Transmission of SARS-CoV2 during long flight: findings from
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During the first 6 months of 2020, SARS-CoV-2 spread to almost all countries and infected and more than 4 million persons worldwide. Air travel is contributing to the extent and speed of the pandemic spread through the movement of infected persons; consequently, in March, many countries either completely halted or substantially reduced air travel.

This study aimed to assess the role of in-flight transmission of SARS-CoV-2. Researchers investigated a cluster of cases among passengers on a 10-hour commercial flight. Affected persons were passengers, crew, and their close contacts. They traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them.

Key findings:

-- Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%).

-- Seating proximity was strongly associated with increased infection risk.

-- No strong evidence supporting alternative transmission scenarios was found.

-- In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight.

These findings have several implications for international air travel. First, thermal imaging and self-declaration of symptoms have clear limitations, as demonstrated by case 1, who boarded the flight with symptoms and did not declare them before or after the flight. Second, long flights not only can lead to importation of COVID-19 cases but also can provide conditions for superspreader events.

Therefore, Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers’ risk for infection, the number of passengers traveling, and flight duration.

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