Listen: Is It Safe to Fly?

How to assess risk when you have to travel

On this episode of the podcast Social Distance, the staff writer James Hamblin and the executive producer Katherine Wells discuss the perils of air travel and the best ways to prepare for it.

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What follows is an edited and condensed transcript of their conversation.

Katherine Wells: We’ve got a question for you from an anonymous person:

I am a healthy 76-year-old thinking about taking a nonstop flight from Nevada to Baltimore. I want to see my daughter and her family, including my grandkids, who have been fantastic about quarantining. I could self-isolate in their basement. For the flight, I have an N95 mask and gloves, and a protective face shield. Icing on the cake—I can wear a diaper to avoid public restrooms. Should I get on that plane?

James Hamblin: The answer for her, just to cut right to it, is that she should get on the plane. She shows, just in that question, a level of vigilance and attentiveness that if everyone were that thoughtful and careful about the precautions they took, we’d all be able to travel safely.

The air in the cabin of a plane is constantly turning over. A lot of new air is coming in from the outside, and whatever air is recirculated is run through these high-efficiency HEPA filters, the same things they use in hospitals. They’re rated to catch 99.9 percent of viruses. And the whole cabin’s air is supposed to turn over every two to three minutes. The chance of spreading a virus widely within the cabin of a plane is next to zero as long as that system is on. And there haven’t been confirmed cases of coronavirus spread on airplanes to more than one other person ever since we started having people rigorously wear masks and told sick people to definitely not travel. There have been cases where sick people have traveled internationally and people around them have not gotten sick.

Wells: Okay. But you have no control over the other people on the plane and there are many well-documented examples of people not wearing masks on planes, including, recently, Ted Cruz. Does that change things?

Hamblin: Right. There is a theoretical possibility that you get seated next to someone who has been really inconsiderate and is symptomatic and refuses to wear a mask. And I don’t know what recourse airlines have in compelling them to. But we haven’t heard about violent showdowns where someone’s refusing to wear a mask. It seems that people mostly have been pretty good about that.

Wells: But what if she walks on the flight and it’s full and the person sitting next to her either doesn’t have a mask or is wearing it incorrectly?

Hamblin: Yeah, that’s an unfortunate situation, but from what we’re seeing, there aren’t reports of lots of transmission on planes, especially since people started taking these precautions. So, yes, it’s a risk—but it’s a very small risk. I think that as more and more people start to travel, there’s probably going to be some interesting confrontations and maybe even legal battles about this.

Wells: I’m going to tell you what I would do if I were her in that situation: I would insist to the flight attendant that I needed a different seat and say that I’m an at-risk person and I can’t sit next to the person.

Hamblin: Yeah, I think that would be a great move. If it’s a full flight, your options might be more limited. But I just have to think that there’s enough collective spirit right now that it wouldn’t just be the flight attendant scolding that coughing person who refuses to wear a mask; it would be, like, the entire seven rows all around that person. [Laughs]

Wells: All right, here’s another question: What about public restrooms? She’s going to wear a diaper to avoid public restrooms. Is that what she should do? You’ve told us about toilet plumes. It seems like public restrooms have the potential to be dangerous, right?

Hamblin: You should not have to wear a diaper. Public restrooms are supposed to have ventilation systems that suck air out of the restroom, and anything lingering in the air is not lingering long.

Wells: Do airplane bathrooms have that?

Hamblin: Airplane bathrooms have ventilation like the rest of the plane. One thing is that you should still wear a mask. I wouldn’t assume it’s safe just because you’re alone. I would still wear the mask. We know that flushing a toilet has the capacity to aerosolize virus, if there was virus in the stool that was in that toilet. We don’t know how much virus would have to be present in order to infect someone, and airplane bathrooms are kind of weird. They don’t have the same swirling water mechanisms—they just suck down. I don’t believe they have specifically been studied as a contributor.

Wells: So the most important thing is: If you’re going to use a public restroom, it’s very important to wear the mask.

Hamblin: Right. There’s one important caveat to this discussion. In 1977, there was a flu outbreak on a plane. The plane was on the tarmac, waiting, and they turned off its ventilation system. Thirty-six out of 54 people on the plane got the flu.

Wells: How long were they sitting on the plane?

Hamblin: Four and a half hours. This was not a brief turning off of the system. This is not a reason to have your heart stop if they turn it off briefly. But it should not be practice that they are turning off the ventilation system and having people sit together right now, and maybe they shouldn’t ever do that. So there’s that. And the other issue is deplaning and boarding, where they tend to turn the air off. And some airlines are thinking of creative ways to try to make that process more efficient so you’re not sitting there for 20 minutes after the plane has landed.

Wells: I know that your answer to the original question is: She should get on the plane. But everything you’re telling me—if it were me, I’d be like, I’m not getting on that plane.

Hamblin: It’s a calculated risk, and if you’re 76 and you want to go see your family and the other alternative is waiting two years? That changes the equation.

Wells: It sounds like what you’re describing is the kind of calculation that is always going to be very individual, and that we have to build this muscle for risk calculation if we’re going to live this way for the next few months or even years.

Hamblin: Exactly. And we can all collectively lower risk if we try to limit things like travel to instances when we really feel we need to.