health risk, on
board the aircraft, to the ATS unit, by the pilot in command, should consist of the following:

■ The designated Airport Authority of the next intended landing destination.

■ The number of persons exhibiting symptoms of a communicable disease.
■ Aircraft identification.
■ The name of the departure aerodrome.
■ Destination aerodrome.
■ Estimated time of arrival and the number of persons on board.

14 ANNEX

BY AIR”
18 (“SAFE TRANSPORT OF DANGEROUS GOODS

Annex 18 sets down broad principles but one of the Standards requires that dangerous goods are
carried in accordance with the Technical Instructions for the Safe Transport of Dangerous Goods by
Air (the “Technical Instructions”). States are required by Annex 18 to have inspection and enforcement
procedures to ensure that dangerous goods are being carried in compliance with the requirements.

9
Dangerous goods are carried regularly and routinely by air all over the world. To ensure that they do
not put an aircraft and its occupants at risk there are international standards which each State, under
the provisions of the Chicago Convention, is required to introduce into national legislation. This system
ensures governmental control over the carriage of dangerous goods by air and gives world-wide
harmonization of safety standards which include the following:

15 CLASSIFICATION
 OF INFECTIOUS DISEASE AND
CLASSIFICATION OF INFECTIOUS SUBSTANCES

Infectious substances are classified in division 6.2 and assigned to UN 2814, UN 2900 or UN 3373.
Cultures are the result of a process by which pathogens are intentionally propagated. This definition
does not include human or animal patient specimens. Patient specimens are human or animal materials,
collected directly from humans or animals, including, but not limited to, excreta, secreta, blood and its
components, tissue and tissue fluid swabs, and body parts being transported for purposes of research,
diagnosis, investigational activities, disease treatment and prevention.

Category A Infectious Substance: These are Infectious Substances in a form that, when exposure to
them occurs, are capable of causing permanent disability, life-threatening or fatal disease in otherwise
healthy humans or animals. They are assigned the following proper shipping name and UN number:

■ ‘Infectious Substance affecting humans’, UN 2814 or

■ ‘Infectious Substances affecting animals only’, UN 2900.

Assignments to UN 2814 or UN 2900 are to be based on the known medical history and symptoms of
the source human or animal, endemic local conditions, or professional judgment concerning individual
circumstances of the source - human or animal. If there is any doubt as to whether or not a pathogen
falls within this category, it must be transported as a Category A Infectious Substance. Category B
Infectious Substances: These are Infectious Substances that don’t meet the criteria for inclusion in
Category A. They are assigned the following proper shipping names and UN number UN 3373:

■ Diagnostic Specimen*,
■ Clinical Specimen*, or
■ Biological Substance, Category B.

To assist in the assignment of an Infectious Substance into Category A see the Indicative List provided
in Table 2-10 in the 2005/2006 ICAO TI’s. That list is not exhaustive. Infectious substances, including
new or emerging pathogens, which do not appear in the Table but which meet the same criteria shall be
assigned to Category A. In addition, if there is doubt as to whether or not a substance meets the criteria
it shall be included in Category A.

Exemptions (check Bra Bheki)

■ Substances which do not contain infectious substances, or substances which are unlikely to cause

disease in humans or animals, are not subject to these Instructions unless they meet the criteria for
inclusion in another class.
■ Dried blood spots, collected by applying a drop of blood onto absorbent material, or faecal occult

blood screening tests and blood or blood components that have been collected for the purposes of
transfusion or for the preparation of blood products to be used for transfusion or transplantation and
any tissues or organs intended for use in transplantation are not subject to these Instructions.

10
■ Substances for which there is a low probability that infectious substances are present, or where the
concentration is at a level naturally encountered, are not subject to these Instructions. Examples
are: foodstuffs, water samples, living persons, and substances that have been treated so that the
pathogens have been neutralized or deactivated so that they no longer pose a health risk.

Reference: IATA Technical Instruction & ICAO Bulletin Human Remains

16 ICAO COVID-19 GUIDELINES AND BULLETINS

ICAO Council Aviation Recovery Task Force (CART 1,2,3)

ICAO Handbook for Cabin Crew Recurrent Training during COVID-19-Doc 10148-

ICAO Handbook for CAAs on the Management of Aviation Safety Risks related to COVID-19 - 10144

ICAO Manual on Testing and Cross-border Risk Management Measures- 10152

ICAO Bulletin - Promoting, Maintaining and Supporting Mental Well-Being in Aviation during the
covid-19 pandemic

Others, refer to ICAO and the SACAA Website

17 WORLD
 HEALTH ORGANIZATION AND THE
INTERNATIONAL HEALTH REGULATIONS (2005)

WHO is the directing and coordinating authority for health within the UN system and it is responsible
for providing leadership on global health matters, shaping the health research agenda, setting norms
and standards, articulating evidence-based policy options, providing technical support to countries and
monitoring and assessing health trends. WHO Member States led the IHR revision, recognizing that
health is a shared responsibility, involving equitable access to essential care and collective defence
against transnational threats. The goal of the IHR is to provide a legal framework for the prevention,
detection and containment of public health risks at the source, before they spread across borders,
through the collaborative actions of States, Parties, WHO and all relevant stakeholders.

The IHR were adopted in 2005 and came into effect in 2007. All State Parties who accepted the IHR
without reservations are legally bound to implement them accordingly. The IHR includes protection for
the human rights of persons and travellers, setting out as a principle that “the implementation of these
Regulations shall be with full respect for the dignity, human rights and fundamental freedoms of persons”
(Article 3). This is in acknowledgement that public health measures which impose limits on movement
or require other interventions at a personal or community level may at times be warranted for the ‘public
good’ but must be balanced by ethical considerations.

International communication link with competent authorities at other Points of Entry

Competent authority (ports health) at each point of entry has current contact details of officers in charge
of international communication with other points of entry abroad and means of communication and
procedures are available to inform relevant public health measures taken pursuant to the International
Health Regulations, such as:
■ Communication with competent authorities at other points of entry, internationally, to provide relevant

information regarding evidence found and control measures still needed on arrival of affected
conveyance.

11
■ Local, intermediate and national levels (including National IHR Focal Point) have current contact
details of competent authorities at points of entry, and which are current and regularly updated,
documented and tested procedures.

Competent authority at each point of entry has current contact details of officers at local, intermediate and
national levels, including contact details of National IHR Focal Point and means of communication and
procedures are available to inform relevant public health measures taken pursuant to the International
Health Regulations such as to communicate with NFP in order to inform WHO within 24 hours of receipt
of evidence, as manifested by exported or imported:
■ human cases
■ vectors which may carry infection or contamination or
■ goods that are contaminated, that may cause international disease spread or additional health

measures and their health rationale within 48 hours of implementation.

Report all available essential information on event occurring and point of entry by competent authority to
health authority at local, intermediate or national level for public health assessment, care and response
and communication with competent authorities at other points of entry, nationally, to provide relevant
information regarding evidence found and control measures needed on arrival of affected conveyance.
The International Health Regulations are implemented through the National Department of Health in
South Africa and based on this plan practiced at international airports.

Diagram 2: WHO International Health Regulation depicting Core Capacities at the Ports of Entry-Example
Airport

Refence: WHO-INTERNATIONAL HEALTH REGULATIONS (2005)

12
18 NATIONAL
 LEGAL INSTRUMENTS: AVIATION PUBLIC
HEALTH PLAN

In line with Annex 9 of ICAO, the Civil Aviation Act, 2009 (Act 155 Disaster Management Act) was
amended to make provision for the establishment of the Aviation Public Health Plan under Part 113.01.2
of the Civil Aviation Regulations 2011.The regulations stipulate that the Director shall establish a National
Aviation Pandemic Preparedness plan in preparation for an outbreak of a communicable disease posing
a public health risk or public health emergency of international concern. Part 113 of the Civil Aviation
Regulations is applicable to the approval and operations of organizations conducting-

■ Commercial Air Transport Operations;

■ Aerodrome Operations; and
■ Air Traffic Service Operations

19 THE
 CIVIL AVIATION REGULATIONS (CARS), AND
ASSOCIATED TECHNICAL STANDARDS

PART 64.02.2 OF THE CIVIL AVIATION REGULATIONS AND TECHNICAL STANDARDS

In line with Annex 9 Facilitation, Part 64 of the Civil Aviation Regulations and Technical Standards
were amended to ensure that cabin crew is trained to identify symptoms and signs of communicable
disease and to ensure that they protect themselves and others while managing suspected cases of
communicable disease. Cabin crew will be the first point of contact and will be responsible for managing
the cabin and continuous communication with the Pilot-in-Command on the progress of the suspected
case of communicable disease.

IDENTIFICATION AND MANAGEMENT OF SUSPECTED CASES OF COMMUNICABLE DISEASE

a) Identify symptoms and signs of communicable diseases as contained in the Aircraft Declaration
Document contained in Annex 9;
b) Describe the steps followed when using universal precaution kits by the crew managing a
suspected case of communicable disease;
c) State the management of communicable disease when there is availability of space on board an
aircraft;
d) State the management of a suspected case of communicable disease when there is limited space
on board an aircraft;
e) Describe the areas to be disinfected by cabin crew in the lavatory where there is limited space on
board an aircraft;
f) Describe the management of a suspected case of communicable disease, where the passenger
is tolerating or not tolerating the mask;
g) Describe the process to be followed when handling body fluids, management of a damp and
humid mask;
h) Describe the use of a biohazard bag; and

13
i) Describe which passengers are issued with a passenger locator form and the reason why these
documents have to be handed over to public health authorities;
j) When a public health threat has been identified, cabin crew will issue passenger locator forms
on board an aircraft which will be collected by the public health authorities to ensure accessibility
of passengers’ and/or crews’ travel itineraries or contact information for the purposes of tracing
persons who may have been exposed to a public health event of international concern such as
communicable disease. Airline and Charter Operators are required to make available adequate
stocks of the Passenger Locator Forms, for use at their international airports and for distribution to
aircraft operators, for completion by passengers and crew.

Reference: Guidelines and Cardio Pulmonary Resuscitation on Board and ICAO Training Manual
Cabin Crew and ICAO Annexure 6

PART REGULATION 91.07.21 OF THE CIVIL AVIATION REGULATIONS: PASSENGER HEALTH

AND SAFETY

In line with Annex 9 Facilitation, Part 91 of the Civil Aviation Regulations and Technical Standards was
amended to ensure that aircraft operators have a procedure in place to manage suspected case of
communicable disease on board an aircraft, cabin crew notifies the Pilot, who in turn informs the air
traffic controller to ensure that appropriate public health measures are in place to manage the suspected
case when the aircraft lands.

a) The PIC of an aircraft shall notify air traffic control where it appears that any person displays the
symptoms and signs of communicable disease as provided in Document SA-CATS 91;
b) The owner or operator of an aircraft shall establish procedures for—
i. evaluation by flight crew member or cabin crew member of a person who displays the
symptoms referred to
ii. in sub-regulation (1); and
iii. notification of the air traffic control by the PIC of a suspected case as prescribed in Technical
Standard.

The report required by CAR 91.07.21 to the air traffic control shall contain, in addition to the person
suspected of being infected, the following details –

a) aircraft identification;
b) departure aerodrome including all technical or other stops;
c) destination aerodrome;
d) estimated time of arrival;
e) number of persons on board;
f) number of suspected cases on board; and
g) nature of the public health risk, if known.

TECHNICAL STANDARD 91.07.21 PASSENGER HEALTH AND SAFETY

A communicable disease could be suspected and require further evaluation if a person has a fever
(temperature 38°C/100°F or greater) that is associated with certain signs or symptoms such as appearing
obviously unwell, persistent coughing, impaired breathing, persistent diarrhea, persistent vomiting, skin
rash, bruising or bleeding without previous injury, or irrational behaviour.

14
 PART 91.07.36 DISINFECTION OF AIRCRAFT CIVIL AVIATION REGULATIONS

In line with Annex 9 Facilitation, Part 91 of the Civil Aviation Regulations and Technical Standards was
amended to ensure that aircraft operators have a procedure and training on the disinfection of an aircraft
of a suspected case of communicable disease.

a) An owner or operator of aircraft shall, as and when required by the Department of Health, ensure
that an aircraft is disinfected according to the guidelines prescribed by the Department of Health;
b) An owner or operator of an aircraft shall apply the following procedures when disinfecting the
aircraft;
c) disinfection shall be limited solely to the container or to the compartment of the aircraft in which the
passengers or cargo were carried;
d) disinfection shall be carried out where there is contamination or suspected contamination of
surfaces or equipment of the aircraft by any bodily fluids including excreta;
e) disinfection shall be undertaken in accordance with procedures provided by the aircraft manufacturer
and subject to any requirements or conditions issued by the World Health Organization;
f) the contaminated areas shall be disinfected with compounds possessing suitable germicidal
properties appropriate to the suspected infectious agent;
g) disinfection shall be carried out expeditiously by cleaners wearing suitable personal protective
equipment;
h) flammable chemical compounds, solutions or their residues likely to damage aircraft structure, or
its systems, or chemicals likely to damage the health of passengers or crew, shall not be used for
disinfection of aircraft;
i) when aircraft disinfection is required for animal health reasons, only those methods and
disinfectants prescribed by the International Office of Epizootics shall be used.

Reference: Disinfection on board IATA and ICAO CART 3

TECHNICAL STANDARD FOR DISINIFECTION MISSING

PART 91 .07.37 TECHNICAL STANDARD - DISINSECTION OF THE AIRCRAFT

In line with Annex 9 Facilitation, Part 91 of the Civil Aviation Regulations and Technical Standards was
amended to ensure that aircraft operators have a procedure and training on the Disinsection of an
aircraft of a suspected case of communicable disease.

PART 91 .07.37 TECHNICAL STANDARD - DISINSECTION OF THE AIRCRAFT

91.07.37: An owner or operator of aircraft shall ensure that aircraft departing from the States listed in
Document SA-CATS 91 is dis-insected according to the guidelines prescribed in Document SA-CATS
91. An owner or operator of aircraft shall –

a) limit routine dis-insection of aircraft cabin, flight deck, cargo and baggage compartment with
an aerosol while passengers and crew are on board, to same aircraft operations originating in,
or operating via, territories that are considered to pose a threat to public health, agriculture or
environment;

15
b) ensure a period review of the requirements of dis-insection of aircraft and modify them, as
appropriate, in the light of all available evidence relating to the transmission of insects in the
aircraft;
i. authorize or accept only those methods whether chemical or non-chemical or insecticides,
which are recommended by the World Health Organization and which are considered
efficacious;
ii. ensure that the procedures for dis-insection are not injurious to the health of passengers and
crew and that they result in minimum of discomfort to the passengers and crew.
c) The Director shall provide to aircraft operators appropriate information, in plain language, for crew
and passengers, explaining the provisions of this regulation, the reasons for and the safety of dis-
insection;

Reference: WHO Vector Control

DEPARTURE FROM LIST OF COUNTRIES DECLARED AS YELLOW FEVER RISK COUNTRIES

91.07.37: An owner or operator of aircraft shall ensure that an aircraft departing from the list countries
declared by the World Health Organization as yellow fever risk countries must be disinfected prior to
departure;

a) The list of countries declared by World Health Organization yellow fever risk countries shall be
published in the SACAA’s website by the Director;
b) The following methods and guidelines for aircraft disinfection shall be used by the owner or
operator of an aircraft:
i. When dis-insection has been performed in accordance with procedures prescribed by the
World Health Organization, the Director shall accept a certification on the General Declaration
or, in the case of residual dis-insection, the Certificate of Residual Disinfection;
ii. An owner or operator of aircraft shall keep records of the dis-insection in the form of a
Certificate of Residual Disinfection or certification on the General Declaration and such
certificate shall be presented or made available to the appropriate authorities in the country of
destination;
iii. An owner or operator of aircraft shall ensure that –
any insecticide or any other substance used for dis-insection does not have a deleterious
effect on the structure of the aircraft or its operating equipment;
iv. flammable chemical compounds or solutions likely to damage aircraft structure shall not be
used to disinsect the aircraft.”

NOTE: Detailed Guidelines WHO Yellow Fever Countries List(??)

PART 92.00.10 OF THE CIVIL AVIATION REGULATIONS (PACKING AND PACKAGING)

a) 92.00.10: A shipper shall ensure that all dangerous goods which the shipper prepares or offers for
conveyance by air, are packed in accordance with the provisions of this part and the requirements
and standards as prescribed in Document SA-CATS 92.

16
b) A shipper shall ensure that any packaging used for the conveyance of dangerous goods by air
shall –
i. comply with the material and construction specifications of, and be tested initially in accordance
with the requirements and standards as prescribed in Document SA-CATS 92; and
ii. be of good quality and constructed and securely closed so as to prevent leakage caused
by changes in temperature, humidity, pressure or vibration under normal conditions of
conveyance by air.
c) A shipper shall ensure that inner packaging is packed, secured or cushioned to prevent its breakage
or leakage and to control its movement within the outer packaging during normal conditions of
conveyance by air;
d) A shipper shall ensure that packaging in direct contact with dangerous goods is resistant to any
chemical or other action of such goods and cushioning, and that absorbent materials do not react
dangerously with the contents of the receptacles;
e) A shipper shall ensure that packaging for which retention of a liquid is a basic function, is capable
of withstanding, without leaking, the pressure as prescribed in Document SA-CATS 92;
f) No receptacle used for the conveyance of dangerous goods by air shall be re-used by the shipper
until such receptacle has been inspected by such shipper and found free from corrosion or other
damage;
g) If a receptacle, used for the conveyance of dangerous goods by air, is re-used by the shipper,
all necessary measures shall be taken by the shipper to prevent contamination of subsequent
dangerous goods conveyed therein;
h) If, because of the nature of their former contents, uncleaned empty receptacles may present a
hazard, the shipper shall ensure that such receptacles are tightly closed and treated according to
the hazard that they constitute; and
i) A shipper shall ensure that no harmful quantity of any dangerous substance adhere to the outside
of a package.

PART 92.00.12 LABELLING AND MARKING OF THE CIVIL AVIATION REGULATIONS ( PACKING
AND PACKAGING)

a) Any person who offers any package containing dangerous goods for conveyance by air, shall
ensure that such package thus offered is labelled with the appropriate label or labels in accordance
with the requirements and standards as prescribed in Document SA-CATS 92;
b) Any person who offers any package containing dangerous goods for conveyance by air, shall
ensure that such package thus offered is marked with the proper shipping name, UN number,
class of hazard, and subsidiary risk, and that any authorisation reference of the contents of the
package is in accordance with the requirements and standards as prescribed in Document SA-
CATS 92;
c) Any person who offers any package containing dangerous goods for conveyance by air, shall
ensure that each packaging which is manufactured in accordance with a packaging specification
as prescribed in Document SA-CATS 92, is marked with the appropriate packaging specification
marking as prescribed in Document SA-CATS 92;
d) No packaging shall be marked with a packaging specification marking unless such packaging
complies with the appropriate packaging specification as prescribed in Document SA-CATS 92.

17
 PART 92 (CHECK) INSPECTION FOR DAMAGE OR LEAKAGE BY OPERATOR

The operator shall remove an aircraft from service immediately when such aircraft is contaminated by
radioactive materials and shall not return such aircraft to service until the radiation level resulting from
the fixed contamination at any accessible surface and the non-fixed contamination, is below the values
as prescribed in Document SA-CATS 92.

a) Any person responsible for the conveyance and opening of packages containing infectious
substances who becomes aware of damage to or leaking from such packages, shall –
b) avoid handling such infectious substances, where possible;
c) inspect adjacent packages for contamination;
d) inform the appropriate public health authority or veterinary authority of such damage or leakage;
e) provide the appropriate authority of the country of transit with information regarding any possible
contamination; and
f) notify the shipper or the consignee accordingly.

PART 92 SA CATS 92.00.10 - PACKING AND PACKAGING

a) The requirements and standards for the packing of dangerous goods are contained in Part 3 of the
Instructions;
b) Material and construction specifications and testing;
c) The material and construction specifications of packaging and the requirements and standards
for the testing of packaging are contained in Parts 3 and 7 of the Instructions and such packaging
must, if required by the Instructions, be tested by an approved testing facility.

PACKAGING FOR RETENTION OF LIQUID

Packaging for which retention of liquid is a basic function, must withstand the pressure prescribed in
Part 3; 1.1.6.1 of the Instructions or must comply with Part 3; 1.1.6.2 of the Instructions.

92.00.12 LABELLING AND MARKING

a) Labelling of packages;
b) The requirements and standards for the labelling of packages that contain dangerous goods are
contained in Part 4, Chapter 3 of the Instructions;
c) Marking of packages.

The require2ments and standards for the marking of packages that contain dangerous goods are
contained in Part 4, Chapter 2 of the Instructions;

a) Marking of specification packaging.

Each outer or single packaging used for dangerous goods, for which specification packaging is required
in Part 3 of the Instructions, must bear the markings appropriate to the contents as prescribed in Part 7,
Chapter 2 of the Instructions.

18
 92.00.12 INSPECTION FOR DAMAGE OR LEAKAGE BY OPERATOR

The radiation level resulting from the fixed contamination at any accessible surface and non-fixed
contamination must be below the values prescribed in Part 5; 3.2.4 and Table 5-6 of the Instructions.

NOTE: Detailed Guidelines on Annex E for Packaging of GD & Human Remains on board IATA

Reference: ICAO Bulletin for Human Remains

PART 138 AIR AMBULANCE REGULATIONS AND TECHNICAL STANDARDS

Emergency Medical Services (EMS) play a vital role in responding to requests for assistance, triaging
patients, and providing emergency medical treatment and transport for ill persons. However, unlike
patient care in the controlled environment of a healthcare facility, care and transports by EMS present
unique challenges because of the nature of the setting, enclosed space during transport, frequent need
for rapid medical decision-making, interventions with limited information, and a varying range of patient
acuity and jurisdictional healthcare resources.

To further refine personal prevention and protection requirements for crew members, maintenance
personnel and cleaning staff, air ambulance personnel and patients, it is crucial to improve requirements
on environment hygiene, disinfection and maintenance for aircraft, and introduce prevention and control
measures for air ambulance operators. Although ICAO does not have the SARPS for Air Ambulance
Operations, the Authority has regulations under Part 138 to ensure oversight of air ambulance operators.
Part 138.01.1: This part applies to – 

i. Aircraft registered in the Republic and engaged in commercial air ambulance operations; 
ii. Foreign-registered aircraft operated by an air service operator licensed in terms of the Air Services
Licensing Act, 1990 or the International Air Services Act, 1993 and engaged in commercial air
ambulance operations; 
iii. Foreign-registered aircraft utilized in commercial air ambulance operations to transport one or more
patients within or out of the Republic; and 
iv. Persons acting as flight crew members, operations personnel and medical personnel in respect of
any air ambulance operation carried out in terms of this part.

The provisions of part 91, part 121, part 127 and part 135 shall apply with the necessary changes to any
aircraft operated in terms of this part.

MEDICAL QUALIFICATION TECHNICAL STANDARDS REQUIREMENTS

138.02.2 Medical personnel and medical service providers involved in air ambulance operations shall
comply with the relevant legislation and regulations administered by the Department of Health, the
Health Professions Council of South Africa and the South African Nursing Council, as the case may be.

TRAINING OF CREW TECHNICAL STANDARDS REQUIREMENTS

Training of flight crew: Flight crew members engaged in air ambulance operations must successfully
complete a course of instruction prior to undertaking flying duties, and the course must include the
following subjects –

a) An overview of the way in which air ambulance operations function, their purpose and limitations; 
b) Orientation to infection control.

19
 PART 138.07.01 INFECTION CONTROL AND FLUID CONTAMINATION

a) The owner or operator of an aircraft engaged in an air ambulance operation shall ensure that –
b) every employee, before performing duty on, or cleaning an aircraft;
c) is familiar with any infection control procedure which may apply in respect of the aircraft; and
d) has taken appropriate precautions before performing duty on or cleaning such aircraft, as
prescribed by the Occupational Safety and Health Act of 1993 (Act No. 85 of 1993) and other
relevant legislation, and set out in the manual of procedure referred to in regulation 138.04.2;
e) Such aircraft shall not be operated unless it is equipped with measures to protect the aircraft
against body fluid contamination;
f) The protection measures referred to in paragraph (b) above are set out in the manual of procedures
and are compliant with the minimum standards as prescribed in the regulations issued by the
Department of Health; and
g) the cleaning agents used for cleaning are non-corrosive or non-abrasive to the aircraft.

Reference: Guidelines Air Ambulance Infection Control Measures

PART CAR 139.02.6 THE ESTABLISHMENT OF THE AERODROME EMERGENCY MANAGEMENT

SYSTEM

In line with Annex 14 of ICAO, Part 139 of the Civil Aviation Regulations and Technical Standards
was amended to ensure that airport operators have a procedure and training in place to manage
suspected cases of communicable disease. The layered defence measures against communicable
diseases include steps being taken individually, at airports and on board. Appropriate measures should
be applicable to all passengers, as well as aviation personnel, including duties such as training or
certification activities, flight and cabin crew, maintenance engineers/technicians, air traffic management
(ATM) workforce, staff that have contact with the travelling public and ground service agents.

Mitigation measures can be categorized into personal and shared responsibilities and may include
some or all the measures such as: engineering factors, environmental control systems, such as the
optimization of heating, ventilation and air-conditioning (HVAC systems) enhanced cleaning and
disinfection; contactless boarding/baggage processing; use of physical barriers and disinfection,
physical distancing and other applicable public health measures.

The aerodrome operator shall establish an aerodrome emergency management system

(AEMS) as contemplated in CAR 139.02.6 which shall include the following, but is not limited to:

■ Aircraft emergencies.
■ Sabotage including bomb threats.
■ Unlawful seizure of aircraft.
■ Dangerous goods occurrences.
■ Building fires.
■ Natural disasters, such as floods, veldt fires, tsunamis etc.
■ Public Health Emergencies .

Refer to CART

20
PUBLIC HEALTH EMERGENCIES INCLUDING COMMUNICABLE DISEASES.
(Check if there is a local reg)
The Part 7 of ICAO Doc 9137-AN/89 is herewith incorporated in terms of section 163(2) of the Civil
Aviation Act 2009 (Act 13 of 2009) list as the minimum standard for an AEMS. The medical equipment
and medical supplies depicted in Appendix 3 table 3-1 of ICAO Doc 9137-AN/8989 Part 7 shall be made
available on the aerodrome. If not self-proficient, the aerodrome operator shall enter into an agreement
with a service provider capable of providing such service to make the necessary medical equipment
and required medication available in the event of an emergency. The aerodrome operator shall ensure
that the agreement is kept current and that the service provider is at all times capable of meeting its
obligations.

NOTE: Detailed Guidelines CART

TECHNICAL STANDARD 172.03.12 DUTIES OF HOLDER OF APPROVAL ANS

The standards and procedures for the provision of services are contained in the manual of standards
and procedures for Air Traffic Services.

PART 172.03.12 (1) THE HOLDER OF AN APPROVAL MUST –

■ develop and implement contingency plans for implementation in the event of disruption or potential
disruption including but not limited to Public Health Emergencies, of air traffic services and related
supporting services in the airspace for which they are responsible for the provision of such services;
■ ensure that the plans referred to in paragraph (m) are closely coordinated with the air traffic services
authorities responsible for the provision of services in adjacent portions of airspace and submitted
for approval to the ICAO Council.

STANDARDS AND PROCEDURES MANUAL SECTION 9 EMERGENCY PROCEDURES: CHAPTER

7 COMMUNICABLE DISEASES
Introduction: Article 14 ICAO – Each contracting State agrees to take effective measures to prevent
the spread by means of air navigation of cholera, typhus, smallpox, yellow fever, plague and any other
such communicable disease as the contracting States shall from time to time decide to designate. ICAO
PANS ATM

Procedures (check)
a) The pilot-in-command shall notify ATC as soon as he/she becomes aware of a suspected case of
a communicable disease on board his/her aircraft;
b) The pilot-in-command shall notify ATC as soon as he/she becomes aware of a suspected case of
a communicable disease on board his/her aircraft. The ATSU receiving notification of a suspected
case of a communicable disease onboard an aircraft in flight shall advise, as soon as practicable,
on the following:
– The designated Airport Authority of the next intended landing destination
– The name of the departure aerodrome
– Estimated time of arrival;
– Number of persons on board
– Number of suspected cases, and their nature
– The aircraft operator or its designated representative
c) Where the destination aerodrome is outside of an ATSU’s jurisdiction clear coordination shall
be maintained between the ATSUs involved, stating the nature of the suspected case of the
communicable disease on board the flight and such notification actions conducted by the ATSUs;

21
d) Each ATSU shall maintain a list of contact numbers of the relevant Airport Authorities within their
jurisdiction.

NOTE: It is accepted that the designated Airport Authority and/or the operator will in turn notify other
relevant parties concerned in accordance with pre-established procedures as laid down by that Airport
Authority.

Reference: ICAO Annex 11 – Air Traffic Services and Procedures for Air Navigation Services – Air
Traffic Management

20 OTHER APPLICABLE NATIONAL LEGISLATION

The Minister of Transport has under section 155(1) of the Civil Aviation Act, 2009, (Act No. 13 of 2009)
made these Regulations. Other relevant national laws (as amended) related to the implementation and
enforcement of the Aviation Pandemic Preparedness Plan include:

a) Airports Company Act No. 44 of 1993;

b) Air Traffic and Navigation Services Company Act No. 45 of 1993;
c) Air Services Licensing Act No. 115 of 1990;
d) International Air Service Act No. 60 of 1993;
e) Criminal Procedure Act No. 51 0of 1977;
f) South African Police Service Act No. 68 of 1995;
g) Immigration Act, Act 13 of 2000;
h) Customs Control Act, 2014 (Act No 31 of 2014;
i) Diplomatic Immunities and Privileges Act 35 of 2008;
j) Private Security Industry Regulations Act 56 of 2001; and
k) Security Officers Act No. 92 of 1987;
l) Other applicable legislation.

21 RISK MANAGEMENT MODEL

The risk assessment approach set out by the IHR was incorporated as a general principle, including
the use of IHR Annex 2 “Decision Instrument for the Assessment and Notification of Events that may
Constitute a Public Health Emergency of International Concern” sets out the basic framework for public
health risk management that has been adopted for this document. The Rapid Risk Assessment of Acute

22
 Event detection Event
& notification verification

1 2

Monitoring Preliminary/
and 6 3 immediate
evaluation arrangements

5 4

Public health Risk

response assessment

Diagram: Public Health Events is a useful reference on the risk assessment

process for infectious diseases transmitted in air travel.

22 GENERAL
 RISK MANAGEMENT PRINCIPLES APPLIED TO
AIR TRANSPORT

Multi-layered risk management process is considered essential in the context of a public health risk and
it is a management framework and aligned with the intent of the WHO “Considerations for implementing
a risk-based approach to international travel in the context of COVID-191.’’ The objective of this process
is to identify the residual risk, considering various risk mitigation measures in place for unknowingly
transporting an infectious passenger or translocating the SARS-CoV-2 virus. This approach is scalable
in complexity and considered the baseline for more sophisticated processes end-to-end risk assessment
models.

The proposed risk assessment process relies on a continuous process that considers risk holistically by
defining a risk scenario instead of focusing on a single hazard or threat. The determination of an inherent
risk results from evaluating the likelihood of the risk scenario, as well as defining the resulting impact. It
is essential to consider risk mitigation measures, which are already in place when conducting the initial
assessment of the inherent risk. This step does not consider future or potential management measures
as it intends to provide the “as is” situational assessment. The result provides States with information
relevant to determining if the risk scenario lies within its public health management capacity.

The modelling of a risk scenario is the starting point in the process, based upon the existing situational
assessment but considering multi-agency collaboration within the context of the State. A generic
baseline example for such a scenario could be “the risk to be assessed is of an infectious person being
on board an international flight” or “the risk of translocation of the virus through air transport”. The risk
scenario will need to address a State’s view on the most critical aspect of public health management.

23
The process then progresses through different available mitigation measures that affect the overall risk.
It is designed in a way that the efficacy of each mitigation measure can be assessed either qualitatively
or quantitatively.

This technique is often advisable only when the risk is small but may need to be considered in complex risk
scenarios. Risk mitigation is the most appropriate strategy in the context of pandemic risk management
in air transport. In the further conduct of the risk assessment process, it might be necessary to employ
most of the available mitigation measures such as requiring masks, completion of passenger locator
forms, testing, physical distancing, quarantine, etc., at airports and during flights.

With regards to Covid-19 ,vaccination is probably the strongest risk mitigation tool that is effective, with
increasing use globally, but factors such as access to vaccines and vaccine hesitancy is a concern and
it delays the overall response to contain the pandemic. In multi-layered defence models, the various
mitigation measures are depicted as layers (e.g. based on the James Reason Swiss Cheese Model
– see Figure 2-1). Risk-free travel is not possible, but the risk can be reduced through the combined
application of these mitigation measures. Currently, there may be limited scientific peer-reviewed
evidence-based efficacy for these mitigation measures, and the scope of their impact on transforming
the inherent risk is based on expert consensus and available evidence. However, the availability of peer-
reviewed scientific evidence is increasing. As a result, much of the risk assessment is qualitative and, as
such, provides the flexibility to be adopted and integrated into national public health and aviation plans.
The risk assessment process will consider the chosen mitigation measures, and regularly evaluate how
they affect the likelihood and impact of the inherent risk.

Although this risk assessment model was used for Covid-19,the model must be evaluated based on the
mode of transmissions of future disease, prevention, management and other considerations have to be
taken into consideration.

AVIATION MULTILAYERED STRATEGY BASED ON THE JAMES REASON SWISS CHEESE MODEL
Health risks (as related to air transport) can be approached in a similar way to aircraft safety and
must be addressed together. To this end, aeroplane manufacturers, for example, have created end-to-
end risk assessment models which calculate the risk of virus transmission and virus translocation by

24
modelling steps and parameters in the door-to-door, air travel journey. One example leverages an open
data platform, considering a variety of airport, aircraft, personal health and safety considerations, and
different testing and quarantine scenarios. The model covers the complete air travel, from entering the
departure airport to leaving the arrival airport and relying on internal expertise and safety experience.
The model’s objective is to support agencies involved in the management of in making performance-
based, data-substantiated decisions when applying and evaluating risk management principles and
strategies to secure air travel for the flying public.

There are currently different models that compares approaches such as screening ,these should be
considered in the future as they provide an avenue to compare the relative performance of different
screening and quarantine strategies and to determine which approaches may be appropriate for country-
pair-specific travel journeys. It is built as a web-based tool that will provide users a flexible interface
to compare multiple screening options for travel between any two selected countries with available
prevalence data of communicable disease . The inclusion of prevalence data allows for computation of
a “post-screening prevalence” for screened travellers (calculated using the negative predictive value)
in order to compare the starting prevalence of the origin country, the post-screening prevalence for a
variety of screening options, and the prevalence of the destination country. This allows for comparison
of the prevalence among screened travellers to the existing prevalence in the destination country.

One more model is a multi-disciplinary, adaptive, software-based risk management tool designed to
support risk-based decision-making that restores safety, confidence and convenience in commercial
aviation. The model employs a semi-quantitative, deterministic modular approach with group-structured
mixing to demonstrate relative effectiveness of layered disease control measures that protect against
airborne and surface borne disease transmission throughout the end-to-end travel journey in global
transportation systems.

Faced with a fast-evolving communicable disease, the risk assessment process must be regularly
reviewed so that mitigation measures are keeping the risks within the capacity of its public health
system. WHO has developed a suite of health service capacity assessments in the context of the
COVID-19 pandemic to support rapid and accurate assessment of current, surge and future capacities
of health facilities.
Reference: Manual on COVID-19 Cross-border Risk Management 2011

23 BUSINESS
 CONTINUITY PLANS FOR PUBLIC HEALTH
EMERGENCIES IN AVIATION
The objective of developing business continuity plans for public health emergencies in aviation is to
provide guidelines for airlines, airports, air traffic services on how to address the specific issues of a
public health emergency of international concern, such as a pandemic and radiation accident, in a BCP.
Most Airport, Airline and ATC operators already have a BCP, however; the available guidelines from
IATA, ACI, aim at assisting States to review the accepted different steps in a BCP and will suggest where
special input may be required when dealing with a public health emergency of international concern.

The focus and objectives of the BCM framework should be:

■ defining alternatives for continuing critical services;

■ defining organizational priorities and timeframes;
■ reducing adverse impact during crisis; and
■ recovering as many critical processes as possible during the crisis

25
PROCESS
As can be seen in the diagram below, the accepted process is identical for any type of crisis, including
public health emergencies.

Business Business
Risk Recovery Training &
Impact Continuity
Assessment Strategy Testing
Assessment Plan

Airports, Charter, Airline,ANS, other operators must review their guidelines on business continuity plans
based on risk assessment.

NOTE: Detailed Guidelines on Annex IATA, CANSO, ACI, WHO and others

24 VARIOUS
 STAKEHOLDERS IN THE MANAGEMENT OF
PUBLIC HEALTH EVENTS

1. National Department of Transport

2. National Department of Health
3. Civil Aviation Authority
4. Facilitation Committee (DOT)
5. MNORT (DOH)
6. DIRCO
7. HOME AFFAIRS
8. Customs
9. Airport Representatives
10. Airline Representatives
10. Travel Agencies
12. Handling Agents
12. Tourism
14. Academic Institutions
15. Laboratories
16. SAHPRA
17. SANAS
18. Others

26
25 ROLES
 AND RESPONSIBILITIES OF THE NATIONAL
DEPARTMENT OF TRANSPORT

The responsibility includes the establishment of the NATFP, the aim of which is to adopt all practicable
measures to facilitate the movement of aircraft, crews, passengers, cargo, mail and stores, by removing
unnecessary obstacles and delays. The challenge of a NATFP is to address and harmonise the interests
of all entities involved in facilitation, to promote the growth of a safe, reliable and viable air transport
industry, without interfering with legal requirements (e.g. security and safety provisions).

The NATFP is designed to meet the international Standards and Recommended Practices (SARPs)
contained in Annex 9 to the Convention on International Civil Aviation Organization (ICAO), 1944
(Chicago Convention), as well as related aviation facilitation provisions found in other annexes. The
purpose of a NATFP is to implement the mandate imposed on Contracting States by the Chicago
Convention to provide for and facilitate the border-crossing formalities that must be accomplished with
respect to aircraft engaged in international operations and their passengers, crews and cargo.

The Programme also aims to provide a framework to guide the improvement and optimization of aircraft,
crew, passenger and cargo flows through airports and to improve customer service, while maintaining
appropriate security requirements. The NATFP ensures that the national requirements, policies and
procedures covering all relevant provisions of Annex 9 are consistently outlined as specified within
the relevant Regulations in various Departments. The NATFP also ensures that, while committed to
facilitating efficient clearance for arriving and departing aircraft, South Africa shall maintain high-quality
security, effective law enforcement and proficient customer service.

The benefits of the NATFP are:

a) to maintain or increase the quality of aircraft, crew, passenger and cargo flow;
b) to maintain or increase the level of passenger service and the cost-effectiveness and efficiency of
processes and procedures;
c) to facilitate, accommodate and encourage the growth of air transport;
d) to contribute to a positive experience meeting the needs of the travelling public;
e) Strengthening of the role and responsibility of the Facilitation Programme during Public Health
Emergencies is required.

Reference: National Transport Facilitation Document

26  OLES AND RESPONSIBILITIES OF THE NATIONAL AIR

R
TRANSPORT FACILITATION COMMITTEE

The establishment of a National Air Transport Facilitation Committee (NATFC) is mandated by Annex 9
to the Chicago Convention. Its purpose is to coordinate facilitation policy issues and activities between
departments, agencies, and other organizations of the State concerned with, or responsible for, various
aspects of international civil aviation as well as with aircraft and airport operators. The Department
of Transport is the custodian of ICAO Annex 9 (Facilitation). The Committee provides a forum for
consultation and information sharing about facilitation matters amongst Government stakeholders,
Government representatives of other air transport-related communities and the private sector.

NOTE: Detailed Guidelines on Annex NAFT Doc

27
MEMORUNDUM OF UNDERSTANTING BETWEEN NATIONAL DEPARTMENT OF TRANSPORT
AND HEALTH

The South African Civil Aviation Authority is currently the focal point to ensure the drafting and continuous
revision of the Aviation Pandemic Preparedness Plan Policy on behalf of the National Department of
Transport through the Facilitation Committee. Policy formulation continuously takes place through
consultation with the office of the World Health Organization, the National Department of Health (Centre
for Disease Control and Ports Health Directorates) and the aviation industry. Consultation with industry
and the National Department of Health has taken place and a signed Memorandum of Understanding is
in place to ensure that a framework for liaison between National Departments of Transport and Health is
signed by the Director Generals to ensure that the Transport Department comply with the ICAO Annexes
and the Department of Health complies with the WHO International Health Regulations (2005). The
purpose is to ensure effective coordination of policy investigation within their respective responsibilities,
to ensure aviation safety and to minimize the spread of communicable disease by means of air travel.

Under the Memorandum of Understanding, both the DOT and DOH are committed to close co-operation
to minimize duplication of regulatory efforts and to avoid any conflict between regulatory requirements
where both authorities have an interest. This Memorandum of understanding describes the scope of the
SACAA responsibilities, for safety of crew and passengers, and seeks to differentiate the overlapping
safety and health responsibilities of the SACAA Medical Department and the Department of Health.
Interface between the SACAA and DOH may arise in many ways, for example, in the regulation of
safety of aerodromes, training of crew, communication (media) and health and safety of aircrew and
passengers. This will be addressed by discussions at the working level to agree on how the statutory,
and the standards issued under them, should be interpreted in particular circumstances and to determine
ways of reconciling any differences that may arise. Reference to high level of management may be
necessary in some cases.

27 ROLES
 AND RESPONSIBILITIES OF THE NATIONAL
DEPARTMENT OF HEALTH AND TRANSORT DIRECTOR-
GENERALS

During Disaster Management the Director Generals, Ministers and other senior government officials
plays a role in the development of public health emergencies of international concern. It is encouraged to
engage political leadership structures at national and sub-national levels, towards improving collaboration
and public health practices at the Point of Entry and in the Aviation, sector including consultations and
alignment of statements among different partners at regional and national level to reinforce collaboration
and cooperation to achieve the same goal;

As part of the lessons learned from the Covid-19 pandemic ,the outcome of the Africa ICAO -WHO
and Member States concluded that to address the deficiencies noted in several States during the
COVID-19 pandemic such as political, business and government authorities’ interference, neglect and
lack of coordination including relegated esteem to ensure effective CAPSCA program implementation
and relevance should be addressed ,as part of the implementation of this plan, these issues should be
addressed in details to minimize recurrences;

Senior Government Officials both health and aviation are encouraged to document and share best
practices/lessons learned to create institutional memory and guide future interventions and research.
Close working relationship within the CAPSCA framework should be promoted in the use of available
scientific evidence, and harmonization on the implementation of travel measures.

28
The Director-General Health must;

a) Identify a competent authority in line with the WHO International Health Regulations (2005), who
shall be responsible for the implementation of health measures in points of entry under these
Regulations;
b) the competent authority referred to above shall be an employee of the National Department of
Health or any other person authorized by the Director-General;
c) assess and develop core public health capacities in points of entry as required by the International
Health Regulations (IHR) 2005;
d) ensure points of entry are compliant with the requirements of the IHR (2005);
e) designate and ensure the functioning of the National IHR Focal Point;
f send to the World Health Organisation a list of ports authorized to offer:
i. the issuance of Ship Sanitation Control Certificates,
ii. the issuance of Ship Sanitation Control Exemption Certificates only,
iii. extension of the Ship Sanitation Control Exemption Certificates for a period of one month until
the arrival of the ship in the port at which the Certificate may be received;
g) communicate changes to the status of ports referred to in the above sub-regulation to the WHO.

The Director-General Transport must;

a) Identify together with the SACAA appoint a Focal Person for the ICAO -WHO Collaborative
Arrangement for the Prevention and Management of Public Health Events in Civil Aviation in line
with ICAO Annex 9;
b) The DG in consultation with the SACAA must ensure that there is valid MOU between the National
Department of Health and Department of Transport to meet the ICAO Annexes and WHO
International Health Regulations;
c) The DG of Transport in consultation with the Facilitation Committee and the SACAA must ensure
that the Aviation Pandemic Preparedness Plan is in place and accommodate all the stakeholders
in involved in public health mitigation measures;
d) The DG and the SACAA must ensure that there are current regulation to meet ICAO Annexes.

NOTE: Detailed Guidelines on Annex International Health Regulations (2005)

28 FUNCTIONS
 OF A PORT HEALTH OFFICER (COMPETENT
AUTHORITY) IN AVIATION

A Port Health Official is responsible for, but not limited to, the following:

a) Monitoring baggage, cargo, containers, conveyances, goods, postal parcels and human remains
departing and arriving from affected areas, so that they are maintained in such a condition that
they are free of sources of infection or contamination, including vectors and reservoirs;
b) Ensuring, as far as practicable, that facilities used by travellers at points of entry are maintained
in a sanitary condition and are kept free of sources of infection or contamination, including vectors
and reservoirs;

29
c) The supervision of any derating, disinfection or decontamination of baggage, cargo, containers,
conveyances, goods, postal parcels and human remains or sanitary measures for persons, as
appropriate under these Regulations;
d) Advising conveyance operators, as far in advance as possible, of their intent to apply control
measures to a conveyance, and shall provide, where available, written information concerning the
methods to be employed;
e) The supervision of the removal and safe disposal of any contaminated water or food, human or
animal ejecta, waste water and any other contaminated matter from a conveyance;
f) Taking all practicable measures consistent with these Regulations to monitor and control the
discharge by ships of sewage, refuse, ballast water and any other potentially disease-causing
matter which might contaminate the waters of a port, river, canal, lake or other international
waterway;
g) Supervision of service providers for services concerning travellers, baggage, cargo, containers,
conveyances, goods, postal parcels and human remains at points of entry, including the conduct
of inspections and medical examinations as necessary;
h) Effective contingency arrangements to deal with an unexpected public health event and contact
tracing; and
i) Communication with the National IHR Focal Point on the relevant public health measures taken
pursuant to these Regulations and the IHR (2005).

Reference: WHO International Health Regulations (2005)

29  OLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN

R
CIVIL AVIATION AUTHORITY

a) Consultation and drafting of regulations in compliance with ICAO Annexes 6,9,11 (PANS ATM),14
18,19 and others) and guidelines;
b) Coordinate training of the aviation and health sector to ensure compliance to WHO-IHR (2005)
and ICAO Annexes and Article 14;
c) Provide Aviation Public Health Technical Support to the DOT Facilitation Committee, ICAO
Regional office and SADC where State Assistance is required;
d) Develop and review the Aviation Pandemic Preparedness Plan in consultation with the aviation,
health and other sectors;
e) Approve public health procedures applicable to the aviation operators;
f) Conduct audits and monitor compliance to public health measures;
g) Ensure collaboration between the aviation authority, aviation medical examiners, aviation medical
assessors, other healthcare professionals, peer support groups and aviation personnel to support
the mental health and well-being for all aviation personnel;
h) Provide appropriate guidance and support to aviation medical examiners to manage the impact
of communicable diseases of internal concern on mental health and well-being in a consistent
manner;
i) Encourage stakeholders to make available appropriate resources and tools to minimize the mental
health impact of communicable diseases of internal concern, including peer support programmes,
by referring to ICAO guidance and other relevant support material;

30
j) Communicate on a regular basis to all stakeholders the means to maintain licensing and proficiency
to enable safe performance of duties;
k) Conduct training on public health issues to aviation and health sector;
l) Provide Public Education through media of regulations and public health measures to passengers;
and
m) Other public health measures in aviation.

30 ROLES
 AND RESPONSIBILITIES OF A DESIGNATED
AIRPORT

In terms of the CAR, 2011 a designated airport operator of an aerodrome intended for public use with
scheduled commercial operations shall be in possession of a valid aerodrome licence issued subject to
compliance with safety and public health regulatory requirements.

Responsibilities of a designated airport operator:

a) A designated airport operator shall be responsible for developing an airports public health plan that
will include among others conducting risk health assessment, prevention, managing in consultation
with airport stakeholders. This responsibility may be delegated to an airport stakeholder or a
person with equivalent status. A designated airport operator shall ensure designation of an aviation
public health person responsible for development and implementation of the airport public health
programme;
b) The airport operator shall establish, implement, and maintain a written Airport Aviation Pandemic
Preparedness Plan to meet the requirement of the National Aviation Pandemic Preparedness Plan
and CAR, 2011;
c) A written plan for enhanced cleaning and disinfection should be agreed upon by the airport health
authority, airport operators and service providers, according to the standard operating procedures
outlined in the WHO Guide to Hygiene and Sanitation in Aviation;
d) All cleaning and disinfection staff should be made aware of the cleaning and disinfection plan. It is
necessary to ensure staff are using products effectively, including the concentration, method and
contact time of disinfectants, and addressing areas that are frequently touched and most likely to
be contaminated, such as:
i. Airport information desks, passengers with reduced mobility (PRM) desks, check-in areas,
immigration/customs areas, security screening areas, boarding areas, etc.
ii. Escalators, elevators and lifts, handrails.
iii. Washrooms, toilets and baby changing areas.
iv. Luggage trolleys and collection points: cleaned with dispensable wet wipes or disinfectants,
ensuring that disposal bins are made available.
v. Seats prior to security screening and in boarding/check-in areas.
vi. Parking shuttle buses and airside buses.
e) Employees should be equipped with PPE based on the risk of exposure (e.g. type of activity) and
the transmission dynamics (e.g. droplet spread). PPE could include disposable gloves, masks,
goggles or face shields, and gowns or aprons. For staff and teams working shifts, handovers
should be conducted in a contact-free manner, i.e. via telephone, videoconference, electronic
logs, or at least through physical distancing;

31
f) Maintenance and repair work in public areas should be prioritized and their schedule adjusted
or postponed if it is non-essential. Staff training should maximize the use of online training and
virtual classrooms. The use of physical separators between selected staff and passengers is
recommended in areas of repeated exchanges and transactions;
g) A designated airport operator shall arrange supporting resources and facilities required for aviation
public health services and ensure that the public health plans are tested through at regular intervals
using desk, partial and full-scale simulation exercises;
h) Risk assessment should be conducted for airport terminal access by passengers which may
be restricted to workers, passengers and persons accompanying passengers with disabilities,
reduced mobility or unaccompanied minors in an initial phase, as long as it does not create crowds
and queues, which would enhance risks of transmission as well as create a potential security
vulnerability;
i) Airport measures to control access to the security screening checkpoint may need to be considered,
as well as possible modifications to standard screening, in order to comply with new public health
sanitary guidelines;
j) Depending on the public health requirements, airport authorities may have to provide hand
sanitizers and disinfection products prior to the expected time of their use by passengers and
staff at screening access points. Screeners and passengers should maintain physical distancing
to the extent possible or wear the appropriate PPE to mitigate the risk of exposure. Rearranging
of security checkpoint accesses and layouts should be considered with the objective of reducing
crowds and queues, to the extent possible, and maintaining physical distance while maintaining
desirable throughput;
k) Where social distancing is required, floor-markings, tensile barriers, or other suitable means should
be established within the queueing area to help secure the proper distancing recommended by the
appropriate authorities. Procedures involving passengers presenting boarding passes and other
travel documents to security personnel should be performed, to the extent possible, while avoiding
physical contact and in a way that minimizes face-to-face interaction;
l) Directing passengers to use automatic boarding pass scanners at access points while maintaining
appropriate physical distance, using mobile boarding pass scanners operated by the security staff.
Conducting a visual inspection of the boarding pass and relevant identification documentation, as
needed by standard operating procedures;
m) Following a major outbreak, at the early stages of the restart phase, carry-on baggage that would
need to use the overhead bins should be limited to facilitate a smooth boarding process;
n) Electromechanical equipment such as boarding bridges, escalators and elevators must be
inspected and periodically tested or started up. Inspections of such decommissioned equipment
are essential before returning them to service for passenger use, based on manufacturers’
recommendations and national building codes. Maintenance protocols need to be defined and
deployed and where conditioned air is needed, power should be maintained in all outdoor-based
equipment such as jetways and pre-conditioned air units;
o) Where external pre-conditioned air (PCA) and fixed electrical ground power are available at the
stand, an aircraft can switch off its auxiliary power unit (APU) after arrival. A PCA system takes in
ambient air through an intake filter and provides conditioned air to the cabin. External air sources
are not processed through the aircraft’s high-efficiency particulate air (HEPA) filter. The aircraft
APU should be permitted to be used at the gate to enable the aircraft’s air conditioning system to
be operated if equivalent air quality from PCA is not available;
p) Protocols and precautions need to be in place for arriving passengers who are exiting the landside
area. Consideration should be given to the greeter’s area as well as the terminal’s exit area;

32
q) Airport operators must ensure increased use of air conditioning and effective filtration systems to
keep air clean, reduce re-circulation and increase the fresh-air ratio. Horizontal airflows should be
limited, and regular maintenance procedure of the ventilation system must be part of the airport’s
procedure submitted to the Authority;
r) Self-sanitizing technology may also be considered for integration within kiosks with touch screens,
to allow for the disinfection of the screens between each use. Whenever possible, airport and other
stakeholders should use contactless processes and technology, including contactless biometrics
such as facial or iris recognition. Such digital identification processes can be applied to self-service
bag drops, various queue accesses, boarding gates and retail and duty-free outlets;
s) Automated gates and mobile scanners’ reader surfaces should be disinfected with the same
frequency as for any other high-touch surface;
t) An orderly boarding process will be necessary to reduce physical contact between passengers,
especially once load-factors start increasing and close cooperation between the airline, airport and
government is vital during public health emergencies to mitigate public health risk.

The airport operator must ensure that the following measures are implemented to minimize risk of the
spread of communicable disease:
■ Automated door systems and automatic toilet flushing system;
■ Taps and soap/hand sanitizer dispensers; and
■ Automated hand- towel dispensers.
■ Other measures

Governments should ensure that the customs clearance process is as speedy as possible and that
appropriate measures are taken in case of physical baggage inspections;

Cleaning schedules should be aligned based on flight schedules to ensure a more frequent, in-depth
disinfection of luggage carts, washrooms, elevator buttons, rails, etc.

Reference: Preventing Spread of Corona Virus Disease (Covid-19), Guidelines for local and
International Airports and ICAO CART 3

31 ROLES
 AND RESPONSIBILITIES OF THE EMERGENCY
OPERATION CENTRE

a) The Emergency Operation Centre (EOC) has ensured that there is a flow chart to initiate the
aviation emergency response plan process;
b) The command-and-control system has to be established for management of a public health
event on the day, and Public Health Authority Personnel have to participate in development of the
aviation preparedness plan together with other airport stakeholders;
c) The EOC plan has to form part of the procedures submitted to the Authority for approval.

32 ROLES AND
 RESPONSIBILITIES OF BAGGAGE AND CARGO
HANDLING DURING PUBLIC HEALTH EMERGENCIES

Responsibilities of the Ground Handling Service Providers. The ground handling service provider
shall develop a ground handling operation manual, which shall meet the national requirements. The
developed manual shall be submitted to the Authority for approval.

33
a) All efforts need to be made to provide a speedy baggage claim process and ensure that passengers
are not made to wait for excessive amounts of time in the baggage claim area;
b) Maximize use of available arrival baggage carousels to limit the gathering of passengers, and,
where possible, use of dedicated baggage carousels for flights from high risk areas;
c) Cleaning schedules should be aligned based on flight schedules to ensure a more frequent, in-
depth disinfection of luggage carts, washrooms, elevator buttons, rails, etc;
d) Self-service kiosks or online options for passengers needing to report lost or damaged luggage
should be made available;
e) The use of baggage delivery services, where the passenger’s baggage can be delivered directly
to their hotel or home, should be encouraged.

PARKING POSITION OF AIRCRAFT CARRYING SUSPECTED CASE OF COMMUNICABLE

DISEASE

The pilot- in-command (PIC) needs to be advised where to park the aircraft. Such information will
normally be communicated to the PIC by air traffic control. This may be on a remote stand, or, depending
on the situation, on the apron with or without an air bridge attached. It should be noted that parking an
aircraft a distance away from the terminal building is likely to delay the public health assessment of the
situation and may make passenger handling more complicated. There is no evidence to suggest that the
public health risk is greater if the aircraft is parked adjacent to the terminal, with an air bridge or steps
used for disembarkation. In principle, the aircraft arrival should be managed by a system that is as close
to routine as possible, but is close also to an isolation medical room, public health facility, and a parking
accessible to ambulances. The airport plans should, ideally, have a pre-designated parking bay for the
aircraft with a suspected case of communicable disease on board.

Aircrew and ground crew need to be advised concerning the opening of aircraft doors, disembarkation
and the information to be given to travellers prior to the arrival of the medical team. Action should be
taken to disembark the travellers as soon as possible after the situation has been evaluated and a public
health response has been instituted, if needed.

33 ROLES
 AND RESPONSIBILITIES OF THE SECURITY
SCREENING DURING PUBLIC HEALTH EVENTS

a) Appropriate procedures should be implemented in coordination with relevant government

departments in order to respond to any passengers showing signs of illness;
b) Hand sanitizers and disinfection products should be provided prior to passengers and staff
screening access points where possible;
c) Screeners and passengers should maintain physical distancing to the extent possible or wear the
appropriate PPE to mitigate the risk of exposure;
d) Rearranging of security checkpoint accesses and layouts should be considered with the objective
of reducing crowds and queues, to the extent possible, and maintaining physical distance while
maintaining desirable throughput. This should include both divestment areas and those areas
where passengers retrieve their screened cabin baggage.

34
Procedures involving passengers presenting boarding passes and other travel documents to security
personnel should be done, to the extent possible, while avoiding physical contact and in a way that
minimizes face-to-face interaction. Should there be a need to identify a person wearing a non-medical
or medical mask against a government-issued photo identification, the non-medical or medical mask
could be removed temporarily if physical distancing measures are met. Appropriate signage should be
deployed that clearly informs about subsequent steps of the process. Possible solutions include:

a) Directing passengers to use automatic boarding pass scanners at access points while maintaining
appropriate physical distance;
b) Using mobile boarding pass scanners operated by the security staff;
c) Conducting a visual inspection of the boarding pass and relevant identification documentation, as
needed by standard operating procedure;
d) Automated gates and mobile scanners’ reader surfaces should be disinfected with the same
frequency as for any other high-touch surface;
e) Gate areas, VIP lounges and other services in this area also see a high passenger volume and
various flow monitoring tools, physical installations, floor markings and adapted wayfinding need
to be evaluated and deployed;
f) Enhanced cleaning and hygiene measures may need to be scheduled and deployed to contribute
to the limiting of the virus spread.

AIRPORT TENANT RESPONSIBILITIES

An airport tenant is responsible for:

a) Ensuring the establishment of their own public health procedures and submitting them to the
airport operator who will ensure approval by the Authority;
b) Airport tenants must attend public health meetings and must train and participate in simulation
exercises to ensure that they understand their role during an emergency.

NOTE: Detailed Guidelines on Annex ICAO CART

RESPONSIBILITIES OF AIRLINES AND CHARTER OPERATORS

a) In terms of Part 121 CAR 2011, an air carrier shall not operate an aircraft unless such operator
is the holder of a valid AOC and complies with the conditions of an AOC including the operations
specifications attached thereto and an air services licence issued in terms of the Air Services
Licensing Act, 1990 (No.115 of 1990), or the International Air Services Act, 1993 (No. 60 of 1993).
Aircraft Operator’s responsibilities;
b) An air carrier registered in the Republic providing international service [commercial air transport
operation] in or from the Republic and domestic commercial air transport operators, shall develop,
implement, and maintain a written Aircraft Operator’s Public Health SOP which meets the
requirements of the Aviation Pandemic Preparedness Plan and CAR, 2011. A copy of the air
carrier operator’s public health plan shall be submitted to the Authority, for approval in accordance
with the CAR, 2011;
c) An AOSP shall specify the measures, procedures and practices to be followed by the operator
to protect passengers, crew, ground personnel, aircraft and facilities from suspected cases of
communicable diseases These will include but are not limited to identification of suspected cases
prior to boarding, management on board an aircraft and those in transit;

35
d) In the case of a passenger suspected of having a communicable illness, a crew member is to
be designated to care for the passenger. That crew member must don the Person Protective
Equipment provided in the UPK before engaging in close contact with the ill passenger. The
ill passenger should be fitted with a medical mask and provided with appropriate assistance.
Separate the ill person from the other passengers by a minimum of 1 metre. Where possible, this
should be done by moving other passengers away. Depending on cabin design, 1 metre is usually
two seats left empty in all directions. If possible, assign one toilet for use only by the ill passenger.
The designated crew member(s) should comply with decontamination procedures established by
the operator before resuming other duties;
e) A passenger who develops symptoms in-flight should be assessed by the local public health
authorities after landing and prior to disembarking the aircraft following national protocols;
f) Safety demonstration equipment should not be shared to the extent feasible to reduce the
likelihood of virus transmission. If it must be shared, alternate means of demonstration without the
equipment should be considered or the equipment should be thoroughly sanitized between use.
Each operator must develop a procedure for cardiac arrest based on risk assessment and mode
of transmission; An air carrier shall make an application to the Authority for the designation of an
official responsible for the implementation of the public health plan;
g) Public Health requirements for scheduled foreign air operations;
h) A foreign air operator providing scheduled international commercial air transport operation in the
Republic shall establish, implement and maintain a written supplementary station procedure that
meets the national public health requirement. The developed procedure shall be submitted to the
Authority for approval;
i) A foreign air operator providing scheduled international commercial air transport operation in
the Republic shall appoint an official responsible for the establishment, implementation, and
maintenance of a written supplementary station procedure;
j) The following procedures for infection control need to be in place: crew rest compartments, training
devices, use of lavatories, universal precaution kits, accommodation, management of suspected
cases, food and beverage service; limit interaction on board, luggage checked-in except small
hand luggage, newspapers and magazines; food and beverage, seat assignment processes, and
others must in place;
k) An appointed foreign air operator providing scheduled international commercial air transport
operation in the Republic shall appoint an official responsible for the establishment, implementation,
and maintenance of a written supplementary station procedure and participate in public health
training, simulation exercises and workshops organized by the health and aviation regulators;
l) Essentially, upon arrival at the airport, in addition to having a designated parking point for the
arriving aircraft and the airport health service provider, public health officers need to have quick
and efficient access to the aircraft, using appropriate personal protective equipment (PPE) and
hand hygiene supplies. For many communicable diseases, disposable gloves and good hand
hygiene (at times in combination with surgical masks) are sufficient unless otherwise specified by
the public health authority;
m) An ill traveller should be taken by a medical escort from the aircraft to an area suitable for further
assessment/treatment. Appropriate infection control measures should be applied;
n) A traveller having a communicable respiratory disease should wear a mask unless the traveller is
unable to tolerate it. If a mask is worn consistently by the ill traveller this precludes the need for
others to wear a mask. All disposable materials in potential contact with an ill traveller need to be
removed using biohazard precautions;

36
o) Before the disembarkation, travellers and crew on the same aircraft as the ill traveller should remain
segregated from other travellers until traveller seating details, contact details and destination
have been obtained and they have been advised by public health authority staff of any necessary
preventive measures. If contact tracing is deemed necessary, the Passenger Locator Form
(PLF) as depicted in Annex is recommended. In the current recommendations, contact tracing is
normally done for those travellers seated in the same row and two rows in front and behind the
index suspected case;
p) There should be a designated area in the airport that will allow privacy, good ambient light,
ventilation, easy cleaning, access to designated toilet facilities, crew rest compartments and
telecommunications for the assessment where necessary of small groups of suspect travellers.
This designated area should cater for the assessment and management of various categories of
fellow travellers (e.g. family members, others in travel group, those sitting near to the ill person,
entire aircraft) should the need arise due to the suspected illness of the ill traveller, until given
public health clearance;
q) Charter and Airline public health procedures and business continuity plans of the management of
suspected cases of communicable diseases have to be current and submitted to the Authority for
approval and have to form part of the national and airport contingency plans;
r) Air Operators involved in repatriation of human remains must ensure that regulations from DOH
and guidelines from the Authority are complied with prior to repatriation. [The repatriation of
human remains is a process whereby human remains are transported from a State where death
occurred to another State for burial.] Most airlines offer services for the transportation of cremated
and non-cremated human remains, but they require cooperation and coordination of various
stakeholders (Department of Health and others) to ensure that the process is conducted efficiently
and in compliance with relevant international regulations and national rules of the departure and
destination States;
s) Operators must develop procedures for crew members who are involved in flights with a layover
during public health emergencies of international concerns. These procedures should consider
issues such as crew medically quarantined or detained for observations while on layover or after
returning due to exposure or known symptomatic passenger or crew member on board or during
the layover;
t) If crews need to layover or transit at an outstation, air operators should ensure compliance
with relevant public health regulations and policies together with measures identified by a risk
assessment conducted by the operator that takes account of specific local conditions;
u) Operators must conduct a risk assessment and develop procedure for crew arrangement who may
need to commute arrangements (between airport and hotel, if needed): The air operator should
arrange for the commute between the aircraft and the crew’s individual hotel rooms ensuring that
hygiene measures are applied and that the recommended physical distancing, including within the
vehicle, is observed to the extent possible;
v) Cargo flight crews should apply the same health and safety considerations as passenger flight crews
and are collectively included in the crew section of this document. Whilst air cargo consignments
do not come into contact with the travelling public, the cargo acceptance and handover process
does include interaction with non-airport employees. The cargo module addresses aviation public
health including physical distancing, personal sanitation, protective barriers for points of transfer
to the ramp and the loading and unloading, and other mitigation procedures; and
w) Cleaning procedures and other public health measures must consider highly populated areas
such as Possible routes of infection before boarding the aircraft include: En-route to the airport by
public transport, In line at the check-in counter, waiting in the gate area, access to the aircraft via
“jetways” or transport to the aircraft by bus and other crowded and confined spaces.

Reference: DOT -Guideline Prevention and Control Measures for Airline Transportation,
Disinfection of Cargo and Disembarkation of buses & ICAO CART 3 Document

37
 AIRPORT STAFF REQUIREMENTS DURING AN OUTBREAK OF COMMUNICABLE DISEASE

Any airport worker who has been exposed to the prevailing PHEIC through a family member at home
will not report for work until the defined incubation period (to be defined by public health authority) is
over. If during the incubation period the worker falls ill, he/she will be treated and will not report for
work until full recovery and/or the requisite time recommended by the national health authority has
elapsed. If diagnosed with the prevailing PHEIC, he/she will be treated and will not report for work until
full recovery and/or the requisite time recommended by the State health authority has elapsed. Airport
workers entering the transit area (sterile airside area) will be subject to screening prior to entry to the
airside and any suspected case will be referred for secondary screening.

Detailed Guidelines on Annex ICAO CART

GROUND HANDLING SERVICE PROVIDERS

Air carrier handling agents represent the starting point for passenger facilitation since it is their job to
process departing passengers. Public health procedures for handling agents shall include, but are
not limited to, identification of suspected cases of communicable diseases at check-in counters and
reporting the matter to superiors and ports health/public health professional when there is a need.

a) Expansion stanchions may be needed to allow for broader spacing of passengers at check in
areas, moving of portable boarding scanners for passengers to scan boarding cards, toward
avoiding the need for personnel to avoid handle boarding cards, and increased frequency to wipe
down arm rests, seats, and backs of wheelchairs are other probable requirements and must be
provided for;
b) If the handling agents are employed by contractors, they shall be provided with written public health
procedures for the measures for which they are responsible. Contractors shall be able to prove that
their agents are adequately trained in the public health mitigation measures aspects of their duties;
c) Procedures on the disinfection of equipment such as wheelchairs, social distancing on airport
busses must be approved by the Authority. All check-in counter staff should be trained so that
they are able to identify travellers who may have a communicable disease of public health concern,
or alternatively a checklist can be provided to the staff to assist in identifying such travellers;
d) This checklist can be in the form of a list of symptoms and the site of the outbreak. Any traveller
responding positively to the checklist can be sent for secondary screening by public health
authorities prior to completion of the check-in;
e) Check-in staff shall have access to appropriate personal protective equipment (PPE) and;
f) hand hygiene supplies. For many communicable diseases, disposable gloves and good hand
hygiene (at times in combination with surgical masks) are sufficient unless otherwise specified by
the public health authority. Ground handling agents will also develop a business continuity plan
for their staff in case there is shortage caused by the outbreak. Ground handling agents shall
retrieve the baggage of the passenger (and that of any accompanying person/s), ensure customs
clearance and ferry the baggage to the ambulance pick-up point;
g) There is no evidence to support the cleaning and/or disinfecting of baggage including items arriving
from areas where a communicable disease has been reported. This would include the checked
bags of a suspect case of communicable disease on board a flight;
h) When an aircraft arrives with a possible passenger with communicable disease or with an affected
passenger and Ramp Buses are required, assess the situation beforehand: Provide and identify a
limited number of buses for that service, use the same buses for the whole disembarkation service
and disinfect once the process is finalized. Limit the number of passengers in the bus.

Detailed Guidelines on Annex ICAO CART

38
 ROLE OF OPERATORS DISINFECTION OF THE AIRCRAFT

a) A procedure must be developed and approved by the Authority and the Department of Health for
the disinfection of the various area of the aircraft to mitigate the spread of communicable disease
to provide a safe, sanitary operating environment for passengers, crew and ground staff;
b) The cabin should be cleaned and then disinfected at an appropriate frequency to accommodate
safe operations for the passengers and crew and the frequency should account for the operation
of the aircraft and the potential exposure of the cabin to an infected person;
c) Disinfection methods should be adopted in consultation with the aircraft manufacturer and
based on an appropriate safety risk assessment and the risk assessment should be informed by
recommendations from airframe manufacturers and reference instructions from appropriate health
organizations on application to be effective against viruses and advice should be obtained from
WHO, ICAO, IATA and Aircraft Manufactures;
d) Periodic equipment inspection to detect long-term effects or damage given the lack of data
on the long-term effects of much more frequent application of disinfectants and to contacting
manufactures for guidance on alternate disinfectants should damage be observed;
e) Following their instructions for ensuring proper application, ventilation and use of personal
protection equipment;
f) Airlines should review their operating procedures to minimize the number of personnel who need
to contact high-touch surfaces such as access panels, door handles, switches during outbreaks to
ensure appropriate disinfection take place;
g) The cargo and compartment touch surfaces should be cleaned and disinfected at an appropriate
frequency to accommodate safe operations for the ground staff;
h) Care should be taken as IPA is flammable, so precautions should be taken around potential
sources of ignition and pay particular attention to hidden ignition sources as many aircraft have
electronic boxes mounted in the cargo compartment; and
i) Airlines should be mindful of regular maintenance to both air systems and water systems to ensure
they continue to protect the passenger and crew from viruses.

BAGGAGE AND CARGO HANDLING DURING PUBLIC MEALTH EMERGENCIES

Responsibilities of the Ground Handling Service Providers. The ground handling service provider
shall develop a ground handling operation manual, which shall meet the national requirements. The
developed manual shall be submitted to the Authority for approval.

a) All efforts need to be made to provide a speedy baggage claim process and ensure that passengers
are not made to wait for excessive amounts of time in the baggage claim area;
b) Maximize use of available arrival baggage carousels to limit the gathering of passengers, and,
where possible, use of dedicated baggage carousels for flights from high risk areas;
c) Cleaning schedules should be aligned based on flight schedules to ensure a more frequent, in-
depth disinfection of luggage carts, washrooms, elevator buttons, rails, etc;
d) Self-service kiosks or online options for passengers needing to report lost or damaged luggage
should be made available; and
e) The use of baggage delivery services, where the passenger’s baggage can be delivered directly
to their hotel or home, should be encouraged;

39
f) Protect cargo handling staff and truckers during the handover points for physical freight (in
warehouse) and documentation;
g) Airlines should establish maintenance procedures to be applied after disinfection procedures
in order to check the Flight Deck, Passenger Cabin and Cargo Compartment for the correct
positioning of control handle, circuit breakers and control panels’ switches and knobs. Access
panels and doors’ closure also should be checked.

Detailed Guidelines on Annex ICAO CART AND IATA

RECCOMENDATIONS FOR AIR SYSTEM OPERATIONS DURING PUBLIC HEALTH

EMERGENCIES

Risk assessment should be conducted by the operator considering a mode of transmission of the
disease and other factors.

a) The aircraft manufacturers recommend maximizing total cabin airflow and care should be taken
to avoid blocking air vents (particularly along the floor). These are general recommendations for
cabin air considerations and there may be exceptions for specific aircraft models. It is strongly
recommended that operators consult with the aircraft OEM for questions specific to an aircraft
type;
b) Operations without the air conditioning packs or external pre-conditioned air (PCA) source should
be avoided and external air sources are not processed through a high-efficiency particulate air
(HEPA) filter especially when the mode of transmission is respiratory (droplet or airborne;
c) Operators must consider using of the aircraft APU should be permitted at the gate to enable the
aircraft’s air conditioning system to be operated, if equivalent filtration from PCA is not available;
d) If the aircraft has an air recirculation system, but does not have HEPA filters installed, reference
should be made to OEM published documents or the OEM should be contacted to determine the
recirculation system setting;
e) It is recommended that fresh air and recirculation systems be operated to exchange the volume of
cabin air before boarding considering the following:
i. For aircraft with air conditioning, run the air conditioning packs (with bleed air provided by APU
or engines) or supply air via external PCA source at least 10 minutes prior to the boarding
process, throughout boarding and during disembarkation;
ii. For aircraft with HEPA filters, run the recirculation system to maximize flow through the filters;
iii. For aircraft without an air conditioning system, keep aircraft doors open during turnaround
time to facilitate cabin air exchange (passengers’ door, service door and cargo door

Detailed Guidelines on Annex ICAO CART AND IATA

34

 OLES AND RESPONSIBILITIES OF CATERING SERVICES
R
DURING PUBLIC HEALTH EMERGENCIES

a) A procedure and training is required on how the loading and offloading of catering trolleys should
be done when a public health event of international concern is handled. These should include but
are not limited to dealing with catering equipment used during flight. The processes for cleaning
/ disposal of cutlery / crockery / glassware as well as the cleaning of catering carts in case of
suspected communicable disease should be defined;

40
b) The precautions that catering staff should take to avoid contamination during catering handover
to cabin crew and any special procedures that should be adhered to in when securing or sealing
catering trolleys need to be outlined and explained. It is necessary to strictly use only disposable
utensils for cutlery and dinnerware and any additional PPE for catering staff;
c) For potable water truck tanks, Handling Agents must refer to the applicable guidelines from WHO
IATA, Airport Handling Manual (AHM 440) and others during a public health event of international
concern and ensure the following: a. Try to rotate the potable water trucks (based on a timescale
that does not require the full scale taking into service procedures) or downscale operations by
keeping only certain trucks in service while taking others OOU;
d) Potable water trucks’ water tanks shall be kept empty and dried as much possible. The level
indicators, if installed, shall be removed to be cleaned and dried and shall be kept dried in place;
e) If stored filled, the tank shall be filled with water to maximum, leaving no space for possibility of
growth of microbes;
f) The water shall be dosed with adequate chlorine, chlorine dioxide or hydrogen dioxide. Lavatory
unit tanks should be emptied, cleaned and left to air dry with hatch left partially open but covered to
prevent ingress of any foreign objects. A company shall not provide for catering stores or supplies
unless approved and designated by the Director of the Authority. An approved public health
procedure must document.

Detailed Guidelines on Annex IATA, Airport Handling Manual (AHM 440 and WHO)

35 ROLES
 AND RESPONSIBILITIES OF THE AIR TRAFFIC AND
NAVIGATION SERVICES (ATNS)

The Air Traffic and Navigation Services (ATNS) Company of South Africa provide for air traffic
management, navigation, training, and associated services within the Republic.

Air traffic control centres are responsible for notifying the airports when there is a suspected case on
board an aircraft and to direct the aircraft to a designated parking. The communication procedure and
business continuity procedure of the air traffic control centre must be current and submitted to the
Authority for approval. Such procedures must form part of the national and airport contingency plans.
Any air traffic controller with symptoms (indicate list of symptoms) and/or fever will not report for work
but will proceed to his/her doctor. If diagnosed with the prevailing PHEIC, he/she will be treated and will
not report for work until full recovery and/or the requisite time has elapsed recommended by the national
health department depending on the alert stage based on WHO.

a) The purpose of this document is to examine human resource and operational and safety
considerations for the Air Navigation Service Provider (ANSPs) to ensure that public health
procedures are revised and submitted to the Authority for approval;
b) Traffic Management never shuts down throughout public health crises as they keep airspace
open for repatriation flights, cargo and other essential traffic while simultaneously implementing
measures to protect essential staff and ensure operational continuity;
c) The reduction of traffic levels due to public health emergencies results in reduction in staffing
necessary to manage the operation. This brings many latent safety risks to the surface, such as
monotony, boredom and reduced vigilance;

41
d) Despite the high level of automation of the main functions for the provision of ATS, the human
element continues to be the link that allows interaction of the different systems, directing their
operation. In this sense, the vulnerability of the human element to the contagion raises the need to
protect the integrity of personnel both in the work environment and in the context of their interaction
with daily life;
e) Ensure basic risk management procedures are implemented and adequately discussed,
considering basic staff requirements to support the ANS;
f) Operators must establish and implement enhanced cleaning and disinfection procedures for all
ANS facilities, including door handles, handrails, surfaces (e.g. desks, tables and armrests) and
objects (e.g. telephones, keyboards);
g) The use of personal communication adapters (headsets or microphones) can significantly increase
the possibility of contagion, and therefore such items should be disinfected before and after use,
and properly stored;
h) The operator must ensure combined communication measures are in line with guidance from
occupational health and safety officers and other relevant stakeholders;
i) ANSPs should consider whether training, including simulation practice, is necessary, particularly
with respect to the least common situations (including unusual runway configurations) and high
demand to address the following: rosters to maintain balance, refresher training to maintain
awareness, online live virtual teaching or computer-based self-study modules and personnel
proficiency;
j) Mental health issues of staff need to be monitored and Wellness and Peer Support strengthened;
k) Operators must establish and implement enhanced cleaning and disinfection procedures for
communication equipment (headset, microphones, phones, others) as well as equipment such as
voice communication systems (VCCS or handset radios) and consoles;
l) The Air Traffic and Navigation Services (ATNS) Company of South Africa provide for air traffic
management, navigation, training, and associated services within the Republic. Air traffic control
centres are responsible for notifying airports when there is a suspected case on board an aircraft
and to direct the aircraft to a designated parking area;
m) Communication procedures and business continuity procedures of the air traffic control centre
need to be current and submitted to the Authority for approval and to form part of the national and
airport contingency plans;
n) Any air traffic controller with symptoms of communicable diseases/infectious disease must not
report for work but will proceed to his/her doctor;
o) The operator must continually conduct risk assessment and amend public health procedures and
business continuity plans for submission to the Authority.

Detailed Guidelines on Annex ICAO CART

ROLE OF OPERATORS FOR CREW WHO LAYOVER DURING PUBLIC HEALTH

EMERGENCIES

Operators must have procedure for all crew that need to layover or transit at an outstation are aware of
the measures necessary to reduce the risk of transmission of public health emergencies of international
concern, risks assessment must be conducted on the mode of transmission ,severity in terms of mortality
and morbidity and the following must be complied with:

42
a) If crews need to layover or transit at an outstation, air operators should ensure compliance
with relevant public health regulations and policies together with measures identified by a risk
assessment conducted by the operator that takes account of specific local conditions;
b) The air operator should arrange for the commute between the aircraft and the crew’s individual
hotel rooms ensuring hygiene measures are applied and the recommended physical distancing,
including within the vehicle, to the extent possible;
c) At all times, the crew must comply with relevant public health regulations and policies and here
should be one crew member per room, which is sanitized prior to occupancy depending on the
public health requirements and risk assessment; and
d) Crew members experiencing symptoms suggestive of infectious disease during layover or transit
should report it to the aircraft operator and seek assistance from a medical doctor for assessment.

Detailed Guidelines on CART,WHO Local Health & Transport/CAA Regulations

36 ROLES
 AND RESPONSIBILITIES OF IMMIGRATION
OFFICERS DURING PUBLIC HEALTH EMERGENCIES

a) Procedures for border control and customs processes may need to be temporarily revised to
increase physical distancing;
b) Where equipment already exists, the use of automated border control (ABC) equipment, digital
passenger identification (biometrics) as well as technology (thermal screening) could serve as
an additional health screening measure and could speed up the immigration process, with the
objective of reducing queuing and minimizing contact between border officials and passengers;
c) Furthermore, some governments are requiring passengers to complete health declarations or
health attestations before departure or on arrival as an initial assessment measure, which could
be used to identify passengers that might need a secondary assessment;
d) The identity verification process should be automated with the use of biometric technology and the
use of contactless technology, automated border control or eGates should be encouraged in order
to enhance transaction time and limit interaction between passengers, officers and staff;
e) For flights arriving from higher-risk areas where there are cluster or community transmission, a
particular section of the arrivals terminal could be utilized to increase physical distancing, and/or
smart thermal cameras could be placed at appropriate locations to screen arriving passengers, in
consultation with the public health authorities;
f) The boarder control staff must form part of the airport emergency plan and participate in the
simulation exercise, the procedure for public health emergency must be submitted to the Authority
with the airport public health plans.

Refer to ICAO CART 3

SOUTH AFRICAN REVENUE SERVICES (SARS)

The prime responsibility of the SARS with respect to aviation security is to provide a customs and excise
service at international airports where goods may be imported or exported, or where goods may be
landed for transit, or where persons entering or leaving the Republic may disembark or embark. The
SARS enforces the provisions of the Customs and Excise Act of 1964, and the laws promulgated there
under and shall:

43
a) Border control and customs processes may need to be temporarily revised to increase physical
distancing. Where equipment already exists, the use of automated border control (ABC) equipment,
digital passenger identification (biometrics) as well as technology (thermal screening) could serve
as an additional health screening measure and could speed up the immigration process, with the
objective of reducing queuing and minimizing contact between border officials and passengers
during public health emergencies;
b) Coordination with various border regulatory authorities (e.g., immigration, health) should be
established for measures facilitating the clearance of entry/arrival, such as enabling contactless
processes (e.g., relating to the reading of passport chips, facial recognition) to minimize spread of
communicable disease;
c) Where declarations are needed on arrival, government officials should consider electronic options
(e.g., mobile applications and QR codes) to minimize human-to-human contact. Information could
be sent in advance via government portals. For customs formalities, where possible, green/red
lanes for self-declarations are recommended;
d) The identity verification process should be automated with the use of biometric technology. Use
of contactless technology, automated border control or e-Gates should be encouraged in order to
enhance transaction time and limit interaction between passengers, officers and staff;

Procedures must be in place where transfer security screening is needed, it should follow appropriate
sanitary requirements as previously described in the departure process.

37 ROLES
 AND RESPONSIBILITIES IN THE MANAGEMENT
OF MEDICAL WASTE AND DISPOSAL BY AIRLINES AND
AIRPORTS

a) The airline and Airport Operator must develop operating procedures for the containment and
disposal of used PPE and regulated medical waste;
b) Contaminated waste must be carefully placed inside a biohazard bag (or plastic bag labelled
“biohazard” if nonavoidable) and the bag securely tied or taped shut to avoid leaking. The bag
must be kept in a secure place until it can be safely collected for disposal;
c) The waste material must be handed over to the competent port health authority on arrival for
disposal;
d) All waste or other materials used by the patient should be stored separately in a sealed biohazard
bin and dry solid waste (such as used gloves, dressings) must be put into leakproof biohazard bags;
e) Sharp items, such as used needles or scalpel blades, must be discarded immediately after use
in puncture-proof sharps containers. Store suctioned fluids and secretions in sealed containers.
Handling patient body fluids may create splashes and should be avoided;
f) All waste must be disposed in accordance with organization protocols as well as with local and
national regulations for Category A infectious substances. Additional cleaning methods may also
be used, though are not required (e.g. Ultraviolet germicidal irradiation, chlorine dioxide gas, or
hydrogen peroxide vapor). These should not replace the manual disinfection;
g) Suctioned fluids and secretions should be stored in sealed containers for disposal as regulated
medical waste at the destination medical facility in accordance with local requirements and
handling that might create splashes or aerosols during flight should be avoided.

Detailed Guidelines on Annex CANSO & ICAO Air Traffic Services Guidance Material for operation in a
Covid-19 context
44
38 MANAGEMENT
 OF MEDIA AND PUBLIC EDUCATION
DURING PUBLIC HEALTH EVENTS

COMMUNICATION AND CO-OPERATION WITH OTHER STATES

It is important for the Regional States to implement the ICAO and WHO Health measures in a
harmonized fashion through the implementation of Public Health Corridors by supporting Civil Aviation
Authorities (CAAs) in sharing information, applying mutually accepted public health measures and
concluding bilateral or multilateral agreements. This measure can be accomplished by the Republic
considering entering collaborative arrangements in order to increase the sustainability of the aviation
health system by avoiding unnecessary duplication of public health controls. The arrangement may be
based on verification of equivalence of the health outcome ensured by the application of effective health
controls both at the departure and destination countries.

The Republic shall cooperate with other States in the development and exchange of information
concerning national aviation public programmes, training programmes and quality control programmes,
as necessary.

Exchange of information

a) On request, the Authority through the Department of Transport shall make a written version of
the appropriate parts of the Aviation Public Health available to relevant aviation authorities of
Contracting States to the Chicago Convention of 1944;
b) If necessary, the Authority shall co-operate with relevant aviation authorities of Contracting States
in order to adapt this National Public Health Plan to achieve consistent practices and procedures
between States, and to enhance international aviation public health mitigation in general;
c) Upon receipt of a request to exchange information relating to aviation security programmes and
regulations, the Department of Transport shall analyse the request and shall co-operate with the
requesting State provided that the request does not contravene Section 107 of the Civil Aviation
Act, 2009.

39 COMMUNICATION AND COLLABORATION WITH ICAO

a) The Authority, through the Department of Transport, is responsible for providing ICAO is a Focal
Point, Member and Chair and Technical Advisor of the ICAO-WHO CAPSCA Programme and will
continue State Assistance Missions with ICAO and WHO to ensure a harmonized approach in
implementing public health preventative and management risk measures;
b) South Africa and SADC is encouraged to make use of online tool available on the ICAO website
to facilitate the conclusion of Public Health Corridors between SADC States (bilateral/multilateral)
and working together with ICAO Regional Offices to support the Public Health Corridor iPack to
support the aviation industry resilience in the event of outbreak;
c) A framework should be established at regional and continental level to enhance and strengthen
collaboration, cooperation, coordination, commitment and communication between all stakeholders
involved in the management of Public Health Events in aviation with clear objectives, responsibilities
and activities including specific trainings;

45
d) The Republic shall consider exchanging information and participate at ICAO meetings with other
Contracting States to ensure that the guidelines are representative of inputs from the region;
e) The National Air Transport Facilitation Committee (NATFC) and utilize CAPSCA, to enable
seamless implementation of relevant health related SARPs, taking into account a multi layered
risk based approach to establish their health measures bust be supported by both high level
department of Transport and Department of Health;
f) Department of Health and Department of Transport are required to nominate CAPSCA Focal
Points and communicate their details to their accredited ICAO Regional Office and the focal Point
should maintain close contact with the National IHR Focal Point for any inquires related to public
health events involving the aviation sector in liaison with ICAO and WHO Regional Offices;
g) The COVID-19 pandemic highlighted the limited available scientific evidence, the lack of
harmonization on the implementation of travel measure such as travel bans, and the use of the
“precautionary approach” by various countries parties, imposing measures such as travel ban.
The linkage of the point of entry with the public health surveillance system is highly recommended
and South Africa needs to take a lead to prevent the recurrence in the future.

40 INTERNATIONAL COOPERATION

a) International Organizations such as WHO, Africa CDC, ICAO, ACI, RSOO, RECs etc. should
establish Memorandum of Understanding aiming to strengthen the collaboration and cooperation
within the CAPSCA framework, SA must support the strengthening of these agreements;
b) South Africa was mostly impacted by Covid-19 in the continent based African Union, it is important
that the CAA and Department of Transport take a lead at the AFI, African Union and Regional
meeting to support the sustainability of the CAPSCA Programme;
c) Department of Health and Department of Transport are required to nominate CAPSCA Focal
Points and communicate their details to their accredited ICAO Regional Office and the focal Point
should maintain close contact with the National IHR Focal Point for any inquires related to public
health events involving the aviation sector in liaison with ICAO and WHO Regional Offices;
d) The COVID-19 pandemic highlighted the limited available scientific evidence, the lack of
harmonization on the implementation of travel measure such as travel bans, and the use of the
“precautionary approach” by various countries parties, imposing measures such as travel ban.
The linkage of the point of entry with the public health surveillance system is highly recommended
and South Africa needs to take a lead to prevent the recurrence in the future;
e) The Republic shall consider entering into collaborative arrangements with other States in order to
increase the sustainability of the aviation public health system and avoid unnecessary duplication
of security controls;
f) The arrangement shall be based on verification of the equivalence of the security outcome to
ensure that there are effective public health controls at point of departure;
g) The arrangement shall be based on bilateral agreements, memoranda of understanding,
memoranda of incorporation or one-stop public health agreements;
h) Agreements to ensure one-stop public health is the process whereby passengers and cabin
baggage and hold baggage or shipment of cargo are not re-screened at a connecting airport if
they have been satisfactorily screened at their airport of origin. One-stop public health can be
holistic (exempting passengers and hold baggage from re-screening) or itemised (exempting only
passengers or only hold baggage from re-screening).

46
41 RESPONSIBILITY
 MEDIA AVIATION AND PUBLIC HEALTH
EDUCATION DURING PUBLIC HEALTH EMERGENCIES

In a public health emergency it is important for the stakeholders involved to define communication that
will be conducted by airlines, airports, ANS, the Civil Aviation Authority and Department of Transport,
Department of Health. Government officials must ensure that public passenger education and must work
with aviation stakeholders must work together to distribute accurate information quickly. Information
must be as clear, simple and consistent as possible across the entire passenger travel experience.

a) Departing Travellers planning a journey by air should seek information on any potential travel
hazards as part of their travel planning and this should include considering their personal health
status and any contra-indications for travel at various points in their itinerary;
b) The aviation sector provides information regarding medical clearance for travellers with health
conditions that may impact their suitability for air travel;
c) Passengers should be encouraged to make use of mobile computer program applications, so-
called apps, to help departing travellers stay current with emerging situations including disease
outbreaks;
d) Passenger education to visit a travel health clinic or international vaccination centre to collect
health information about the country they are going to visit and be vaccinated if needed and travel
agents may also provide information regarding possible health risks to travellers during travel
planning or ticketing;
e) In the event of a serious public health hazard or emergence of an infectious disease threat,
government, airlines and airports may issue travel alerts, including providing health information at
airports;
f) Passengers who are ill or presenting with symptoms /signs of communicable disease should are
advised to not travel and visit their medical practitioner for medical clearance;
g) The National Department of Health have a responsibility to communicate potential public health
risks in a timely and appropriate manner. The availability of electronic information sources has
improved public health authorities’ as well as the aviation sector’s ability to communicate public
health risks to travellers.

42 ROLES
 AND RESPONSIBILITIES OF THE SOUTH AFRICAN
POLICE SERVICE (SAPS)

The SAPS have the following responsibilities:

a) Routine surveillance and patrol of all airports’ terminal areas;

b) Surveillance of arriving and departing passengers for persons who may pose a public health threat
to civil aviation;
c) Managing unruly passengers and staff who are non-compliant to public health measures; and
d) Enforcement of compliance with public health measures at the airport.

47
43  OLES AND RESPONSIBILITIES OF THE RESCUE AND
R
FIRE FIGHTING (RFF) SERVICES AT AIRPORTS

The procedure and responsibilities of personnel from Fire and Rescue Services who participate in the
development and testing of the Airport Emergency Plan for Public Health emergencies must be clearly
defined.

44  OLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN

R
REVENUE SERVICES (SARS)

The prime responsibility of the SARS with respect to aviation security is to provide a customs and excise
service at international airports where goods may be imported or exported, or where goods may be
landed for transit, or where persons entering or leaving the Republic may disembark or embark. The
SARS enforces the provisions of the Customs and Excise Act of 1964, and the laws promulgated there
under and shall:

a) Border control and customs processes may need to be temporarily revised to increase physical
distancing. Where equipment already exists, the use of automated border control (ABC) equipment,
digital passenger identification (biometrics) as well as technology (thermal screening) could serve
as an additional health screening measure and could speed up the immigration process, with the
objective of reducing queuing and minimizing contact between border officials and passengers
during public health emergencies;
b) Coordination with various border regulatory authorities (e.g., immigration, health) should be
established for measures facilitating the clearance of entry/arrival, such as enabling contactless
processes (e.g., relating to the reading of passport chips, facial recognition) to minimize spread of
communicable disease;
c) Where declarations are needed on arrival, government officials should consider electronic options
(e.g., mobile applications and QR codes) to minimize human-to-human contact. Information could
be sent in advance via government portals. For customs formalities, where possible, green/red
lanes for self-declarations are recommended;
d) The identity verification process should be automated with the use of biometric technology. Use
of contactless technology, automated border control or e-Gates should be encouraged in order to
enhance transaction time and limit interaction between passengers, officers and staff;
e) Procedures must be in place where transfer security screening is needed, it should follow
appropriate sanitary requirements as previously described in the departure process.

45 CORPORATE GOVERNANCE AND TRADITIONAL AFFAIRS

The Department for Corporate Governance and Traditional Affairs has the responsibility for national
disaster management policy, programmes and response which includes the responsibility for providing
medical and social resources;

It is important that consultation take place between Department of Transport and representatives of
Disaster Management to ensure that the regulations issued are in line with ICAO requirements;

48
46  ROLES AND RESPONSIBILITIES OF THE SOUTH AFRICAN

NATIONAL DEFENCE FORCE (SAMHS)

The role of the SAHMS is to intervene in public health measures of international concern to assist the
following but not limited to:

a) Repatriation of South African Citizens;

b) Assist the various government departments including public heal where required;
c) Enforcement of public health measures;
d) Others

47 ROLES
 AND RESPONSIBILITIES OF THE DEPARTMENT
OF INTERNATIONAL RELATIONS AND CO-OPERATION
(DIRCO)

a) DIRCO is responsible for providing special diplomatic formalities during the arrival or departure of
VIP and high-profile visitors while ensuring that public health measures are not compromised;
b) It is also the task of the DIRCO to notify relevant bodies charged with the responsibility of public
health measures at airports and aircraft operators, before making these diplomatic arrangements;
c) It is DIRCO’s responsibility to make every effort to ensure that the repatriation flights of foreign
citizens meet public health measures;
d) Participate in ensuring that public health in aviation CAPSCA Programme is supported by the
African Union;
e) Support harmonization of public health measures globally to minimize future unnecessary travel
bans.

48 ROLES
 AND RESPONSIBILITIES GENERAL AVIATION
CONSIDERATIONS IN PLANNING THE AVIATION
INDUSTRY’S RECOVERY PUBLIC HEALTH EMERGENCY

In keeping with its inherent flexibility, General Aviation operations vary enormously in type and scale.
The numbers of persons on board a GA flight can be two orders of magnitude less than the number
of paying passengers carried on jet airline aircraft. This fact alone greatly reduces the public risk of
contagion from GA operations, which range from recreational and some private flights, where the pilot
or members of immediate family of the same domicile are on board, through to operations supporting
business activities, which at times may involve unrelated persons. The guidelines have to be developed
which will include amongst others:

a) Pilots must conduct a health self-assessment based on the prevailing public health condition of
their health prior to flying and can adapt to measure;

49
b) Headsets and personal equipment should not be shared and for larger operations (say, more than
100 people present at a site), an isolation room for personnel who arrive with symptoms and a
protocol for their removal may be appropriate;
c) Non-contact electronic delivery and submission of flight briefing, and notification documentation
should be preferred over in-person attendance and telephone methods;
d) For General Aviation , the Public Health should be envisaged as extending from
i. the places and activities when a person arrives at an airport for a flight, until the person leaves
the airport at the end of the operation. It is critical to recognise that this may, or may not,
include a person traversing a hangar, airport terminal, fixed base operator (FBO), aero club,
flight training school or external public area. Instead of focusing
ii. on the physical locations GA participants will pass through, attention should be directed to
selectable and scalable measures that may be taken to keep the participants
iii. safe from infection, or from passing infection to others using appropriate risk management
principles; and
e) It has to be taken into consideration that General Aviation flights do not generally use public
airport terminals, or and many do not utilise FBO facilities and that many flights can start and end
at the operator’s own hangar or tie down facility on a private or public
i. airport;
f) Public health measure for the Aircraft and personel such as but not limited to
i. disinfect aircraft with area sprays, such as Lysol, while being careful to avoid
ii. overspray on avionics screens and the usse disinfectant wipes on all areas
iii. accessed by hands: door latches, oil dipsticks, switches, levers, avionics buttons, yoke,
throttles, door and ignition keys, etc.
g) Consider of “chair-flying” a mission from pre-flight to post-flight in each aircraft and use sanitizing
wipes throughout; and
h) Training of the general aviation community and development of regulations and guidelines by the
Authority which should be approved in preparation for public
i. Health events are required

Reference: Annexure T ICAO General Aviation Considerations in Planning the Aviation

Industry’s Recovery from COVID-19

RESPONSIBILITIS OF INCIDENT AND ACCIDENT INVESTIGATORS DURING PUBLIC HEALTH

EMERGENCIES

Although aviation activity has reduced in some sectors, new risks have emerged as a direct result of
the pressures being felt across the industry. Unsurprisingly, accidents and serious incidents continue to
occur during public health emergencies of international concerns; States are obliged under Annex 13 to
the Chicago Convention to institute investigations and progress them as swiftly as possible.

Considerations must be made by accident investigators to protecting the health staff and their families;
and second, overcoming obstacles to normal ways of working (such as travel restrictions, limited scope
for face-to-face meetings, reduced access to own and 3rd party facilities and resources, challenges
maintaining effective communications;

Accident investigators are generally well equipped with appropriate personal protective equipment
(PPE) for operations in the field in a hazardous environment, however additional stocks of consumables
including decontamination products may be required;

50
Plans and procedures to see if they need adaption for investigations during a public health emergencies
and a thorough deployment-specific risk assessment should be conducted to help inform a go/nogo
decision authorised at the appropriate level
Contingency planning beforehand may be beneficial, such as identifying the travel resources that may
be available depending on the location of the accident;

Consideration on increased reliance on the host nation (State of Occurrence) to help facilitate the
deployment of Accredited Representatives and a need to use its contacts and influence across
government departments to help expedite the issuing of visas and get a quarantine exemption for the
investigation team should be considered as they may be travel bans

To avoid difficulty and friction in the travel time following an accident, should try to get agreement in
advance from the relevant authorities within their countries that those engaged in accident investigation,
including advisors and experts, will be recognised as critical safety workers exempt from travel restrictions
and quarantine when arriving in or returning to the country;

Every deployment should be assessed case-by-case and if the risks are high, consider alternatives to
deploying. Increased use can be made of local authorities and trusted agencies to gather and secure
the physical evidence for assessment later;

Interviews may be conducted remotely via phone or video conference and increased use can be made
of transmitted photos and video, including potentially a live video feed, to enable accidents investigators
and advisors to get ‘eyes on’ the evidence to assess it and direct the action to be taken; and

A procedure and training should be developed based on the prevailing situation;

Reference: Annexure U ECC ACC Guidance note on conducting investigations during a

pandemic

49 ROLES
 AND RESPONSIBILITIES OF CARGO REGULATED
AGENTS

Regulated Agents are to consult guidelines updated from time to time to ensure correct handling of
Human Remains, particularly where such have died as a result of a communicable disease. This is to
safeguard the staff and clients of cargo operations and contain possible spread of the disease.

50 REGIONAL
 COLLABORATIVE ARRANGEMENT IN PUBLIC
HEALTH CORRIDOR

a) It is important for the Regional States to implement the ICAO and WHO Health measures in
a harmonized fashion though the implementation of Public Health Corridors by supporting Civil
Aviation Authorities (CAAs) in sharing information, applying mutually accepted public health
measures and concluding bilateral or multilateral agreements;

51
b) This measure can be accomplished by the Republic considering entering collaborative
arrangements in order to increase the sustainability of the aviation health system by avoiding
unnecessary duplication of security controls;
c) The arrangement may be based on verification of equivalence of the health outcome ensured by
the application of effective health controls both at the departure and destination countries.

51 COMMUNICATION

STATES
AND CO-OPERATION WITH OTHER

The Republic shall cooperate with other States in the development and exchange of information
concerning national aviation public programmes, training programmes and quality control programmes,
as necessary.

Exchange of information

a) On request, the Authority through the Department of Transport shall make a written version of the
appropriate parts of the Aviation Public Health legislation available to relevant aviation authorities
of Contracting States to the Chicago Convention of 1944;
b) If necessary, the Authority shall co-operate with relevant aviation authorities of Contracting States
in order to adapt this National Public Health Plan to achieve consistent practices and procedures
between States, and to enhance international aviation public health mitigation in general;
c) Upon receipt of a request to exchange information relating to aviation security programmes and
regulations, the Department of Transport shall analyse the request and shall co-operate with the
requesting State provided that the request does not contravene Section 107 of the Civil Aviation
Act, 2009.

52 COMMUNICATION WITH ICAO

a) The Authority, through the Department of Transport, is responsible for providing ICAO is a Focal
Point, Member and Chair and Technical Advisor of the ICAO-WHO CAPSCA Programme and will
continue State Assistance Missions with ICAO and WHO to ensure a harmonized approach in
implementing public health preventative and management risk measures;
b) The Republic shall consider exchanging information and participate at ICAO meetings with other
Contracting States to ensure that the guidelines are representative of inputs from the region.

53  OREIGN STATE AND AIR CARRIER AUDIT PUBLIC

F
HEALTH PROTOCOLS

a) A foreign State, appropriate Authority and foreign air carrier providing commercial service in the
Republic shall be required to submit an audit or oversight request with the date and scope of audit
in writing, 4 weeks prior to the audit or oversight to the Authority;

52
b) The said notice must include the names, passport details of the auditors and authorised persons,
the dates and scope of the audit. Failure to comply with this protocol shall result in the rejection of
the request;
c) Ad hoc inspections will be conducted on foreign operators to ensure compliance with public health
ICAO Annexes.

CONTINUING AIRWORTHINESS MANAGEMENT ORGANISATIONS DURING PUBLIC HEALTH

EMERGENCIES

Aviation operations will be affected heavily by the public health events of international concerns and an
unprecedented number of aircraft that have been parked/stored. The lack of demand in air travel often
cause financial pressure on air operators, as well as on their service. Gradually, as travel restrictions
are being lifted and as operators are preparing to resume passenger flights and demand increases,
operators will need the aircraft that have been parked/stored and return them back to service. Due to
the high number of aircraft involved and the limited supporting resources available to perform the work
due to the public health crisis, organisations and personnel are expected to experience difficulties and
increased risks. Organisation Management Systems play an essential role in identifying the hazards,
developing control measures to mitigate the associated risks and thus in ensuring a safe RTS of all
aircraft.

a) Procedures have to be developed for the Approved Maintenance Organisations (AMOs) to support
the Return to Service (RTS) of aircraft that have been parked/stored due to the extraordinary
situation resulting from such as public health emergencies of international concerns;
b) Issues such as but not limited to :
i. Has any environmental or accidental damage occurred to the aircraft during parking/storage?
ii. Does the aircraft match its damage chart?
iii. What is the current aircraft deferred defects status (including MEL / CDL)?
iv. Is there any maintenance task previously carried forward?
v. Is the status of the aircraft software updated to the latest version?
vi. Have cybersecurity checks been considered to ensure that no security breaches have
occurred;
vii. Others

Reference: EASA Return to service of aircraft after storage: guidelines for COVID-19

ROLE OF AVITION TRAINING ORGANIZATIONS IN CABIN CREW TRAINING DURING PUBLIC

HEALTH EMERGENCIES

Restrictions to mitigate the spread of the respiratory and other communicable disease, physical
distancing and workplace closures make it difficult for cabin crew members to complete the required
annual recurrent training programme, mainly with regard to hands-on and simulated exercises such as
donning of emergency equipment and participating in group drills. As the inability to complete these
portions of recurrent training will result in a lapse of cabin crew qualifications (and licences, where
applicable), a contingency plan should be implemented.

a) Operators must put alleviation measures such as the development of online recurrent training
programmes by the operator can reduce the severity of operational training disruptions as this will
enable a seamless transition when the normal operation of recurrent classroom (i.e. face-to-face)
training programmes resumes;

Reference: ICAO Handbook for Cabin Crew Recurrent Training during COVID-19

53
b) Operators may consider developing procedures on Digital Learning for Cabin Crew Training
provide guidance on designing, developing and using digital learning for cabin crew safety training
information on the processes, and resources involved in digital learning development;
c) Interactive platforms (e.g. webinars) can be used to cover topics that typically call for group
discussions and “question and answer” (Q&A) sessions and theoretical aspects related to
equipment and procedures may also be covered in the online recurrent training programme;
d) Procedures for the completion of modules and method for tracking completion, the use of
progressive assessments (e.g. quizzes) by the operator, based on module content, to establish
cabin crew understanding and assessment methods (invigilated assessment in class with physical
distancing, or online non invigilated assessment in lockdown circumstances.

Reference for more details on the ICAO Handbook for Cabin Crew
Recurrent Training during COVID-19

ROLES AND RESPONSIBILITIES OF THE MEDIA DURING PUBLIC HEALTH EMERGENCIES

There are particular challenges in providing clear information and advice during a pandemic. Scientific
knowledge will at first be limited, the pattern of disease spread may be variable across the country,
and public concern may be high. Consistent, clear public messaging, aligned at national and local
level, is critical to a successful and collaborative SA-wide response to a pandemic. This will help to
maintain public trust and support, as well as in increasing uptake of recommended actions such as good
respiratory and hand hygiene practices, effective and responsible use of antiviral medicines, and uptake
of vaccination. As well as consistency of public messaging, it is vital that communications within and
between national and local health and resilience organizations are also clear and consistent. Pandemics
require the whole of society to respond, and this response will be improved if everyone has access to
the information they need, in a form which works for them. This is not an easy task, but one which all
organizations should strive towards. The following departments have to develop media policies for their
communication during public health emergencies to mitigate the risk of confusion:

a) Role of Department of Transport

b) Role of Department of Health
c) Role of Civil Aviation Authority
d) Role of airports
e) Role of airlines
f) Role of ANS
g) Others

Internal communications between public health, civil aviation authority, air navigation system, the
airport authority and airline operators should be described clearly in airport contingency plans (i.e. a
communications plan for public health event) and tested during regular preparedness plan exercises.

54  OLES AND RESPONSIBILITIES GENERAL AVIATION

R
CONSIDERATIONS IN PLANNING THE AVIATION
INDUSTRY’S RECOVERY PUBLIC HEALTH EMERGENCY

In keeping with its inherent flexibility, General Aviation operations vary enormously in type and scale.
The numbers of persons on board a GA flight can be two orders of magnitude less than the number

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of paying passengers carried on jet airline aircraft. This fact alone greatly reduces the public risk of
contagion from GA operations, which range from recreational and some private flights, where the pilot
or members of immediate family of the same domicile are on board, through to operations supporting
business activities, which at times may involve unrelated persons. The guidelines have to be developed
which will include amongst others:

a) Pilots must conduct a health self-assessment based on the prevailing public health condition of
their health prior to flying and can adapt to measure;
b) Headsets and personal equipment should not be shared and for larger operations (say, more than
100 people present at a site), an isolation room for personnel who h) arrive with symptoms and a
protocol for their removal may be appropriate;
c) Non-contact electronic delivery and submission of flight briefing, and notification documentation
should be preferred over in-person attendance and telephone methods;
d) For General Aviation, the Public Health should be envisaged as extending from
i. the places and activities when a person arrives at an airport for a flight, until the person leaves
the airport at the end of the operation. It is critical to recognise that this may, or may not,
include a person traversing a hangar, airport terminal, fixed base operator (FBO), aero club,
flight training school or external public area. Instead of focusing
ii. on the physical locations GA participants will pass through, attention should be directed to
selectable and scalable measures that may be taken to keep the participants
iii. safe from infection, or from passing infection to others using appropriate risk management
principles; and
e) It has to be taken into consideration that General Aviation flights do not generally use public airport
terminals, or and many do not utilise FBO facilities and that many flights can start and end at the
operator’s own hangar or tie down facility on a private or public
i. airport;
f) Public health measure for the Aircraft and personel such as but not limited to
i. disinfect aircraft with area sprays, such as Lysol, while being careful to avoid
ii. overspray on avionics screens and the usse disinfectant wipes on all areas
iii. accessed by hands: door latches, oil dipsticks, switches, levers, avionics buttons, yoke,
throttles, door and ignition keys, etc.
g) Consider of “chair-flying” a mission from pre-flight to post-flight in each aircraft and use sanitizing
wipes throughout;and
h) Training of the general aviation community and development of regulations and guidelines by the
Authority which should be approved in preparation for public
i. Health events are required
i) Reference Annexure …. General Aviation Considerations in Planning the Aviation Industry’s
Recovery from COVID-19

55  ESPONSIBILITIES OF INCIDENT AND ACCIDENT

R
INVESTIGATORS DURING PUBLIC HEALTH EMERGENCIES

Although aviation activity has reduced in some sectors, new risks have emerged as a direct result of
the pressures being felt across the industry. Unsurprisingly, accidents and serious incidents continue to
occur during public health emergencies of international concerns; States are obliged under Annex 13 to
the Chicago Convention to institute investigations and progress them as swiftly as possible.

55
Considerations must be made by accident investigators to protecting the health staff and their families;
and second, overcoming obstacles to normal ways of working (such as travel restrictions, limited scope
for face-to-face meetings, reduced access to own and 3rd party facilities and resources, challenges
maintaining effective communications;

Accident investigators are generally well equipped with appropriate personal protective equipment
(PPE) for operations in the field in a hazardous environment, however additional stocks of consumables
including decontamination products may be required;

Plans and procedures to see if they need adaption for investigations during a public health emergencies
and a thorough deployment-specific risk assessment should be conducted to help inform a go/nogo
decision authorised at the appropriate level Contingency planning beforehand may be beneficial, such
as identifying the travel resources that may be available depending on the location of the accident;

Consideration on increased reliance on the host nation (State of Occurrence) to help facilitate the
deployment of Accredited Representatives and a need to use its contacts and influence across
government departments to help expedite the issuing of visas and get a quarantine exemption for the
investigation team should be considered as they may be travel bans

To avoid difficulty and friction in the travel time following an accident, should try to get agreement in
advance from the relevant authorities within their countries that those engaged in accident investigation,
including advisors and experts, will be recognised as critical safety workers exempt from travel restrictions
and quarantine when arriving in or returning to the country;

Every deployment should be assessed case-by-case and if the risks are high, consider alternatives to
deploying. Increased use can be made of local authorities and trusted agencies to gather and secure
the physical evidence for assessment later;

Interviews may be conducted remotely via phone or video conference and increased use can be made
of transmitted photos and video, including potentially a live video feed, to enable accidents investigators
and advisors to get ‘eyes on’ the evidence to assess it and direct the action to be taken;and

A procedure and training should be developed based on the prevailing situation.

Reference Material: ECAC ACC GUIDANCE NOTE ON CONDUCTING INVESTIGATIONS DURING

A PANDEMIC

CHALLENGES AND LESSONS LEARNED FROM THE COVID-19 PANDEMIC

a) International Organizations such as WHO, Africa CDC, ICAO, ACI, RSOO, RECs etc. should
establish Memorandum of Understanding aiming to strengthen the collaboration and cooperation
within the CAPSCA framework.
b) Lack of the enacting of the WHO International Health Regulations(2005,which were required to
be implemented by States in 2012) by the National Department of Health;
c) Lack of consideration of the ICAO Annexes and Recommendations by the Disaster Management
Team when developing regulations for public health;

56
d) Need for the support of the ICAO Collaborative Arrangement for the Prevention and Management
of Public Health in Civil Aviation by the high-level African Union, ICAO AFI and other Regional
Offices from both ICAO and WHO;
e) Lack of support for the Regional Public Health Corridors Health Corridors, there is a need to
prioritize mutual agreements to ensure sharing of public health regulations;
f) Development of ICAO Standards and Recommended Practices for Air Ambulances for both fixed
wings and helicopters considering personel,equipment and others;
g) Development of ICAO Standards and Recommended Practices for Air Ambulances for both fixed
wings and helicopters considering personel, equipment and others;
h) Development of ICAO Standards and Recommended Practices passengers with Cardio Pulmonary
Resuscitation by cabin crew during public health emergencies of international concerns;
i) Development of ICAO Standards and Recommended Practices or Guidelines on the return to
service of aircraft after long period of storage during public health events of international concerns;
j) Development of the guideline for recovery of general aviation considerations in planning the
Aviation Industry’s recovery from public health;
k) A framework should be established at regional and national level to enhance and strengthen
collaboration, cooperation, coordination, commitment and communication between all stakeholders
involved in the management of PHE in aviation with clear objectives, responsibilities and activities
including specific trainings;
l) Support of the national coordination mechanisms such as the National Air Transport Facilitation
Committee (NATFC - DOT and MNORT-Health) and utilize CAPSCA, to enable seamless
implementation of relevant health related SARPs, taking into account a multi layered risk-based
approach to establish their health measures;
m) Strengthen multi-sectorial capacities building activities including public health training and
simulation exercises with priority on low income and low resource regional countries;
n) The COVID-19 pandemic highlighted the limited available scientific evidence, the lack of
harmonization on the implementation of travel measures, and the use of the “precautionary
approach” by State parties, imposing measures such as travel ban, countries like South Africa
who conducted testing and genetic sequencing which benefited the globe were punished through
restriction,this approach will encourage non-disclosure of new scientific discovery or lack of
support for research with future outbreaks;
o) Encouraged to engage political leadership structures at national and sub-national levels, towards
improving collaboration and public health practices at the Point of Entry and in the Aviation, sector
including consultations and alignment of statements among different partners at regional and
national level to reinforce collaboration and cooperation to achieve the same goal;
p) Deficiencies noted in several during the COVID-19 pandemic such as political and government
authorities’ interference, neglect and lack of coordination including relegated esteem to ensure
effective CAPSCA program implementation and relevance;
q) Promotion and advocacy for risk-based approach, when determining additional restriction
measures to be applied to international air traffic;
r) Clarity on the impact of disaster management regulations on existing public health in aviation
regulations and memorandum of agreements, these were not considered during the Covid-19
pandemic which caused unnecessary delays;
s) Department of Health to consider existing innovations developed by aviation regional and global
partners such as Africa CDC and International Air Transport Association;

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t) Clarity definition of where ICAO Annexes and WHO IHR (2005) are applicable and who take
possible legal litigation or insurance claims at National level should passengers or crew take
action; and
u) There is a need for the development of guidelines for accident investigators public health guidelines.

Reference: Conclusions from the Eighth CAPSCA Africa Meeting, Virtual, 8 -10 February 2022

CONCLUSION
Timely detection and notification of a potential public health risk is critical to the management of a
public health event. The aviation sector is faced with increasing challenges in ensuring travellers are
healthy enough to travel prior to boarding, partly because of increased use of advance online check-in
procedures. If a communicable disease is suspected on board an aircraft in flight, flight crew are required
to notify public health authorities. If a country or region is experiencing an increase in infectious disease
or has been affected by a biological, chemical or radiological event, national health authorities may issue
a health travel alert. Depending on the risk assessment, a health travel alert may be implemented as
a national response, or on the unified advice of WHO in coordination with other international agencies
(e.g. the International Atomic Energy Agency, IAEA, for radiological events).If a traveller with a potentially
communicable disease is identified at the point of origin (e.g. by a physician at a health centre or travel
health clinic), the traveller should be advised to delay travel until they have recovered. If the traveller
has a notifiable communicable disease that may pose a health hazard to the public (examples include
TB and measles), the public health authorities should be alerted for case management and contact
investigation.

If an area is affected by a potentially serious outbreak of disease, WHO or other countries may implement
travel advisories or notices, including recommending against travel to that area. The latter is an unusual
action with potentially significant socioeconomic impacts (15, 16). IHR Article 2 specifically encourages
State Parties to avoid unnecessary interference with international traffic and trade.

DURING THE BOARDING PROCESS

A competent authority (airport health authority) or other authorities may detect an illness or a potential
health hazard at the time of departure in either travellers (airline passenger agents, security and passport
control inspectors, cabin crew) or cargo (air freight operators). Travelers Unusual or severe illness in
departing travelers may be detected by port health or other authorities. In this event, passengers may be

58
interviewed or subjected to a health assessment before being allowed to board. Passenger agents for
some airlines and airports are given training to help identify travellers who appear to be unfit to fly, either
at the counter, in the passenger lounge prior to boarding or at the time of boarding. Passenger agents
should seek medical advice before allowing the ill passenger to check in or to board the aircraft. The
traveller may be requested to delay travel until they are well enough or have received medical approval to
travel. If a traveller refuses to delay his/her travel, the airline may exercise their right to refuse boarding.
The aviation sector is faced with increasing challenges in ensuring travellers are healthy enough to
travel due, in part, to the use of online booking, advance check-in and self-tagging of baggage. This
reduction in passenger contact, along with some airlines using unassigned seats, may also impair an
airline’s ability to support public health authorities during disease investigations

DURING FLIGHT

Once passengers or cargo have been boarded and the flight is in progress, event detection will rely
on the awareness of the cabin crew. As noted, cabin crew are responsible for the safety of passengers
during flight but have limited capacity to detect and respond to medical or potential public health events.
If a medical emergency occurs, the cabin crew may be able to seek advice from a ground-based medical
service provider or the assistance of a medically trained passenger on board. In serious cases, the pilot in
command may consider diversion in order for the unwell passenger to receive the required treatment. In
all cases, communication between the air crew and ground operations is necessary to ensure all parties
are aware of the situation. The reporting of illnesses and deaths on board to public health authorities
(via ATS) is mandated in many countries (17). In all cases, the pilot should notify air traffic control, as
per ICAO provisions (2- Annex 11) of any suspected cases of communicable disease or evidence of a
public health risk on board. IHR Annex 9 “Health Part of the Aircraft General Declaration” is available
to be used after landing to report an ill person on board. Although not all State Parties require its use,
it provides a communication tool for State Parties to acquire information regarding health conditions on
board during an international voyage and health measures applied to the aircraft. If required, the State
Party and airport should include the procedure for its use in emergency planning documents. During
the 2009 Influenza, A H1N1 pandemic, WHO, in collaboration with ICAO and IATA, developed H1N1-
specifi c event management guidance in air travel, with recommended procedures for cabin crew. This
guidance supports the IHR and may be useful for application during similar events or for developing
preparedness plans.

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 UPON ARRIVAL AND/OR DURING TRANSIT TO NEXT TRANSPORT

If evidence of infection or contamination is not detected during the flight, it may be detected upon arrival
at an intermediary or final destination by port health or other authorities in the airport. An example of this
measure is the public health ‘entry screening’ of flights originating from an -affected country. Passengers
and/or cargo may be subject to an epidemiologic investigation conducted by port health if the itinerary
information suggests there was any travel in or near an affected area or other possible contacts with
infection or contamination prior to arrival. If, for instance, a flight is arriving from a region or city that is
known to be affected by an infectious disease or by biological, chemical or radiological exposure, an
investigation may be conducted. At the request of port health, airlines may also request some or all
passengers provide information on their itinerary and contact details. This information may be collected
on a voluntary basis on public health Passenger Locator Forms (PLFs) from arriving travellers. Blank
PLFs should be stored on site by port health at a designated airport or be available from regional or
public health authorities for all airports. Because of the resource requirements necessary to securely
store and utilize the personal information from PLFs, it is important that SOPs are developed to indicate
when to request a PLF, from whom and where and how the information from these forms will be used
and subsequently stored or destroyed. For further information, refer to contact tracing.

FINAL DESTINATION

Travellers arriving from an affected region or who may have been exposed to a potential public health
risk during air travel may be contacted by public health authorities at their final destination to ascertain
their health status. Cargo may also need to be assessed for potential disease reservoirs on arrival.
Passengers who are ill or become ill after arrival may self-refer to a local physician or health centre. The
IHR requires State Parties to maintain core capacity for surveillance at all levels and at all times to ensure
that public health events are detected and reported to the appropriate authorities. Public health events
can be detected through the national health surveillance system and related to travel afterwards. These
events may require follow-up measures at PoE and must be communicated to PoE health authorities.
Risk assessment should be performed once the public health authorities are notified that a contagious
patient has travelled within the previous days/weeks, and appropriate measures should be taken (e.g.
contact tracing) according to national or other guidelines for that disease.

Based on the lessons learned from the Covid-19 pandemic, regulations, guidelines will be developed
coordinated by the authority for ICAO Annexes previously not considered by Collaborative Arrangement
and Management of Public Health in Civil Aviation and lessons learned by the Authority in consultation
the aviation sector, to ensure better preparedness locally, regionally and internationally.

Ms Poppy Khoza
Director of Civil Aviation
29 March 2022

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