How to fly long haul, stay safe from COVID and actually be comfortable

A clear bag full of mini toiletries, a 14-hour flight and a new stamp in the passport — it might all seem like a distant memory.

If you’re preparing for your first long-haul flight since the pandemic began, this will be the first time you’ll have to navigate the terminal and the plane while also having to protect yourself from COVID-19.

And as Australian states open their borders and we dare to make Christmas plans, it’s wise to think about how to keep safe while travelling domestically too.

Preparing for flights is no longer as simple as weighing your luggage and setting an early alarm, but experts have offered us advice on how to travel comfortably and arrive safe.

Be prepared

One of the new non-negotiable items on your new pre-travel to do list is downloading your international vaccine certificate.

You’ll also need to be aware of and meet the entry requirements for your destination, and any stopover locations.

If that involves a negative PCR test, you’ll need to think about the specific requirements of that. It could mean making a booking at a private laboratory test for within three days of your flight.

There is going to be a whole lot more paperwork and preparation to do before you fly, so leave yourself time to get it done.

Once you’ve got that sorted, experts recommend thinking about how to best protect yourself in transit.

In Australia, you must wear masks inside airports and onboard departing flights and you will only be flying with people who are vaccinated or have exemptions.

But these circumstances may change as you move across the world.

Jennifer Sisson, chief medical officer of Travel Doctor-TVMC and dean of the faculty of travel medicine at the Australasian College of Tropical Medicine, said travellers had a “personal responsibility” to do as much as possible to prevent the spread of COVID-19.

“Australians will be mixing with people from everywhere, from countries with different risks of COVID,” she said.

“We have to remember a lot of the world is not vaccinated yet and that’s going to continue to be a risk to us.”

That means a return to some of the most simple, but effective infection control practices — hand washing, using hand sanitiser, wearing a well-fitting mask and social distancing as much as possible.

A line of people all wearing full PPE, hazmat suits stand in an airport
When flying, experts say you need to be prepared and pack spare personal protective equipment. (Reuters: Thomas Peter)

Dr Sisson recommends packing a hygiene kit in your carry-on luggage.

“That includes masks — disposable masks — hand sanitiser, disinfectant wipes, so they’ve got all of those things available to use,” she said.

“In general masks are thought to be good for four to five hours, so generally after sitting with a mask on for that period of time we would say it’s a good idea to change it, so people do need to take a reasonable supply of masks with them and they all need to be disposed of properly as well.”

In airports across the world and as you board flights, you may find masks and other hygiene items are made available to you, so take the opportunity to stock up.

It’s also a good idea to travel with plastic snap-lock bags. If you’re unable to dispose of used masks promptly, keep them stored securely until you can.

Onboard the plane

Over the past 18 months, airlines have been open about their cleaning protocols.

Qantas says its planes are cleaned with a disinfectant, “with a focus on the high contact areas of seats, seatbelts, overhead lockers, air vents and toilets”.

While you’re getting settled, Dr Sisson suggested giving your seat a once over with a disinfectant wipe.

“When you first get to your seat, wipe down all the areas you’re likely to be touching regularly.”

A man wearing a mask holds a tray while standing in the aisle.
Airlines and airports will make some supplies, including sanitiser sachets, available to passengers. (AFP: Jack Taylor)

You’ll also have to manage your expectations about just how much you can move around inside the cabin during the flight.

The International Air Transport Association (IATA) says passengers need to “avoid unnecessary movement” and “congregating when waiting to use the toilet”.

“Avoid touching your eyes, nose or mouth, especially after contact with commonly touched surfaces,” the association said.

The IATA also warned food and beverage services might be simplified to decrease crew movement and interaction with passengers.

A 14-hour flight is one situation where you may have long wished to be socially distanced.

“While the bookings on planes are relatively light, they will continue to spread people as much as possible in terms of seating,” Dr Sisson said.

“And at the airport, prior to leaving, avoid getting into big crowds as much as possible.”

The air up there

A pilot in a face mask giving the thumbs up out the window of the plane
Ventilation on planes is often better than many buildings, but its the proximity to other passengers that makes experts worry. (Reuters: Mohamed Abd El Ghany)

The departure halls of an airport might provide enough space to social distance, but eventually there is a high chance you will end up in the very small space that is an economy seat with a stranger just a few centimetres away.

World-leading expert on air quality and its health implications Lidia Morowska said the close proximity on planes was the biggest risk factor.

“The difference is the space — the volume — is much smaller and normally the ventilation is much better in terms of air exchange per hour. It’s very fast ventilation, so from that point of view, it is better than in many environments on the ground,” she said.

“However, the issue is proximity to people.

“On the ground, we are saying we should be separated by 1.5 metres, this is of course impossible on the plane where we are basically sitting and touching another passenger.

“So before the ventilation takes effect and removes the virus potentially emitted by someone, there is enough possibility the passenger sitting next to that person will inhale it and this is happening over hours and hours of a long-haul flight, so the risk increases, there is no doubt about this.”

Dr Morowska said it was important to remember the increased transmission risk of the Delta variant.

You know you’ll have to wear a mask on the flight, and change it periodically, but the fit of the mask is also very important.

“If you want to protect yourself, you need to ensure that there’s a good fit,” Dr Morowska said.

“You can have a very good mask in terms of efficiency where the virus doesn’t go through the mask, but if the mask is not fitted properly, if it’s loose on the face, then … [the virus] is going around the mask to the face and it’s not doing anything,” she said.

On a long flight, you have to eat food and drink water.

Dr Morowska said the best strategy was to wear a well-fitting mask for as long as you could, and accept the small risk that comes with taking it off to quickly eat and drink.

Getting home again

Qantas staff stand with 'welcome home' paddles
To return home, Australians will have to provide a negative PCR result from within 72 hours of their departure time.(AFP: Saeed Khan)

You made it overseas, the holiday was amazing and now you turn towards the long journey home.

Getting back into Australia will require a negative PCR test result within 72 hours of your departure, so make time to get that done and be careful in the days before it.

“We know the Delta virus has an incubation period of about four to five days, so it’s a lot shorter than it used to be,” Dr Sisson said.

“You don’t want to be getting exposed in the days before you’re going to be getting your PCR test to return home, so that’s really important.”

And you may have thought about packing a few rapid antigen tests.

Those tests could help give you peace of mind, but ultimately if you have symptoms, you should get a PCR test and that’s also the standard of test you’ll need to re-enter Australia.

“The result of a rapid antigen test is not always reliable, but I think with time it’s going to be fairly normal for people to be travelling with these and using them” Dr Sisson said.

“I think if people do use them and they get a positive result, they can’t assume it is a true positive.

“Generally we would always recommend they get it confirmed by having a PCR test.”

What else can you do?

We know activities such as singing and talking to someone in close proximity increase the risk of transmission.

You may not have needed another reason to avoid eye contact with the person next to you, politely don headphones and evade a long-haul conversation, but for the record, Dr Morowska says avoiding “situations where you are talking to someone directly for a long period of time” will help keep you safe.

She also suggested keeping an eye on your hydration level and sinus health to stay comfortable while flying.

“If your respiratory tract is dry then you are at a much higher risk of contracting anything, so keeping that saline solution [handy] and hydrating, is a very important measure,” she said.

“It’s important in any situation, but particularly on the plane, where usually the humidity is lower than other environments, so the potential for dehydration is higher.”

Travel during the pandemic really involves a constant assessment of your risk and taking steps to reduce it.

Dr Sisson reminds us that “vaccination doesn’t work the same in everyone” and urges each individual to think about a scenario where they contract COVID overseas, how severe the disease could be and what they would do to look after themselves.

“There are people who are at much higher risk than others,” she said.

“So it’s really important for anyone who has any concerns to make sure that they see their GP or go to a travel clinic to have an assessment if they have any health issues that they worry about in terms of their risk of COVID.”

Travel insurance does not cover Australians in places where the Department of Foreign Affairs and Trade (DFAT) has recommended we “do not travel”.

DFAT’s global “do not travel” advisory has now been lifted and insurance is once again available for travel to some parts of the world.

And COVID cover is now possible, so you can start to address the risk of high medical and cancellation costs should you contract the disease.

“You can get COVID cover and it ends up costing about 10 per cent extra,” Dr Sisson said.

“There will be circumstances where travel insurance is not available. For example, they’re not covering COVID on multi-night cruises.”

Dr Morowska said once we start travelling, “we will immerse ourselves in environments where there are infections” and in places where there are minimal precautions taken, such as the United Kingdom.

“All the [infection control] measures will reduce the risk, but they will not bring it completely to zero,” she said.

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How to fly long haul, stay safe from COVID and actually be comfortable