Advice by James Bikales
As cuffing season meets coughing season and airport crowds are reaching pre-pandemic levels, more travellers are probably getting on a plane when they're not feeling 100%.
Health experts warn it’s best not to fly if you have any symptoms (and not just for selfless reasons).
Not only do you risk getting the passengers around you ill, but the environment on board could make you feel even worse.
“Many of the conditions on aircraft can exacerbate your symptoms when you have a respiratory illness,” said Henry Wu, an associate professor of medicine at Emory University and director of the Emory TravelWell Center.
Here’s how flying while sick could affect you and your fellow fliers, and what experts say you should do about it.
Flying can make congestion, sore throat and dizziness feel worse
Respiratory illnesses affect your sinuses and Eustachian tubes, which connect your middle ear to your throat.
Both are air-filled chambers, so when you’re on a plane, the pressure inside needs to equalise with the cabin pressure after take-off and upon landing.
When you're sick, however, the passages for drainage from those tubes become inflamed and narrow, making equalising pressures more difficult, said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.
“If you’ve got inflammation blocking your means of equalising the pressure, that's going to hurt,” he said.
The pain could continue even after your flight as inflammation prevented the pressure from equalising, Adalja added. It could also lead to trouble hearing, vertigo, and in rare cases, even damage to the eardrum, Wu said.
Aircraft cabins also had low humidity, which could exacerbate irritation of your mucus membranes and worsen a sore throat, Wu said.
It could also be a challenge to stay hydrated while flying, especially when you’re sick, leading to light-headedness or feeling faint, he added.
How to know if you're too sick to fly
Wu recommended travellers with any respiratory symptoms or fever got tested for coronavirus and the flu, and considered delaying their trip, even if they suspected it was only a common cold.
“It may be difficult to discern the common cold from the more serious respiratory infections like Covid or flu or RSV, which is particularly dangerous for infants,” he said.
With the risk of spreading the sickness and exacerbating symptoms, Wu said it was better for travellers to be conservative about flying with an illness “for their own comfort and health as well as everyone else’s”. He added that he had even seen airlines restrict travellers from boarding if they were visibly ill.
Adalja said anyone feeling shortness of breath before a flight – whether due to a severe respiratory illness or a chronic condition – should not travel, as lower oxygen levels in the air could impair your ability to oxygenate your blood. Most importantly, consult your doctor if you felt ill before a flight because each individual's risk factors were different, Adalja said.
Jeffrey Linder, a professor of medicine at Northwestern University, said the “calculus has changed” in recent years to reduce the need to travel while ill, thanks to the ability to quickly test for Covid and the proliferation of remote work.
“If you can’t get your symptoms under control with over-the-counter medicines, you should try to avoid flying,” Linder said.
How to manage your symptoms on a flight
If you must travel while sick, there are a few ways to prevent your symptoms from getting worse.
The most important factor was keeping your nasal and middle ear passages as open as possible, especially during take-off and descent, Linder said.
He recommended taking an oral decongestant like 12-hour Sudafed a few hours before flying, followed by a nasal decongestant spray 30 minutes before flying and 30 minutes before descending (nasal decongestant sprays should be used for only up to three days in a row).
Adalja also recommended the Valsalva maneuver – holding your nose and blowing out – as well as using saline spray to ensure your passages are as clear of mucus as possible before flying.
It was also important to remain hydrated and wear a high-quality mask if you had to be flying while sick, Wu noted. Wearing a mask could have the added benefit of maintaining higher humidity in your oral and nasal passages, he added.
Above all, Wu recommended that travellers stay home if they felt sick, even if there were no longer coronavirus test requirements in place or mandatory masking on planes.
“The most we can do is just to everyone take their own precautions, whether you’re sick or not, to try to keep the aircraft and airports as safe as possible for everybody.”
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