As the number of coronavirus cases rises across the United States this winter, completing any air travel will be full of fraught decisions – which airlines still have social-distancing protocols, whether to lounge in the airport, and when (if ever) it’s safe to take off a mask. But longer flights and those that require a layover at another airport will be perhaps the most anxiety-inducing because they represent more time of risk for picking up the virus.

Recent studies on in-flight transmission of the coronavirus make clear that longer flights have been superspreader events; the longer a group of people is gathered, the higher the risk of the virus becoming airborne gets. Health experts have warned travelers that airports and public transportation can facilitate the spread of the coronavirus.

“The problem is not only the plane – it’s the airport, the transit before the airport, anywhere that gets crowded, really,” says Carlos Acuna-Villaorduna, an epidemiologist at Boston Medical Center who has expertise in modeling the projected spread of viruses. “This is a respiratory virus, and it only needs close proximity to spread.”

So what is a traveler to do if the options are either boarding a long, potentially crowded flight or breaking up the journey with a precautionary layover?

Doctors say one option will typically be better than the other. Here’s what to consider if you’re up against a long flight during the coronavirus pandemic.

Consider whether you’re taking a flight that’s several or more hours long, similar to the seven-hour journey Irish researchers said this summer was linked to 59 cases in the country. Is it wise to reduce your time in a single air cabin by including a stopover at an intermediary airport, or is there greater risk in introducing another ground stop?

David Freedman, an infectious-disease expert at the University of Alabama at Birmingham who frequently reviews travel-related coronavirus studies, says the risky boarding and deplaning process almost always outweighs the benefits of breaking up the journey.

“If you change planes, you’re hitting one more airport. And there is a huge amount of risk in the airport, but boarding and deplaning is the riskiest part of that,” Freedman says. “So doing that process an extra time really increases the risk. . . . The only advantage of breaking it up would be that, if you’re sitting next to somebody on your flight who is infected, it would cut your odds” of infection.

Freedman notes that there are no existing studies on the risk of a layover specifically, but researchers have often pointed out that airport spaces such as security lines and gates where passengers congregate could be responsible for cases linked to travel.

Acuna-Villaorduna says research has signaled that planes’ air filtration systems are more efficient than standard ventilation ones.

“If you need to do an international flight, the risk in the airplane itself is relatively low,” he says. “So stopping at an airport, being in lines again, that probably is introducing a risk that is higher than being in a plane.”

A study by the Department of Defense found in October that if passengers wear masks for the duration of a flight, planes’ high-efficiency air filtration systems are effective in preventing aerosol droplets from spreading to other passengers. However, the study does not account for movement in the cabin or passengers removing their masks.

Freedman and Acuna-Villaorduna say they would not split up a long flight with a layover if they needed to fly for several hours. But they would prefer the flight be on an airline that is blocking seats for social distancing, to decrease the risk of being seated near someone with the novel coronavirus.

Freedman says there is a scenario in which he would consider inserting a layover.

Flights that are 14 hours are longer, Freedman says, might be worth breaking up under the right conditions. Those ultralong trips that introduce more exposure to others also create a greater probability that some passengers will remove their masks to eat and drink. A recent study by New Zealand health officials found that an infected man on an 18-hour flight to the country spread the coronavirus to at least four other passengers.

Freedman also points out that longer flights have a greater chance for onboard bathrooms to become contaminated with the coronavirus if anyone onboard is infected, since on a shorter flight more passengers are likely to avoid the lavatory altogether.

How long is long enough to warrant a potential layover? “Ten hours, I would definitely fly straight, Freedman says. “But a superlong haul of 14, 15 hours, I would really want to think about the intermediate airport.”

Factors to consider about a layover include: “How likely is it to be busy . . . how vigilant they are about their covid precautions?” Freedman advises researching any layover airport before choosing the stop, making sure it is not prone to delays or poorly ranked for cleanliness.

Airports most likely to be best for a pit stop are those with reputations for being high-tech and efficient in their cleaning methods. Airport awards for cleanliness have primarily been given to those in Asia. Tokyo, Seoul, Singapore and Doha are the cleanest airports, according to ratings by Skytrax.

 

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