Each week, we answer "frequently asked questions" about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at firstname.lastname@example.org with the subject line: "Weekly Coronavirus Questions."
When I booked a flight from Boston to Washington, D.C., in mid-January, I knew that sharing confined indoor spaces with strangers was a risk in the middle of a pandemic. But a year into living with the coronavirus, I figured it wasn't a huge risk.
1) It's a short flight.
2) Everyone knows how to wear a mask and social distance by now.
3) Surely airlines have adopted measures to help reduce chances of transmission if a traveler is infected but doesn't yet know it.
I was so naive.
My 11:15 a.m. flight was delayed to 12:39 p.m. Then to 1:32 p.m. Then it was canceled and rebooked for 4 p.m. And delayed to 4:45 p.m. Then we all got on the plane — and got off again, when the plane's electronic system broke on the runway.
So I had many hours to observe my fellow passengers. They streamed by with masks on — but often hanging below their noses, nostrils fully exposed. One man took off his mask to cough. Dozens of people clumped at the gate, many less than 6 feet apart — the recommended spacing to minimize risks of transmission. The plane was packed with passengers. And people were quite literally in each other's faces when we boarded and deplaned.
When I shared my experience with a colleague, she said, and I quote: "Aaaaaaaaaaaaaaakkkkkk!"
I was left with many questions. Freelance contributor Sheila Mulrooney Eldred and I went searching for answers.
Is it really up to a passenger whether to wear a mask (properly or at all)?
In some countries, there is federal guidance. In India, for example, the government declared in May that all flyers must wear masks ... and even gloves. (Gloves aren't necessarily protective. Read this.)
In the United States, there is no federal law that requires masking in public spaces. But states do. And U.S. airports follow state public health guidelines in most spaces. So you may hear repeated loudspeaker announcements reminding you of the state mandate to mask up.
Once at a ticket counter or gate, you'll be under the jurisdiction of that airline's rules – and the same applies on board the plane. In the U.S., all major airlines require masks for passengers ages 2 and up and may specify what types of masks are acceptable (those with vents are a no-no).
But what happens if a traveler's mask is below the nose while wandering the terminal?
At some airports, such as Denver International Airport, passengers may get a reminder from airport staff — or an offer of a free disposable mask. But not every airport encourages its employees to address the situation. So should you call out a traveler whose mask has slipped below his nose? Only if you can do so gently and without provoking that person — best not to prompt a screaming match, which will certainly increase aerosolization, says Abraar Karan, a Harvard Medical School physician. Instead, avoid food courts and people eating or drinking in the gate area. Take advantage of empty gates to hang out in before the gate agent calls you to board.
And consider upgrading your own mask before you fly, perhaps to the type of mask classified as KN95 and certified by the National Institute for Occupational Safety and Health. Whenever you're in a situation where not everyone is wearing a face covering properly, "you'd feel a lot more comfortable if you had a really good mask on," Karan says.
Is there any way to make sure passengers don't crowd each other at airports?
On Sunday, Pien Huang saw airline staff admonish a man because he was standing in the entryway to the tunnel connecting the gate to the plane, and holding up the line — but the same staffers made no efforts to get people to stand 6 feet apart in that line.
"The reality is, you can have masking and distancing rules, but whether or not people follow them and whether they're easily enforceable is a very different thing," says Dr. Henry Wu, director of Emory TravelWell Center and an associate professor of infectious diseases at Emory University School of Medicine. "The aircraft environment itself can be a contentious, high-stress situation; crews have always had a tough time dealing with passengers who don't want to follow their policies."
To some degree, airline and airport staff should play a role in enforcing such rules, Wu says. But while he's strongly in favor of public health policies, a more effective path to adherence is encouraging people to mask and distance so compliance is pretty much baked into our brains – like wearing a seat belt, he says.
"The more habitual and common people make it the more people will have peer pressure to do it. We're clearly not there yet," Wu says.
Until then, protect yourself at the airport by staying away from crowds until it's time to board, Karan says. Eat beforehand so you're not tempted to hit the food court (and don't have to take your mask off for an in-flight refueling).
Minimize the number of airports you'll enter by booking a direct flight if possible.
If you can spring for TSA PreCheck, you'll cut down on the time spent in line for the security check.
And we said it before, but we'll say it again: Find an empty gate area to wait in until your boarding call.
Whatever happened to the policy of no middle seats?
Earlier in the pandemic, many airlines were not booking middle seats to create more distance between passengers. The only major U.S. airline to keep up this practice is Delta Air Lines, which has pledged not to book middle seats through March.
While it's easy to understand why many airlines have given up that policy — bottom lines! — it's not great news for passengers.
"If you have someone right next to you without a mask on or coughing or sneezing or a mask that's poorly fitting, the bets are off," Karan says.
A study of a September flight from Dubai, United Arab Emirates, to New Zealand shows how much proximity matters: At least four people within two rows of a contagious passenger were infected with the coronavirus.
And unfortunately, you can't count on airlines or public health departments to notify passengers if someone on your flight is subsequently diagnosed with COVID-19.
"It is really important, but it gets complicated on a flight," says Karan, pointing out how quickly people disperse. "You can still do it, but it takes a lot of resources, and we're at a point in the epidemic where transmission is so high."
Some airlines in other countries have implemented policies and precautions aimed at reducing risk, such as China Airlines' guidance for people not to touch their eyes, nose or mouth during the flight.
Should I take any comfort in the new policy of testing passengers flying into the U.S.?
This week, the Centers for Disease Control and Prevention announced that every passenger flying into the U.S. would be required to present a negative test for the coronavirus, taken within the last three days, before boarding.
But passengers who test negative before their flight may turn out to have the disease once they get to their destination, because it usually takes a few days after infection for tests to catch the virus.
So how effective will this policy be?
"I think that it depends," Karan says. "It will help in the sense that it'll catch some people who are infectious. Now the question is, how will it be enforced? Policy without enforcement is just words on paper."
And airlines are responsible for that – they're required to check testing documentation for incoming international passengers before issuing a boarding pass.
"It might help," Wu says. "[But] on the other hand, in and of itself, it's not a solution. It's just one of many things to help us improve the situation."
Postscript: Pien Huang is now living in the post-flight limbo recommended by the CDC for domestic travelers:
- Consider getting tested with a viral test three to five days after your trip and reduce nonessential activities for a full seven days after travel, even if your test is negative. If you don't get tested, consider reducing nonessential activities for 10 days.
- If your test is positive, isolate yourself to protect others from getting infected.
And she's not planning to take any flights in the near future.