Air Evacuation of Citizens During the COVID-19 Epidemic

BACKGROUND: The coronavirus epidemic originated in China, having its epicenter in Wuhan. This was the first place in the world to adopt social distancing measures to contain the disease on January 23^rd, 2020. After the initial isolation, several countries started making diplomatic plans to evacuate and repatriate their citizens, with the permission of the Chinese authorities. Due to the high risk of exposure of the transported passengers, evacuations were conducted with preventive measures against contamination by biological agents.CASE REPORT: We report the air evacuation of 39 passengers from China to Brazil. Five passengers were transported to Poland and the remaining 34 went to Brazil, where they remained in quarantine for 14 d. The mission was triggered on February 4^th, named "Operation Return to Brazil" (Operação Regresso à Pátria Amada Brasil), and conducted by military personnel of the Brazilian Air Force. The mission was accomplished in 6 days; the flight from Wuhan lasted 25 h 20 min; and, additionally, there were on-ground preparations.DISCUSSION: Only with adequate isolation and protective measures was it possible to air evacuate the potentially contaminated passengers in the initial phase of the pandemic. Specific protective equipment (Personal Protective Equipment - PPE) is mandatory for missions in which the properties of the potentially contagious biological agent are not fully known, as was the case. Due to the risk of contamination of passengers and the likely evolution of the transport into an aeromedical evacuation, protocols stating the minimum safety conditions for this kind of patient transport must be followed, with consideration for the patient as well as the crew.Gomes ED, Ronconi MABR, Santos MB, Júnior PP, Franco AZP, Haberland DF, Borges LL.