En español | Todd Cullop, who lives in Washington state, wants to visit his mother on the East Coast as much as he can while she battles cancer. He canceled a flight in the early phases of the coronavirus outbreak, but when he and his two sons flew out to Washington, D.C., to see her in August, they found that navigating half-empty airports and uncrowded airplanes was largely a positive experience.
“We just zipped through security,” says Cullop, 55. Their Southwest Airlines flights were roughly half full, so they changed seats to distance themselves from other passengers. The worst part, he says, was wearing a mask all day.
Americans like Cullop are slowly booking flights again, motivated by family needs, cheap fares and cabin fever after months of staying home. On Oct. 15, 950,000 passengers passed through U.S. airport security checkpoints, up from about 100,000 on April 20, according to the Transportation Security Administration (TSA) — though far fewer than the 2.58 million passengers who flew on Oct. 15, 2019.
But is flying safe during a pandemic?
The risk of infection
In a new study on the risk of COVID-19 infection on flights, the Department of Defense found that the odds of the tiny virus droplets expelled by an infected passenger reaching the “breathing zone” of another passenger are only 3 in 1,000 — assuming that both are wearing masks. The study, undertaken in partnership with United Airlines and Boeing, used a mannequin built with the ability to release aerosols that included tracer particles in its simulations.
The lengthy report concluded that “Aerosol exposure risk is minimal even during long duration flights, but typically highest in the row” of someone infected. It also recommended the continued use of masks, HEPA filtration systems and disinfectant cleaning onboard. (The report notes that scenarios such as “talking to a neighboring passenger while eating or drinking without a mask” were not studied.)
The Centers for Disease Control and Prevention (CDC) website concurs: “Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on airplanes.” But it also adds that “social distancing is difficult on crowded flights, and sitting within 6 feet of others, sometimes for hours, may increase your risk of getting COVID-19.”
And while there are no statistics on the number of people who’ve caught COVID-19 on planes, it appears that at least some may have.
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On a 15-hour Boston-to-Hong Kong flight in March, two passengers likely transmitted the virus to flight attendants, according to a study in the November 2020 edition of the Emerging Infectious Diseases (EID) journal. In another EID study, 16 passengers on a 10-hour flight were likely infected by one symptomatic passenger. Long flights, the study concluded, could potentially “cause COVID-19 clusters of substantial size, even in business class-like settings with spacious seating arrangements."
Some passengers are unaware that they're infected when they fly. On March 9, a 24-member tourist group flew with 78 other passengers from Tel Aviv to Frankfurt. One week before the roughly 41/2-hour flight, the tour group interacted with a hotel manager, who was later diagnosed with COVID-19. Seven members of the group tested positive for coronavirus when they arrived in Germany, according to a study published by the JAMA Network. (It's not clear whether any of the 78 other passengers were infected.)
Precautions taken by airlines
Despite the risks, sitting on an airplane is probably safer than sitting in a crowded bar, some medical experts say. Most planes are equipped with high-efficiency particulate air filters — better known as HEPA filters — which can remove at least 99.97 percent of dust, pollen, mold, bacteria and airborne particles that are 0.3 microns in size, the Environmental Protection Agency states. American Airlines notes that its HEPA filters circulate the cabin air every two to four minutes, replacing it with filtered air and fresh air from outside the aircraft. “Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on airplanes,” the CDC notes.
All carriers have announced enhanced aircraft cleaning procedures, including the use of hospital-grade disinfectants, though not necessarily before every flight. Southwest reports, “We deep clean each plane from nose to tail for nearly 6-7 hours every night.” American Airlines has started testing an antimicrobial protective coating called SurfaceWise2 that is able to make the coronavirus inactive on aircraft surfaces for up to seven days.
How you can lower your risk of infection
Disinfect your seat area. To further reduce the odds of contracting COVID-19, flyers should disinfect their seating area. Pack a travel kit with hand sanitizer, a sanitizing spray bottle and sanitizing wipes, suggests Darrin D'Agostino, an internal medicine physician and executive dean of the Kansas City University School of Medicine and Biosciences. “As soon as you sit down, the first thing you should do is clean your environment,” he says.
The virus lives longer on plastic than on other materials — roughly 50 percent of the virus can survive up to seven hours on plastic, he says — so clean surfaces such as armrests, seat trays and the wall next to a window seat.
Clean your hands. Wash or wipe them with sanitizing wipes — as often as four times every hour, D'Agostino says (that's what he recommended to his 77-year-old father, when he flew recently).
Wear a mask. They're required when you fly, for good reason: Experts consider them a key tool for preventing the spread of the virus. On a January flight from Wuhan, China, to Toronto, a symptomatic traveler did not infect any of the other 350 passengers, according to a report in the Canadian Medical Association Journal. One possible reason cited in the report: The infected flyer was wearing a mask.
The best face coverings include N95 masks without valves and surgical and polypropylene masks, recent research from the Duke University Medical Center found. Handmade cotton masks are also effective, but forget about bandannas and neck gaiters: In the study, they offered scant protection against droplet emissions. As for gloves, there's little evidence that they're useful. “If anything, the gloves actually increase your risk of not washing your hands often enough,” D'Agostino says. “And when you take them off, you're exposing your hands to whatever's on the gloves.”
The Centers for Disease Control and Prevention suggests that when considering a trip, ask:
- Whether COVID-19 is spreading in your community or the area you're visiting. If so, you may have a higher chance of becoming infected or infecting others
- If you or a loved one has an underlying condition that might increase the risk for complications from the disease
- If you'll be able to maintain a 6-foot distance between yourself and others during travel and at your destination
- Whether the destination requires that visitors quarantine themselves for 14 days upon arrival
Choose an airline blocking middle seats. Social distancing is vital, so consider airlines such as Alaska, Delta, Hawaiian, JetBlue and Southwest, which aren't selling the middle seat, at least for now. In a Massachusetts Institute of Technology study, aviation safety expert Arnold Barnett calculated that the risk of getting COVID-19 from a nearby passenger is one in 7,700 if the middle seat is empty — and one in 4,300 if every seat is sold. If the plane isn't full, ask a flight attendant if you can move to an empty row (in one of the EID studies, “seating proximity was strongly associated with increased infection risk").
Be extra cautious in the airport. With people congregating from locations around the country — including regions with rising coronavirus rates — big-city airports can be infection spreaders. “The airport is the place we worry about most, because in some ways it's controlled chaos, and in other ways it's pure chaos,” D'Agostino says. “All you need is one person not wearing a mask to put everybody at risk. The strategies within the airport, I believe, need to be tightened up across the country."
This includes, for example, directing and controlling passenger traffic as people walk to and from gates. New technologies may also help. In September, Delta announced that it would work with the TSA to introduce antimicrobial bins for security screenings at airports in Atlanta, Minneapolis/St. Paul, Los Angeles and New York City. The antimicrobial technology, Delta says, will prevent the growth and spread of bacteria in the bins.
The TSA is asking travelers to use enhanced precautions during airport screening, and encouraging mask wearing at checkpoints. Some airports are requiring mask wearing, and airlines are requiring face coverings at check-in counters, gates and other areas.
You'll find lots of hand-sanitizing stations throughout many airports, many of which are advertising their enhanced cleaning procedures. Louis Armstrong New Orleans International Airport recently added 30 hand-sanitizing stations, for a total of 40 airport-wide, and touts its use of a EPA-approved chemicals to clean and sanitize high touch areas such as hand rails, door handles, TSA bins, seating areas and other hard surfaces."
Consider driving. Instead of flying, road trips might be a safer alternative. Driving with people you know is certainly safer than wandering through an airport with strangers, though the risks increase once you leave the car. To prevent infection, the Mayo Clinic recommends steps such as disinfecting gas pump handles and packing food and beverages to reduce roadside stops. Hotels are also a risk. Before you book a room, do your COVID homework: The CDC suggests asking about cleaning and disinfecting procedures, along with options such as online check-in and keyless rooms. Once you're there, avoid the elevators. Some hotels are keeping rooms empty for 24 hours after a guest leaves, which can reduce the risk of spreading the virus.
As the CDC has noted, your safest bet is to stay home. Travel remains a big reason why COVID-19 continues to sweep the country, whether by plane, train or automobile. Yet for someone like Cullop, staying home is not an option. He's returning to the D.C. area to see his mother and he'll pack plenty of masks, hand sanitizer and disinfecting wipes for the flight. “I don't think I'll do anything different from last time,” he says. “I'll just try to be prepared."