Transmission of SARS-CoV-2 during air travel: a descriptive and modelling study

Abstract

Objectives To explore the potential of SARS-CoV-2 spread during air travel and the risk of in-flight transmission. Methods We enrolled all passengers and crew suspected of being infected with SARS-CoV-2, who bounded for Beijing on international flights. We specified the characteristics of all confirmed cases of COVID-19 infection and utilised Wells-Riley equation to estimate the infectivity of COVID-19 during air travel. Results We screened 4492 passengers and crew with suspected COVID-19 infection, verified 161 confirmed cases (mean age 28.6 years), and traced two confirmed cases who may have been infected in the aircraft. The estimated infectivity was 375 quanta/h (range 274–476), while the effective infectivity was only 4 quanta/h (range 2–5). The risk of per-person infection during a 13 h air travel in economy class was 0.56‰ (95% CI 0.41‰–0.72‰). Conclusion We found that the universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19. KEY MESSAGES The COVID-19 pandemic is changing the lifestyle in the world, especially air travel which has the potential to spread SARS-CoV-2. The universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19 on an aircraft. Our findings suggest that the risk of infection in aircraft was negligible.

Bioaerosol distribution characteristics and potential SARS-CoV-2 infection risk in a multi-compartment dental clinic

“…Wang et al [ 64 ] used 100 quanta/h for aircraft COVID-19 infection risk analysis. However, Zhang et al [ 65 ] reported that the quantum generation rate of SARS-CoV-2 during air travel was 375 per hour. In addition, Chen et al [ 66 ] showed that the SARS-CoV-2 quantum generation rate was 185.63 per hour by estimating the virus emission rate using the Diamond Princess Cruise Ship.…”

The role of precautions: Organising a medical conference during COVID‐19 pandemic—Lessons from IADVL MIDDERMACON 2021

“…36.1% of attendants travelled by aeroplane to the conference, which has a negligible risk of transmission of infection due to proper screening and mitigation measures 14 . Breakthrough infection of COVID after the conference was 0.173% (1/576), lower than the 2.605% rate (39/1497) in a study by Bergwerk et al (which was a hospital‐based study), indicating that the risk of transmission is low when the majority of attendants are vaccinated, and safe preventive measures are followed 15 .…”

The emission and dynamics of droplets from human expiratory activities and COVID-19 transmission in public transport system: A review

“…Table 6 lists the 22 studies on COVID-19 transmission and/or prevalence on airplanes. Among them, 13 studies reported in-flight transmission rates ranging from 0% to 10% with a median of 0.36% [ 7 , 12 , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] ]. The highest transmission rate of 10% was reported on a domestic flight in Japan where 14 passengers were infected [ 87 ].…”

“… 1.4 × 10 −6 – 1.3 × 10 −7 Pang et al, 2021 [ 84 ] 18 flights from Europe to England No NA 0.20% (17/2313) on average; Blomquist et al, 2021 [ 78 ] 3.8% within 2 rows from index person Milan, Italy – South Korea N95 face mask An 11-h evacuation flight carried 299 passengers. 0.30% (one possible in-flight transmission, potentially via the toilet) Bae et al, 2020 [ 77 ] 830 international flights arriving in Beijing Face mask 161 COVID-19 cases confirmed 94 flights, of which, in-flight transmission observed on 2 flights 0.36% (flight 1); Zhang et al, 2021 [ 85 ] 0.42% (flight 2) Wuhan – other cities, China NA 175 COVID-19 index cases among 5797 passengers on 177 flights during Jan. 4–23, 2020 0.33%–0.60% (overall); Hu et al, 2021 [ 12 ] 0.7% (the middle seat); 9.2% (adjacent to the index case) Boston, USA–Hong Kong, China NA A 15-h flight carried 294 passengers. 1.4% (4/294) Choi et al, 2020 [ 79 ] Dubai, UAE - Auckland, New Zealand Face mask not mandatory An 18-h flight carried 86 passengers.…”