With air travel down over 90% since the start of the pandemic you might expect that flying is a primary mechanism for transmitting the SARS-CoV-2 virus. It’s not. Despite passengers bringing the virus into the country on planes, and spreading it from one region to another via plane, that’s how people with the virus got around – not where infection clusters are known to have developed.
Professor Joseph Allen of Harvard studies exposure assessment science in the School of Public Health and has written on infectious disease mitigation on planes. He writes in the Washington Post “Airplanes don’t make you sick.”
On most planes everyone is facing the same direction. There’s a seat back between them. People are wearing masks which is imperfect but does help to limit spread.
Most planes have HEPA filters that match what’s recommended in hospitals where COVID-19 patients are being treated. Most virus particles are going to be filtered out. And air flow on board doesn’t travel throughout the entire passenger cabin. (One study contradicts this, suggesting that in 2003 22 SARS cases are thought to have come from a Boeing 737 flight from Hong Kong to Beijing..)
Well, the Washington Post's story about how droplets spread on airplanes wins the award for "gif most likely to give me nightmares FOREVER" https://t.co/vwW3w1Ti3v pic.twitter.com/tQSLMRufN1
— 💀 damned sinker 💀 (@dansinker) April 28, 2020
This doesn’t mean you will not catch COVID-19 on a plane. But it does make your chances much lower. I’d offer several caveats, however:
- Air filtration doesn’t help if the person beside you is shedding the virus, you’ll be exposed before the virus hits the filters.
- These filters haven’t been enough to protect many hospital workers from contracting the virus.
- You’re unlikely wearing as much personal protective equipment as doctors in hospitals should be. On the one hand there’s much greater risk intubating a sick patient than sitting near them, on the other hand your PPE probably isn’t as good. (I do have Chinese KN95 masks and South Korean KF94 masks, these respirator masks aren’t taking supplies away from medical professionals, however there are reports of poor quality counterfeits as well.)
- Not all planes have HEPA filtration, 50 seat regional jets and turboprops often will not.
Finally if you’re flying out of a coronavirus hot spot like New York (still) or even perhaps Chicago your chances of sitting near someone with an asymptomatic or pre-symptomatic case of the virus is heightened.
Nonetheless the point is well taken that actually flying on a plane isn’t riskless, but is probably much lower risk than you think – you probably need to actually get unlucky and sit right near someone, not just be on the plane with them. However being on a plane is likely less of a risk than many other indoor activities.
Flight attendants have contracted the virus, but it’s also not clear that the transmission is usually passenger-to-flight attendant. They may pick up COVID-19 from each other (it’s often harder to social distance from colleagues than passengers in this reduced-service environment) or during layovers.
Of course you’re not just dealing with the plane itself. You have to go to the airport. If you’re taking public transport or Uber, there’s exposure risk. You’re transiting through the airport as well. You’re going through the TSA checkpoint, which many times prior to the pandemic I’ve described as like coming face-to-face with the monkey from Outbreak.
Most of the changes Professor Allen recommends, unsurprisingly, deal with airports.
For starters, airports should mandate mask wearing; increase ventilation rates; make bathrooms touchless; consider deploying upper-room germicidal UV fixtures in areas with high-occupant density; institute temperature screening; deploy hand-sanitizer stations; and, once passengers arrive at their gates, require that they stay in their designated area except for bathroom usage.
Airlines should ensure gate-based ventilation is operating during boarding and disembarkation; carefully choreograph the loading of airplanes; mandate mask use; and provide meals and bottled water during boarding and discontinue in-flight meal and drink service.
Two months ago I wrote that it’s safer to travel than you think. I wasn’t telling you to travel, and older people with pre-existing conditions I think probably shouldn’t. However actual risk of travel differs greatly from the perceived risk.
Wash your hands. Don’t use public restrooms where you can avoid it (including the lavatory on board). And bring plenty of hand sanitizer, which TSA is permitting you to bring in larger than 3 ounce quantities. Wipe down your personal spaces, even knowing that airlines are doing this more than ever before. And wipe down your bags as well, and.. keep washing those hands.
Bottom line
Stay home if you can’t tolerate risk
And for all the lecturers that will say it is irresponsible because you Might be spreading the virus, again, anybody who does not want the risk, anywhere in the world, can stay home
And now, drumroll, let’s start the parade of idiots replying
@Gary: if it comes down to wearing a mask while on an airplane, or not wearing a mask, common sense tells me that, during a viral respiratory outbreak, it is probably a good idea to wear a mask. The risk increases on trips over 8 hours and if you are within 8 pax of the viral/bacterial carrier. Tuberculosis is also a risk–I think I read somewhere it is about 7% if you are in the immediate vicinity of someone who is an active TB carrier. And nobody wants the person seated next to them to let out a heavy, germ-laden sneeze.
Frankly, I never gave it much thought before, but now I am re-thinking my flight strategy. If a mask provides me and other geezers 50+% percent protection, so much the better. An alternative would be to wear a mask when entering the lavatory–I understand the Covid germs float up from the feces in the toilet. The other option might be to carry a pocket-sized spray container of 99.99% disinfectant. Better yet, the airplanes can be designed to emit the airborne disinfectant after each pax exits the lav.
@Doug: “And for all the lecturers that will say it is irresponsible because you Might be spreading the virus, again, anybody who does not want the risk, anywhere in the world, can stay home”
Essential workers such as those working in a supermarket often can’t quit without being denied unemployment and likely make low enough wages they have little saved to allow them to quit. Is their health/safety a lower priority than your ability to not be mildly inconvenienced? Travel, big parties, etc. will come back, but it is not a good time to do it as you putting others in jeopardy, especially those who are helping us get through this crisis.
When the AIDS epidemic was beginning in the 80s, there were all sorts of scary theories about how it might spread, from toilet seats to kissing, and do-gooders were ready to turn the world upside down to stop it. Somehow the mentality was a lot different back then, and we now realize that it was a lot harder to get than first hypothesized. Covid will be the same, with the nonsense about “asymptomatic spreading” and transmission through pets being debunked. Even in the hottest of hot spots, most of the deaths are in nursing homes (which many governments like NY/NJ/CT forced to accept Covid positive patients) and social events with lots of close contacts like weddings, etc. I’ll be on the first plane as soon as I have someplace to go, and some assurance that I’ll be able to get back into the US afterwards.
Count me as another idiot replying in the parade. A lot of people have no alternative than to be out in situations where they’re not comfortable about the risk. This *certainly* includes a lot of cabin crew who’d rather be at home or in a lower risk job, but have no financially possible way to make that choice or change right now. I have many friends in that category. It’s not like it’s difficult or against our own self-interest for each of us out there flying to just make the safest choices we can like Gary says. It helps us and helps everyone else too.
As an M.D. with access to accurate medical information I find it distressing that you are providing “medical” type information without all the data. Anyone can take a piece of data and use it to support their position. Sadly you will never know the harm you may do by supporting those who think this is all “overblown”, etc.
Yes many will use this to support their own behavior – BUT – as long as asymptomatic people can potentially infect me (and others) without any knowledge and we don’t have adequate contact tracing nor understand “superspreaders”, etc. non-essential travel may be a risk too far.
OK, Doug, and you are number one in your own parade. One pom-pom is in honor of not utilizing punctuation and the other is for your reeking hauteur. Bottom line.
This post answers the question posed in the headline affirmatively. Yes, flying actually puts you at risk of contracting CV-19. Period. The debate is only about the severity of the risk.
If one must travel, the amount of risk is irrelevant. But almost all air travel is discretionary. Why assume unnecessary risk especially when experts can’t quantify the risk with certainty. Even assuming that being on an airplane is not terribly risky, one is still subject to the risks posed by other parts of travel and being in public generally.
Travel has always been enjoyable — until now. The last flight I was on was March 13. It was no fun as passengers regarded each other as potential threats. The tense atmosphere was reminiscent of flights following 9/11.
Now airlines have reduced or eliminated most service, lounges are closed, and everybody is walking around in masks. There would have to be a darned good reason for me to even think about getting on a plane risking infection and subjecting myself to the kind of miserable experience travel has become. Others will have no problem with these conditions.
P.S. There are many young healthy people who have CV-19 without symptoms and there are many others who got it, survived without hospitalization, but wished they were dead while dealing with the virus.
I don’t think people realize…this is a PANDEMIC, not just your normal cold or flu wandering around. We need to work as a CIVILIZATION to try to protect those most at risk. If you NEED to go to another city, fine, fly, and take precautions. However if you don’t need to pack into a tin can sitting next to 100-300 people you don’t know, perhaps you can wait a year or two for the betterment of EVERYONE IN THE WORLD. Enjoy the area around you, I know we are all addicted to travel, but maybe, just maybe, you will make travel better in years future by NOT traveling this year?
@Doug – you called it!
@Doug,
Scientists and doctors are not idiots to suggest staying at home and social distancing.
A good candidate for an idiot is one who ignores science.
Cheers.
Thank you, est net.
@Mak, asymptomatic spread is not nonsense. Please research facts as the society in the U.S. appears to have a tremendous struggle with truth vs. QAnon and other nonsense.
Happy hour!
@doug
Exactly. 7,500 people a day die from something over than covid in the USA. This virus has been her longer than first thought and less deadly than predicted.
If you a risk averse then flying is a risk, driving to the airport is a risk. There are risks in life. If you want to stay home and order uber eats and TP from Walmart for the rest of you life go right ahead. However we haven’t come up with a cure for dying. We are all going to do it at some point on our lives. Individuals should be allowed to choose their own risks.
Experts say drinking and smoking will kill you, give you cardiovascular disease, cancer etc. Yet people still drink and smoke.
The risk of infection is only one reason people are shying away from flying. It is also because under the current conditions is not very fun. People treat you with suspicion. You treat others with suspicion. Service is non-existent. Lounges are closed. Everyone is wearing masks. Qatar Airways crews are in hazmat suits. You may have to quarantine at your destination or when you get home. And, to top it off, if you are traveling for pleasure, much of what you want to do at your destination will be closed or offering a decreased level of experience. So, I am not afraid of getting sick from flying. I love flying too much to want to experience it in its current state. That is why I am not flying.
@joelfreak – well said.
You use the phrase “older people with pre-existing conditions.” I believe the correct phrasing should be “older people and people with pre-existing conditions.” Older people are more vulnerable whether or not they have pre-existing conditions, and people with pre-existing conditions are more vulnerable whether or not they are old.
@al k
And so is the one that fears venturing out due to one more (and less deadly) thannotyer factors
@john r
The real problem out of this will be all the idiots that will live in fear for years to come and try to tell everybody how to live their lives
I hope all of those stay at home and let the rest of us move on
Just because a poster says he’s a MD doesn’t give the post any more credibility. Doctors can give medical advice but I wouldn’t exactly rely on them exclusively to craft public or economic policy.
Why people have to come on here to convince others why their decision is the only right way is beyond me.
So is this: “The airplane air does not make people sick, People make people sick”… as is… “Guns do not kill people, people kill people” Not sure why anyone would say being on a airplane does not make you sick.
@ Peter
These scientists and physicians who’ve studied virology, epidemiology, microbiology, immunity, and Public Health for decades…..what do they know?
Far more prudent to rely on the experience of social media posters, cable TV commentators, and radio talk show hosts who have “studied” this virus for nearly 11 weeks.
Shocking. Blogger who makes his money when people travel posts an article stating go ahead and travel. News at 11.
I love the idiots who keep comparing Covid to eating, drinking, smoking, car crashes, lightning strikes, pool drownings, etc. Because those are all so easily transmitted face to face and also went from 0 to 1,500,000 incidents in two months. Totally apples to apples.
Last time I checked air travelers spread the virus around. I am also seeing high numbers of new infections every day.
Isn’t that what matters? The economy can’t recover if we keep spreading the virus around.
@Mak
The parallels with AIDS are pretty thin. Very early in the AIDS epidemic the high risk activities associated with transmission were identified; I’m pretty sure that people are aware of the fact if they’re engaging in anal sex or intravenous drug use, contrasted with a complete ignorance of being in close proximity to an asymptomatic spreader of COVID.
Asymptomatic spread is a fact, as has been shown in healthcare workers unknowingly spreading it to residents in care facilities.
@Paolo You must be very young to think this and probably not alive or aware when AIDS was new on the scene. There was in fact much discussion and worry about transmission from waiters, through water fountains, pools, etc., and it was a major controversy when children with AIDS were allowed to go to school with healthy kids – and not because of fear that they would be having unsafe sex. It took several years for the public to understand that casual contact was riskless, and you might google Ryan White, a child with AIDS who had to fight for the right to go to school to read about this period in history. That the public always knew how difficult it was to transmit AIDS, and that people weren’t terrified of it, and that politicians and demagogues didn’t take advantage of that terror, is revisionist history.
I would be interested in seeing any non-anecdotal example of “asymptomatic spread.” Lots of breathless news stories from a junk science filled media to a science ignorant public, but no actual evidence. We know that viruses need a mechanism to spread and don’t move like magnetism or gravity. If you are not ill enough to shed virus, you likely don’t have enough virus to shed in casual settings. That is reality, and if we take temperatures as is done in countries that have conquered Covid without impoverishing themselves or eliminating civil liberties (US/Europe style), such as Singapore, Taiwan, Korea, etc. we would go a long way towards limmitting spread without destroying society.
@Charlie, that’s one thing we don’t have good data on. Have you seen statistics that carefully separate out healthy older people from older people with serious underlying conditions? What is the risk difference between being 66 and healthy and being 89 with cancer or being 34 with an immune deficiency? Too often media generalize and lump together people of very different profiles in catch-all categories.These are just some of the many pieces of information we don’t seem to be able to come up with. Where I live, 80% of the deaths have been people who reside in nursing homes.
Jaymar01:
And what have these scientists said? They have been wrong over and over again. Do I need to lookup Fauci’s quotes for you? Do you not remember they were telling us not to wear masks a few weeks ago? So how about using your own common sense?
Why do you rely solely on the people who have been wrong on this time after time?
They, like the rest of us are learning new things, but as in the case of the masks, it looks like it is harder for them to make a change, even though it is obvious to society as a whole. Basically, when we have new information we can make a decision and act on it. If the people in charge did that, they would look wishy washy. Since they have made a statement about something, they need to be 90% sure they are incorrect before they change, while we can take actions on 55/45.
Asymptomatic transmission is real. What is interesting though is that it appears the risk of transmission drops precipitously five days after symptoms appear.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2765640
@Mak you are right and wrong re AIDS. It was common knowledge among the hardest hit populations pretty early on that unprotected sex and intravenous drug use was the primary transmission route for HIV. The average person may not have understood this (or chose to not) until the government published Understanding AIDS sometime in the late 80s. But the hysteria surrounding AIDS I think far surpasses any craziness we are seeing related to COVID – but that remains to be seen.
@UA-NYC, So you’ve never heard of second hand smoke or car crashes killing anyone besides the careless driver? Actually second hand smoke kills 600,000 people worldwide every single year. But I’m an idiot, so I can’t bring this up because you are the brilliant apple genius who is good at name calling, not reasoning.
@est net: “As an M.D. with access to accurate medical information”
With all due respect, you seem to be overstating your knowledge. Let’s face it: there is little “accurate” medical information regarding how COVID-19 spreads. We have some information, but it has little to do with medical knowledge and a lot to do with data (aka, being an MD doesn’t help – being able to read data does). We know that confined indoor spaces with prolonged close contact and limited air flow is bad (a meat processing plant, your living room, a cruise ship or naval vessel, possibly a subway). We know that you’re very unlikely to pick up COVID-19 outdoors. We seem to have a hunch that warm, sunny conditions — and maybe humid climates — are good for avoiding the virus. Other than this, we know very little about how the virus spreads.
@Doug. +1.
Additional comment: The funniest thing is when people solemnly pretentiously speak for “Science”. I wonder who gave them the deep voice modulator and god like reverb. To them I say, “Riddikulus” [ Harry Potter’s Boggart-Banishing Spell]. Then the squeaky bow tie wearing nerd comes out.
The airlines are asking for masks boarding but about half do not wear them during flight.
Load factor on the few flights flying has jumped way up.
I was on a couple Allegient flights last week with about 15-minute turnaround.
TSA lets you bring onboard up to a 12-oz bottle of hand sanitizer and a pack of wipes. Take them.
“If you’re taking public transport or Uber, there’s exposure risk.”
Yes, I’m more concerned about the ground transportation than the flight. That’s a tough nut to crack.
Article from the Lancet analyzing spread. Two of the infected subjects took flights, and not short ones, and those flights apparently spread the disease to nobody, while other activities certainly did.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30314-5/fulltext
@Berisha I see where the JAMA article says that asymptomatic isolation should be part of a containment strategy, but I don’t see any evidence of asymptomatic spread. Much of the confusion is over language. A person might have a fever and no other symptoms, and in the popular literature be considered “asymptomatic” but that is in fact a symptom, and allows us to identify the contagious from the non contagious.
As to the comparison with AIDS, its hard to compare hysterias, but there were certainly wild speculative fears and government interference with human rights. You might look up when the US began allowing entry of HIV positive foreigners (hint, its a lot later than you think). While there were hysterical and incorrect fears, and a convenient group of already marginalized scapegoats, there was still at least the general belief in liberty that prevented the government from coming close to the impositions on personal liberties they have managed today. Today the vast majority of Americans are happy to get their $1200 checks and about half of the USA get their income or support from a government check that won’t stop (and allows government workers to avoid even the pretense of working or inconvenience of commuting). The government was also smarter this time in that they closed down the courts and made redress impossible.
@DaveS – what’s the R0 number for second hand smoke, .000001? Great comparison vs. a highly infectious disease that caused a global pandemic and likely Great Recession best case.
@doug & erik -1
@ Ojs -1 Harry Potter, nothing but childish fiction as you are.
@Flying Boat Interesting to note you only believe in what chump says and not scientists like Fauci. When are you going to show some common sense and drink Mr. Clean and put ultra-violet light up your arse?
@John ” But almost all air travel is discretionary. Why assume unnecessary risk especially when experts can’t quantify the risk with certainty….The last flight I was on was March 13.”
John what was so terribly urgent that you were on a flight in mid-March?
This really isn’t about anyone being right or wrong. If you don’t believe that you can easily catch the virus, by all means do nothing and venture out into the world just like you did last year. If you believe that you can catch it easier than others think, you could stay home, but you could also go out and do everything you can to protect yourself.
What this is really about is TRUST. The world has a huge trust issue and if corporate America does not show that it is doing absolutely everything possible to keep people safe and well, then people are not going to spend their money.
I personally think that the airlines need to do social distancing on the air planes. And because that means few people on the plane, they need to raise ticket prices. It’s that simple. Because don’t trust the airline to limit the number of passengers on a plane I have decide to take a few extra days and drive. I will not spend my money on the airlines.
@Rog if you think Fauci is more scientist than politician you might look back to when he let tens of thousands of HIV patients due of AIDS by denying them access to AZT retrovirals until his bureaucracy approved it. I’m old enough to remember when ACT UP AIDS activists had “die-ins” in front of his office to protest his callous indifference to human life. Now suddenly he’s a progressive hero.
@UA-NYC, my argument is not that extreme measures were not necessary, but that once R<1 for COVID, we need to stop treating it so exceptionally and regard it in context with other risk factors that we live with and evidently accept. It wasn't COVID that caused the Great Recession, but the reaction to it – and, again, it may well have been necessary. We don't need to prolong and intensify that as well as the mental and emotional hardships many are suffering by letting it stop us from working, going to school, enjoying the company of friends and family, and generally doing the things that make us human, apart from sitting in front of a screen at home. Yes, for a time social distancing, wearing masks in certain contexts, and obsessive cleansing will be important, but if we can't live life until the virus is completely defeated, we are creating a dismal world.
@Mak So who is the scientist, chump or Fauci?
I agree with @Robert.
@DaveS Better to be alive in a dismal world than to be dead in an exciting world.
Is the travel essential? No? Then why are people travelling? The case counts are going up in many states. Those filters won’t do anything for you if you end up sitting in the area of an infected person. If seated on the aisle you will have people going back and forth all flight long. Is it safer than a crowded train? Probably. Is it safer than simply staying at home until the cases are brought under control? Absolutely not. You are stuck in a metal tube with people for a prolonged period of time. Not to mention that you are not getting on or off a plane without going through an airport, so you will have all that potential exposure as well. Not sure why there is a constant drumbeat on this blog to push people to engage in non-essential travel when things are far from under control.
@Charlie, that’s where we differ, and I respect your right to make your decisions. But if I see R<1 and I know the things I need to do to minimize the risk significantly of getting COVID or passing it on, I want to be able to enjoy life. This blog exists because people like to fly places and like to do award trips, not because people want to spend an indefinite part of the rest of their lives sitting in front of a computer at home. If the risk from COVID is growing exponentially then indeed it's time to hunker down. That happened. If it's not, I want to go to a beach even if a shark may eat me; I want to go bowling though I may break my toe if I drop the ball on it; I want to see Africa though I may get food poisoning; I want to ride a roller coaster even though I might throw up; I want to drive to a gathering of friends even though I may have an accident. And I will take into account the need to be cautious about getting COVID at the same time. We all accept many risks, bigger and smaller, as a part of living life.
@DaveS
+1
It is beyond me how intelligent well travelled people that read this blog can not grasp the concept of risk tolerance and see all of us who are eager to travel, as irresponsible citizens..
Some will never get it
I can not wait to get on a plane
@DaveS,
WHATABOUTISM is not a very effective debating technique.
@Rog
Neither. The United States government is run by a legion of self-serving phonies from every side. Some are plainly and obviously phonies (Trump) and some do a better job of fooling people (Fauci), but they’re all cut from the same cloth, all operating without knowledge but completely without humility. Don’t be fooled.