With the world still well in the throes of the COVID-19 pandemic, airport operators are looking at what the future of their world will be like. For many, the airport of the future will be borrowing heavily from the lessons hospitals employ today.
That was the topic of conversation during a recent AAAE hosted, HDR sponsored, panel discussion titled Health Resiliency in Aviation.
The panel, consisting of Bruce Goetz, vice president of operations and COO of Tucson International Airport; Douglas Carney, senior vice president of real estate, facilities and operations at Brigham and Women’s Hospital; Bill Peduzzi, senior vice president and aviation director at HDR; Chris Bormann, HDR’s east region health director; Rebecca Hupp, airport director for Boise Airport; with moderator Carter Morris from AAAE, discussed applying principles from the health care industry to the future of airport operations.
“From a health care facility perspective, you have these hubs where the sick people go and you’re mixing all that biocontainment issues in one spot. Aviation has the parallel where we have the ability to move those around the world faster than any industry,” said Peduzzi. “So, there is this idea of containment that is common to both.”
Peduzzi added that while health concerns and mitigating the spread of disease was always considered by airport designers and operators, it was not until recently that is was at the forefront of their minds.
“We need to be really clear about what we are trying to achieve,” said Bormann. “The very essence of creating a safer airport environment is this criteria to prevent the airport environment from becoming an accelerator for disease transfer and in fact a declarator.”
Bormann broke down the risks airports face and the steps they can take to address them through three lenses: Design solutions, operational responses and behavioral modification. Further, he classified actions that can be taken into the Now, Near and Next.
Now is what an airport can do immediately, Near will require some work from an airport and its designer to achieve, while Next are aspirational goals that Bormann said will take research and time to successfully enact.
For the three lens, the Next includes plans like air quality and directing airflow at key locations such as bottle necks and entrance portals, managing and regulating bottles neck, and enacting confidence building campaigns to bring the public back into airports.
For the Near, Bormann listed antibacterial finishes on high traffic surfaces, the establishment of third party standards, like airlines enacting touchless check in, and preventing passenger concentrations.
Then for the Next, the goal is airports that can respond automatically and dynamically to reduce, weaken or even eliminate contagions, UV light decontamination and communicating the current risk status to passengers in ways such as crowd density, current air quality, etc.
When combining the Near category for the three lenses, what Bormann describes for the future is a smart airport.
“What if airports, as a building, could continuously self-monitor its own physical environment? Monitor it for infectious disease and contagion presence, then assign a risk factor. What if, based on that risk factor, the building could automatically alter itself to mitigate some of the disease transfer and improve safety in general? What if the building had an automatic response to initiate air and surface sanitation actions, passenger flow separation? Operational and behavioral protocols could be enacted immediately,” Bormann said.
And while a thinking airport is possible for the future, airports are currently enacting segments of it today to combat the current crisis.
In Boise, one of the key things Hupp said the airport has done is increase the air flow to help keep the airport as healthy as possible.
“We increased the air flow, because we, from a sustainability perspective, had increased our indoor/outdoor exchange and are using air exchangers to bring new air into the building to cool it in the evening. So, we’ve increased the amount of fresh air throughout the day.”
Hupp said the airport has also increased its use of technology to allow tenants to pay online and allow for making airport badging appointments online. Long term, she said they are looking at ways to stagger employee shifts and enact a long-term remote work policy.
“We’ve done a bi-weekly check in with all of our employees, asking them how comfortable they are returning to the work place, asking them if they have clear direction, if they can accomplish their work with the tools that they have,” Hupp said, adding the response from airport employees has been positive.
In Tucson, Goetz said that one of the things they did right away was develop a campaign to help ease travelers’ fears.
“Put yourself in the passenger’s shoes. Think about their journey and what sort of questions would you be asking and what would you want to see during your walk through the airport?” Goetz said.
Thusly, the airport has erected social distancing signs and added hand sanitizer stations for passengers to throughout the airport use from the moment they arrive. They’ve also put an emphasis on creating a contactless experience. Where Tucson can’t do touch free, they put in other measures – toe kick buttons on elevators and are soon installing UV light sanitizers on escalator handrails.
Goetz said they have also increased their air filtration and plan to further augment it.
“You can increase your filtering and we were able to go up to the highest grade we could without overwhelming the system, but then we are also looking at UVC systems inside the ducts and a plasma ionization system,” described Goetz.
Hospital Help
COVID-19 has a largely droplet-based transmission mechanism, with people to people transmission being its main vector. Carney said this is important to remember when talking about touchless processes and one they keep in mind at the Brigham and Women’s Hospital.
“We need to differentiate between sick people who come to the hospitals and pandemics, because the pandemic is everywhere, it’s not just at the hospital. This is one of the fundamental differences, this idea that it doesn’t exist in certain places – it exists everywhere,” Carney said.
With the knowledge in mind that infection is more likely from who you encounter in a walkway than it is an elevator button, Carney said that from the pandemics outset, the hospital has enacted an assessment system for its employees, which has now been extended to patients too.
Everyone morning, employees have to use an app the hospital has to verify they do not have any symptoms of COVID-19 and have not recently traveled from any highly infected states, then sign it before entering the hospital.
It’s a system that Carney thinks could be easily adopted by airports.
“Is it perfect? Of course not. But I think for an airport, that might not be a heavy lift. I already have to show my license, I have to show my boarding pass and there are simple apps out there that I can say I don’t have symptoms right now. And I think that is appropriate,” he said.
Carney acknowledged that some places have enacted temperature checks but stressed they are not that effective at slowly COVID-19’s spread.
“If you look into that, a relatively low percentage of people present with a fever, so that is more of a feel-good thing than a real security measure,” he said.
Key to both an airport and hospital are the volumes of people and guests that each bring in. Controlling the flow of those people is a measure taken by hospitals to keep clean and soiled people separate and has been shown to reduce infection. For example, hospitals will keep sick patients and the employees exposed to them away from operating areas.
“It really keeps the two movements through the hospital separate and that has profound impacts on infection control, operations and efficiency,” Carney.
Bormann said that airports could adopt similar practices and try to keep incoming and outgoing people more separated.
“The airport is also a large lobby. You have not only huge airflow challenges but huge masses of people problems. So, if there was a way to separate the passing of people in separate flows that could help mitigate disease transfer in the airport,” Bormann said.
For airflow, one of the challenges airports face that hospitals don’t is the size of the area. Hospitals are able to continuously take stale air out and put fresh air in thanks to their smaller sized rooms. Because of the size of airports, Carney said that that same method of air exchange offers diminishing returns. However, what airports can do to is direct airflow.
“You can direct air flow away from risks and groups of people,” said Carney. “There are a lot of principals from hospitals that can be applied if you scale them up.”
For example, Carney said that one of the steps that is built in automatically to hospital HVAC systems are HEPA filters, which he said may not be that hard for airports to install.
These are all steps airports should be thinking about for the future as COVID-19 will not be the last pandemic, the panel warned.
“This is not the last pandemic we are going to face, not even in gray-haired lifetimes. Unfortunately, I think this is a reality of our time,” Carney said.
This Pandemic and the Next
Discussing whether or not there were other areas airports may be overlooking by just focusing on how to combat CVOID-19’s transmission mechanisms that might leave them exposed to other pathogens, Carney said it isn’t likely an airport would face the same concerns a hospital does. Ebola, he said for example, spreads through bodily fluids and while hospitals have to worry about things like blood borne pathogens, airports can be probably sleep easy on both.
Instead it’s important not start becoming lax with the current threat. COVID-19 is still a new virus and research is continuing with it; undiscovered dangers could still lurk.
“I think the hardest thing for us to all deal with, and this is hotly debated about COVID-19 right now, is as a droplet-based transmission mechanism, that is one set of strategies,” Carney said. “If it’s determined that it is actual aerosolized and creates aerosols, that is a fundamental change in the vector between people and makes it far more difficult to control, especially with large volumes of people. That would be, if I were an airport operator and wanted to have bad dreams and lose sleep at night, that is what I would worry about.”
Bormann echoed the increased stress and challenges an aerosolized virus possess.
“The aerosol effect, it’s invisible, its everywhere, it can be blown around,” he said. “It would take a whole other set of design considerations. We like the fact that the droplet is heavy and it lands on things. It lands on things that can be cleaned, sanitized and wiped down. When it doesn’t land and it is everywhere and can be inhaled, that is a whole other set of challenges.”
The thought isn’t meant to be pessimistic, with Bormann adding that these are factors that airports need to consider not just with COVID-19 but are all possibilities of the next pandemic. And the tool to help tackle these risks could be the smart airport.
“We have to be able to look at all of these scenarios and that is why having the idea of an environment that can self-regulate down to a molecular level to be able to ascertain the risk scenario that you might have at any one time is probably our first line of defense,” Bormann said.
An airport’s weapon of the future may be something already employed in hospitals called laminar flow.
“In infection control, the direction of air flow matters just as much as how much air flow. What laminar flow means, generally, the air is supplied at the ceiling level in a direct line to the floor where it is then taken out of the room,” Carney described. “The premise behind that is that it would take whatever infectious agents are in the room straight away from the patient.”
Peduzzi and Carney proposed the possibility of implementing such an air flow system in areas like TSA checkpoints, gate and boarding areas, which could then be controlled autonomously by sensors able to tell when an area is becoming too crowded and viral transmission is likely.
“My hypothesis is that could meaningfully reduce something like a droplet-based transmission system and even, potentially, an aerosol-based transmission system,” said Carney.
Ultimately, many of the proposed solutions will be affecting the way airports are designed and put together in the future.
“All this is going to be affecting the way the buildings are put together. The ability to compartmentalize some of this is, by its very nature, is going to be required in a way that gets away from the trend that we’ve been focusing on,” Bill said. “Which is more open, more ability to not just sit but be a consumer while you sit, virtually or otherwise. All of that needs to be reconsidered in this new environment.”
