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International Civil Aviation Organization

ASSISTANCE VISIT METHODOLOGY, QUESTIONNAIRE,

CHECKLIST AND REPORT

Dr Anthony EvansChief, Aviation Medicine

Montreal, Canada

Acknowledgement – Dr Teresa BasseyHead, Aeromedical Standards Department

Nigerian Civil Aviation Authority

Refers to various documents:

• WHO – IHR (2005)– Case Management on board– Guide to Hygiene and Sanitation in Aviation

• ICAO – Health related documents (SARPs etc)– Guidance to States

• IATA– Guidelines

• ACI– Guidelines

CAPSCA‐Frankfurt July 2012

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ASSISTANCE VISIT METHODOLOGY, QUESTIONNAIRE, CHECKLIST AND REPORT

CHECKLISTIt is comprehensive

Broken down to component parts:

‐ Administrative

‐ Documentation

‐ Emergency Operation Center (EOC)

‐ Rescue And Fire Fighting (RFF) Services

‐ Immigration

‐ Customs

‐ Cargo And Baggage Handlers

‐ Air Navigation Service Provider (ANSP)

‐Medical Services

‐ Security

‐ Infrastructure

‐ Aircraft Operators

‐MediaCAPSCA‐Frankfurt July 2012


CHECKLIST

Each major component is further broken down to questions related to the component

Contains reference to guidance materials relating to the component parts.

Contains Tick boxes indicating whether the airport has complied(YES or NO)

Contains a Remarks column for each component


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CHECKLIST

AREAS REFERENCE YES NO REMARKS

A. ADMINISTRATIVE

Which entity fulfils the function of the “Competent Authority” (as

defined in the WHO International Health Regulations (2005)i.e which entity has responsibility for implementation of , in particular IHR(2005) Articles 24,25,27,28,30,31,32,35,36,38,40,41,43,46, and Annex 1(B),4,5 and 9

IHR Article 1, Definitions

Do the Civil Aviation Regulations cover public health emergency related provisions of ICAO Annexes and guidance material?

National documentation

Annex 6 National documentation



CHECKLIST Cont.AREAS REFERENCE YES NO REMARKS

A. ADMINISTRATIVE

Annex 9Annex 11Annex 14Annex 18PANS ATM Doc 4444


Is a contact point established for policy formulation and operational organization of preparedness plan for aviation

ICAO wed based Guidelines for States, Section “ General preparednessNational Documentation

Does the Public Health Authority have designated personnel at the airport?

Has the State established a national committee for Public Health Emergency planning?

National Documentation

IHR Annex 1, A, 3

Is this Committee involved in airport/ aerodrome Public Health Emergency Planning?

ICAO Annex 14, 9.1.1‐ 9.1.3

Is the Civil Aviation Authority involved? ICAO Annex 14, 9.1.19.1.3

Is the Public Health Authority involved? ICAO Annex 14, CAPSCA‐Frankfurt July 2012

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CHECKLIST Cont.


A. ADMINISTRATIVE

Is the Civil Aviation Authority involved? ICAO Annex 14, 9.1.19.1.3

Is the Public Health Authority involved? ICAO Annex 14, 9.1.19.1.3

If so, under a formal contract/agreement? ICAO Annex 14, 9.1.19.1.3

Are aircraft operators involved? ICAO Annex 14, 9.1.19.1.3



CHECKLIST Cont.


A. ADMINISTRATIVE

Are the Rescue and Fire Fighting services involved?

ICAO Annex 14, 9.1.19.1.3

Is the Air Navigation Services Provider involved? ICAO Annex 14, 9.1.19.1.3

Are the Immigration/Customs Services involved? ICAO Annex 14, 9.1.19.1.3

Are the security services involved? ICAO Annex 14, 9.1.19.1.3

Are private health services involved? ICAO Annex 14, 9.1.19.1.3

Are the service providers involved? (Airlines,Ground Handling Service (GHS), cargo, etc.)

ICAO Annex 14, 9.1.19.1.3

Are formal contracts/agreements utilisedspecifying the involvement of stakeholders?



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B. DOCUMENTATION

Does the airport have in place a Plan for Public Health Emergencies?

ICAO Annex 14, 9.1.19.1.3

Is it part of the Airport Emergency Plan? ICAO Annex 14, 9.1.19.1.3

Is it compatible with the national AviationPreparedness Plan for Public Health Emergencies?

ICAO Annex 9, 8.16

Is it compatible with the National Preparedness Plan for Public Health Emergencies?

ICAO web‐based Guidelines for States….Section ”General Preparedness”

Has the Airport/Aerodrome Emergency Plan been tested by conducting full‐scale exercises and/or table‐top exercises? Specify what and when

ICAO web‐based Guidelines forStates….Section ”General Preparedness”

Preparedness planning involves;

a. Public healthb. Regulatory aviation authorityc. Airport operatord. Aircraft operatore. Air traffic management f. Other service providersspecify

ICAO web‐based Guidelines forStates….Section ”General Preparedness”National documentation

CHECKLIST Cont.




B. DOCUMENTATION

Does the airport have in place a Plan for Public Health Emergencies?

ICAO Annex 14, 9.1.19.1.3

Is it part of the Airport Emergency Plan? ICAO Annex 14, 9.1.19.1.3

Is it compatible with the national AviationPreparedness Plan for Public Health Emergencies?

ICAO Annex 9, 8.16

Is it compatible with the National Preparedness Plan for Public Health Emergencies?

ICAO web‐based Guidelines for States….Section ”General Preparedness”

Has the Airport/Aerodrome Emergency Plan been tested by conducting full‐scale exercises and/or table‐top exercises? Specify what and when

ICAO web‐based Guidelines forStates….Section ”General Preparedness”

Are the stakeholders familiar with Annex 6, in particular Attachment B (Medical Supplies)?

ICAO Annex 6, Attachment B

Are the stakeholders familiar with Annex 9, Chap. 8, Appendices 1 (General Declaration) and 13 (Public Health Passenger Locator Card)?

ICAO Annex 9, Appendices 1, 13

Specify (1) who collects the General Declaration and Passenger Location Cards and (2) who processes the information on arrival.


CHECKLIST Cont.


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B. DOCUMENTATION

Are the stakeholders familiar with Annex 11, in particular Attachment C (Material Relating to Contingency Planning)?

ICAO Annex 11, Attachment C

Are the stakeholders familiar with Annex 14,Chapter 9 (Aerodrome operational services,equipment and installations) in particular paragraph 9.1 (Aerodrome Emergency Planning)?

ICAO Annex 14, Chapter 9

Are the stakeholders familiar with the International Health Regulations (2005)?

WHO IHR (2005)

Are the stakeholders familiar with ICAO Procedures for Air Navigation Services‐Air Traffic Management, Doc. 4444, in particular paragraph 16.6: “Notification of suspected communicable diseases on board an aircraft, or other public health risk”?

ICAO PANS‐ATM, Doc4444

Is there a national Preparedness Plan for a PublicHealth Emergency?

WHO IHR (2005) Article13

Which stakeholders receive training concerning thenational Preparedness Plan for a Public Health Emergency (airport personnel, public health authority, etc.)?


Is there a National Aviation Preparedness Plan for a Public Health Emergency of International Concern (PHEIC)? Is this Plan part of a National Public Health Emergency Plan?

ICAO Annex 9, 8.16



CHECKLIST cont.


B. DOCUMENTATION

Does the Preparedness Plan include phases asdefined by WHO in “Pandemic Influenza Preparedness and Response 2009”?

WHO Pandemic InfluenzaPreparedness & Response,2009

Is there a National Business Continuity Plan forPublic Health Emergencies?


Is there an Airport/Aerodrome Operator BusinessContinuity Plan for Public Health Emergencies?

Airport/aerodromeoperator documentation


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CHECKLIST


C. EMERGENCY OPERATION CENTRE (EOC)

Is there in place a flow chart to initiate the aviation emergency response plan process?


Do Public Health Authority personnel participate indeveloping the aviation preparedness plan?

Command and control systems is established for management of public health event on the day

ICAO web‐basedGuidelines forStates….Section ”GeneralPreparedness”National documentation



CHECKLIST Cont.


D. RESCUE AND FIRE FIGHTING (RFF) SERVICES

Do the RFF Services participate in the development and testing of the Airport Emergency Plan for Public Health emergencies?

Are personnel familiar with related guidance material available on www.capsca.org

ICAO web‐basedGuidelines for States….Section ”GeneralPreparedness”

www.capsca.org


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CHECKLIST cont.


E. IMMIGRATION

Does the immigration service participate indevelopment and testing of the Airport EmergencyPlan for public health emergencies?

ICAO web‐basedGuidelines forStates….Section ”GeneralPreparedness”

Are there procedures for handling passengerssuspected of being affected by a communicableDisease?

Airports CouncilInternational web‐basedGuidelines for airportoperators….Section 6

Are personnel trained about protective measures forhandling from suspected passengers?


ACI web‐basedGuidelines for airportoperators….Section 6

www.capsca.org



CHECKLISTAREAS REFERENCE YES NO REMARKS

F. CUSTOMS

Does the customs service participate in development and testing of the airport Emergency Plan for public health emergencies?


Are there special procedures for handling luggage from passengers suspected of being affected by a communicable disease?

IATA web‐based Guidelines for aircraft operators…Section “Air Transport andCommunicable;Diseases”. See “Cargoand Baggage Handlers”

Are customs personnel trained to use appropriate protective measures for handling luggage from suspected passengers?


IATA web‐basedGuidelines for aircraftoperators…Section “AirTransport andCommunicable; Diseases”

www.capsca.orgCAPSCA‐Frankfurt July 2012

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G. CARGO AND BAGGAGE HANDLERS

Do personnel handling cargo participate in development and testing of the airport Emergency Plan for public health emergencies?


Are relevant personnel trained to use protective measures for handling cargo that may contain infectious substances (ICAO Annex 18 – The Safe Transport of Dangerous Good by Air)?

ICAO TechnicalInstructions for the safetransport of dangerousgoods by air, Chapter 6

Are cargo and baggage handlers trained to use appropriate protective measures for handling luggage from suspected passengers?


IATA web‐basedGuidelines for aircraftoperators…Section “AirTransport andCommunicable; Diseases”

www.capsca.org



REFERENCE YES NO REMARKS


PANS‐ATM (Doc 4444)


ICAO Annex 11,Attachment C


www.capsca.org

CHECKLIST Cont.


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I. MEDICAL SERVICES

Is the airport medical service provided by the Stateor a private enterprise?


Has the service provider received training inmanaging public health emergencies?

WHO IHR (2005) Annex1, B

Has it established a communication process with thePublic Health Authority?


Has ease of access to the affected aircraft by medicalservice providers been considered in designating anaircraft parking position?


Are medical service providers aware of (1)Notification procedure of a suspected case by thepilot in command (2) Health part of the aircraftgeneral declaration?

1 ‐ ICAO PANS‐ATM2 ‐ICAO Annex 9,Appendix 1

Is there a procedure enabling the public healthauthority to communicate with the affected aircraftbefore landing?

WHO technical advice forcase management ofInfluenza A (H1N1) inAir Transport

Does the service provider participate in thedevelopment and testing of the airport emergencyplan for public health emergencies?

ICAO web‐basedGuidelines for States….Section ”GeneralPreparedness”




I. MEDICAL SERVICES

Does it use and process (1) the General Declarationand/or (2) the Public Health Passenger Locator Card?


Does it have access to the suspect or affectedtraveller’s assessment area?


Does it have procedures for transfer of suspect oraffected travellers to specialized evaluation units?

WHO IHR (2005) Annex1, B

Does it have procedures for aircraft disinfection? WHO Guide to Hygiene and Sanitation in Aviation

What disinfectant product(s) is used to disinfect anaffected aircraft?

WHO Guide to Hygieneand Sanitation in Aviation

What procedure used? How long does it normally take?

WHO Guide to Hygiene and Sanitation in Aviation

Is the service provider aware of relevant aspects ofthe IHR (2005)?

IHR (2005)

In the case of an affected aircraft carrying asuspected case of a communicable disease, areefforts made to minimize the delay to other travellersand the return to service of the aircraft?


CHECKLIST Cont.


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J: SECURITY

Does the aviation security (AVSEC) providerparticipate in the development and testing of theairport emergency plan for public healthEmergencies?


Are there procedures in place for managing aviationsecurity in the designated passenger assessment areafor suspect or affected travellers?


Are personnel trained in the use of protectivemeasures for managing suspect or affectedTravellers?


CHECKLIST Cont.




K. INFRASTRUCTURE

Are the international passenger flows mixed, onarrival and departure?


Is there a designated parking position for an affectedAircraft?

ACI web‐based Guidelines for airport operators….Section 6

If so, where is the designated position? National documentation

Are there provisions for maintaining electricity,water supply, waste disposal, etc. at the aircraft afterparking?


Does the airport have a designated holding orwaiting area for suspect or affected travellers?

WHO IHR (2005) Annex 1, B

If so, does the designated area have easy access forpassengers (air bridge, ground transportation, etc.)?


CHECKLIST Cont.


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K. INFRASTRUCTURE

What screening measures are to be available?

Questionnairetemperature

WHO Pandemic Influenza Preparedness & Response 2009National documentation

Availability at short notice(48 hours) if required ICAO web based Guidelines for States Section ‘Screening’

Designated area for screening is provided

Short term holding area is provided is provided for travellers undergoing health assessment

Information concerning public health action being taken is available to travellers in holding area

ICAO web based Guidelines for States Section ‘Screening’

IHR Annex 1B

WHO IHR (2005) Article 32

Requirements considered for screening equipment

MaintainanceCalibrationPersonnel training

ICAO web based Guidelines for States Section ‘Screening’

CHECKLIST Cont.




K. INFRASTRUCTURE

Does the designated area have easy access toemergency medical services?


Does the designated area have power supply,lighting, air conditioning and adequate services?


Is the position of the designated area promulgated toappropriate personnel?


Are screening measures available to be rapidlyintroduced? If so, for:1‐ Entry?2‐ Exit?3‐ Transit?


What screening measures are planned to beavailable?


Are facilities available to enable rapid testing ofbiological specimens? What are they?


CHECKLIST Cont.


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L. AIRCRAFT OPERATORS:

Do the aircraft operators participate in thedevelopment and testing of the airport emergencyplan for public health emergencies?

ICAO web‐based Guidelines forStates….Section ”GeneralPreparedness”

Are aircraft operators aware of (1) Notificationprocedure of a suspected case by the pilot incommand (2) Health part of the aircraft generaldeclaration?

1 ‐ ICAO PANS ATM2 ‐ICAO Annex 9,Appendix 1

Are aircraft operators aware of IATA guidelines for:cabin crew; maintenance crew; bird‐strike; cleaningcrew; passenger agents?

IATA web‐basedGuidelines for aircraftoperators…Section “AirTransport andCommunicable Diseases

CHECKLIST Cont.





Do the aircraft operators have procedures enabling cabin crew to identify travellers suspected of having a communicable disease

Do the aircraft operators have procedures for managing a suspected case of communicable disease on board a flight

IATA web‐basedGuidelines for aircraftoperators…Section “AirTransport andCommunicable Diseases

IATA web‐basedGuidelines for aircraftoperators…Section “AirTransport andCommunicable Diseases guidelines – cabin crew

Are ground personnel familiar with WHO global influenza preparedness plan

WHO Pandemic Influenza Preparedness & Response 2009

Number of trained personnel assigned for these duties, in relation to volume and frequency of travellers


CHECKLIST Cont.


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Are arrangements for documentation and interpreters considered?

Have personnel undergone a training programme to recognize disease symptoms?

Are personnel familiar with procedures regarding prompt assessment, care and reporting of ill travelers?

WHO IHR (2005) Article 32



M. MEDIA

Is there a communications strategy and plan? CAPSCA Global Meeting Conclusion

CHECKLIST Cont.


OUTLINE

PREAMBLE

METHODOLOGY

QUESTIONNAIRE

CHECKLIST

REPORT



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REPORT

The final report contains the description of the State and airport assistance visit. This will usually comprise but not be limited to the following:

documentation exchanged with the CAA authorities; AV Checklist responses by the CAA and stakeholders; list of attendees; agenda; presentations made at the assistance visit meeting; issues discussed during the assistance visit meeting prior to the airport visit list of findings by the assistance visit team; recommended actions, with target completion dates; any other issues raised by the stakeholders.

The Assistance Visit Report template including the checklist is available for download on the CAPSCA web site at: www.capsca.org.



REPORT TEMPLATEINTERNATIONAL CIVIL AVIATION ORGANIZATION

COOPERATIVE ARRANGEMENT FOR THE PREVENTION OF SPREAD OF COMMUNICABLE DISEASE THROUGH AIR TRAVEL (CAPSCA)

ASSISTANCE VISIT REPORT

STATE AND AIRPORT, CITY

(Dates)

EXECUTIVE SUMMARY

Maximum 1 page summary of organisations and facilities visited, main observations and associatedrecommendations, assistance provided, any other key mission results, and items of particular interest toICAO.ICAO, WHO and CAPSCA Representatives:

Names, Titles, Offices ICAO CAPSCA Regional Coordinator Technical Advisors Team Leader Technical Advisor(s) WHO representative (when available) At least one member from each sector (Civil Aviation & Public Health) OJT for Technical Advisor (optional)

Place of Visit: City, State

Dates of Visit: Dates


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Officials met: Name, Title, Organisation, E‐mail address• Civil Aviation Authority (aviation medicine, facilitation, aerodromes, air trafficservices, flight operations/standards/safety)

• National Public Health Authority including IHR Focal Point / WHO IHR ContactPoint

• Airport (rescue and fire fighting service, police, immigration, customs, porthealth, quarantine, medical, security, operations, public information, mediarelations, handling agents)

• Air Navigation Services Provider Aircraft operators• WHO Regional/Country Office (when available)• Other UN agencies, e.g. OCHA, WFP (optional)• Tourism Authority• National emergency/disaster response agencies

Objectives of the Visit:

Promote and facilitate communication & collaboration between the aviationand public health sectors

Provide information on ICAO and WHO Public Health Emergency (PHE)requirements for the aviation sector

Evaluation of existing provisions Assist States by providing advice and training

REPORT TEMPLATE Cont.



Scope of the Visit: PHE planning & preparedness in the civil aviation sector

All stakeholders involved in a response to a PHE in the aviation sector

Summary of Activities:

Day 1 ‐Meeting/Training

Day 2 am ‐ Briefing and Airport visit

Day 2 pm ‐ De‐briefing meeting and discussion of the visit results

Meeting Agenda: Opening Remarks by: ICAO, WHO, CAA, PHA

CAPSCA

ICAO Health Related SARPs & Documents

IHR (2005) related to Points of Entry (airports)

Public Health Authority on the National PHE Plan as applicable to the aviation

sector

CAA on the national aviation sector PHE Plan as part of the National Plan

Airport operator on the PHE part of the Airport Emergency Plan

Air Navigation Services Provider on its PHE Plan

Aircraft operator on its PHE Plan

CAPSCA Assistance Visit methodology, checklist & report



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Airport Facilities Visited: All facilities having a role in PHE planning/response, such as:

Emergency Operations Centre

Passenger screening locations and facilities

Medical Services/Response – clinic

Immigration & Customs

ATC Tower

Passenger quarantine/assessment/holding facility/room/area

Designated aircraft parking position, if applicable

Rescue and Fire Fighting Services

Any other agency / area / facility involved in a public health emergency

References and

Documents Reviewed:

ICAO Annexes 6, 9, 11, 14, 18 SARPs & Doc 4444

WHO IHR (2005)

ICAO, WHO, ACI & IATA guidelines

National PHE Plan – Aviation part

Airport Emergency Plan (PHE part)

ANSP Emergency Procedures (PHE part)




(insert photos and other images when useful to illustrate)

1 Introduction

1.1

2 Visit and Observations

2.1

3 Conclusions and Recommendations

3.1

APPENDICES:

A Checklist

B Observations and Recommendations

C Meeting/Visit Agenda

D List of Participants



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FINAL REPORT

The results of the assistance visit are provided to the CAA and can only be made public by them.



SUMMARY

PREAMBLE

METHODOLOGY

QUESTIONNAIRE

CHECKLIST

REPORT



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International Civil Aviation Organization

ASSISTANCE VISIT METHODOLOGY, QUESTIONNAIRE,

CHECKLIST AND REPORT

Dr Anthony Evans

Chief, Aviation Medicine

Montreal, Canada