Better buckle up, passengers.
A new report released by the Centers for Disease Control and Prevention (CDC) has suggested that the new coronavirus can be spread on airplanes by asymptomatic carriers.
In the study, presented in the peer-reviewed journal Emerging Infections Diseases, researchers looked at evidence of in-flight transmission of COVID-19 from asymptomatic patients because previous data was inconclusive. In-flight transmission by people with symptoms of COVID-19, on the other hand, is well established.
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The studied evacuation flight flew from Milan, Italy, to South Korea in late March for an 11-hour trip; 310 passengers were originally scheduled to board, but 11 were refused entry after showing symptoms of COVID-19. Both on the ground and in the air, the flight crew followed strict infection control procedures from the Korea Centers for Disease Control and Prevention (KCDC).
In the sky, all passengers wore N95 respirator masks, except when they ate and used the toilet. After arriving in South Korea, the 299 passengers were quarantined for 2 weeks at a government quarantine facility, completely isolated from each other, where they were frequently examined for symptoms of COVID-19.
On April 2, the first day of quarantine, six passengers tested positive for COVID-19 and were hospitalized. Two weeks later, the six passengers showed no symptoms of the viral illness and were reportedly asymptomatic.
On April 15, the 14th day of quarantine, however, a woman who initially tested negative after disembarkation tested positive for the coronavirus. The traveler wore the N95 mask throughout the flight except when using the toilet, which was shared by passengers nearby – including an asymptomatic person. The woman who tested positive for COVID-19 on April 15 sat three rows behind the asymptomatic passenger.
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To that end, the researchers suspect that the woman’s infection was likely transmitted through in-flight contact.
Ten KCDC crew and eight medical staff were also quarantined at the facility for two weeks and tested for COVID-19 on days 1 and 14 of the quarantine; all 18 people have tested negative for the coronavirus both times.
In further investigation, researchers looked at data from another evacuation flight, which traveled from Milan to South Korea on April 3 under the same strict infection control procedures guided by the KCDC.
During this trip, three passengers were asymptomatic for COVID-19 and one passenger who tested negative on day 1 of quarantine also tested positive on day 14 of quarantine.
“Based on an epidemiological investigation, the authors and KCDC suspect that this infection was also transmitted by contact in flight,” the authors said.
The authors concluded that it is still unclear exactly how the virus was transmitted on airplanes, suggesting that contaminated surfaces or infected people may have a “critical role” in the in-flight transmission of infectious diseases and that more research is needed.
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“Our results suggest the following strategies for the prevention of transmission of SARS-CoV-2 on an airplane,” they wrote. “First, masks must be worn during the flight. Second, because contact with contaminated surfaces increases the risk of transmission of SARS-CoV-2 among passengers, hand hygiene is necessary to prevent infections, ”they wrote.
“Third, physical distance must be maintained before boarding and after disembarking the aircraft.”
In conclusion, the authors insisted that “strict global regulations for the prevention of transmission of COVID-19 by air” could help prevent such public health emergencies in the future.
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