With the gradual onset of spring weather, many physicians likely are making spring and summer travel plans. Trust us, we feel strongly that time away from practice is well-earned and long overdue at this point in the pandemic. We just want to help you plan a vacation with the lowest risk possible. This is especially important if you’re considering air travel. According to the Bureau of Transportation Statistics, air travel dipped significantly in 2020. In December 2020, there were 397,802 domestic airline flights. Compare that with 672,725 flights in December 2019. Declining flight volume has smashed carriers’ bottom lines. According to the International Civil Aviation Organization, national and international airlines lost a combined $371 billion as a result of an overall passenger reduction of 60%. But, why should you care? This translates to savings for those willing/able to travel right now. As the vaccine rollout progresses, it seems airlines will be incentivized to get you flying again. According to a recent Washington Post report, your odds are better of finding a deal on domestic flights rather than international. You’ll find deals where airlines are adding routes and increasing flight capacity, which, for the moment, is at home. The better deals will be for what the airlines call VFR (visiting family and relatives) flights — AKA those that don’t go to typical business destinations. Right now, travelers seem to be gravitating toward outdoor destinations, such as national parks and Florida beaches. So, how to get there safely by air? Here are some important factors to keep in mind. It isn’t just the flight Many of us focus on flying as the main transportation event when traveling domestically or internationally. But think of everything that comes before you stow your tray table. Getting to the airport (by car, cab, or public transit), checking bags, clearing security, killing time before boarding. Each of these encounters is a possible vector of transmission. For example, a study published in October in Open Forum Infectious Diseases investigated how one COVID-positive patient’s bus trips affected other passengers. Among the 243 people the passenger had contact with on buses, 12 tested positive and had confirmed COVID cases. We know transmission can happen while using public transportation, but to what extent? An American Public Transportation Association report sheds some light on the subject. The report looked at 76 million public transit rides in New York City between June 1 and August 18, 2020. The number of COVID cases in New York city during the study window dropped from about 600 daily, to about 250 daily, the report says. Cases also fell in Hartford, Connecticut while public transit ridership stayed steady. However, while ridership was constant, case numbers jumped in San Francisco, Salt Lake City, Columbus, Ohio, and Austin. “An analysis of public transit ridership in multiple cities over the past three months shows no correlation with the rise or fall of local COVID-19 cases,” the report reads. “Case studies underscore that case rates are tied primarily to local community spread, rather than correlated to public transit ridership rates.” But, just in case, it’s important to stick to the same best practices: Maintain six feet of distance, wear a mask (double up cloth and fabric if you don’t have an N95), practice good hand hygiene, and most importantly, get a vaccine if it’s available to you. Safety on board According to an October JAMA Patient Page, COVID risk is low in aircraft cabins. Most planes use HEPA filtration that’s on par with hospital operating rooms. They also circulate a mixture of fresh and recycled air. Furthermore, overhead air jets promote downward circulation. Any airborne particles have a tendency to get pushed toward the floor, where they’re taken up by air outlets and passed through HEPA filtration again. This system also allows very little airflow between rows of seats. The JAMA report says that only about 40 COVID cases around the world have been linked to air travel thus far. Harvard researchers also issued a report on this subject in October. They recommended: Continuous air circulation and filtration Downward ventilation to disperse particles Universal mask-wearing Social distancing when getting on and off the plane Disinfection of high-touch surfaces Requiring passengers to self-report no COVID symptoms “This layered NPI approach, with ventilation gate-to-gate, reduces the risk of SARS-CoV-2 transmission onboard aircraft below that of other routine activities during the pandemic, such as grocery shopping or eating out,” the researchers wrote. Testing options As of writing this, the CDC is not recommending a COVD-19 test requirement for domestic travel, CNN reported. Some destinations, however, require proof of a negative PCR test. This has prompted some airlines to provide passengers traveling to these destinations with tests. Travel + Leisure has a list of the airlines and associated test costs. Things get a little more complicated for international travel. Not only will many countries require you to show proof of a negative PCR test within 3 days of entry, the US now requires the same to come home. “If you plan to travel internationally, you will need to get tested no more than 3 days before you travel by air into the United States (US) and show your negative result to the airline before you board your flight, or be prepared to show documentation of recovery (proof of a recent positive viral test and a letter from your healthcare provider or a public health official stating that you were cleared to travel),” the CDC says. In other words, plan ahead. Find a testing facility and schedule a test before you arrive so you can actually get home. What you need to know before you fly this spring and summer: You must account for transmission risks while getting to the airport. Research has shown that there are risks for public transportation, but they appear to be low. Air circulation and HEPA filtration make flights themselves pretty safe. That said, you’ll want to wear a mask and stick to social distancing protocols. Right now, the CDC does not require testing to travel domestically. However, some states may require a negative test to visit, and most countries are doing the same. Plan ahead. Source
