Flight for Life

What it takes to fly an Ebola patient safely back from Liberia

Randy Davis uses both his legal expertise and his piloting experience at Phoenix Air.
Photo by Kay Hinton.

A pilot since his teens, Randall "Randy" H. Davis 79L turned his love of flight into his life's work, earning a law degree and specializing in aviation law. 

He is general counsel for Phoenix Air Group in Cartersville, Georgia, one of the largest international air ambulance and special mission companies in the world. In August, he traded his suit and tie for a pilot uniform as part of a three-pilot team that brought missionary Nancy Writebol from Liberia to Georgia for treatment at Emory. 

Phoenix is under contract with the US Department of State as the only air carrier in the world with the capability to transport highly contagious patients using an airborne biological containment system (ABCS). 

The ABCS is a flexible, clear plastic, sealed environment tent erected inside a metal exoskeleton fabricated by Phoenix Air, which holds the tent erect. Inside the tent
is a stretcher, along with a toilet and task lighting. There is an airlock, allowing specially suited medical technicians to enter the negative-pressure, sealed patient isolation chamber to administer care if necessary. Depending on the severity of the contagion, the tent can be collapsed and removed from the aircraft as the patient exits, allowing all virus contaminants to be encapsulated inside the tent, which is then autoclaved to sterilize the contents and incinerated by a special contractor. The metal exoskeleton and air filtration systems remain contaminant-free and can be used again when a new tent and HEPA filters are installed. 

The air inside the tent is highly filtered as it enters and leaves the isolation chamber, and specially designed HEPA filters are disposed of after use. Currently the two special-missions Gulfstream G-III jets owned and operated by Phoenix Air are the only two aircraft in the world certified by the CDC, Department of Defense, and Federal Aviation Administration for deploying the ABCS.  

Phoenix Air holds a contract with the CDC to store ten complete, hermetically sealed ABCS units in its climate-controlled warehouse. Only the director of the CDC and the Secretary of Health and Human Services can authorize deployment of one of these government-owned ABCS units, including the units used to transport Kent Brantly, Nancy Writebol, and a third, unidentified American doctor to Emory, and physician Richard Sacra and journalist Ashoka Mukpo to Nebraska Medical Center. 

The pilots would take turns in control of the airplane, with each taking a few hours at a time on the flight deck. 

“We’d talk to the medical personnel about the patient’s condition. On a normal flight, if something started to go really wrong with the patient, we would land at the closest suitable airfield, but not with these patients. We were told that, other than for an aircraft emergency, we could not land anywhere but Dobbins Air Force Base,” Davis says. “Our medical team is good at dealing with any emergency in the air, and the patients and their families understood this. Our mission was to get them here.”

Extraordinary precautions were taken with the patients, including masking the entire interior of the airplane around the ABCS with protective sterile sheeting to avoid contamination, even though the patients were brought into and out of the chamber in full biocontainment suits. Pilots exited and remained outside of the plane while the patients were being brought in and out.

“When we were on the ground [in Liberia] we had to be careful. The airline terminal was fairly primitive. People do not shake hands, and there were huge dispensers of bleach water outside the terminals where everyone washed their hands,” he says. 

Taking on these highly specialized missions is Phoenix Air’s business, and part of what attracted Davis to his unique role with the company.

“Anytime you are flying folks for a specific purpose, especially people who are as sick as these patients were, this airplane, this equipment is the only way to get them where they need to go safely, efficiently, and in a timely manner,” he says. “That’s what our aviation work is all about.”

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