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Union-led commentary addresses personal safety whilst flying during pandemic

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A commentary in the Transactions of The Royal Society of Tropical Medicine and Hygiene explores the issue of how safe is it to fly in the COVID-19 era and what can be done to enhance personal protection on aircraft and during transit, including mask wearing, seat position and use of alcohol-based sanitizers.

So far, there is limited published evidence about the risk or extent of SARS-CoV-2 transmission on aircraft. However, in-flight transmission of respiratory infections such as tuberculosis (TB), influenza and SARS has been well described and the most relevant and important literature related to these three infections is reviewed in this article. Risk factors for transmission include proximity to index patients and sitting in aisle seats, and it is likely that these also play an important part in the spread of SARS-CoV-2 transmission on board aircraft.

The authors draw attention to the International Civil Aviation Organization (ICAO) guidance on air travel during the COVID-19 public health crisis and advise that passengers should download and read this prior to flying. Based on their review of the current literature and the ICAO guidance, they advise that personal protection on aircraft could be enhanced by always wearing a well-fitting face mask and face shield or sunglasses, wiping surfaces and hands with alcohol-based sanitizers, not touching the face, avoiding queuing for washrooms, changing seats if nearby passengers are coughing and choosing a window rather than an aisle seat. If feasible, passengers would also do well not to eat or drink during the flight as they would not be wearing a face mask and aircraft utensils and cups may be infected through fomites. They conclude by reminding their readership that flying also involves spending time in transit to and from the airport and at the departure and arrival airport, where queues for health checks, immigration, security, luggage collection and customs bring passengers into close contact with one another. Continued use of face masks, eye shields, alcohol-based sanitizers and physical distancing will therefore still be required at these times.

The commentary SARS-CoV-2: how safe is it to fly and what can be done to enhance protection? is written by Prof Anthony Harries, The Union’s Senior Advisor for Research, Dr Leonardo Martinez from Stanford University, USA, and The Union's Former President, Dr Jeremiah Chakaya Muhwa from Kenyatta University, Kenya.