ALERT helicopter won’t transport coronavirus patients

An ambulance transported Jim Tomlin from Libby to the Kalispell Regional Medical Center on March 25 after his condition deteriorated in response to respiratory distress caused by COVID-19.

The 77-year-old Tomlin, who lived with his wife, Marcia, at Bull Lake, was gravely ill and needed the specialized care available at the larger hospital. The ambulance carrying Tomlin traveled U.S. Highway 2 and the roughly 90 miles required to deliver the elderly man.

The Kalispell Regional Medical Center had decided not to transport COVID-19 patients on its ALERT helicopter. Other medical centers or air ambulance operators have wrestled with that same decision in recent weeks.

Tomlin, the first case of coronavirus identified in Lincoln County, became Montana’s first COVID-19 fatality when he died the following afternoon of complications from the respiratory disease. No one has suggested his death could have been avoided by a faster transport to Kalispell.

On Sunday evening, Lincoln County learned of a seventh person in the county who had tested positive for coronavirus. Jennifer McCully, public health manager for the Lincoln County Health Department, said April 6 that the person is a woman in her 60s who had had direct contact with a person known to have tested positive for the highly contagious virus. The woman is not hospitalized, McCully said.

Dr. Doug Nelson, chief medical officer for Kalispell Regional Healthcare, and Dr. Jeffrey Tjaden, the healthcare system’s infectious disease specialist, said during an April 2 phone interview that several considerations informed the decision not to transport COVID-19 patients on the ALERT helicopter.

First, there would be a need for personal protective equipment for the pilot, flight nurse and paramedic aboard the helicopter.

After the flight, the helicopter would be out of service for a time because of the necessity for a prolonged and thorough cleaning, Nelson said. ALERT has one helicopter and one fixed-wing aircraft.

In addition, a pilot or other member of the air ambulance crew might need to be quarantined, a response that would impact the ALERT helicopter’s ability to respond to other critical emergency situations, including traumatic injuries associated with automobile accidents or transport of other patients in desperate need of emergency care.

News reports of a tragic encounter Thursday in the Solomon Islands between a ferry and Cyclone Harold noted that the country’s sole rescue helicopter was grounded because a pilot was in quarantine because of the coronavirus. Dozens of passengers were reported to have been swept overboard and were assumed dead.

A March 18 article in Vertical Magazine, a publication geared toward the civilian helicopter industry, reported that helicopter air ambulance operators “are weighing the risks of transporting patients who test positive or are at high risk of carrying the novel coronavirus.”

The article added, “Because the virus is so contagious, most emergency medical services are transporting patients by ground in specially outfitted ambulances with contained, filtered air circulation and physical separation between drivers and paramedics in the back.”

The executive director of LifeFlight of Maine network noted that it is difficult to equip helicopter crews with personal protective equipment, such as N95 masks and face shields, over a flight suit and under a helmet. Tom Judge told Vertical Magazine that “ground transportation is the primary response if there is any way possible, even over long distances, for patients at high risk of COVID-19.”

In the nation’s Northwest, the Life Flight Network, a not-for-profit air medical service, has bases in Montana in Missoula, Butte and Bozeman. With administrative offices in Oregon, Life Flight Network is owned by a consortium of providers, including Providence Health System.

Life Flight is transporting COVID-19 patients, according to a statement on its website.

“Our crews will utilize [Centers for Disease Control] recommended personal protective equipment, and our aircraft will be cleaned per CDC recommendations, using an EPA-approved disinfectant active against emerging viral pathogens,” the statement reported.

In Virginia, Hannah Curtis is a spokeswoman for Carilion Clinic, a regional healthcare system that serves the Roanoke Metropolitan Statistical Area, with its population of more than 308,000, and much of southwest Virginia.

“Carilion Clinic Life-Guard is still transporting all patients, including those suspected or confirmed to have COVID-19,” Curtis said in an April 3 email.

“After consulting with Carilion Infection Prevention and Control experts, Life-Guard has put measures in place to ensure the safety of their teams and patients,” she said. “These measures, like increased personal protective equipment usage, are based on the current CDC guidelines and industry recommendations.”

Life-Guard has three helicopters in its fleet, Curtis said.

Meanwhile, as of mid-morning on April 6, Lincoln County’s total for positive tests for coronavirus stood at seven cases. The state total reached 300 as of the morning of April 6. There have been six fatalities recorded statewide, a figure that includes Jim Tomlin.

Nelson said Kalispell Regional Healthcare has a longstanding and positive partnership with Libby and Lincoln County. He said he anticipates this relationship will remain important as the coronavirus crisis continues.