By Dr. Susan Northrup, FAA Federal Air Surgeon
The past year has been challenging for aerospace medicine. We have worked closely with our international counterparts, fellow federal agencies such as the Centers for Disease Control and Prevention (CDC), and FAA co-workers to keep the National Airspace System open for business, albeit at a reduced level. Deep cleaning, fixed crews for air traffic controllers, quarantine and isolation protocols, etc., became part of our daily routine. The FAA extended the validity for many time-sensitive qualifications, including medical certificates, several times to accommodate widespread logistical challenges while ensuring public safety. The availability of AMEs (aviation medical examiners) and specialty evaluations has improved significantly, removing the need to extend medical certificates. The last of the medical certificate extensions expired on April 30, 2021.
Our goal remains to certify as many airmen as safety permits.
On March 26, 2021, we provided AMEs with guidance on applicants with a history of COVID-19. In most cases, the AME will be able to issue a medical certificate if you are otherwise qualified. If you had more than mild disease or have persistent symptoms, please discuss your health with your personal physician prior to returning to flying. We recommend this for all pilots. If you maintain a FAA medical certificate, have that conversation with your AME as well. Anyone with a medical should have the documentation from your illness available for your AME to review, regardless of the severity. The AME can guide you on what is necessary. In some cases, the AME might not need any documentation. For others, the AME might want to see the positive test report or doctor’s note requiring isolation for presumptive COVID-19. We defer this to the judgement of the AME. If you were hospitalized, we need the hospital records including admission and discharge notes, testing, and a status report from the treating physician. We also need a status report for anyone with persistent symptoms. You do not need to report a quarantine due to a possible exposure.
Post-COVID conditions (the CDC term, known also as long COVID, long-haul COVID, and chronic COVID) are an area of active research and a concern for flight safety. Defined as new, recurring, or ongoing symptoms more than four weeks after the initial infection with COVID-19, they are not rare. Post-COVID conditions are more likely if you are older, have underlying health conditions, and had more severe disease. Previously asymptomatic healthy and younger individuals have developed post-COVID conditions though. Manifestations include dysfunction of the cardiovascular, respiratory, renal (kidney), or neurological systems. You should report mental health symptoms (“brain fog,” depression, anxiety) or other symptoms such as fatigue, shortness of breath, cough, chest pain, headache, fever, loss of smell or taste, dizziness when standing, joint or muscle pains, or chest pain to your AME.
Remember that all certificated pilots (including student, sport, recreational, private, commercial, and airline transport) must comply with 14 CFR section 61.53. It states that if you have a disqualifying condition, medication, or treatment, you may not fly until it is resolved. Section 61.53 applies whether you use a FAA medical certificate, BasicMed, a driver’s license, or fly balloons or gliders.
Unfortunately, while the vast majority of airmen can be issued a certificate by their AME right away, we have denied a medical certificate for a small number of airman after a COVID infection. Some airmen had other conditions or medications unacceptable for flying. However, the vast majority of these individuals and others who only had COVID-19 simply failed to provide the information we requested. Our goal remains to certify as many airmen as safety permits. Please help us to do so.
Dr. Susan Northrup received a bachelor’s degree in chemistry and a medical degree from The Ohio State University, as well as a master’s degree in public health from the University of Texas. She is double board certified by the American Board of Preventive Medicine in Aerospace Medicine and Occupational Medicine. She is a retired U.S. Air Force colonel and a former regional medical director for Delta Air Lines. She is also an active private pilot.