Question: I need to travel to see a sick relative. What are my chances of catching COVID-19 if I take an airplane flight?
Answer: Most people assume that being cooped up in a commercial airliner is an extremely risky place to be during a pandemic. After all, passengers are in close proximity to a bunch of strangers for many hours. And there’s no doubt that infected travellers have been largely responsible for rapidly spreading SARS-CoV-2 – the coronavirus that causes COVID-19 – around the planet.
But your odds of catching the virus while onboard a plane may be actually less than you think. Frequent air exchanges, combined with safety precautions such as wearing face masks, can significantly reduce the chances of the virus being transmitted from person to person, according to infectious-diseases specialists.
“I think the risk of getting COVID-19 in flight is quite negligible,” says Dr. Jerome Leis, medical director of infection prevention and control at Sunnybrook Health Sciences Centre in Toronto.
He says that despite the large number of cases and frequent travel worldwide, there is very little documented evidence that people have contracted the virus during a flight.
Dr. Leis points to the example of Canada’s first two confirmed cases of COVID-19. The married couple travelled from Wuhan – the original epicentre of the outbreak – to Guangzhou, China, where they boarded a plane to Toronto and arrived back in Canada on January 22nd.
The husband was already experiencing mild symptoms, such as a dry cough, during the flight. His wife became symptomatic the following day so both were considered infectious while they were travelling.
After they sought medical care, and tests showed they had COVID-19, Toronto public health staff went to work contacting 25 individuals, including crewmembers and passengers seated within three rows of the couple. These contact tracing efforts, plus 14 days of monitoring, revealed that no one had been infected by the couple who apparently wore masks.
So, what might explain the lack of viral transmission in an airplane packed with 350 passengers? SARS-CoV-2 doesn’t really travel far from the host, say medical experts.
The virus is primarily spread through respiratory droplets from an infected person coughing, sneezing or talking. The droplets might be propelled up to a distance of one or two metres before landing on nearby surfaces. Smaller aerosols, tiny particles that may stay aloft a while longer, are not believed to play a significant role in COVID-19 transmission.
On an airplane, such particles would be quickly swept up by the ventilation system, says Dr. Susy Hota, medical director of infection prevention and control at the University Health Network (UHN), a collection of medical centres in Toronto.
She notes that the air inside a plane is normally exchanged between 15 and 20 times an hour. And, in particular, the air passes through HEPA (high-efficiency particulate air) filters capable of trapping potentially harmful substances including viruses.
“Aerosols are unlikely to be hanging around long enough to actually result in an infection,” says Dr. Hota.
Of course, the larger respiratory droplets are still a concern. Many airlines, which are struggling financially, have resumed their customary practice of booking middle seats. That means it’s possible to be seated directly beside an infected individual.
“If you are wearing a mask and the person next to you is wearing a mask, that will substantially help reduce the risk – but it won’t bring it down to zero,” says Dr. Andrew Morris, medical director of the antimicrobial stewardship program at Sinai Health and UHN.
Overall, though, experts believe that the time spent on the plane isn’t particularly risky – especially if your seatmates are members of your household and you wear a mask as well as sanitize nearby surfaces.
In fact, the flight itself might be the least of your worries. “It’s not just the plane ride you have to consider – it’s how you’re getting from point A to point B and everything in between,” says Dr. Janine McCready, an infectious-diseases specialist at Michael Garron Hospital in Toronto.
Travel, she explains, often involves taking ground transportation, eating in restaurants, using public toilets and staying in places where you may not have control over your surroundings.
You also have to think about whether you are going to a region where there is a lot of local transmission of COVID-19, says Dr. McCready. Being in a high-transmission area could increase the likelihood of exposure to the virus.
And if you’re visiting older family members, or someone who is not in good health, there’s a chance you might bring the virus with you and potentially infect them.
“Is it worth it?” asks Dr. McCready. “People have to make their travel decisions based on their own tolerance for risk.”
Sunnybrook’s Patient Navigation Advisor provides advice and answers questions from patients and their families. This article was originally published on Sunnybrook’s Your Health Matters, and it is reprinted on Healthy Debate with permission. Follow Paul on Twitter @epaultaylor.
If you have a question about your doctor, hospital or how to navigate the health care system, email AskPaul@Sunnybrook.ca
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Just flew out of Florida,Atlanta ,Seattle and Vancouver on 10th day of Quarantine and no symptoms as of yet
I am a retired airline pilot. I would not fly on an airline at this point. The HEPA filter installed on these jets is absolutely miniscule in size and the recommend change cycle is every 6,000 flight hours. Also if you are in the path of the return air from the cabin to the filter you are essentially getting bathed by everything behind and in front of you. I wish someone would do some honest research on this before claiming that it’s not that big of a risk.
I think this is in accurate. Having had a spray paint booth with 20,000 cfm per minute I would sill have paint in the nose area when not wearing a mask.
For a plane to be a place where it is improbable to contract the virus. The plane would need to have the doors open with people wearing the emergency masks.
Sure the planes have HEPA filters but you would need enough air movement to feel a draft in front of your face to offer any true protection
If it’s safe to sit next to someone with the virus because your wearing a mask, why are we continuing with social distancing and masks in the UK? Also they don’t allow peanuts on board flight when someone has a severe allergy due to the risk of particles circulating, surely that shows we can still pick up air borne virus’s.
The reason is you cannot say please social distance on an airline but people want or need to fly anyway. Plus the HEPA filters and you can turn on the gasper air thing. People take the risk. The idea is to lower risk, the lower the better.
You need a certain amount of things to get sick, a peanut particle is probably going to be much bigger than a virus particle. Or maybe it takes less peanut to get sick than it does virus. Again, it’s a risk. Getting rid of peanuts on flights is an easy thing to do. Getting rid of virus is not.