Published on: Nov 17, 2020, Last Edited: May 05, 2021
When you travel by air to the United States from another country, either alone, with friends or family, you are sharing a confined space with hundreds of travelers for what could be six hours or more. There are known side effects of flying that everyone should be aware of, such as deep vein thrombosis, hypertension, earache, and dehydration. These are caused by limited mobility, changes in cabin pressure, altitude, and oxygen levels which, in most people cause only minor discomfort. However, those with underlying health conditions may be more susceptible to other health complications that are related to hygiene. Aircraft hygiene concerns have been highlighted more recently due to the COVID-19 pandemic. This article reviews hygienic considerations travelers should take into account when flying to the United States.
The transmission of respiratory infections is spread mainly through droplets when a person coughs or sneezes, and these droplets tend to fall close to the infected person, usually within one meter. However, the microbes can then be transferred onto other surfaces such as door handles, trays, and magazines, which other people touch. They, in turn, touch their face, rub their nose and eyes, and so the infection spreads. To catch the virus, you need to be close to an infected person or to touch something that they have touched. In that sense, you are no more at risk on a plane than in any other enclosed public space.
It is commonly thought that diseases are spread through the aircraft via the air-circulation system, so if someone coughs at the back of the plane, the pathogens are sent to the front through the tiny nozzle you adjust to get cool air on your face. This is highly unlikely, as there are High-Efficiency Particulate Air (HEPA) filters fitted on all commercial aircraft. These remove at least 99.9% of microscopic particles from the air, and with 20 to 30 air changes per hour, the air on a plane is thus more likely cleaner than that in your home or your office.
During a typical 40-minute turn-around aircraft cleaning in between flights, there is only enough time to tidy up and vacuum. Intensive and thorough cleans are usually completed after the last flight of the day. This will involve wiping down and disinfecting trays, lavatories, overhead bins, and seats. According to Christian Rooney, manager of JetWash Aero, a specialist aviation cleaning company responsible for cleaning the planes, they only do a deep clean of the aircraft every four to six weeks, and although the disinfectants used will destroy pathogens and viruses, the antimicrobial protection lasts for just 10 days. However, during COVID-19, many airlines have been allocating more time to cleaning and disinfecting surfaces, as well as carpet and seats, at a higher frequency.
More people now are turning to Personal Protective Equipment (PPE), examples include face masks, gloves, eye protection. These are used for everyday chores and activities, but just how effective are these on a flight?
Gloves provide good protection for your hands and may reduce the likelihood of transmission if worn and disposed of correctly. Also, gloves help protect the skin. If you have a cut or an abrasion on your skin, gloves may help protect against infections. Germs and bacteria can survive on various materials for several hours or even days. If you do wear gloves on a plane, make sure to dispose of them after use and bear in mind cross contamination risks.
There is a debate over the effectiveness of face masks. Provided they are well fitted and cover the nose, several studies have shown they will offer some protection by filtering out droplets if you happen to be in direct line of an infected person when they cough. They also act to prevent you from touching your nose and mouth, a common entry point for viruses. However, even by using a mask, your eyes remain vulnerable.
Used in conjunction with a face mask, safety glasses or goggles can provide effective protection from splatter if someone coughs or sneezes in your direction. Look for those that shield the sides of the eyes as well. For comfort, spectacles are better than elasticated goggles.
Dr. Paulo Alves, a fellow of the Civil Aviation Medical Association, stated recently that the most effective measure is to wash your hands frequently with soap and water and use hand sanitizer in between washes. Hand sanitizers and wipes can be used to wipe the surfaces around your seat where it is more likely for droplets to land after someone coughs or sneezes. They can also be used to disinfect your hands when you are not able to access the lavatories to wash your hands. Most importantly, avoid touching your face whenever possible.
Choosing a window seat will reduce the risk of catching something from a cough or sneeze, because there is only one person who can sit next to you, and you will be more than one meter from the aisle, where people are passing all the time. This tactic only works on a three-three configuration, with the aisle down the middle.
By reducing the amount of time sitting on the aircraft, you are reducing your level of exposure to pathogens. On long-haul flights, the percentage reduction is minimal, but on flights of two-three hours, it can make a difference. Your position on the plane is significant when using this tactic, especially on larger planes where people are called forward by seat numbers. Choose one of the front rows for the least exposure, but away from the aisle where people queue for the toilets.
Viruses can survive on coins for up to four hours and dollar bills for up to 72 hours, so it would be a good idea to pay for any in-flight purchases by card, contactless if possible, and always clean the card with a disposable disinfectant wipe after someone else has handled it even if they were wearing gloves.
You will frequently be in contact with your passport, wallet or purse throughout your journey. Upon your arrival to the U.S., Customers and Border Protection (CBP) will likely ask to view your passport for proof of having an ESTA or a visa. In such instances, it would be advised to use hand sanitiser or a disinfecting wipe to clean your passport cover. Similarly, should your payment card or boarding pass be handled by airline representatives, you should aim to clean either item once it has been returned. By learning about the experience of traveling on an ESTA, you can prepare yourself for the various touch-points during your journey were for peace of mind you can prepare the use of disinfectant wipes or hand sanitiser to wipe down your belongings.
Whilst it is highly unlikely that serious diseases like influenza and coronavirus can be passed through the aircraft’s air-circulation system, or even a common cold, there are still issues around the cleanliness and levels of hygiene that mean personal protective measures are recommended. The use of PPE should be considered if you have underlying health issues or if required by the air carrier. PPE should not be used only as a substitute of other things like hand sanitizer and disinfectant wipes for surfaces. Lastly, washing your hands with soap and warm water as often as you can will also help reduce the likelihood of getting infected by cold or flu strands.