NASA Commercial Crew Program and Medical Operational Challenges

BACKGROUND: NASA embarked on the Commercial Crew Program to launch astronauts into low-earth orbit from US soil and dock with the International Space Station (ISS). The eventual industry providers selected were SpaceX (SpX) and Boeing. These commercial transportation systems are vital to ensure crew availability on ISS for research and discovery. OVERVIEW: NASA/SpaceX Demo-2 (DM2) mission launched from the Kennedy Space Center in 2020 as the historic first crewed test-flight of the Crew Dragon spacecraft with two NASA Astronauts onboard. DM2 represented the first flight in 9-years from US soil since STS-135 in 2011. The 63-day mission ended with splashdown in the Gulf of Mexico, the first US water recovery in 45-years since Apollo-Soyuz. Validation of system hardware and operations allowed four-person crews to launch on subsequently missions (Crew-1, Crew-2, Crew-3, Crew-4, Crew-5 to date), which included International Partner crewmembers. DISCUSSION: A multitude of operational, training, medical, and technical issues needed to be addressed between NASA Medical Operations, the commercial provider SpaceX, and the Department of Defense. These included Flight rule development, occupant protection, pressurized suit testing, communication plans during mission phases, and emergency simulations for supporting Flight Surgeons and Biomedical Engineers. In providing crew experience with expected launch and entry G-force profile, Centrifuge training was established. Preventive health measures via the Health Stabilization Program were especially vital during the global COVID-19 pandemic. Unique aspects arise for SpX Dragon parachute splashdown and shipboard recovery operations in the Atlantic Ocean and Gulf of Mexico. The new Commercial Crew Program is indeed a wonderfully challenging and exciting era for human spaceflight.