Air Travel and the Pandemic: an Epidemiologist’s Perspective

by Peter Schnall, MD, MPH*

An epidemiologist walks into an airplane

Prior to COVID-19, I was a frequent flyer: traveling internationally almost monthly for both work and personal reasons, and logging more than one million miles in the past decade. As a physician/epidemiologist, I have had a research and public health focus on working conditions and their impact on physical and mental health for the past 30 years. During plane trips, when passengers beside me asked me what I did for a living, I would talk with them about the impact of work on health, question them about their jobs, and of course, answer many questions they had about how work might impact their health. As the COVID-19 pandemic has vast and mounting impacts on work and working conditions, I believe flying and speaking with others would be even more interesting now.

While flying continues to be a required work activity — not only for airline personnel but for the many business travelers whose jobs require them to fly, air travel (and all public transportation) is more dangerous for the foreseeable future.

Photo by Suhyeon Choi on Unsplash

Pandemic air travel risks

COVID-19 threatens all of our health. To have healthy work and be able to return from work healthy, the COVID-19 pandemic must be controlled. Going to a workplace where the risk of contracting COVID-19 is great, is a threat to many of us, and therefore puts greater demands on our nervous systems. Many articles and studies are reporting increasing stress symptoms among working people and the public as a result of the pandemic. One form of stress found at certain kinds of jobs, such as bus driving, is called threat avoidant vigilance (abbreviated TAV), but it may also be a consequence of the COVID-19 pandemic. The body’s natural response to threatening situations is characterized by biological arousal including increased respiration and blood pressure. A response akin to TAV may now occur when people go outside in public during COVID-19 or need to travel on public transportation or fly in a crowded airplane — situations experienced as threatening and requiring enhanced vigilance to reduce our risks.