- Experts say there is some risk to flying on an airplane during the COVID-19 pandemic.
- How high the risk is depends on factors such as ventilation inside the plane as well as if the airline fills the middle seats.
- They say passengers should practice mask wearing and physically distancing not only on the plane but inside the terminal.
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.
For many of us, it’s been the summer of the “staycation.”
Their fears may be justified.
That certainly makes a crowded airplane seem potentially risky.
Earlier this summer, the Department of Transportation released guidelines to help airports and airlines protect passengers and airline workers by implementing safety measures such as mask wearing, enhanced cleaning and disinfecting, and limiting seating for passengers.
So just how safe is it to board a plane right now?
Healthline consulted with several experts — including one who penned new research estimating the likelihood of contracting the virus on a plane — about whether it’s safe to jet to your favorite destination, the risks that are involved, and what you can do to protect yourself.
There haven’t been reports yet of super spreading events on airplanes.
Good ventilation could be a factor.
“Based on the ventilation systems on aircraft, I think it would be very unlikely you’d have a super spreading event where 50 people on the flight get sick from one person,” said Dr. Henry Wu, an assistant professor and senior physician at the Emory University School of Medicine and director of the Emory TravelWell Center in Georgia. “Unless there’s a malfunction in the ventilation system, I just think it’s very, very unlikely.”
But could somebody spread the virus to the person next to them, or to someone in the row in front of them, or in back of them?
“I think we should assume it’s possible and that it does occur, even if it’s a little hard to prove,” Wu told Healthline.
It’s difficult to prove because travel involves contact with many people — in the cab ride to the airport, in the airport terminal, in the airport bathroom, and then on the airplane.
Any sort of public activity during a COVID-19 outbreak is going to involve some risk, according to Wu.
“What’s unique about air travel is the close proximity you have to potentially more than one person, potentially with others from parts of the country, or even world where there may be higher risk of COVID-19,” he said. “You typically on a flight may not have a lot of control over where you sit. Obviously, flights vary in duration and the longer the flight or the exposure to that situation, the more that risk increases.”
While driving in a car to your destination may offer more control, with air travel you’re merely along for the ride.
“It doesn’t necessarily mean it’s so dangerous that none of us should do it, but it does introduce a level of uncertainty which you cannot completely eliminate,” Wu said.
Precautionary measures the airlines are taking and consistent mask wearing can reduce risk, but it’s always there.
“Since the risk cannot be completely mitigated, I do still advise travelers to carefully weigh the importance of the trip as well as their personal risk factors or people in their families if they have risk factors for severe illness,” Wu said. “I think the reality is that air travel, like many activities in public, do bring in some unique situations that may increase your risk of COVID-19.”
Increased disinfection procedures, electrostatic spraying of cabins, and ultraviolet light used to disinfect surfaces are just some of the measures being taken by airline carriers.
One point of contention has been spacing between passengers, as pointed out by Arnold Barnett, a professor of management science and statistics at the Massachusetts Institute of Technology, who recently released research focused on the middle seat.
“Basically, there is a disagreement among airlines on a safety matter, which is very rare,” he explained to Healthline. “Usually, if there are disagreements, they’re very covert. This is very overt.”
Many airlines are limiting the number of seats for sale on their flights, which allows for seat spacing between individuals not traveling together. Using his mathematics and statistics knowledge, Barnett set out to estimate the risks.
“I thought, well, what is the risk level if you fill the plane? What is the risk level if you keep the middle seat open but otherwise fill the plane, and how big is the difference?” Barnett said. “Instead of just saying it’s safe or it’s not, can we put a number on it? And that’s what I tried to do.”
In a pre-print that has not yet been peer reviewed, Barnett estimated that if all seats are full, the chance that you would contract the novel coronavirus is about 1 in 4,300.
If the middle seat is kept empty, but the plane is two-thirds full with window and aisle seats, the odds drop to about 1 in 7,700.
These are estimates that he doesn’t deem as particularly safe.
“I personally don’t think it’s so low,” he explained. “It’s about the same as the risk of 2 hours on the ground.”
Additionally, Barnett found you’re more likely to die by contracting the novel coronavirus on a plane versus dying in a plane crash.
“I did a paper earlier this year and estimated the death risk per flight is something like 1 in 34 million [in a crash],” he said. “And now we’re talking about something which is clearly higher than one in a million, so it’s really many times the risk.”
Durland Fish, PhD, a professor emeritus of epidemiology at the Yale School of Public Health in Connecticut, found the Barnett paper “interesting, but theoretical and based upon assumptions that may or may not be accurate.”
“Nevertheless, his conclusion that empty middle seats would reduce risk is important and makes sense,” Fish told Healthline. “Hopefully, it will be adopted by all of the airlines.”
With the airlines losing millions as this crisis continues, Fish thinks they should invest in an experimental study to demonstrate travel safety with real data.
“Aerosolized particles can be measured, and patterns of dispersal can be determined,” he explained. “Artificially generated aerosols or normal aerosols from uninfected people placed in specific areas should provide insight as to the fate of potentially infective particles and risk of encounter by other people.”
“The airlines seem not to be doing much to demonstrate safety other than saying what measures they are taking,” he added. “But skeptical people like me are not going to believe them without providing objective data.”
Proximity to others should always be on the brain when traveling, whether it’s in the terminal, in the airplane, or elsewhere on your journey.
Wu recommends keeping a radius around yourself to the extent that it is possible.
“I think ideally the more space you can put in between people on a flight or anywhere for that matter, the better,” said Wu. “I think that both intuitively and in terms of how things like droplets spread, distance does certainly help. I think keeping the (middle) seat empty, most of us believe will reduce the risk.”
While Wu described air ventilation on airplanes as “quite good” due to frequent air exchanges and the use of HEPA filters, “Highly efficient filtration or ventilation still does not eliminate the risk of those immediately around you.”
Wu agreed that Barnett’s conclusion that keeping the middle seat empty reduces the risk.
“Compared to a totally full flight, (that) makes intuitive sense,” he said. “It’s what we’ve always been assuming, and it’s also what we think is occurring in the way we understand how this disease spreads.”
“The airflow in the cabin from the ceiling to the floor and from the front to the rear may have been associated with a reduced transmission rate,” the study said. “It could be speculated that the rate may have been reduced further had the passengers worn masks.”
Wu said that the duration of your flight is also something to consider.
“If you were to be unlucky enough to be sitting next to somebody with COVID infection, the chance of transmission depends on many factors, but one is the duration that you’re exposed to that,” he explained. “So a 4-hour flight is going to be twice the risk as a 2-hour flight.”
Fish has given the topic of flying on an airplane a lot of thought.
He’d like to travel from New England to Naples, Florida, but is concerned about the risk of flying — a 4-hour journey with connection — and with the risk of being in the Sunshine State, where the infection rate is 20 times that of Connecticut.
To decrease risk, there are a few things he recommends.
Pay for priority boarding when possible and “try to be first on the plane, and then choose a window seat in the last row opposite the lavatory,” he said. “This would eliminate contact with other passengers while boarding and anyone sitting behind me.”
To avoid contact while leaving the plane, “I would wait in my seat until everyone else is off the plane and then make my exit.”
Fish recommended using the lavatory on the plane versus one in the terminal, which can be more heavily trafficked.
“I would wait in an isolated area within sight of the boarding area for the connection. I would also carry my own water and food,” he said.
Barnett, who noted that he’s not flying right now, said if he did fly, he would take a flight with an airline that keeps middle seats open and “would actively fly the airlines that are doing more to reduce risk than the airlines that are doing less.”
Wu, who hasn’t yet had a reason to fly, said the standard recommendations being enforced by the airlines are important to follow in the airplane and in the terminal.
“If you are in a very crowded terminal, especially if you’re stuck in a line where distancing may be difficult, that may be a risky situation,” said Wu. “Fortunately, by most reports airlines and airports are taking precautions to try to maintain distancing — hopefully those are successful.”
Wu lamented that the face-covering practice has been the subject of “so much controversy and confusion.” Having worked in a COVID-19 clinic where he’s seen patients with the novel coronavirus every day, he stressed the value and importance of masks.
“People should also consider there’s a possibility that they are infected with either asymptomatic infection or an infection that has not become symptomatic yet,” said Wu. “And traveling from a high incidence area to a low incidence one can result in spreading the infection, too. So, it works both ways.”
If you’re contemplating flying somewhere, definitely do your homework first.
“In the end, it’s obviously a personal decision of what is important enough to travel (for),” Wu said. “But I do encourage folks to empower themselves by fully understanding the risks as well as understanding the ways to lower those risks and making a really informed decision of whether or not to travel.”