Abstract
BackgroundAs an emerging virus, SARS-CoV-2 and the risk of transmission during air travel is of high interest. This paper is a retrospective estimate of the probability of an infectious passenger in the air travel system transmitting the SARS-CoV-2 virus to a fellow passenger. MethodsLiterature was reviewed from May–September 2020 to identify COVID-19 cases related to air travel. The studies were limited to publicly available literature for passengers; studies of flight crews were not reviewed. A novel quantitative approach was developed to estimate air travel transmission risk that considers secondary cases, the overall passenger population, and correction factors for asymptomatic transmission and underreporting. ResultsThere were at least 2866 index infectious passengers documented to have passed through the air travel system in a 1.4 billion passenger population. Using correction factors, the global risk of transmission during air travel is estimated at 1:1.7 million; acknowledging that assumptions exist around case detection rate and mass screenings. Uncertainty in the correction factors and a 95% credible interval indicate risk ranges from 1 case for every 712,000 travelers to 1 case for every 8 million travelers. ConclusionThe risk of COVID-19 transmission on an aircraft is low, even with infectious persons onboard.
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