COVID-19 Variants and Their Implications for Airline Pilots

Health Watch

By ALPA Staff

Over the last few months, the delta variant has caused a sharp rise in the number of COVID cases and consequent hospitalizations and deaths in North America, while the lambda variant, another mutation of the coronavirus, has made significant inroads in South America.

The good news is that the available treatments—the mRNA vaccines from Pfizer and Moderna and the more traditional, virus-based Johnson & Johnson option—remain reasonably effective in preventing illness and extremely successful in thwarting more dangerous complications. Just recently, the Pfizer vaccine received full approval from the U.S. Food and Drug Administration while the Moderna and Johnson & Johnson vaccines are available on the U.S. market under the agency’s emergency use authorization.

“It’s been well documented that persistent fatigue, respiratory compromise, and a host of other symptoms such as loss of taste or sense of smell may persist for some individuals following COVID-19 infection,” says Dr. Quay Snyder, ALPA’s Aviation Medicine Advisory Service (AMAS) aeromedical advisor. “Of particular concern are the reports of neurological, cognitive, and psychiatric symptoms after infection, even with less acute cases,” he observes. “These conditions may lead to additional medical certification screening requirements for pilots recovering from the virus.”

The FAA addressed pilot immunization for the current pandemic in its Safety Alert for Operators (SAFO) 20009 on May 25, 2021, acknowledging, “Crewmembers are encouraged to get a COVID-19 vaccine. Those who hold an FAA-issued airman medical certificate must comply with any applicable medical requirements following vaccination.” For example, pilots who are hospitalized after contracting the virus must check with their aviation medical examiners before their next exam to see what documentation may be required for ongoing medical certification.

In the wake of the fast-spreading delta variant, which became dominant in July, several U.S. airlines, including Frontier, Hawaiian, and United, have announced vaccine mandates for their employees. While U.S. law doesn’t prohibit companies from taking this type of action, the Association has been very clear that any vaccination requirements are an issue that must be bargained for and ultimately agreed to by each ALPA pilot group.

In Canada, the federal government announced on August 13 that it would require immunizations as early as the end of September for airline pilots and other transportation workers. According to a recent public statement, the government made this decision because the vaccines have proven to be the most effective tool available to reduce the risk of COVID-19 and to protect the country’s broader public-health interests.

“Vaccinations are our best line of defence, and for those few who are unable to be vaccinated, accommodation or alternative measures, such as testing and screening, may be determined in each situation, to protect broader public health by reducing the risk of COVID-19,” the statement said. In addition to the immunizations approved for use in the United States, Health Canada and Transport Canada have also authorized the AstraZeneca vaccine.

However, questions remain about the emerging effects of the delta variant and what to expect. The number of “breakthrough infections”—instances when those immunized become infected—is escalating. The delta variant causes a significantly higher viral load than other variants, and those with breakthrough infections may consequently exhibit more severe symptoms.

As Air Line Pilot went to press, the U.S. Centers for Disease Control and Prevention (CDC) was reviewing the possible need for a booster for those who previously received the single-dose Johnson & Johnson vaccine or the two-dose Moderna and Pfizer vaccines. However, the health agency is recommending that moderately to severely immunocompromised individuals receive a booster at least 28 days after the completion of the initial two-dose mRNA vaccine series.

The CDC reports that any serious side effects from coronavirus vaccines that could cause long-term health problems are extremely unlikely and, according to a recent CDC study, these vaccines are still 90 percent effective in preventing hospitalizations and other serious complications related to COVID-19.

This article was originally published in the September 2021 issue of Air Line Pilot.