Swine flu and air travel.

Probably you’ve been reading about the new swine flu outbreak on Effect Measure and Aetiology. At this stage, public health officials are keeping careful watch on this epidemic to try to keep it from becoming a pandemic.
And this is the news in the back of my mind as I need to arrange air travel in the coming months. Nothing makes me want to book airline tickets more than the project of being in a metal tube with germy humans.
I did some poking around to see what kinds of measures the airlines might be taking to avoid helping spread swine flu and the people carrying it around.


US Airways issued a travel advisory:

The airline said it will waive standard change fee, advance reservation and ticketing requirements for customers with travel to, from or through Mexico City on the dates of April 24th through April 30th.
The change will allow airline travelers to move their entire itinerary up to seven days before or after the scheduled origination date.

In other words, folks with plans to travel to, or through, Mexico City can opt out of doing so without eating the value of their plane tickets while the swine flu epidemic there seems to be at its height. (Also, the airline is letting folks trade in their tickets to Mexico City for tickets to alternate destinations.)
Mexicana seems to be offering similar options:

The airline says it “is offering international passengers traveling to Mexico City, or who are required to catch connecting flights at the Mexico City airport, the option of rescheduling their flights and/or travel dates at no extra charge.’
Flyers have to be booked to travel between April 24 and April 30.

These measures, of course, are aimed at protecting healthy travelers from traveling to regions where they are likely to acquire swine flu.
As far as measures intended to keep those travelers who might have swine flu from spreading it, I found this:

CNN reports that San Diego International Airport , near the Mexican border, has posted signs encouraging airline passengers top wash their hands frequently, and cover while they cough. There have been reports of more flyers showing up at airline gates with surgical masks in place. National Public Radio reports cleaners and workers at Mexico City’s Benito Juarez International Airport have already donned surgical masks, and that signs line the terminal cautioning passengers to take precautions against the spread of the disease.

Here, I’d like to suggest that the airlines might do a lot to cut down on the spread of swine flu and similar contagious diseases if they had a policy in place that allowed people with symptoms to reschedule their flights without paying big penalties. If the cost of a plane ticket is relatively high (to the traveler) and if there’s no reasonable way to reschedule for a minimal fee, then people are going to keep getting on planes when they don’t feel well. This means that face-masks and stepped up cleaning of aircraft notwithstanding, sick people on planes will likely sicken healthy people on planes.
And then, the germs have won.
Of course, the airlines want to fill every seat on every flight. It costs a lot to fly a commercial airliner, even with fuel prices down a bit. But it seems to me that a policy that let people reschedule when they’re coming down with symptoms of something contagious might create a pool of people who, once healthy, would be looking to fill some of the seats that opened up when other ailing travelers decided that they shouldn’t be bringing their germy selves on a plane. It might also build some goodwill between the airlines and customers, and possibly coax some people who avoid flying because they don’t want to be sitting next to a feverish, coughing vector of disease into flying again.

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Posted in Current events, Ethics 101, Medicine.

9 Comments

  1. My understanding is that many (most? all?) airlines already allow waiver of change fees for non-refundable tickets if you provide them with a doctor’s letter confirming that you were unable to travel on the originally scheduled flight due to illness.

  2. If that’s the case, then *publicizing* this policy might be a really good thing (since I reckon plenty of people who don’t know such a policy is in force travel while sick because they think their non-refundable tickets really are non-refundable).

  3. I’ve been a travel agent for nearly 30 years. The days of doctors notes getting you out of a non-refundable ticket or penalties are long gone (7-10 years?). You can only get out of a ticket if you or a family member dies. Unfortunately, if you’re sick there’s no empathy from the airlines – either you fly sick or you pay.

  4. Hi Bruce – I had a look at this a while ago as part of my company’s Pandemic policy review. The answer is not a lot. There was a product that you could get for a while that acted as a n-95 filter you plugged into your seat’s air vent. Train this on your face and the idea was it would create a “zone of purity” around you. Problem is of course it did not work very well. However, keep your vent on and aimed at you anyway as most airlines have HEPA filtration on the air recirculation system which should block your average virus if properly maintained.
    Apart from that, same precautions as anywhere – hospital style hand hygeine using alcohol based cleanser gel (remember you can only have a certain amount of liquid on international flights so make sure it is the right size). The gel should be at least 60% Alcohol.
    Flu virus will enter via your airway, or less likely by ingestion or through your eyes.
    Use appropriate hand hygeine before touching your face or eyes(hard this, most people scratch their face several times every 15 min) or eating. Clean the outside of your food packaging as well. Also sanitze after visiting the toilet or moving around the cabin and touching things. Toilets on planes are filthy, so be extra vigilent. Nitrile gloves make for an easier surface without nooks and crannies to clean but again they are uncomfortable. Remember, just having the glove on will not stop a virus getting into your airway.
    If permitted you should wear a N-95 (european standard P2) HEPA mask. Note, – a surgical mask protects others, not you so it needs to be the mask needs to be the right kind. They are available online but only deal with a reputable supply company(n-95s are hot, uncomfortable and you will look like a muppet but better than dying I guess. Look up “fit testing” on google to see how to use it. Most of them are fold flat disposable. Silicone spray painters types are the same level of protection (with correct filter, has to be HEPA – the purple one) but is re-usable. If $ is no object a PAPR pump and filter feeding the mask will be more comfortable but I doubt you would be allowed to take it on or use it.
    When you get to your destination treat clothing as contaminated. Before you wander around your new environment contaminating it, remove clothing and wash as much as possible.
    Sanitize hands, remove clothes, bag them (or even better straight in the disinfectant) in an entry area and sanitize hands again. Have a full shower with antiseptic gel.
    Rememebr that the “infected” clothes need to be soaked in nappy cleaner and dried in a very hot dryer or in full sun before being re-used. Luggage should be sanitized. Wear protective gear whilst laundering / cleaning as the virus can remain active on damp cloth for a long time.
    Viruses do not breed by themselves like bacteria but can be tough little buggers. They do not light UV light.
    At the end of the day – it is only a flu. The same precautions you would ordinarily use but more so as the stakes may be higher.

  5. Even if it’s true that for some airlines a doctor’s note is sufficient, visiting a doctor is an expensive burden for millions of uninsured and underinsured people. Many people, if they simply “feel like they might be coming down with something” (i.e., when they’re at their most contagious), are not going to visit the doctor.
    Anyone who’s gone to the expense of buying a plane ticket, and gone to the trouble of making travel arrangements, needs to be trusted to know when it’s best to reschedule.

  6. I cancelled a flight with American Airlines in early June because my daughter was diagnosed with swine flu.We were told by her doctor that she could not travel. I was told by a rep from AA that we would have full credit for our fares. This was not the case. I just tried to re-book with our “credit” and was informed that we were being charged a $150.00 penalty per ticket for cancelling. Their cusomer relations department informed me that AA no longer waives fees for illness. I am trying to fight this since the illness was the swine flu.

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