From leaving your house to arriving at your hotel, how can you avoid catching coronavirus on your holiday? Travel health specialist Richard Dawood explains how to tilt the odds in your favour. 

Travel-related respiratory infections have perhaps not received sufficient attention until now. It is too soon to know how coronavirus will behave as time unfolds, but we do know that colds and flu occur more frequently in people who travel than in those who stay at home. 

People worry about sharing air in the aircraft cabin, but in fact cabin air is relatively safe – and among all of the coronavirus cases reported so far, not a single one has been attributed to in-flight transmission.  

Cabin air is filtered, and while the air conditioning system is operating normally (for example, during a flight and while the engines are on), air flows vertically downwards from the top of the cabin to floor level, rather than simply swirling around. As far as airborne disease transmission is concerned, you are potentially at highest risk from ill passengers seated immediately behind, beside or in front of you, with some additional potential exposure from high-traffic areas – the aisles and the toilet areas. In theory, choosing a low-traffic position in the cabin – such as a window seat – should help to minimise any risk. 

Wearing a face mask on board is not necessary nor recommended. (The one possible exception I would make to this would be in the case of an extended delay on the ground, with engines switched off.) Surgical masks are for protecting others, not for protecting the wearer, and can only filter out coarse droplets. True protection from fine airborne particles in a medical environment requires a well-fitting, high filtration medical-grade mask. Both options are uncomfortable and impractical to wear for the full duration of a long-haul flight. Furthermore, in a contaminated environment, the outer surface of the mask quickly becomes contaminated. 

In practice, untrained mask-wearers handle their masks frequently – including taking them off to eat or drink, transferring any possible infection to their hands, their face, and shared surfaces around their seat, potentially increasing contamination. Studies suggest that widespread mask-wearing does not reduce the risk of transmission. 

Most likely, the overall increased rate of colds and flu among travellers – and by extension, any possible increased risk of coronavirus – relates to the entirety of the journey: airport taxis, buses, trains, crowded terminals, the inevitable stresses and frustrations, and meeting new people (and their germs) at your destination, each as a contributing factor. The Telegraph’s Global Health Security Editor, Paul Nuki, has written a piece looking into how to avoid the spread of respiratory diseases on public transport.

All this said, it’s worth remembering that for now at least, the odds are very much in your favour: case numbers are still very low, and now could prove to be the safest time to travel for weeks or months to come.

Here are some thoughts about tilting the odds of avoiding coronavirus in your favour:

Studies suggest that widespread mask-wearing does not reduce the risk of transmission

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Before you go, and planning

  • Where possible, travel off-peak, out-of-season, or at less crowded times. Respiratory viruses spread most easily in crowded places.

  • Have a flu jab – it is not too late. Flu vaccination does not protect against coronavirus but flu is currently a much more likely cause of fever and respiratory symptoms, now with the added risk of isolation and/or quarantine.

Setting off, and at the airport

  • Don’t be embarrassed to speak up: if your taxi to the airport has a driver who is coughing or unwell, take a different cab, or at least open the windows.

  • Hand hygiene is the most effective protective measure you can take: stay aware of everything you touch and where your hands have been. Frequently-handled surfaces such as handrails, security trays, lift buttons, security survey buttons, taps, toilet door handles, baggage handles, and perhaps even your mobile phone, are not germ-free. There is no point being totally obsessive, and it is perfectly fine to touch all of these things as long as you then cleanse your hands before bringing them to your face, and touching or handling food (which is often the first thing people do when finally able to relax on board a flight). 

On the plane

  • Take hand sanitizers and antiseptic hand wipes, and use them immediately before eating or touching your face. Once seated on your plane, you can also use wipes to clean your armrests, touchscreens, remote controls at your seat, and your tray table – though it is not remotely practical to create your own sterile bubble in which to travel.

  • Airlines generally clean hard surfaces throughout their cabins at the end of each day, and public health authorities are introducing stricter guidelines for hygiene and decontamination, especially if a person is taken ill on board.

At your destination

  • You can’t control everything. Bear in mind that the need for good respiratory etiquette may not be fully appreciated at your destination. There’s not much you can do if someone coughs or sneezes directly at you, other than hope they are infection-free.
  • Avoid crowded spaces, where possible.

Dr Richard Dawood is a specialist in Travel Medicine at the Fleet Street Clinic.

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