In-flight transmission of COVID-19 on flights to Greece: An epidemiological analysis

Abstract

Background The emergence in China in late 2019 and subsequent progression of a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19) was highly facilitated by international travel. We present 5 cases of probable in-flight transmission in Greece. Methods We studied international passengers arriving to or departing from Greece from February 26 through March 9, 2020. Contact tracing extended up to 4 days before the onset of symptoms and focused on close contacts. Close contacts were defined as persons sitting within a distance of <2 m for >15 min, including passengers seated two seats around the index case and all crew members and persons who had close contact with the index case. Results We investigated 18 international flights with 2224 passengers and 110 crew members. Main countries of departure included Northern Italy, Israel and the United Kingdom. In accordance with the national surveillance investigation, in these flights there were 21 index cases and 891 contact traced cases. Six index cases were symptomatic during the flight. Of the 891 contact traced cases, 4 passengers and 1 crew member developed laboratory-confirmed infection (3 with COVID-19 and 2 with asymptomatic infection); they travelled on the same flight with two COVID-19 cases. Conclusions Air travel has played a central role in the progression of the COVID-19 pandemic. However, there are scarce data about in-flight transmission. Our extensive investigation showed five cases of probable in-flight transmission. Efforts should be placed in order to ensure the prompt implementation of appropriate infection control measures on board.

Air travel in a COVID-19 world: Commercial airline passengers’ health concerns and attitudes towards infection prevention and disease control measures

“…35 While IATA suggests that risk of in-cabin COVID-19 transmission is low 13 , COVID-19 has spread globally because of the movement of infected individuals by air travel. [9][10][11][12] Moreover, the IATA COVID-19 survey concluded that 36% of respondents would at least wait six months before considering traveling by air, with an additional 14% indicating they would not travel before a year or more from the moment the pandemic shows a true global decline and 5%…”

“…7 SARS-CoV-2 spread worldwide and was declared a global pandemic 8 in less than 3 months, driven principally by the movement of infected individuals by air. [9][10][11][12] The emergence of COVID-19 and its associated travel bans have reduced international passenger traffic. As of 8 October 2020, 1.2 billion passengers have travelled worldwide 13 , compared to the over 4.5 billion in 2019.…”

Sustainable border control policy in the COVID-19 pandemic: A math modeling study

“…2 shows that even with open border, both entities are experiencing decreasing cases very similar to close border policies between each other. We further simulate infections during the trip (including in-flight [ 41 ] but not limited to) by doubling the number of infected people upon arrival comparing to the numbers at departure. The simulation suggests that even with a high infection rate on the road, both entities can withstand the imported risk and maintain a decreasing trend for both the identified new cases and the number of hospitalized patients over time.…”

COVID-19 pandemic and air transportation: Successfully navigating the paper hurricane

“… Parker and Mahomed (2020) The role of hypoxia and thrombosis is underestimated during COVID-19; regular oximetry scanning should be implemented. Pavli et al (2020) Based on 18 international flights bound to Greece, revealed five cases of probable in-flight transmission among 2,224 passengers. Schwartz et al (2020) Based on a lack of infection on a flight from Guangzhou to Toronto, it is concluded that in-flight transmissions are rare; especially in the presence of face masks and milder symptoms.…”