AIRPLANE TRANSMISSION: a first-ever documented likely case of transmission aboard airplane. A 44-year-old man was chatting w/ wife & son on flight when he let guard down, allowing his face mask to slip below his nose—the lapse led to #COVID19 infection https://www.bloomberg.com/news/articles/2020-07-28/mask-advocates-cite-plane-transmission-study-in-call-for-mandate

2) Researchers apparently did a full investigation and detailed tracing of the incident. They conclude: “the temporal, spatial, and exposure evidence suggests that #SARSCoV2 transmission may have occurred during the flight”. #covid19

3) Notably, “during flight, Case 16 moved to Seat 30F and sat there for an hour. In the seats around Seat 30F, there were four infected passengers, with Case 11 and Case 12 sitting on the left side of him, and Case 7 & Case 8 sitting behind him on right” https://www.sciencedirect.com/science/article/pii/S1477893920303124

4) “All cases wore masks most of time and none of the cases visited a hospital or had contact with suspected or confirmed COVID-19 case during their travel. Case 16 departed from Hangzhou to Singapore on 19 Jan 2020. None of the travelers in his tour group had visited Wuhan...”

5) “Case 16 reported that he had not visited a hospital and had no contact with individuals suspected of having or confirmed with having COVID-19 before boarding the plane. Moreover, he wore a mask while in Singapore. During air travel, all 16 case passengers wore masks.”

6) “However, they removed their masks when they ate dinner or drank water provided during the flight. While he talked, he reported that he did not wear his mask tightly, and his nose was outside of mask”

7) Notice how Person #16 was also the only case who did not depart from Wuhan. All other positive cases were from Wuhan.

This also points to how tricky air travel is in spreading the virus. The other Wuhan passengers were part of a tour group. Air travel helps spread .

8) Do we have direct video evidence? Do we have genetic analysis that his strain came from his neighbors? No and no. But this is as good as it gets given data on timing and geography, and what we now know about aerosols and stability in cool dry (airplane) air.

9) I’m not advocating to never get on airplanes — just be sure to wear a mask and maybe prudent to NOT take it off to snack. And prudent if @AmericanAir and @United didn’t sell all middle seats at 100% capacity!

10) Clarification—by “first ever”—I meant first scientific paper. One other IATA investigation into a March 2 flight from to Vietnam suggested a passenger transmitted #COVID19 to as many as 14 + 1 crew. Twelve of these passengers were sitting close. https://www.iata.org/contentassets/f1163430bba94512a583eb6d6b24aa56/covid-medical-evidence-for-strategies-200609.pdf

11) Also, “an informal survey of 18 major airlines identified 4 episodes in first 3 months of 2020 of suspected in-flight transmission to crew, and 4 more where one pilot transmitted to another. This group of airlines represented 14% of global air traffic in that period.