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3 COVID-19 Risks and Mitigation on Commercial Aircraft
Pages 15-28

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From page 15...
... COVID-19 TRANSMISSION ON COMMERCIAL FLIGHTS In the early days of the COVID-19 pandemic, there were multiple anecdotal reports of passengers on commercial aircraft infecting fellow passengers, but a lack of concrete data makes it difficult to determine the reality behind the reports. Joshua Barocas, an assistant professor at the Boston University School of Medicine, discussed what is known about in-flight transmissions of the COVID-19 virus.
From page 16...
... Flying carries significantly higher risks than staying on the ground, even though those risks can be reduced by taking certain measures, such as leaving the middle seat empty. POSSIBLE MODES OF TRANSMISSION Understanding the risk of COVID transmission -- and finding ways to minimize that risk -- begins with forming a clear understanding of the ways in which COVID or other infectious diseases can be transmitted from one person to another.
From page 17...
... Consequently, fomites facilitate indirect transmission from person to person. For example, she said, "if while I sneeze I cover my mouth, and then leave the room and shut the door with the door handle, I have deposited expelled matter from my upper respiratory tract on the door handle.
From page 18...
... In particular, the study aimed to characterize the airplane cabin microbiome, to quantify transmission opportunities, and to create seat maps defining the risk of infectious disease transmission from an infected individual. To gather data, a team of graduate students and postdoctoral fellows took flights -- a total of 10 flights, or 5 round trips -- between Atlanta and various destinations on the West Coast.
From page 19...
... Given the relative dearth of data and a firm understanding of how virus transmission occurs on airplanes, Hertzberg had some simple advice for anyone who flies on a commercial plane: "Get a window seat, don't move, and wash your hands and keep those hands away from your face." Aerosol Dispersion in Commercial Aircraft Cabins Santarpia described the aerosol dispersion research his group conducted, sponsored by the U.S. Transportation Command, on the conditions of Patriot Express flights.
From page 20...
... is operating in an optimized fashion, the rapid dilution and mixing and purging of aerosol from around every person on the airplane and the airframe's high exchange rate and downward ventilation design probably limit the transport of aerosol throughout the aircraft, which then minimizes aerosol exposure risks." In short, a passenger's risk of being exposed to aerosol produced by a nearby infected person is significantly lower because of the cabin airflow on the Boeing 767 and 777. The average breathing-zone penetration from nearby seats is just 0.0148 percent for the 767 and 0.0176 percent for
From page 21...
... Silcott, et al., 2020, "TRANSCOM/AMC Commercial Aircraft Cabin Aerosol Dispersion Tests," Transportation Research Information Services, Accession Number 01756337, https://trid.trb.org/view/1747446. the 777, corresponding to about a 99.98 percent reduction in aerosol.
From page 22...
... Gerba said his group has done studies in which they released bacterial viruses similar to human viruses in office buildings to study transmission. "We put the bacterial virus on one person's hand, or in another case, we planted the virus on the door knob of an office building with about 100 people," he said, "within 4 hours, 50 percent of the surfaces are contaminated with the virus." Experiments conducted in in hotels, conference settings, health care environments,
From page 23...
... Chan School of Public Health, Harvard University, reviewed the 2013 National Academies report Infectious Disease Mitigation in Airports and Airplanes7 and spoke about how the lessons from that report could be applied to reduce the spread of COVID-19. There was general agreement among the workshop participants about the different techniques that can and should be applied to reduce the risk of COVID-19 transmission, so to avoid redundancy, not every recommendation by every participant is reproduced here.
From page 24...
... Testing done more than 3 days in advance of travel did very little, and testing done 3 days before travel caught only about 10 percent of infections, but that number got better as the departure got closer, with testing on the day of departure identifying more than 40 percent of infected passengers. Adding symptom monitoring improved the results, from about 30 percent when the testing was done 3 days before departure to nearly 60 percent when done on the day of departure.
From page 25...
... First, the probability of onward transmission is a function of mitigation measures, such as mask wearing and social distancing on the plane. "There is no one single strategy that is particularly effective at reducing onward transmission," she said, "but when used in combination they can be quite effective," which is the second key point: layering mitigation measures will improve effectiveness.
From page 26...
... Possible tactics include putting the symptomatic person in an isolation seat, one that has either been reserved on the plane or that is created by moving people away, providing N95 masks to people who are nearby, as well as to the patient and crew, and to have in-flight antigen testing to confirm the infection and, if necessary, lay the groundwork for contact tracing. Insights from the National Academies of Sciences, Engineering, and Medicine Report Infectious Disease Mitigation in Airports and Airplanes Following Rivers's talk, Joseph Allen spoke about some of the findings in the 2013 Infectious Disease ­ itigation in Airports and Airplanes10 report and discussed in particular parts of that report that are applicable to M the current pandemic.
From page 27...
... The National Academies report also had recommendations for dealing with aircraft passengers in order to decrease the risk of disease transmission, and one of the recommendations was to carry out a healthy traveler campaign. As part of that campaign, the airline would distribute health traveler kits containing masks, gloves, hand sanitizer, and alcohol hand wipes.
From page 28...
... Ultimately, Gerba said, the goal is to use quantitative microbial risk assessment to evaluate and compare these different interventions, quantifying the potential reduction in risk from each of the technologies and determining which are most effective in which situations. For example, one study looked at the effect that hand sanitizers or disinfectant wipes for desks had in reducing the spread of a virus on the surfaces of an office building, and they showed it was possible to reduce the risk of surface-based transmission by 90 percent by using the right strategies and the right products.


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