Suppose you have airplane tickets for a day or two from now.  $300?  $400? $500? More?  Maybe you are going on a business trip, or a winter vacation, or to visit friends or relatives.  Or even flying back home.  All good right?

But your nightmare strikes a night or two before your flight.  You wake up drenched from night sweats, with a sore throat, and feeling like hell.  Before you can even take your temperature, the nausea hits you as you race to the toilet, not sure if it will be diarrhea, vomiting, or both simultaneously.

You’ve got the flu.  And this years variety (named H3N2) is a notoriously bad flu.  This years flu is national news and it is for real, sadly with some people literally dying from it.

To Fly or Not To Fly

Here are a few scenarios to think about when flying during flu season:

  • You are sick with the flu and have an upcoming trip.  Do you cancel or rebook, paying the change fees and “current applicable fares” when you call the airline?  Or do you get a reasonable agent who will waive fees if you can send a doctors note?  Or do you just suck it up and fly?
  • You are sick with the flu and away from home. You are scheduled to fly home.  The same questions as above apply, except you want nothing more than to be in your own bed (with your own bathroom) getting better.  Does that change anything?
  • You are perfectly healthy but the person next to you isn’t.  Your flight is full and the person next to you is coughing, full of mucous, and dripping fever sweat in the seat separated with one small armrest.   What do you do or say?  Will you be the one not flying that day if you say something?

Where does the responsibility rest?

In my opinion it starts with the sick person.  You have a highly contagious disease (like the flu).  Do not fly.  Much like drunk people shouldn’t drive, people with highly contagious diseases, where the ramification to otherwise healthy people may end up being death, should not fly.  Again, do not fly.

The second level of responsibility is with the airlines.  I believe many airlines incentivise passengers to fly at all costs with exorbitant change fees and policies.  Sure a gate agent may appraise a passenger as too sick to fly, which should yield a waiver of said fees. But gate agents do not have the kind of medical training to accurately do such an appraisal.  Not to mention the full loads and crammed quarters in a tube of recycled air.

The third level of responsibility is with the government.  But this is the era of the government removing regulations and consumer protections at every possible chance, plus putting a premium on profiteering.  Passengers bill of rights?

Sadly, the final level of responsibilities lies with other passengers to question a visibly sick person.  Though unfortunately too many flight attendants and gate agents have created a culture of fear for passengers to speak up about anything. Ask any question and get kicked off the flight – that is how the friendly skies work these days right?

Infectious Diseases vs Contagious Diseases

In the airlines defense, it is challenging to appraise the difference between an infectious disease and a contagious disease.  All contagious diseases are infectious, but not all infectious diseases are contagious.  Many diseases, contagious or not, show the exact same symptoms.

An infectious disease is one you get from a germ like a bacteria or virus, or a mold or parasite.  A contagious disease is something that can be transmitted directly from one person to another person.

Rabies is an infectious disease – you get it from a virus transmitted through bites or scratches from an animal. However, rabies is not contagious.  You won’t get it from sitting next to another passenger with rabies (unless they bite you which hopefully never ever happens).  Likewise, malaria is an infectious disease, but you will not get it from sitting next to, or even kissing, a person with malaria.  Therefore it is not contagious.

Contagious diseases can be spread through direct physical contact or more casual contact.  Syphilis is a contagious disease, but you need some direct and specific physical contact to get syphilis from another person.  That kind of contact is highly unlikely (and inappropriate) on an airplane.

A cold or flu can be transmitted simply by breathing the air that a sick person has exhaled – a more casual form of contact and highly likely with the recycled air on an airplane.  You can get pink eye from touching something that someone who has pink eye touched, then touching your eye.  And finally norovirus – the plague of cruise ships – is highly contagious.

Protecting Yourself While Flying

There are a few basics that will help you a little bit:

  1. Clean the seat and especially the tray table with Purell.  Do not put any food directly on the tray table.
  2. Keep the air vent on a little bit.  Movement of the air, although recycled, helps dissipate germs.
  3. Get a window seat and look out the window a lot to avoid breathing in air someone immediately exhaled.
  4. Use a nasal lubricant (like saline) to keep your mucous membrane moist.
  5. Take a shower and change clothing as soon as possible after landing.
  6. Get a flu shot.

Why Not Fly With the Flu?

  1. It is morally wrong to endanger others.
  2. The dry cabin air dries out your mucous membrane which makes your own immune system less effective, therefore your flu gets worse.
  3. Your body is probably dehydrated, and the dry cabin air will dehydrate you more. Be dehydrated and sick enough and you can quickly get to a point of renal failure.  You will not get much help at 35,000 ft.

Funny thing is, almost everything I wrote in this post applies also to trains, or the office, or theaters, or any other public place where people are in close quarters.