Up  In  The  Air

Ask the DOC

During this pandemic I have been reluctant, if not unwilling, to travel by airplane for several reasons, which means that I would have missed my family’s annual Christmas reunion in Texas this weekend (it was wisely cancelled). Let’s face it, wearing a mask, especially for a prolonged amount of time, can be annoying and uncomfortable. As I write this, the rule is masks are supposed to be worn if you cannot socially distance, particularly in an indoor setting. I considered that being in an airplane, which has recirculated air, is the definition of a lack of social distancing. Therefore, it was my belief that airline travel would put a person at higher risk for getting the virus. Then, last month, I read an article in the Journal of the American Medical Association. The authors are members of not just the AMA, but also the Aerospace Medical Association, the International Airline Medical Association, and the International Air Transport Association.

The article was an eye opener for me. The authors stated that “the risk of contracting COVID-19 during air travel is lower than from an office building, classroom, supermarket, or commuter train.” Allow me to pass on their reasoning to you. As you probably know, the virus is emitted when someone talks, coughs, sneezes, or sings, mainly in droplets that can be propelled a short distance, therefore the social distancing and mask rationale. A person can become infected if these virus particles reach their nose or mouth, either directly or via hands. The article states that air enters the airplane cabin from overhead inlets and flows downward toward floor-level outlets. Air enters and leaves the cabin at the same seat or row and there is little forward or backward airflow between rows, making it less likely to spread respiratory particles between rows. In addition, the seat back acts as a physical barrier. The air filtering and recycling in modern airliners is much faster than normal indoor buildings. Half of the air is from outside, and the other half is recycled through HEPA filters of the same type used in operating rooms. In addition, during flight most people tend to remain relatively still, with little face-to-face contact.

According to the authors, the number of suspected or confirmed cases of in-flight COVID-19 transmission between passengers around the world is very small (42 as of 10/1/20) as compared to transmission aboard high-speed trains in China (2300 known cases for an overall rate of 0.3% among all passengers). Wearing face coverings further reduces risk, as it does in other settings where physical distancing cannot be maintained.

Of course, airlines can and have taken other steps to reduce transmission like temperature checks of passengers and crews, asking about symptoms, adjustment of food and beverage service, control of access to aisles and bathrooms to reduce contact, and contact tracing in the event that a passenger develops an infection. Passengers can take additional steps themselves like wearing a mask, not travelling if feeling unwell, and maintaining distance. Also, aim the overhead nozzle directly at your head and keep it on full, stay seated, sanitize your hands frequently, and avoid touching your face.

For additional information go to:


Questions and comments may be sent to This email address is being protected from spambots. You need JavaScript enabled to view it..

 By Peter Galvin, MD

Sign up via our free email subscription service to receive notifications when new information is available.