I MISS the cacophony of sounds at an airport. The sounds of baggage wheels, a boarding pass being torn off and my passport being stamped. All of those were comforting reminders that I was either almost home or soon to be somewhere new and exciting.
It only seemed like yesterday when we were all talking about infrastructure expansion plans for airports around the world and the anticipated growth in passenger numbers. Today, we are at a point where the skies are empty all because of one pandemic called Covid-19!
Covid-19 has spread rapidly around the globe, killing more than 300 000 and infecting more than 4,8 million people as of May 19, according to the Johns Hopkins University.
That air travel can act as a conduit for the rapid spread of newly emerging pandemics is a chilling reminder that dangers of pandemics exist and we have to collectively work together to develop vaccines and bring in measures that stop the spread infectious diseases such as Covid-19.
In recent years, there have been many documented outbreaks of infectious diseases associated with movement of people via air or other forms of transport. However, despite sensational media stories, the risks of transmission of respiratory viruses inside aircraft cabins are unknown.
The accessibility, speed, efficiency and volume of air travel bring with them the challenges for the spread of infectious diseases, with implications for public health and safety.
Over the past few weeks, as countries scrambled to stop the spread of Covid-19 and keep their citizens safe, there has been a global effort to curb the movement of people. Some governments went into panic mode, shutting their borders and restricting travel.
If the debate is to be moved forward, fundamental questions will therefore need to be asked. How do we begin the long journey to recovery from Covid-19? How can airlines, airports and all relevant stakeholders step up and deliver a safe, healthy and secure journey in a world where constraints will be higher?
What follows is a summarised view of what is likely to change in the world of travel and what measures the airlines and airports will have to introduce.
Is there evidence that Covid -19 is transmitted onboard an aircraft?It is believed that that there is limited evidence that suggests that there is a risk of the coronavirus transmitting from person to person aboard an aircraft.
According to the Centres for Disease Control and Prevention (CDC), the risk of contracting Covid-19 is believed to be high only when people are in close contact with each other and exposed to respiratory droplets from an infected person who coughs or sneezes.
Vick Stover Hertzberg, director of the Centre for Nursing Data Science at Emory University in the United States, a bio-statistician and a lead author of a separate study on how infection can spread aboard an airplane, says the transmission of Covid-19 increases only when an infected person is sitting in a row in front of you, the row behind you and the two seats on either side of you, often referred to as the perimeter of risk.
Recent evidence also suggests that there is low risk of transmission of the virus among passengers aboard an aircraft. In support of this evidence, low transmission of the virus was noted aboard an aircraft travelling between China and Canada (CMAJ, 2020).
Two patients travelled from Wuhan to Guangzhou in China, then Guangzhou to Toronto in Canada, arriving on January 22, 2020. The index patient was symptomatic with a dry cough during the 15-hour flight. His wife also developed a cough. Both tested positive for Covid-19.
The airline subsequently contacted all the passengers aboard the flight through the media. Close contacts included 25 passengers sitting within two metres of the index case during the flight, the crew, and one close contact on arrival in Toronto. One close contact developed cough symptoms; however, throat swabs and nasopharyngeal swabs were negative for Covid-19. Five non-contact passengers had minor symptoms but were negative for Covid-19.
There are other plausible reasons that support the notion why Covid-19, which is believed to spread primarily by respiratory droplets, has not resulted in more on-board transmission, and why air transport is different from other modes of public transport when it comes to transmitting viruses. According to the International Air Transport Association (IATA), the differences include:
High Efficiency Particulate Air (HEPA) filters on aircraft (further information highlighted in this article)Air flow from ceiling to floor further reduces the potential for transmission. Furthermore, air flow rates are high and not conducive to droplet spread, unlike in indoor environments.
All of the studies reviewed in this article support the hypothesis that there is low to no transmission of Covid-19 so far aboard planes. However, at the same time these studies have thrown up many questions in need of further investigation, given the small sample size for the research.
Measures to reduce transmission
We will now be living in a world where public health policy influences travel and travellers’ behaviour in different countries.There is already wide discussion regarding finding ways for airlines and airports to know the health status of all passengers before they step aboard an aircraft.
In a report titled The Rise of Sanitised Travel, Simplifying says that in the age of “sanitised travel”, travellers will be required to upload an immunity passport confirming the presence of anti-bodies for Covid-19.
Nevertheless, the strategy has not escaped criticism from different aviation stakeholders in that there still seems to be a problem of unco-ordinated actions with regards the specific measures dealing with the Covid-19 threat.
Despite this criticism, airlines and airports are steps ahead of their respective governments in implementing and looking at further measures that assure every traveler that health and safety are taken seriously.
London Heathrow Airport has announced a raft of trial screening measures including ultraviolet sanitation, facial recognition thermal screening technology to track body temperature, and contact-free security screening equipment.
Wizz Air recently became the first carrier to resume overseas flights to Romania, Hungary, Portugal and Spain from Luton and Gatwick. The low-cost airline has implemented new protocols that are in line with government regulations to support physical distancing during boarding and enhanced cleanliness on board. Measures include social distancing involving passengers sitting two metres away from each other on the plane, contact-less in-flight payments and all those onboard must wear face masks, and in-flight magazines have been taken away.
United Airlines will block middle seats, and some aisle seats. However, this social distance measure to block seats is controversial and these methods have been strongly contested and face a barrage of criticism from different airline executives. Social distancing on aircraft will challenge viability and there are many critics who believe that leaving the middle seat empty will reduce unit revenues and raise unit costs.
IATA believes some airlines’ maximum load factor will fall to 60% on a wide body Boeing 777-300 passenger aircraft. It will be interesting to see how this debate evolves over the next few months.
Other social distancing measures around the world by airlines and airports that have been introduced include the carrying out of temperature checks at airports and aboard planes, reducing and eliminating in-flight services, such as beverage and food sales, passengers and the wearing of masks by crew.
The environment in an aircraft cabin differs in several ways from other indoor environments, for example in offices and homes, due to the extremely high occupant density and the confinement of passengers to their seats for long periods.
Airlines have come into intense scrutiny for the safety and cleanliness of their cabins. Most airlines are stepping up their approach to the Covid-19 outbreak, by cleaning their cabins more often; additionally to their normal cleaning programme, airlines are using a high-grade disinfectant to wipe down common surface areas in galleys and lavatories; using stronger hospital-grade disinfectants; using a fogging system to disperse sanitising spray throughout the cabin (Atmosphere Research Group, 2020).
Air quality in the aircraft cabin
One area that has long been of concern for the travelling public is the quality of air in aircraft cabins. Air quality, in the context of airline cabins, refers to the extent to which airflow, low humidity and air pressure and contaminants such as pollutants and infectious disease pathogens affect the healthfulness of the air.
To keep the airline clean as it circulates within the cabin, most airlines equip their aircraft fleet with High Efficiency Particulate Air (HEPA) filters similar to the ones used in hospitals and capable of capturing respiratory virus particles.
HEPA filters and the direction of airflow (from ceiling to the flow) within the cabin give added protection against any transmission of Covid-19 from one passenger to another. HEPA filters also provide a complete air change about 15 to 30 times an hour. According to aviation experts, the complete air total volume of air on an aircraft that is refreshed every two to three minutes, which is more frequent than in most air-conditioned buildings, where the air is changed every five to ten minutes.
There is a well-established body of global literature and research addressing airline passengers’ health and well-being that focusses on preventing and ameliorating the effects of jet lag, dehydration and, most notably, venous thromboembolism (blood clots) aboard an aircraft.
Additionally, there is further research regarding infection control and the prevention of the spread of infectious diseases via sea travel, including guidelines focussing on the containment and prevention of respiratory infectious diseases such as coronavirus. However, there is, by comparison, a dearth of corollary published literature on infection control and the prevention of infectious diseases associated with air travel.
It is clear that the impact on aviation of Covid-19 will be long and complex. The recovery will also change the way we will travel. Recovery will require a coordinated global tourism response that will strengthen collaboration at national and local levels which allow the tourism sector to tackle the issues around disease transmission. It will be important for all measures implemented to be focussed on outcome-based scenarios and supported by strong science-based facts.
When the lockdown is over, there is no doubt that the next airline trip anyone takes will not be the same, but travellers can be reassured that this is an industry that is committed to make air travel safe at all costs. I will certainly be flying again and Covid-19 will be defeated!
Zimbabwe-born Mambara, who has a demonstrated history of working in the airlines/aviation industry, is currently the country manager (UK and Ireland) for Royal Brunei Airlines.