Royal Flying Doctor Service Coronavirus Disease 2019 Activity and Surge Modeling in Australia

Abstract

There is a coronavirus disease 2019 (COVID-19) pandemic. We aimed to describe the characteristics of patients transported by the Royal Flying Doctor Service (RFDS) for confirmed or suspected COVID-19 and to investigate the surge capacity of and operational implications for the RFDS in dealing with COVID-19. Methods: This was a prospective cohort study. To determine the characteristics of patients transported for confirmed or suspected COVID-19, we included patient data from February 2, 2020, to May 6, 2020. To investigate the surge capacity and operational implications for the RFDS in dealing with COVID-19, we built and validated an interactive operations area-level discrete event simulation decision support model underpinned by RFDS air medical activity data from 2015 to 2019 (4 years). This model was subsequently used in a factorial in silico experiment to systematically investigate both the supply of RFDS air medical services and the increased rates of demand for these services for diseases of the respiratory system. Results: The RFDS conducted 291 patient episodes of care for confirmed or suspected COVID-19. This included 288 separate patients, including 136 men and 119 women (sex missing = 33), with a median age of 62.0 years (interquartile range, 43.5-74.9 years). The simulation decision support model we developed is capable of providing dynamic and real-time support for RFDS decision makers in understanding the system's performance under uncertain COVID-19 demand. With increased COVID-19−related demand, the ability of the RFDS to cope will be driven by the number of aircraft available. The simulation model provided each aviation section with estimated numbers of aircraft required to meet a range of anticipated demands. Conclusion: Despite the lack of certainty in the actual level of COVID-19−related demand for RFDS services, modeling demonstrates that the robustness of meeting such demand increases with the number of operational and medically staffed aircraft.

Aeromedical retrieval diagnostic trends during a period of Coronavirus 2019 lockdown

“…As many remote Australian communities have limited access to COVID-19 testing and management facilities, coupled with higher chronic disease risk factors, it is likely that during mass infection many of these patients will require air ambulance transfer to inner-regional and major city hospitals. 16 This study highlighted interesting trends during a period of social isolation and lockdown. Future research should consider whether the overall numerical reductions in cardiovascular disease were due to less clinical cases, or a result of less people seeking treatment.…”

Mental Health Crises in Rural and Remote Australia: An Assessment of Direct Medical Costs of Air Medical Retrievals and the Implications for the Societal Burden

“…8,9 Furthermore, increased environmental challenges including drought, fires, and climate change, and the recent Coronavirus pandemic, are placing greater pressure on the mental health of many rural and remote communities. [10][11][12][13] In this context, the Royal Flying Doctor Service (RFDS) provides air medical retrievals for Australians living in rural and remote communities experiencing health crises, including acute mental health presentations. Patients are typically transferred by aircraft to large metropolitan or inner regional public hospitals for urgent acute care.…”

“… 8 , 9 Furthermore, increased environmental challenges including drought, fires, and climate change, and the recent Coronavirus pandemic, are placing greater pressure on the mental health of many rural and remote communities. 10 , 11 , 12 , 13 …”

Hospital in the air: Royal Flying Doctor Service retrievals and challenges before, during and after, Australia's COVID‐19 lockdown in 2020

“…Gardiner 2 had previously modelled that if COVID‐19 transfers were to increase to a threshold of 10 patients per day per RFDS area of operation, Australia's Hospital in the Air 's current fleet of 77 aircraft across its 23 Australian bases would not be able to satisfy this insuperable COVID‐19 workload demand. Low‐priority transfers and patient repatriations would face delays until the COVID‐19 surge back‐log was able to cleared.…”

“…Fortunately, COVID‐19's worst‐case disaster scenario 2 did not eventuate for the RFDS. Nevertheless, COVID‐19's conflagration into a global public health threat incited aeromedical services worldwide to rapidly protocolise and simulation‐train locally adapted personal protective equipment (PPE) policy, safe advanced airway management, aircraft disinfection and rescue base social habits, 3 with the support of the Air Medical Physician Association 4…”