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Negatively Pressurized Conex (NPC) and NPC Lite (NPCL)

Designed in response to the COVID-19 pandemic and the United States Transportation Command's Joint Urgent Operational Need (JUON) request for the high-capacity airlift of COVID-19 passengers, the NPC and NPCL systems enable safe isolation of and in-flight medical care for HCID individuals, while protecting the aircrew and preventing contamination of the aircraft. The systems can be configured in many ways to either transport COVID-19 patients who require in-flight medical care by an Aeromedical Evacuation (AE) Team or to quarantine ambulatory passengers who do not require in-flight medical attention.

The NPC is based on a modified 40-foot international intermodal metal shipping container with an air-handling system and can be carried aboard a C-17 Globemaster III. The smaller 30-foot NPCL is certified for use aboard the C-17 Globemaster III and multiple C-130 Hercules variants. The NPC is used for intertheater operations, and the NPCL is used for intratheater operations.

Both the NPC and NPCL systems consist of an anteroom and a patient room. The anteroom serves as a designated decontamination space for medical professionals to don personal protective equipment (PPE) prior to entering the patient room or to doff PPE prior to exiting the unit. To ward against infectious disease spread, the device uses an aft negative pressure blower system, in which fans circulate the air in a controlled fashion between the unit and the aircraft cargo compartment. 

The system's onboard equipment ensures negative air pressure inside the unit to minimize risk of infection. The air circulation pathway consists of six high-efficiency particulate air (HEPA) filters, and air flows from the least contaminated to the most contaminated areas. Air is pulled from the aircraft cargo compartment through the forward inlet HEPA filters to prevent contamination of the aircraft and enters the device’s anteroom through two HEPA filters, after which the air enters the patient room through two HEPA filters. Finally, the air flows back to the cargo compartment through two more HEPA filters.

Each NPC can hold 30 seated passengers, 22 ambulatory patients who can walk with minimal assistance, eight litter patients or variations thereof. By contrast, the smaller NPCL can hold 15 seated passengers, nine ambulatory patients, two litter patients or variations thereof. Both models allow medical personnel to use all medical supplies and equipment carried by AE crews and Critical Care Air Transport Teams, allowing for the same level of care available on any USAF AE mission.

The NPC and NPCL build upon the existing capability of its predecessor, the Transport Isolation System (TIS): an infectious disease containment unit first developed for Ebola patients in 2014. In response to the COVID-19 pandemic, Air Mobility Command (AMC) began operationalizing the TIS, but the unit had a limited transport capacity of only two to four patients. As a result, on March 28, 2020, USTRANSCOM published a JUON request for a high-capacity patient transport module for individuals infected with COVID-19 and other highly infectious diseases. In April of 2020, AMC and Air Force Materiel Command sought a solution. A DOD team led by the U.S. Air Force Agile Combat Support Directorate leveraged an existing Other Transaction Authority agreement within the Countering Weapons of Mass Destruction Consortium to award the contract to an industry team consisting of UTS Systems, Highland Engineering Inc., and Delta Flight Products. With the support of Army Contracting Command, the usual four-month contracting process was reduced to one week, allowing the Air Force team to deliver a prototype only 13 days after the award of the contract.

The Air Force Life Cycle Management Center’s Air Force Chemical, Biological, Radiological and Nuclear Defense (CBRND) Systems Branch led the endeavor to produce a prototype, in partnership with the Joint Program Executive Office for CBRND. With the extensive support of other organizations across the USAF, DOD and academia, the collaborative effort culminated in the rapid development and acquisition of the NPC, providing a robust patient movement capability in the midst of the COVID-19 pandemic. 

The NPC proof-of-concept prototype was delivered to Joint Base Charleston, South Carolina, on April 21, 2020, and passed demonstration testing aboard a C-17 Globemaster III on April 30, prompting AMC to authorize production of NPC units and pursue a parallel effort for the NPCL model to support intratheater airlift on all variants of the C-130 Hercules family of aircraft across the DOD and the U.S. government. On June 7, 2020, the first NPC was delivered to Joint Base Charleston, South Carolina, to begin testing and operational utility evaluation. On June 15, 2020, the NPC had its test flight, and on June 24, the first operational NPC arrived at Ramstein Air Base, Germany, from Joint Base Charleston, South Carolina, to stand alert. On June 30, 2020, the NPC made its maiden flight for operational use out of Ramstein Air Base, Germany, a mere 95 days after USTRANSCOM’s JUON request. By July 1, 2020, the first NPC operational mission had flown 12 patients from the U.S. Central Command (USCENTCOM) area of responsibility to Germany for advanced medical treatment.

The first NPCL was delivered June 1, 2020, to Joint Base Charleston, South Carolina, for testing and operational utility evaluation. On June 25, 2020, the NPCL system was certified for operational use aboard the C-17 Globemaster III, as well as the following C-130 Hercules variants: C-130H, C-130J, EC-130J, HCMC-130J and LC-130H. On July 3, 2020, the NPCL arrived at Ramstein Air Base, Germany, and it was used operationally for the first time on Aug. 16, 2020, in Afghanistan. 

The NPC is operated by AMC at Dover AFB, Delaware; Travis AFB, California; Ramstein Air Base, Germany; and Al Udeid Air Base, Qatar. The NPCL is operated by AMC at Dover AFB, Delaware; Travis AFB, California; Kadena Air Base, Japan; Ramstein Air Base, Germany; Bagram Air Base, Afghanistan; and Al Udeid Air Base, Qatar.

AMC’s 11 NPC’s and six NPCL’s have overseen the transport of over 266 patients on 44 missions. The total fleet of NPC and NPCL systems will consist of 60 units (30 of each model). Units not deployed to operational locations will be stored at Marine Corps Logistics Base, Albany, Georgia, and will be maintained by the Joint Enterprise Fielding and Surveillance organization.  The systems will be on alert to respond within hours to future pandemic and evacuation missions requiring biocontainment. 

General Characteristics
Primary Function: Aeromedical transportation of HCID patients
Manufacturer: UTS Systems of Fort Walton Beach, Florida; Highland Engineering Inc. of Howell, Michigan; and Delta Flight Products of Atlanta, Georgia
NPC: length, 39 feet 12 inches (12.18 meters); width, 7 feet 11 inches (2.41 meters); height, 8 feet 6 inches (2.58 meters)
NPCL: length, 29 feet 10 inches (19.09 meters); width, 9 feet (2.74 meters); height, 8 feet (2.44 meters)
Approx. Delivered Weight: NPC = 19,500 lbs; NPCL = 13,000 lbs
Prototype and Testing Cost: $2 million