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

Jinjun Zhang; Fei Qin; Xinyan Qin; Jianren Li; Sijia Tian; Jing Lou; Xuqin Kang; Huixin Lian; Shengmei Niu; Wenzhong Zhang; Yuguo Chen

doi:10.1080/07853890.2021.1973084

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

Ann Med. 2021 Dec;53(1):1569-1575. doi: 10.1080/07853890.2021.1973084.

Authors

Jinjun Zhang¹, Fei Qin², Xinyan Qin³, Jianren Li¹, Sijia Tian¹, Jing Lou¹, Xuqin Kang¹, Huixin Lian¹, Shengmei Niu¹, Wenzhong Zhang¹, Yuguo Chen⁴

Affiliations

¹ Beijing Emergency Medical Center, Beijing, China.
² School of Electronic Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, China.
³ Uninted Family Healthcare, Beijing, China.
⁴ Emergency Department, Qilu Hospital, Shandong University, Jinan, China.

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 MESSAGESThe 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.

Keywords: COVID-19; SARS-CoV-2; air travel; aircraft; infectious diseases; transmission.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Travel / statistics & numerical data*
COVID-19 / diagnosis
COVID-19 / epidemiology*
COVID-19 / prevention & control
Disease Transmission, Infectious / prevention & control
Disease Transmission, Infectious / statistics & numerical data*
Environmental Exposure / statistics & numerical data*
Female
Humans
Male
Models, Theoretical
Risk Factors
Risk Reduction Behavior
SARS-CoV-2 / isolation & purification

Grants and funding

This study was supported by the Beijing Municipal Science and Technology Project [Z191100004419003], National Key R&D Program of China [2020YFC0846600], and Shandong Provincial Key Science and Technology Innovation Project [2020SFXGFY03].