How To Stay Healthy While Flying: A Pilot & An ER Doctor Weigh In
- Updated: 07/11/2024
Like so many travelers, I frequently wonder how to stay healthy while flying during uncertain times. To answer my questions I went straight to the experts – a pilot and an ER doctor.
Table Of Contents
The Experts
My pilot is V.K. Badrinath, a good friend with over 26 years of international experience flying a wide range of aircraft ranging from light singles to commercial turboprops and heavy jets. He is currently an Instructor Pilot for a global airline and Airbus A330 and A320. He has traveled domestically and internationally throughout the pandemic. He was enthusiastic to answer these questions and share what he knows.
My ER doctor and husband, Jordan Moskoff, M.D., has over 20 years of experience working in Emergency Medicine both in the Bronx and Chicago. Although he would prefer to be known for his skill with the smoker than for his medical advice – he does love to travel – and gamely set about answering my questions for the greater good.
The Interview: Tips For Flying During COVID-19
Here is my conversation with both V.K. and Jordan.
Airline Safety Measures
Q: V.K., as a pilot, can you help travelers understand what the airlines have done to improve passenger safety by reducing the risk of COVID-19 transmissions?
V.K.: While airlines have done many things to make people feel safer, the simple reality is that traveling on an aircraft is much the same as going to the grocery. It requires common sense, good judgment, and respect for the well-being of fellow passengers.
Unfortunately, not everyone is blessed with these attributes!
So, let’s talk about some of the things airlines have done, and some of the things that people think airlines have done.
The simple reality is that traveling on an aircraft is much the same as going to the grocery.
First of all, onboard air circulation has not changed at all since COVID. That’s because the air onboard an aeroplane follows a fairly complex path and requires several different systems.
A redesign of the process would likely take years to develop, let alone certify, which is why nothing has been changed regarding the circulation of onboard air. (V.K. recommends this article to learn more.)
However, the good news is that the total volume of air on a large aircraft is generally replaced about 15-20 times an hour, with most aircraft utilizing HEPA filtration systems, which are similar to those found in hospitals. But unfortunately, this might not be enough if the guy next to you wears his mask over his chin.
As for cleaning, most airlines have indeed begun cleaning their aircraft more thoroughly and with solutions specifically designed to battle COVID-19. However, since COVID-19 seems to be primarily spread through the air, the real question is whether or not these cleaning measures reduce COVID risks in any meaningful way.
Boarding procedures for many airlines have changed with the aircraft finally being boarded from back to front, which reduces exposure and cross-contamination.
The aircraft [is] finally being boarded back to front, which reduces exposure and cross-contamination.
Perhaps the biggest problem with air travel is the passengers’ willingness to wear masks correctly. Although cabin attendants do their best to enforce the rules, they have grown weary of enforcing mask compliance with passengers who are often rude, and sometimes combative.
The bottom line here is that the best thing you can do to protect yourself on an airplane is to do just that.
Protect yourself.
Q: V.K., on that note, before we move on to Jordan, what do you wear to protect yourself when you fly?
V.K.: When I travel as a passenger on airplanes, I double mask and wear a face shield.
The face shield is probably overkill but makes me feel a bit safer, especially when sitting next to a mouth breather whose mask is too loose and constantly slipping down his face.
How To Minimize Risk Of Exposure
Q: Jordan, after two years of responding to COVID-19, you have learned a great deal about the virus and how people can best protect themselves from it. Can you help travelers understand how they can minimize their risk of exposure when flying?
Jordan: I’m glad to hear airlines are using HEPA filters and circulating air 15-20 times an hour – this will go a long way to minimize risk.
That means that as long as passengers in a traveler’s direct vicinity keep their masks up, everyone will be safer, with their risk of exposure to COVID-19 reduced significantly.
There are two ways that airplane travelers can contract COVID-19, through breathing in airborne particles or through touching a contaminated surface and then touching their face, eyes, or nose.
To reduce the risk of exposure via airborne particles, filtered air circulation, such as V.K. mentioned, helps tremendously. It removes virus particles much the same way an open window in a small room would do. To understand how this removal works, think of an opened perfume bottle.
Filtered air circulation removes virus particles much the same way an open window in a small room would.
If a person in the front of the airplane opened a perfume bottle, the people right around the bottle would smell it – and its vapor scent compounds, or particles, first. The reason for this is the perfume particles have the shortest distance to travel to the closest people.
Given enough time to travel, the perfume particles would eventually spread throughout the plane, and all passengers and crew – even in the back, would smell it.
The only way to limit the spread of the perfume particles – would be to give them a way to exit the plane or disperse – like through an open window or a filter. If the perfume particles have an exit route, most passengers would never smell them.
Whether it is for perfume or a virus – this is how particle dispersion and removal works. And it is why a HEPA filter on an airplane, along with excellent air circulation, allows particles – including COVID-19, to be removed – therefore significantly reducing virus exposure risk in small spaces like an airplane cabin.
However, this does not mean travelers should not wear their masks.
If your seatmates or nearby cabin neighbors don’t wear their masks correctly, then the filters won’t be enough. Wearing a mask loosely – where particles can escape through gaps – works like the open perfume bottle example. The people closest to the neglectful mask wearer will be exposed first and possibly before the airplane’s HEPA filters, and the circulation system can remove the particles.
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In addition to wearing a mask, I strongly recommend passengers learn to avoid touching their faces.
It is really hard to do this – given the air pressure change, and the dry air, while flying – to not rub your eyes or nose. But this is how you transmit the virus from surfaces to yourself. I have had to train myself over many years to do this, but it works.
The only way the virus can travel from the surface into you is if you put it there.
The only way the virus can travel from the surface into you is if you put it there.
For example, if someone came up and licked your tray table and it is now covered in virus – technically, you could put your hands on the tray table, and as long as your skin is intact (no cuts or open wounds) and you don’t take your hand and put it in your mouth, touch your nose, or rub your eyes – you will not get ill.
The way you keep yourself safe and avoid virus transmission – at any time, even in this extreme and gross example – is by thoroughly washing your hands or using hand sanitizer (e.g., Purell) immediately before touching your eyes, nose, or mouth. Also, do this before touching any food or drink you plan to put in your mouth.
Additionally – don’t lick the table yourself.
Keep yourself safe and avoid virus transmission by thoroughly washing your hands or using hand sanitizer immediately before touching your eyes, nose, or mouth.
As far as what are the correct types of masks to wear, it depends on the risk tolerance and comfort level of the individual mask wearer.
Tips For Safe Mask Wearing
- Regardless of mask type, keep it over your nose.
- Sanitize your hands before you put on, take off, or adjust your mask.
- Adjust your mask by grabbing the front center fabric and pull into place as needed. Avoid adjusting your mask by touching the edges (especially if you forgot to sanitize your hands), which are closest to your face.
- To remove or put on a mask, always do this by using the earloops. This helps to avoid contamination, as well.
On a long-haul flight where all passengers must provide a negative COVID-19 test result before flying, the risk of COVID-19 exposure is already low. On a trip like this, I would consider wearing only a surgical or cloth mask, which is enough to prevent transmission of respiratory droplets. Additionally, it is more comfortable and easier to wear than an N95 respirator over a long period. It is not easy wearing a respirator correctly for a long time. Trust me, I know.
However, on shorter flights, where passengers do not need to provide negative test results in order to fly and the risk is a bit higher, I would wear an N95 respirator mask because I feel more secure with the tighter fit.
To ensure N95 masks work correctly, they must be fit tightly to your face. Additionally, avoid getting the N95 masks wet (it works by electrostatic charge). Also, do not use one with an exhalation valve.
Overall, mask choice is a judgment call and personal to each traveler’s risk level.
Recommendations For Keeping Things Clean
Q: Jordan and V.K., do you recommend travelers should bring along cleaning supplies while flying? What should travelers expect to clean?
V.K.: At the beginning of the pandemic, I used to wipe down my entire seat area quite enthusiastically, sometimes using upwards of 10 anti-bacterial wipes.
These days, I am not quite as concerned about surface area germs. But, I do think it is a good idea to wipe down armrests, seat belt locking mechanisms, and tray tables – just to be safe.
Jordan: I agree with V.K. completely. Though, I use one wipe for my entire workstation in the E.R.
For travelers, I recommend wiping down the areas you are most likely to touch as good practice. But, keep in mind these areas will not stay perfectly clean throughout the flight – either the virus can fall onto a surface, or it can get transferred through contact from other interactions normal to being on a plane. I recommend re-cleaning the area before you eat.
To keep yourself and your area clean, I recommend bringing a bottle of hand sanitizer (e.g., Purell) and a package of antibacterial wipes.
Managing A Mask While Eating & Drinking
Q: V.K. and Jordan, eating and drinking without a mask while flying still feels fraught. How should travelers manage food and drink with mask-wearing?
V.K.: This is a great question and one without an easy answer.
For short-haul flights, I generally try to avoid eating whilst onboard the aircraft or in the airport. Drinking with a mask on can be made a bit easier with a straw, but this requires a bit of mask maneuvering and probably reduces its effectiveness somewhat.
If possible, travel in Business Class for long haul trips. These cabins have fewer passengers, and the seats are spaced with privacy in mind, which means fewer breathers in your vicinity and a potentially safer dining experience.
If you are in Economy on a long-haul flight, you will soon realise that there is no easy solution.
In the future, I would like to see a small, tent-like structure that could pop-open, fit over a seat and offer protection from the person sitting next to you. Something like this could make onboard eating and drinking safer when traveling, especially with kids.
While many airlines are passing out snacks and serving food, this does not mean that it’s safe to eat! The main rule is to always be mindful of the air that you are breathing, especially when other people are nearby.
Jordan: As mentioned before, the most important thing to remember before touching your mask, food, or drink is to sanitize your hands. Sanitizing your area just before eating with anti-bacterial wipes is a good idea as well.
And while eating or drinking, it is good to minimize your time while not wearing a mask. Possibly, consider eating faster than you would normally, or staggering eating times with your seat mates, especially if you are sitting next to other travelers not in your group.
A good rule of thumb is when someone has their mask off, keep yours on.
Additional Takeaways
Q: Do you have any other tips travelers should keep in mind when flying during a pandemic?
V.K.: The last two years have had a devastating effect on air travel. And although flights and airports initially were relatively empty, the crowds have caught up.
So, plan on arriving at the airport just like you did before the pandemic.
Personally, I avoid moving around the cabin, mostly because of other breathers. Sitting in my own seat, I am exposed only to the people immediately surrounding me. If I start walking around, I am exposed to all of the people I pass, and at the same time, I’m exposing them to me as well.
I avoid moving around the cabin, mostly because of other breathers. Sitting in my own seat, I am exposed to the people immediately surrounding me.
There is some evidence that COVID-19 can be found in fecal material and that this can be aerosolized in toilets. So, when going to the lav (airplane speak), keep your mask on and make sure the lid is closed before you flush.
See my tips for safe flying below.
Tips For Safe Flying
- Keep your shoes on until after the aircraft has taken off. This will protect you in the event that you have to evacuate prior to becoming airborne.
- Keep your mask on.
- Keep your helmet/face shield on.
- Keep your seatbelt on.
- Be nice to the crew.
- Look out your window. Flying is magic!
Jordan: Please don’t ask if there is a doctor onboard – I’m trying to watch a movie.
Jordan and V.K., thank you both for your valuable input. Hopefully, we have answered many questions and concerns travelers have about staying healthy while flying. We appreciate benefitting from your time and expertise.
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Welcome to Gather and Go Travel, a blog inspiring families, adult friends, and couples to explore US and international destinations and to get outdoors. I am Janice, a world traveler to 50+ countries, a travel writer/blogger, and a book lover. Learn more about me, read our story, and how to work with me. Get my latest updates, how-tos, and trip ideas in my monthly Discovery Newsletter.
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11 Responses
Thanks for taking the time to read it!
Sanitizing is crucial not to spread a disease. Health is wealth, so thank you for posting this!
How to Stay Healthy While Flying: A Pilot & an ER Doctor Weigh In” is an invaluable article that combines the expertise of a pilot and an ER doctor to provide practical and well-researched advice on maintaining health during air travel. It addresses a topic of universal concern, especially in today’s globalized world.
Thank you!
Great !!
your guide is so much helpful, Go Ahead.
Thank you for reading and taking the time to share a comment.
These are absolutely awesome! Such a fantastic guide, love it.
Iris, thank you for reading.
Thank you for pointing out that a redesign of the procedure would probably take years to create, let alone certify, and that is why the onboard air circulation has not been altered. My son wants to be a pilot. I’ll encourage my son’s desire, locate him a private pilot training course, and send him this article so he can take care of his health.
Hi Charlotte, I hope your trip goes well and you are able to stay safe and healthy before, during, and after your travels. Good luck! And have a great trip!
I loved learning that flights where passengers have to test for COVID-19 are at a lower risk for exposure. My husband and I are flying across the country in a couple of weeks and want to stay safe and helathy. WE’ll have to get tested for COVID-19 before we leave on our trip.