A Multi-Layered Approach to Flying Safely in the Age of COVID-19
Updated: Nov 7
Experts agree that it is safe to fly as we navigate the global COVID-19 pandemic, but it requires a seamless collaboration between airports and airlines as well as a healthy sense of personal responsibility by frontline employees and passengers.
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Nearly a year into the global COVID-19 pandemic, there is no doubt that many have become exhausted by lockdowns, mandatory quarantines and travel restrictions. With a second wave of infections now reappearing in Europe, the U.S. and elsewhere, the hopes that this would be a short-term problem have faded, with some even predicting that SARS coV-2 (COVID-19) may become endemic, just like the seasonal flu. Short of an effective globally distributed vaccine, which is unlikely to be available on a wide scale before the end of 2021, we may have to learn to co-exist with the virus. By now everyone understands how infectious COVID-19 is and hopefully have embraced frequent hand washing, the use of hand sanitizers, avoiding face touching, practicing social distancing, and wearing a mask or face covering that covers both the mouth and nose when in public or in situations where social distancing isn’t possible.
Since the onset of the pandemic, airport operators, airlines, government transportation agencies and industry organizations such as the International Air Transport Association (IATA) have moved very quickly to implement protocols to protect air travel passengers. Safety is hard-wired into the DNA of the airline industry and all stakeholders have stepped up to ensure the end-to-end health and wellbeing of passengers and team members. On October 27, 2020, Researchers at the Harvard T.H Chan School of Public Health Released their Phase One “Gate-to-Gate” Report of SARS CoV-2 Transmission and Risk Mitigation While Flying. The report, from the Aviation Public Health Initiative (APHI) found that through a layered approach to risk mitigation, including the leveraging of technology and personal behavior modification, “near-normal activity” is now possible while reducing disease transmission. In the video below, Dr. Leonard Marcus, Co-Director of APHI, explains the purpose of the Aviation Public Health Initiative.
The cited study substantiated that a layered approach of Non-Pharmaceutical Interventions (NPI) deployed on commercial aircraft resulted in a very low risk of COVID-19 transmission, making air travel as safe and probably safer than routine activities such as shopping. The layers of protection onboard the aircraft include a ventilation system which circulates and refreshes cabin air on average every two to three minutes filtering out over 99 percent of airborne particulates, including virus clusters, through a high-efficiency particulate air (HEPA) filter. The ventilation system also rapidly disperses exhaled air in a downward direction, effectively countering traveler proximity during flight.
The next layer requires the universal wearing of facemasks by passengers and crewmembers throughout the entire journey, starting at the airport. Social distancing protocols during boarding and deplaning is also essential, and many airlines have implemented processes such as boarding passengers in the rear of the aircraft first, to limit contact.
Additionally, airlines have now implemented rigid cleaning standards for all aircraft including the regular disinfection of touchpoints such as tray tables inflight entertainment systems (IFEs), armrests, lavatories, etc. before every flight. Most airlines have also implemented overnight deep cleaning procedures utilizing the latest approved decontamination processes. In the U.S., for example, American Airlines electrostatically sprays a product called SurfaceWise®2, the only U.S. Environmental Protection Agency (EPA) approved product that provides long-lasting protection against viruses. The product continues to protect against viruses (including COVID-19) and microbes such as bacteria even after new germs and viruses are deposited on surfaces. Similar cleaning processes have been implemented by airlines worldwide. The following video, courtesy of KLM Royal Dutch Airlines, helps explain many of the layers of protection that are in place for the health and wellbeing of airline passengers and crew members.
Another important synergistic layer in the battle against COVID-19 is the requirement that passengers and crewmembers attest that they are free from symptoms and will adhere to airline’s mandatory mask policy. According to the Harvard/APHI study, due to the layered protocols now in place, there is a relatively low risk of contracting COVID-19 while flying. That said, it is important for travelers to evaluate their own personal health situation, risk tolerance and potential consequences of infection. Naturally, anyone who is experiencing symptoms which could be associated with SARS CoV-2 should refrain from travel.
Facemasks while traveling, both at the airport and onboard aircraft, are now universally mandatory and anyone who is unwilling to follow this common-sense protocol should not fly. Failure to follow mandatory facemask policies while flying can result in being added to the airline’s “no fly list” or, in the case or Aerolíneas Argentinas, a five year ban from flying and the filing of a criminal complaint. The bottom line is that masks are both mandatory and effective in minimizing the spread of COVID-19. As stated in the report highlights of the Harvard/APHI study,
“Face masks without exhalation valves or vents or other openings are a critical element in preventing the spread of respiratory infectious diseases while traveling. In fact, face mask requirements are perhaps the most essential layer of a comprehensive set of measures to reduce transmission of COVID-19 throughout air travel.”
Since the wearing of facemasks is not only the responsible thing to do, but also mandatory while flying, we though we would do a “deep-dive” into the various types of masks for the benefit of our readers. An article from Harvard/APHI titled Face Masks in Air Travel helps demystify both the role of masks, the basic types and the effectiveness of each style. First, COVID-19 transmission can occur through the emission of virus-containing aerosols (five microns and smaller) or droplets (greater than five microns) when exhaled by an infected person when coughing, sneezing, speaking or even breathing.
While the larger particles tend to fall to the ground quickly, smaller particles can remain suspended in the air. According to the cited article, individuals infected with COVID-19 are likely to be infectious 2-3 days before the onset of symptoms and an estimated 50 percent of cases are spread by asymptomatic of pre-symptomatic individuals. Additionally, aerosols can accumulate and remain suspended in the air for up to a few hours in poorly ventilated spaces. With that in mind, it should be self-evident why everyone should now be wearing masks, especially as we experience an acceleration of COVID-19 cases.
Types of Masks
The three basic types of masks are cloth, surgical-type and N95 Respirator type. Cloth and surgical masks tend to fit loosely but serve to block droplets from being exhaled by the user, while N95 Respirator type masks fit snugly and are designed to filter out 95 percent of airborne particulates that are .3 microns or larger. It should be noted that exhalation valves on masks allow unfiltered breath from the wearer to be expelled, and therefore are not useful in preventing the spread of COVID-19 and prohibited on some airlines.
According to the Harvard/APHI study, cloth facemasks constructed out of silk, cotton, tea towel or linen are 49-72% effective in filtering out particles containing .02 micron aerosolized viruses. The effectiveness of an individual cloth facemask is driven by many factors including fabric type, tightness of weave, number of layers of fabric, addition of a filter layer and fit. Cotton fabric with a higher thread count and cloth masks with filter material such as cotton batting between layers make them more effective. The study also states that gaps around the tops and sides of masks reduce efficacy and there is emerging evidence that the filtration ability of some well-fitted cloth facemasks might be more effective than surgical masks.
While cloth and surgical masks are acceptable for air travel, as part of our research for this article we evaluated two N95 masks marketed by one of our advertisers,
N95MASKCO.com, who generously provided us with samples. As with most safety equipment, it should be noted that there is a natural tradeoff between comfort and effectiveness. By design, all N95 masks are designed to fit snugly, providing the maximum amount of protection for the wearer. However, because N95 masks may restrict breathing, users with underlying heart or lung conditions should consult with their doctor before using these products.
The first mask we evaluated was a U.S. Center for Disease Control (CDC) National Institute for Occupational Safety and Health (NIOSH) certified N95 cup mask, which is like widely used 3M N95 mask. As previously mentioned, N95 masks filter at least 95% of airborne particulates .3 microns or larger. The N95MASCO.com version we evaluated contains an interior foam strip on the inside for placement over the bridge of the nose as well as a flexible aluminum strip on the exterior for personalized adjustment to the wearer’s face. The mask is secured with two overhead elastic straps, with one secured behind the neck and the other over the ears and behind the head. We found this mask to be durable, comfortable and wearable, with a snug facial fit. Additionally, we tested the mask with eyeglasses and found that fogging can be kept to a minimum by resting the glasses over the mask above the aluminum strip. In terms of air travel, we found the mask functional but due to the double-elastic overhead elastic straps, removal of the mask for food and beverage service would be cumbersome.
The second product we evaluated was N95MASKCO.com’s KN95 Mask. Although not NIOSH certified, this mask is on the FDA’s Appendix A list of approved KN95 masks and offers the similar filtration properties of an N95 mask. The nice thing about this mask is that it packs flat for easy storage and has over-the-ear loops like a surgical mask for easy donning and removal. The KN95 we evaluated has an embedded aluminum tab for personalized fitting over the bridge of the nose and face. We found this mask provided an excellent fit and was durable, comfortable and highly usable in the context of air travel, for those looking for a higher level of personal protection. Like the N95 Mask we evaluated, by moving eyeglasses slightly forward on the KN95, fogging was kept to a minimum.
In conclusion, the Harvard/APHI study explains that until a vaccine or treatment for COVID-19 is widely available, the non-pharmaceutical interventions (NPIs), such as the universal wearing of facemasks, combined with the highly efficient aircraft ventilation system, may reduce infection risk from respiratory particles to less than one percent. As we have highlighted, airports and airlines have taken a multi-layered approach to ensure the health and safety of travelers. We believe passengers can travel with a high degree of confidence, providing they are willing to take personal responsibility for their own hygiene including frequent washing of hands, use of hand sanitizer, by avoiding touching their face (especially eyes, nose and mouth), social-distancing and by wearing a facemask throughout their journey.
Source(s): Harvard T.H Chan School of Public Health/Aviation Public Health Initiative (APHI), American Airlines, KLM Royal Dutch Airlines, Aerolineas Argentinas, N95MASKCO