Should you fly yet? An epidemiologist and an exposure scientist walk you through the decision process

We don’t know about you, but we’re ready to travel. And that typically means flying.

We have been thinking through this issue as moms and as an exposure scientist and infectious disease epidemiologist. While we’ve decided personally that we’re not going to fly right now, we will walk you through our thought process on what to consider and how to minimize your risks.

Why the fear of flying?

The primary concern with flying—or traveling by bus or train—is sitting within six feet of an infected person. Remember: Even asymptomatic people can transmit. Your risk of infection directly corresponds to your dose of exposure, which is determined by your duration of time exposed and the amount of virus-contaminated droplets in the air.

A secondary concern is contact with contaminated surfaces. When an infected person contaminates a shared armrest, airport restroom handle, seat tray or other item, the virus can survive for hours though it degrades over time. If you touch that surface and then touch your mouth or nose, you put yourself at risk of infection.

Before you book, think

While there is no way to make air travel 100% safe, there are ways to make it safer. It’s important to think through the particulars for each trip.

One approach to your decision-making is to use what occupational health experts call the hierarchy of controls. This approach does two things. It focuses on strategies to control exposures close to the source. Second, it minimizes how much you have to rely on individual human behavior to control exposure. It’s important to remember you may be infectious and everyone around you may also be infectious.

The best way to control exposure is to eliminate the hazard. Since we cannot eliminate the new coronavirus, ask yourself if you can eliminate the trip. Think extra hard if you are older or have preexisting conditions, or if you are going to visit someone in that position.

If you are healthy and those you visit are healthy, think about ways to substitute the hazard. Is it possible to drive? This would allow you to have more control over minimizing your exposures, particularly if the distance is less than a day of travel.

You’re going, now what?

If you choose to fly, check out airlines’ policies on seating and boarding. Some are minimizing capacity and spacing passengers by not using middle seats and having empty rows. Others are boarding from the back of the plane. Some that were criticized for filling their planes to capacity have announced plans to allow customers to cancel their flights if the flight goes over 70% passenger seating capacity.

Federal and state guidance are changing constantly, so make sure you look up the most recent guidance from government agencies and the airlines and airport you are using for additional advice, and current policies or restrictions.

While this may sound counterintuitive, consider booking multiple, shorter flights. This will decrease the likelihood of having to use the lavatory and the duration of exposure to an infectious person on the plane.

After you book, select a window seat if possible. If you consider the six-foot radius circle around you, having a wall on one side would directly reduce the number of people you are exposed to during the flight in half, not to mention all the people going up and down the aisle.

Also, check out your airline to see their engineering controls that are designed or put into practice to isolate hazards. These include ventilation systems, on-board barriers and electrostatic disinfectant sprays on flights.

When the ventilation system on planes is operating, planes have a very high ratio of outside fresh air to recirculated air – about 10 times higher than most commercial buildings. Plus, most planes’ ventilation systems have HEPA filters. These are at least 99.9% effective at removing particles that are 0.3 microns in diameter and more efficient at removing both smaller and larger particles.

How to be safe from shuttle to seat

From checking in, to going through security to boarding, you will be touching many surfaces. To minimize risk:

Bring hand wipes to disinfect surfaces such as your seat belt and your personal belongings, like your passport. If you cannot find hand wipes, bring a small washcloth soaked in a bleach solution in a zip bag. This would probably freak TSA out less than your personal spray bottle, and viruses are not likely to grow on a cloth with a bleach solution. But remember: More bleach is not better and can be unsafe. You only need one tablespoon in four cups of water to be effective.

Bring plastic zip bags for personal items that others may handle, such as your ID. Bring extra bags so you can put these things in a new bag after you get the chance to disinfect them.

Wash your hands or use hand sanitizer as often as you can. While soap and water is most effective, hand sanitizer is helpful after you wash to get any parts you may have missed.

Once you get to your window seat, stay put.

Wear a mask. If you already have an N95 respirator, consider using it but others can also provide protection. We do not recommend purchasing N95 until health care workers have an adequate supply. Technically, it should also be tested to make sure you have a good fit. We do not recommend the use of gloves, as that can lead to a false sense of security and has been associated with reduced hand hygiene practices.

If you are thinking about flying with kids, there are special considerations. Getting a young child to adhere to wearing a mask and maintaining good hygiene behaviors at home is hard enough; it may be impossible to do so when flying. Children under 2 should not wear a mask.

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Coronavirus: Big tobacco sees an opportunity in the pandemic

Over the last few months, as COVID-19 has spread around the world, big tobacco has exploited the pandemic to push its branding and products. The industry never misses a trick when it comes to exploiting the chaos of international crises, including wars. The current pandemic is no exception.

The strategy is to use the pandemic to try and shift their image from vilified industry to trusted health partner. The tactics they have employed to achieve this are shameless, even for an industry as controversial as tobacco. There are examples of tobacco companies offering assistance in the form of ventilators, gels, PPE and even cash. They are even involved in trying to develop a vaccine. While there is no doubt that these have been gratefully received by authorities struggling with a chronic lack of resources, the industry has been up to other tricks, too. And one British FTSE 100 company is proving particularly adept.

In March, as many governments began to lock down their populations, British American Tobacco (BAT) began co-opting universal health messages. These were then placed on branded face masks, which were subsequently handed out to social media influencers for free.

Instagram remains one of the key marketing platforms for the industry. In 2019, BAT paid Instagram influencers to promote glo, its heated tobacco device, among other products. One of the hashtags used was #todayiwill.

BAT’s Instagram campaign ran into trouble, though. In December 2019, in a landmark decision, the UK Advertising Standards Authority, ruled against BAT and three other firms for promoting an e-cigarette, Vype, on Instagram, after a complaint by ASH, Campaign for Tobacco-Free Kids and STOP, of which the University of Bath is a partner. Later that month, under pressure to act, Facebook and Instagram announced that “branded content that promotes goods such as vaping, tobacco products and weapons will not be allowed”.

Undaunted, BAT appeared to use the social media platform as a COVID-19 marketing tool, especially in countries where oversight was likely to be less stringent. BAT simply changed the #todayiwill hashtag to #todayIwillstayhome, to reflect the messaging from governments for people to stay at home. Evidence uncovered by the Campaign for Tobacco-Free Kids, which has been tracking BAT’s activities, found that in Kazakhstan among other countries, BAT provided influencers with “today I will stay home” glo masks. Other hashtags used included #glomask.

The company used other COVID-19 hashtags, too. An influencer appeared on one BAT Vype account in Spain, using #frenalacurva, the Spanish for “flatten the curve”. BAT employed similar tactics in Latin America and Europe. This meant if you were searching on Instagram for these government messages, you would come across BAT’s subliminal marketing.

Days before the glo-branded masks started appearing on social media and right in the middle of the pandemic, BAT launched a glossy rebranding exercise unveiling a new slogan “For a Better Tomorrow”. The company replaced its old tired leaf logo with bright rainbow colours.

‘New adults’, new market

BAT’s board told investors that its redefined mission was now “stimulating the senses of a new adult generation”. This essentially means entrapping a new generation of young people into nicotine addiction, from vaping, heated tobacco products to cigarettes.

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