New research suggests the potential for in-flight transmission of COVID-19

Guwahati: Although the risk of in-flight transmission of COVID-19 virus is relatively less, it is however not entirely impossible. Recent studies published in the journal section of the Centre for Disease Control and Prevention have now proven that coronavirus can do so.

The study examined public records for 1,110 persons with laboratory-confirmed COVID-19 in Hong Kong, China, and recorded from January 23 through June 13. They then used the Centre for Health Protection (CHP) public records and the Vote4HK COVID-19 in the Hong Kong database for case-patients who had travelled before diagnosis.

At the time, the Hong Kong government did not introduce any mandatory quarantine and airport screening. Through this they were able to identify a cluster of four persons (two passengers and two cabin crew members) with COVID-19 referred to as patients A–D. They were associated with a commercial flight that departed from Boston, Massachusetts, USA, on March 9 and arrived in Hong Kong on March 10.

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Patients A, a 58-year-old married man who sat in the business class on the flight developed fever, cough on March 13 followed by mild abdominal discomfort and diarrhea two days later. His 61-year-old wife, B sat directly in front of her husband in a business class window seat. She too developed a sore throat and one day later, fever and cough.

Both tested positive for COVID-19 by March 15. Although one cannot assure that they were not COVID-19 positive before the flight was symptomatic during the flight. Before the flight and within the 14-day incubation period, they visited Toronto, Ontario, Canada (February 15–March 2); New York, New York, USA (March 2–5); and Boston (March 5–9). Centre for Health Protection classified the couple as imported cases into Hong Kong.

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Patient C, an asymptomatic 25-year-old was the flight attendant who served patients A and B on the flight. On March 17, patient C tested positive for the virus as well. He was in Boston during March 5-9. Patient D, was a 51-year-old female Hong Kong-based flight attendant on the same flight. Fever and cough developed on March 18 and she tested positive on March 21.

The virus genetic sequences of all the four were found identical, unique, and belonged to a clade not previously identified in Hong Kong, which “strongly suggests that the virus can be transmitted during air travel.” Other than these four, none of the 189 viral sequences deduced from samples collected in Hong Kong from January 21 to May 12 belong to this clade.

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“Our results strongly suggest the in-flight transmission of SARS-CoV-2. No other COVID-19 cases associated with this flight have been identified. We were unable to quantify the virus attack rate on this flight because not all passengers were tested,” stated the study adding that their results demonstrate that COVID-19 can be transmitted on airplanes and to prevent transmission of the virus during travel, infection control measures must continue.

The risk for an onboard transmission during long flights is real and also has the potential to cause COVID-19 clusters of substantial size. This is true even in the case of business class with spacious seating arrangements which are well beyond the established distance used to define close contact on planes.

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