
There have been many mixed studies on inflight Covid-19 transmission risks over the past few months, with a CDC study showing genetic evidence of in-flight transmission from passengers to crew and the latest data from IATA showing a low risk of in-flight Covid infection (44 cases onboard since start of 2020), credited to the effectiveness of High-Efficiency Particulate Air (HEPA) filters and enforced mask wearing. Once again, the question of air travel health and safety is thrown into the spotlight, with even the most avid travellers considering how best to prepare for, and feel confident flying in the new norm.
We have pulled together top tips from leading scientific experts and current studies on how best to mitigate airport and airline risks associated to Covid-19 transmission.
Being anti-social on a flight is key
According to Dr Julian Tang, Professor at University of Leicester, “Talking to your neighbour is the biggest risk, don’t talk — play video games.” Tang, a leading expert in airflow dynamics associated with human to human transmission of airborne pathogens adds, “Although the ventilation systems on planes are very effective in reducing the overall concentration of any airborne pathogen exhaled by passengers, even this cannot be relied upon to remove any exhaled airborne virus that passes between you and your neighbour during talking/breathing (a distance of <0.5 m in economy class) — before you inhale that virus.” He adds, “Think about it like this — if I can smell what you had for lunch on your breath, within that distance, I am inhaling some of your air and anything carried within it. When you are both masked, the amount of exhaled virus is reduced.”
Toilet tactics
Sometimes you just gotta go, however keeping your mask on and cleaning your hands could be key to avoiding any loo nasties — also known as a ‘high-frequency touch area’. A study released by the CDC of a March 31 flight from Milan to Seoul found that a woman tested positive for COVID-19 after the flight while in quarantine. She wore an N95 mask on the flight except when using the lavatory. “The most plausible explanation,’’ according to the study, was “that she became infected by an asymptomatic but infected passenger while using an onboard toilet.”

Mask — check
A recent study in the Journal of Travel Medicine into In-flight transmission of SARS-CoV-2 showed three mass Covid transmission flights without masking, contrasted to five flights with strict masking and 58 cases of zero transmission. This research is encouraging and highlights the effectiveness of mask wearing, however research is still limited on in-flight infection with masks and the middle-seat (social distancing) debate in question. Michael Saag, a University of Alabama Infectious Disease Professor says; “Packing flyers into seats, side-by-side with no space in between is a recipe for transmission, ESPECIALLY if masks are not mandated. The longer the flight, especially in those circumstances, the higher the probability of a transmission event.” Delta and Southwest are currently the only airlines offering the middle-seat free where possible.
Touch-and-go… wash
The travel journey is an array of touch points…from airport to airplane. A recent Harvard study on Air Cabin and Cleaning highlights the key high-frequency touch areas of the air journey to consider as a risk; “Door handles, elevator buttons, faucets, self-service kiosks, point-of-sale keypads, security trays, and luggage cart.” When it comes to airline seats: “ seat cushion, seatbelt (buckle, latch and strap on both sides), seatback cushion, headrest, and armrest (including seat recline button)”. Frequent hand washing and hand sanitizer use after touching certain types of high-frequency touch surfaces is key, as well as remembering to avoid touching eyes, nose and mouth.
What comes next?
The aviation industry is continuing to progress studies into aircraft health and safety in the wake of the pandemic, with Airbus and Boeing conducting live testing. “The way that air circulates, is filtered and replaced on airplanes creates an absolutely unique environment in which you have just as much protection being seated side-by-side as you would standing six feet apart on the ground.” Bruno Fargeon, Airbus Engineering and the leader of the Airbus Keep Trust in Air Travel Initiative.
According to IATA’s Director General and CEO, Alexandre de Juniac, “the risk of contracting the virus on board appears to be in the same category as being struck by lightning”.
Watch out for the latest from The Aviation Public Health Initiative (APHI) who are studying current aircraft, airline, and airport practices and their impact on public health during the COVID-19 pandemic.
For those taking to the skies don’t forget to check out App in the Air’s searchable travel restrictions tool and travel safety filter options in app so you can travel safe and be in-the-know.