People Are Testing Positive For COVID-19 And Flying Anyway

The biggest challenge with how easily SARS-CoV-2 spreads is that pre-symptomatic people are perhaps the most likely to infect others. Some studies suggest that people shed the most virus in the two days leading up to symptoms. So taking temperatures, convincing people to stay home when sick, only goes so far. That’s why healthy people are asked to wear masks, because they may be infecting others without realizing it.

Another big problem though is that even people who test positive for the virus aren’t staying home. Some are hiding their diagnosis, and still traveling. When United began requiring passengers to complete a health screening prior to travel it seemed odd to me – anyone pre-symptomatic wouldn’t know they have the virus, anyone sick would either stay home or lie.

Since Hong Kong tests passengers on arrival, and aggressively tracks contacts and interviews patients, they know about cases where people who tested positive flew anyway.

Hong Kong’s health authority said one infected passenger arrived Sunday from Manila on a Cathay Pacific Airways Ltd. flight, and another was on a Cathay Dragon flight from Kuala Lumpur. Both were diagnosed with Covid-19 before they traveled.

…Biogen Inc. said in March it fired a female worker who returned to China from Massachusetts without disclosing her infection. Local media said the 37-year-old took a large dose of anti-fever medication before she boarded to hide her illness.

…JetBlue Airways Corp. banned a passenger who flew from New York to Florida and notified the crew after landing that he had tested positive for coronavirus

Taking temperatures may help identify people with one common symptom of COVID-19, but people with a low grade fever can take over the counter pain killers like Tylenol (acetaminophen), ibuprofen, aspirin, or naproxen.

Right now in Austin it appears to be taking 4-8 days to receive test results. People getting the free public test report being told it could take as long as 10 days for results. People are recovering from the virus before they confirm they had it.

Suspected positives aren’t required to quarantine. Indeed even those who test positive aren’t being forced to quarantine. And what does contact tracing even look like, at least in my home town?

[E]very day, more than a thousand test results are faxed to Austin Public Health, rather than reported digitally. APH staff members must then sift through the results manually. And in some cases in which people have tested positive, Escott says, the faxed test results don’t include contact information for patients, so staff members have to do detective work to track them down before they can make contact tracing calls.

So between people who don’t know they have the virus, and people who do and choose not to stay home, there’s continued spread – including people flying. The good news is that masks do appear to help limit spread but most importantly flights themselves haven’t been found as a vector for significant spread. There haven’t been case clusters tied back to being on the same plane. Instead it appears people flying with the virus brings the virus from one place to another.

That’s not significant risk where the virus is already spreading, as it is right now in parts of Texas, Florida, Arizona and California – but it’s a bigger deal where the virus is currently under control.

When I drafted this I initially wrote that “it won’t surprise me, then, to see other states follow the lead of places like Hawaii (and previously Texas) imposing quarantines on flight arrivals from certain states.” And that’s already what’s happened with New York, New Jersey, and Connecticut “ordering a mandatory 14-day quarantine on visitors from states with high numbers of COVID-19 cases.”

  • The list of states is to include those “with an infection rate of 10 per 100,000 on a 7-day rolling average or 10 percent of the total population positive on a 7-day rolling average.” (By the way this is a lower threshold than Europe is considering.)

  • Currently that means Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah, and Texas.

So far these sorts of quarantines have been implemented based on arriving flights, which is only a limited proxy for where someone is traveling from. Connect through a third non-outbreak state and avoid the quarantine, while anyone connecting in say Dallas or Phoenix might be subject to quarantine even though they never did more than go beyond the airport.

Governor Cuomo suggests this will apply to drivers and that “police will be stopping cars with out of state plates in New York” and that “hotel employees should be questioning guests about their quarantine.”

About Gary Leff

Gary Leff is one of the foremost experts in the field of miles, points, and frequent business travel - a topic he has covered since 2002. Co-founder of frequent flyer community InsideFlyer.com, emcee of the Freddie Awards, and named one of the "World's Top Travel Experts" by Conde' Nast Traveler (2010-Present) Gary has been a guest on most major news media, profiled in several top print publications, and published broadly on the topic of consumer loyalty. More About Gary »

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  1. We never really know the reasons people fly. There could very well be justification for these passengers. Think that’s the most ridiculous argument ever? I would have agreed with you before I read all the left-wing screeds this past month about how looting and riots are justified because Black people’s “demands” have been “unheard.”

  2. IT’S THEIR RIGHT TO FLY!

    YOU have the right to stay home if you choose, but NO ONE has the right to stop people who chose to travel.

    So SICK of this lockdown, mask-requiring, business-limiting HOAX! It’s truly sad and outrageous, and it’s gone way too far for way too long.

    IF WE WANT TO FLY, we WILL FLY!!!

  3. “The biggest challenge with how easily SARS-CoV-2 spreads is that pre-symptomatic people are perhaps the most likely to infect others. Some studies suggest that people shed the most virus in the two days leading up to symptoms. So taking temperatures, convincing people to stay home when sick, only goes so far. That’s why healthy people are asked to wear masks, because they may be infecting others without realizing it.”

    Interested to see the sources supporting this if you can share. The World Health Organization described such asymptomatic infection “very rare” and I’ve seen nothing suggesting asymptomatic persons are “most likely” to spread it to others. Thanks.

  4. @ Tom — So you believe that people who are currently sick with COVID-19 have the RIGHT to fly?

  5. I live in Austin. Can confirm. Getting a test was much harder than I expected. Symptoms on Friday. Couldn’t get test ‘till Tuesday. Took l 7 days from getting my brain tickled to getting a test result (negative, whew).

    @Mak Pre-symptomatic ≠ asymptomatic

    People, wear a dern mask. It’s not that hard. For the mask haters…what if you’re wrong?

  6. As long as we weren’t imposing wuhan style quarantine including app tracing mask wearing etc most people in the United States will contact the virus. Mask and social distance should help to slow it down that we don’t overwhelm the system but otherwise we have failed to curb the virus and NY has nothing to worry about it is herd immunity that protects them because most people had it here not masks

  7. There should be large criminal fines for knowingly flying with COVID. BTW, does it really take 4 days to get your test results back these days? That’s stupid. It is definitely unfortunate that the Sunbelt states are getting hit by the virus now, but this looks like better news than most people think. Remember, the epidemiologists said you could flatten the curve, not prevent infections. Europe and the USA Northern states prove that there’s a level of infection where the virus fizzles out. It takes a few weeks, and will probably be a shorter epidemic for the South since they already had a bunch of cases. And then the USA should be past this crisis. There’s no evidence that the North is now getting reinfected: to the contrary, hospitalizations keep going down. I suspect things will look very good for America by August.

  8. Because there is no nationally coordinated plan to stop the virus or even to acknowledge the continuing problem, inevitably spread marches on. Trump knows the virus is impervious to lies, bullying and flattery. Our feckless POTUS thinks it is best (for him) if we pretend it just doesn’t exist.

    Defeating Covid-19 is simple. In the US there is no national will to do it unfortunately.

  9. Didn’t New Yorkers get all up in arms when Connecticut was stopping people with New York plates?

  10. @Tom

    There is NO right to fly in commercial aviation. There NEVER HAS BEEN a right to fly. You are at the mercy of governments and private enterprises. They decide whether you fly or not. They always have decided.

    But I’ll tell you what. Since you are so convinced of this “hoax” why don’t you go down to the nearest ICU ward and hang out there without a mask for half a day to…you know…get a feel for things. Then come back and report to us what you found. I do recommend you file that report quickly though…

  11. Holy crap I sincerely hope the first couple posters are trolls but I sadly suspect they are not.

    If you knowingly fly while diagnosed as covid 19 positive I don’t just want a hefty fine. I want a hefty fine AND jail time.

    Wear a mask. It’s not hard and it’s not about *you* it’s about everyone.

  12. “So you believe that people who are currently sick with COVID-19 have the RIGHT to fly?

    Yes! And a right to work, shop, eat at restaurants, go to movies, fitness clubs, get a haircut, attend school and on and on….

  13. Since newer data suggests that the covid19 is, in most cases, similar to influenza, with similar populations at risk, I hope these safety features will continue each and every influenza pandemic season.

  14. There is no right to fly, eat out, go to the gym or anything other than quarantine and get medical treatment. Just like there is no right to drive drunk or smoke in public. It is about public health and safety. Period.

  15. @Tom, if your post is real and that really is what you believe, you need to get NetJets on speed dial, so that you can act as irresponsible as you want. I have flown in May, again in August and September and hope you are not a fellow passenger, if you fly at all. I wear a mask for my fellow passengers to feel as safe as possible and that I am as concerned for their health as mine>
    Would you feel the same way if someone drank 8-10 beers and got behind the wheel of a car because – I WANT TO DRIVE ?

  16. The country is a disaster! We absolutely should be fully on a mandatory basis using the iOS and Android contact tracing API, and you should have to swipe in at any business or even a home to have records that could be used in the event that a person tests positive to expedite contact tracing.

    I already use a number of apps such as Swarm or Google Maps or Facebook that can give ma meticulously accurate time stamped record of every place I have ever been.

    I know that privacy folks would think this would be a bad idea, but I don’t see a downside. The public health benefits outweigh concerns or paranoia about privacy.

    Also in BOS someone asked Governor Baker why we in MA were not puthing forth similar quarantine measures from high impact states, and I think Baker noted that these quarantines were merely strong recommendations but not enforceable by law.

    This shows how our totally chaotic decentralized system is increasing spread and death. Instead of having a nationwide covid tracking database that could do contact tracing in a matter of seconds with mandatory participation required.

    That is funny you guys in AUS still rely on faxes!

  17. “Excellent analogy! I will be using that.”

    Explain how it’s an “excellent” analogy. The individual clearly has no concept of what constitutes a “right”.

  18. James N thinks it is his right to go around infecting others. He sounds about as smart as Trump saying “if we test fewer people, there will be less infections.” Some people refuse to learn anything.

  19. @Mak
    No. The WHO did not say that. Their press conference was a model of bad communication. And I’m sure that many of the so called science reporters only reported that if you didn’t show symptoms you couldn’t infect others. But if you look at what they said, it was that if you were asymptomatic throughout your bout with Covid, you were very unlikely to spread the virus, but those who were only “pre-symptomatic”, you were infectious before you showed symptoms, and those who showed such mild symptoms that you thought it was only a summer cold, or a seasonal allergy, you could still spread the virus.
    The WHO is very much to blame for poor communication. Good communication should be its job one. But we should not pass on misinformation.

  20. “James N thinks it is his right to go around infecting others.”

    Wow, both a straw man and confirmation that he also doesn’t understand the concept of rights. It’s a twofer!

  21. @JimLovejoy The WHO certainly did say that. The correction was that originally they said it was impossible for asymptomatic people to transmit the disease, and after much political tumult that was withdrawn and instead the communication was that such transmissions are “very rare.” If you have different information about the WHO, or if Gary has different information in the scientific literature, I would be interested in seeing it. I am unaware of any scientifically based data which suggests that Covid can easily be transmitted without symptoms, and the nature of respiratory viruses generally is that they transmit directly via symptoms (i.e., mucus from runny nose, droplets from sneezing, etc.).

    Its interesting to me that amidst the panic, people go back to pre-Pasteur notions of science, such that diseases are transmitted not by germs or virii — as Pasteur proved — but by strange mechanisms having to do with the actual things that we now know cause virus. I have an open mind and happy to read evidence that rises above unsupported anecdote, but at this point I put this into the category of idle speculations driven by panic and not science.

  22. I think this goes to the reality that screening questions don’t work. I mean, what terrorist has ever been caught because he told the check-in agent that someone else packed explosives in their luggage? No infections will be prevented because an airline asked if someone is infected. Without accurate rapid testing, airlines will inevitably transport people who are infected — both the irresponsible, selfish &*^*&^ who know but travel anyways and the genuinely pre-symptomatic cases who have no clue. Correct procedures and public health responses should and must anticipate this reality. (e.g., wear a freakin mask already. Unless you really, really hate your grandparents)

  23. @Andy You would be quite surprised because you are too accustomed to the incompetent TSA. In actual fact El Al has prevented several terrorist acts through simple screening, and there is no reason it can’t work here. Everything about Covid is looked at as sui generis, but we have had diseases and other risks before, and far worse ones, and airlines and airports dealt with them with great success.

  24. I find it amazing that Americans refuse to learn how to live with this virus. Expect further recession/depression to continue

  25. Can’t get over how many scientists there are here today. Chopsticks believes it will probably be over in August. Just another example of a fact based scientist. Everyone should keep relying on the scientific genius chump. That boy sure knows what he’s talking about. Yep, the greatest pres this country has ever known.

  26. As a retired electrical engineer who worked for a global Pharma company which is working on a vaccine, I traveled extensively internationally up to COVID. What I am sick of is the “flat earthers” and whining. Pull up your big boy and girl pants. We had a trip planned for Africa and Egypt next month, but until there is a therapeutic or vaccine we are not going anywhere. Ppl who deliberately try to game the system are putting other ppl at risk, including themselves since it is still a guessing game on antibody immunity length. Science knowledge is clearly lacking by some of the comments I read on Gary’s blog.

  27. @Sandra You should feel very free to exercise your right to stay at home for as long as it makes you feel comfortable. But “pull up your big girl pants,” as you say, and understand that you don’t get to dictate the decisions of the rest of us, who have our own right to exercise our own judgment in light of the risks and benefits of travel..

  28. Yes, I agree it is my choice to stay out of the air. I am totally fine w/ ppl flying, However, when ppl purposely fly when they are positive for COVID or do not wear a mask that is a public health issue that affects others, not just the individual w/over 2mm/120K Americans infected/dead (which is undercounted). It needs to be dealt and a process put in place (think S. Korea, HK, NZ, etc) so this country can mitigate the virus which is not going away anytime soon. Btw-the freedom argument doesn’t really make any logical sense or there would not be drunk driving, seatbelt, helmet and other laws. I guess you think ppl should have a right to also have “freedom” to decide for themselves on those issues. Try working in a frontline hospital w/full PPE like I have and get back to me. I’ll wait.

  29. @Mak

    How’s this…we step up contact tracing for everyone who travels and allow folks to use their own judgment as to whether they are safe to fly. If, for some reason, someone travels while sick and is determined to be the source of a chain of infection that leads to someone’s death or disability, that person can be held liable in some fashion. Surely, someone with “big boy/girl/whatever pants” can handle being responsible for their own actions.

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