EMS Ambulance 26 Aug 2021
COVID-positive? Why it’s best to repatriate sooner rather than later
A year after the pandemic struck, the world has learned a lot about COVID-19. We all know the milder symptoms it can cause – a dry cough, fatigue, loss of smell. Sadly, we’re also familiar with what happens when the virus progresses and leads to hospitalisation.
One of the biggest issues with COVID, however, is the sheer speed with which symptoms can change. A patient who seems to be doing well one day can get into severe difficulty the next.
Having organised over 70 coronavirus transports since early 2020, this is something EMS Ambulance has encountered all too often.
The temptation to delay
Medical transports happen for many different reasons – accidents, emergencies, long-term conditions that need specialist treatment in a foreign hospital. When a sick patient tests positive for COVID, however, the situation becomes more complicated. While transporting a COVID-positive patient by road or air ambulance is always possible (see below), it’s also more expensive. So the patient’s family sometimes feels caught in a dilemma. Should they go ahead with the transport now? Or should they wait until their loved one has recovered from the virus?
The problem with waiting
The big issue with COVID is that apparently-mild cases can take a turn for the worse quite quickly – often a week or so after the initial test.
“In symptomatic cases with signs of impaired ventilatory capacity (fever, coughing, shortness of breath etc), the clinical condition of a patient can change rapidly,” explains EMS Ambulance’s Medical Director, Professor Dr Arie van Vugt. “When admission to a hospital is needed for medical support, the situation can deteriorate towards the need for invasive mechanical ventilation within hours.”
Because patients can go downhill so quickly, he adds, it’s not safe to assume that a symptomless patient will necessarily stay that way. “Asymptomatic patients should not estimate the situation as ‘safe to wait’ (although, when vaccinated completely, the chance of dangerous developments is low).”
Delaying the transport, in other words, risks a situation where the patient becomes sicker and sicker, when they could have received round-the-clock specialist care in a hospital abroad.
“In countries with limited resources, only a rapid evacuation should be considered,” says Dr van Vugt. “If this situation occurs, don’t wait to make the decision to repatriate. Twenty-four to 48 hours of delay can result in a fatal outcome.”
How EMS Ambulance transports patients with COVID
If your colleague or loved one has tested positive for coronavirus, the good news it that we can always help them.
“If you’re within Europe, it’s possible to do the transport by road ambulance,” explains Professor van Vugt. “We can do it in isolation, carrying life support and oxygen therapy during the journey if necessary.
“The other option is an air transport. Although a COVID-positive person isn’t allowed on a commercial flight, we can organise the journey by private air ambulance instead. This allows us to carry the patient in complete isolation (with a so-called ‘epi-shuttle’ or ‘IsoArk’ isolation unit), and with advanced life support up to the maximum level of intensive care treatment during the flight.”
Do you have a COVID-positive colleague or loved one who needs to go abroad for treatment? Get in touch with the EMS team today to discuss the options. Whatever your situation, there’s a lot we can do, and we’ll be very happy to advise and help.