AINsight: Aviation Medicine in the Pandemic, Part 3

 - August 14, 2020, 11:55 AM

This story is part of AIN's continuing coverage of the impact of the coronavirus on aviation.

The entire world continues to learn new adaptations and strategies to cope with the Covid-19 pandemic, with ongoing changes occurring literally on a day-to-day basis. Will children return to public schools at all this coming year? Many college sports seasons are now canceled entirely. Most of the remaining professional sports events are being played without spectators.

The most disappointing to me personally is being unable to go scuba diving nor make my near-annual trek to The Masters. But if I am healthy enough to lament the “small stuff,” then at the same time I need to feel grateful and fortunate. That remains something that I focus on during some of the ongoing frustrations and disappointments.

If I or family, friends, and colleagues are healthy, then we have plenty to be thankful for.  Hopefully, in time, the societal burdens due to the pandemic will lessen. We all must exercise patience along the way.

All businesses are making adjustments, including those involved in both corporate and airline flight operations. At one moment there is some small optimism that airline bookings are improving, and then come the dire furlough warning letters being issued.

Aviation medicine is making adjustments, too. The FAA has realized that the process of obtaining a medical certificate is hindered by the pandemic, both in regard to the routine logistics of doing so and also for the inherent exposure risks to pilots and their AMEs.

In recent blogs, I discussed the adjustments being made regarding medical certificate extensions. The original ruling simply stated that the FAA would not take legal action against a pilot who continued to fly in “non-compliance” with medical certificate durations (for up to three months) as outlined in FAR 61.23. In other words, the pilot is knowingly breaking the rules, but no enforcement action will be initiated against that pilot.  

More recent FAA clarifications have occasionally used softer wording, in that the “validity” period of the medical certificate would be extended by the noted three months (even though the “non-compliance” wording remained the seemingly controlling verbiage). Regardless of the ongoing nebulous nature of the wordings, all recent FAA statements make it clear that the FAA has sanctioned flying for up to three months beyond the typical medical certificate durations outlined in the FARs—at least for the time being.

A special FAR (SFAR 118-1) was published on June 29, noting an effective date of June 25. This SFAR provides relief for both medical and operational certification date requirements. The FAA sent clarifications to AMEs on July 1, referencing some of the provisions of the SFAR.

The FAA notes that “more than 57 percent of AMEs are over the age of 60, a demographic at higher risk of severe effects” from Covid-19. I am one of that “aging lot,” but have continued to operate my office full time to support my pilot clients. My staff and I have made several accommodations to comply with accepted medical practices for reducing the risk of transmission of Covid-19.

These accommodations are somewhat inconvenient, of course, but we are happy to do our part to reduce risks to everyone. Pilots who come to my office have been all over the world and will soon leave to points afar once again. I do not want them to get sick from being in my office, and similarly, I do not want my staff or myself to get infected with Covid from a pilot who may be an asymptomatic carrier of the disease.

We cannot lead our lives in complete fear and paralysis, but prudent behavioral modifications and interventions are worth complying with while the virus situation is being sorted out.

In a more recent clarification to AMEs, dated July 7, the FAA stated that the “non-enforcement of expired medical certificates is a rolling 90-day action.” While again, there remained no true use of the word “valid,” the FAA does clearly support that medical certificates may be used for an additional three months.

However, the final rolling action timeline stated is that certificates that would normally expire Sept. 30, 2020, will now be in a non-enforcement status until Dec. 31, 2020. No extensions are stated beyond that date in this most recent guidance.

There is no way for me to predict whether the FAA will extend medical certificates yet again, beyond these stated dates. If they do not, the AME might be burdened with the expectation to perform up to three months of exams in December. I know that I will not have time to do that, and many of the other still-working AMEs may not either.

I recommend that pilots plan their renewal dates carefully and check with their AMEs well in advance to see if there will be available scheduling time should the pilot elect to fly beyond the usual expiration date of their existing medical certificate.

There remains confusion regarding how to handle expiring special issuances. These authorizations require a time limit to be placed directly on the medical certificate itself, stating that the certificate is “not valid for any class after” a specified date. This limitation, directly stated on the medical certificate, makes it impossible for me (or the aviation advocacy groups) to provide a blanket statement to pilots that it is OK to fly beyond that date. We have asked for more specific clarification on this from the Federal Air Surgeon, but so far there has been no formal guidance issued to AMEs.

While awaiting more specific guidance from the Federal Air Surgeon, the process for the AME to obtain a “one-time case-by-case” extension of a special issuance for a pilot requires direct communication with an FAA physician. This process itself is too involved—and is sometimes frustrating and time-consuming—to discuss in this blog, and I encourage pilots to ask their AMEs to do so only if it has been truly impossible to obtain the required data as specified in the special issuance authorization.

The FAA continues to state on its website: “If you are able, we continue to encourage airmen to accomplish their regularly required airman medical certificate exam with an FAA AME” as per normal scheduling and FAR requirements. The extensions exist, but everyone involved, from the FAA to the AME, understands that pilots should stick to their normal renewal cycle if at all possible.

The requirements of FAR 61.53 are not waived by any of the advertised medical certificate extensions. As you know, FAR 61.53—“Prohibition on operations during medical deficiency”—requires pilots to self-ground should there be a new condition of aeromedical concern, worsening or exacerbation of an existing condition (which may already be addressed in a special issuance authorization), and/or if new medications of potential concern are prescribed (or may simply be non-prescription medications being taken on an over-the-counter basis, but have effects that would not be compatible with aviation safety).

Therefore, if a pilot has a new medical situation that may otherwise preclude the issuance of a medical certificate (or may be theoretically grounding at any other time), the extensions cannot be used as a vehicle to continue flying regardless of the new medical concerns. FAR 61.53 applies at all times that a pilot intends to exercise the privileges of a medical certificate, without exception.

I express hope that pilots, their families, ancillary aviation workers, and vendors, and, of course, we aging AMEs and our staff members, all maintain health during these troubled times. I also hope that the world economy recovers and that once again there will be a more prosperous and optimistic future ahead of us.

Let’s support each other along the way, and be thankful for the health afforded by being careful and responsible with virus mitigation protocols.