We don’t know about you, but we’re ready to travel. And that typically means flying.
We have been thinking through this issue as mothers and as an infectious disease epidemiologist and an exposure scientist. While we’ve personally decided that we’re not going to fly right now, we’ll walk you through our thought process on what to consider and how to minimize your risks.
The primary concern with flying — or traveling by bus or train — is sitting within six feet of an infected person. Remember: Even asymptomatic people can transmit. Your risk of infection directly corresponds to your dose of exposure, which is determined by your duration of time exposed and the amount of virus-contaminated droplets in the air.
A secondary concern is contact with contaminated surfaces. When an infected person contaminates a shared armrest, airport restroom handle, seat tray or other item, the virus can survive for hours although it does degrade over time. If you touch that surface and then touch your mouth or nose, you put yourself at risk of infection.
While there is no way to make air travel 100% safe, there are ways to make it safer. It’s important to think through the particulars for each trip.
One approach to your decision making is to use what occupational health experts call the hierarchy of controls. This approach does two things. It focuses on strategies to control exposures close to the source, and it minimizes how much you have to rely on individual human behavior to control exposure.
The best way to control exposure is to eliminate the hazard. Since we cannot eliminate the new coronavirus, ask yourself if you can eliminate the trip. Think extra hard about traveling if you are older or have preexisting conditions, or if you are going to visit someone in those categories.
If you are healthy and those you visit are healthy, think about ways to substitute the hazard. Is it possible to drive? This would allow you to have more control over minimizing your exposures, particularly if the distance requires less than a day of travel.
If you do choose to fly, check out airlines’ policies on seating and boarding. Some are minimizing capacity and spacing passengers by not using middle seats and having empty rows. Others are boarding from the back of the plane. Some carriers that were criticized for filling their planes to capacity have announced plans to allow customers to cancel their flights if the flight goes over 70 percent passenger seating capacity.
Federal and state guidance is changing constantly, so make sure you look up the most recent guidance from government agencies and the airlines and airport you are using for additional advice and for current policies or restrictions.
While this may sound counterintuitive, consider booking multiple, shorter flights. This will decrease the likelihood of your having to use the lavatory and your duration of exposure to an infectious person or persons on the plane.
After you book, select a window seat if possible. If you consider the six-foot radius circle around you, having a wall on one side would directly reduce in half the number of people you are exposed to during the flight, not to mention all the people going up and down the aisle.
Also, check out your airline to see their engineering controls that are designed or put into practice to isolate hazards. These include ventilation systems, on-board barriers and electrostatic disinfectant sprays on flights.
When the ventilation system on planes is operating, planes have a very high ratio of outside fresh air to recirculated air — about 10 times higher than most commercial buildings. Plus, most planes’ ventilation systems have HEPA filters. These are at least 99.9 percent effective at removing particles that are 0.3 microns in diameter and more efficient at removing both smaller and larger particles.
From checking in to going through security to boarding, you will be touching many surfaces. Here are some tips to minimize your risks of infection:
1. Bring hand wipes to disinfect surfaces such as your seat and seat belt and your personal belongings (like your passport). If you cannot find hand wipes, bring a small washcloth soaked in a bleach solution in a ziplock bag. This will probably freak out airport security less than carrying a personal spray bottle, and viruses are not likely to grow on a cloth with a bleach solution. But remember: More bleach is not better and it can be unsafe. You need only one tablespoon in four cups of water to make an effective solution.
2. Bring plastic ziplock bags for personal items that others may handle, such as your ID. Bring extra bags so you can put these objects in a new bag after you have the chance to disinfect them.
3. Wash your hands or use hand sanitizer as often as you can. While soap and water is most effective, using hand sanitizer is helpful after washing to get any parts you may have missed.
4. Once you get to your window seat, stay put.
5. Wear a mask. If you already have an N95 respirator, consider using it but other masks or coverings can also provide protection. We do not recommend purchasing N95 until health-care workers have an adequate supply. Technically, it should also be tested to make sure you have a good fit. We do not recommend that you use gloves, as those can lead to a false sense of security and have been associated with reduced hand hygiene practices.
If you are thinking about flying with children, there are special considerations to keep in mind. Getting a young child to adhere to wearing a mask and maintaining good hygiene behavior at home is hard enough; it may be impossible to do so when flying. Children under 2 should not wear a mask.
Each day, we are all constantly faced with decisions about our own personal comfort and risk. Arming yourself with specific knowledge about your airport and airline and maximizing your use of protective measures that you have control over can reduce your risk. A good analogy might be that every time you get in the car to drive somewhere there is risk of an accident, but there is a big difference between driving the speed limit with your seat belt on and driving blindfolded at 60 miles an hour through the middle of town.
This article is republished from The Conversation under a Creative Commons license.
Kacey Ernst PhD MPH is an infectious disease epidemiologist at the University of Arizona. Her primary projects examine the environmental determinants of vector-borne disease transmission and control; primarily dengue and malaria. Current research projects include an examination of insecticide treated bednet use in western Kenya.
Paloma Beamer PhD is an associate professor in the College of Public Health at the University of Arizona. She holds joint appointments as an associate professor of Chemical & Environmental Engineering and as a research scientist in the Asthma and Airway Disease Research Center. Her research focuses on understanding how individuals are exposed to environmental contaminants and the health risks of these exposures with a special focus on vulnerable populations.