Is It Safe to Fly During COVID-19?

November 11, 2020

Please see the comment at the end of this post regarding conflict of interest for the authors. Thanks to our readers for pointing out that I missed some fine print.

Written by Clay Smith

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”The risk of contracting coronavirus disease 2019 (COVID-19) during air travel is lower than from an office building, classroom, supermarket, or commuter train.”

Why does this matter?
This was a patient information page in JAMA, which we usually don’t cover, but this is of such import for our patients and our own personal lives that I thought we should review it. Anyway, I learned a lot…

Flying tube of germs or flying HEPA filter?
COVID-19 is primarily transmitted via respiratory droplets. Before you aerosol scientists send me hate mail – SARS-CoV-2 simply does not behave like true airborne pathogens, such as measles, varicella, or TB. But it is well known it may spread further than 6 feet under the right circumstances. So, what’s the risk on a plane? There are only 42 known cases of COVID-19 related to air travel across the globe. Contrast that to a transmission rate of 0.3% on high speed trains in China, with 2,300 infected. On a plane, air flows from numerous overhead vents to floor-level air returns, 50% fresh outside air is introduced, and all return airflow passes through a HEPA filter (see figure). Transmission of COVID row to row is unlikely, as there is little airflow between rows. All cabin air is completely exchanged every 2-3 minutes in modern aircraft. Masks, temperature/symptom screening, disinfection, hand-washing, and physical distancing mitigate the risk further. The best thing to do if you need to fly is wear a mask, point the overhead vent at your face, and turn it on full blast. Oh…and wash your hands often.

Source
Risk of COVID-19 During Air Travel. JAMA. 2020 Oct 1. doi: 10.1001/jama.2020.19108. Online ahead of print.

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