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Feeling Sick After Flying? Dealing With A Germ-filled Box In The Sky.

People are torn over whether flying makes you sick. Like most things, it depends on the person, but nonetheless it's important to understand the factors that influence this process. Why would you get sick from air travel? What are airlines and regulators doing about it? And what can you do yourself to prevent it?

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Sick from traveling or sick of traveling? What's going on?
Just get back from a trip overseas and you're feeling sick? Or is this something that happens to you often? Many people complain about getting sick when they return home. Is there something to this line of thought or is it just an urban myth?
It's common to blame airplanes and airlines for your woes. In doing so, are we being fair to them? Or is your illness just a bug you caught overseas? This article will look at air travel and help you figure out if it's easy to get sick and what you can do to minimize your chances of getting sick. 
packed plane.jpg
Obviously being sick is never a good thing. Perhaps you can take solace in the fact that things like sneezing and coughing are simply your body working hard to protect itself. Nevertheless, you probably shouldn't aim to test that. With this in mind, you want to take measures to protect yourself from illness when traveling. Traveling to places unfamiliar to you, especially those very far away, presents your body with foreign stimuli, including bacteria and germs that your body hasn't built a resistance towards. Airplanes present a particularly interesting environment because they are a place where the world intersects: cultures, bacteria, and everything in between coming into intimate proximity to each other. With the convenience of air travel, comes the risk of spreading diseases more easily. Now not only do over a million people take flight each day, but so do a wide variety of germs, influenzas and illnesses.
Diversity of experience is often a beautiful thing, but you don't want it to ruin your vacation, or your return home. So what can you do?
Why can traveling increase my chances of getting sick?
In today's world, one characterized by rampant globalization, people are traveling more than ever. Singaporeans took an average of 5.2 trips last year, with over 58 million people passing through Changi Airport. At first glance, the prevalence of the spread of illnesses must make sense: so many people, with many different backgrounds, in such a small place for so many hours. This intimate proximity, especially on long-haul flights, coupled with the high turnover typical of the commercial airline industry means that germs have a great opportunity to fester and get cozy with you.
Myth: dirty airplane air is to blame!
A lot of research suggests that this is far from the truth. Modern planes typically use a combination of fresh and recirculated air. People are frightened by the notion of "recirculated air," thinking that it just means your breathing in the same dirty air that has been moved around a bit. A study of the percentage of fresh air, which was re-circulated in the cabin (50 percent versus 100 percent), showed that it made no difference in the development of upper respiratory tract infections (common conditions like a cold or flu): aircraft HEPA filters effectively remove bacteria and viruses.
In addition to issues surrounding close-quarters, humidity levels and cleaning practices seem to be the main culprits for the prevalence of illness from flying.
Humidity levels on board airplanes are very low (less than 20%), especially compared to the intense humidity of tropical places like Singapore (80-90%). This is important because the substantial change in humidity causes the drying of nasal passages. This state, when combined fatigue and proximity to someone who is sneezing and coughing, increases a person’s susceptibility, and therefore the likelihood of, infection with cold or flu viruses. This is believed to be the case because of how the low humidity influences the Mucociliary Clearance System, a thin layer of mucus and minuscule hairs in your nose. This defence system traps viruses and bacteria and moves them from the nose to the throat, where they are swallowed and destroyed by acid in the stomach. 
Blonde woman sneezing with hands in front of her face against virus.jpeg
Running a commercial airline is a very expensive endeavor, because of this the industry has very thin margins. In order to stay competitive, airlines must always be concerned with cutting costs. One of the ways they do this is by minimizing the amount of time it takes to turn around a plane: the time between when a plane lands and takes off again. The less time it spends on the ground, the more time it can spend making money in the air. And one of the fastest ways to improve turn time is by neglecting the state of cleanliness of the cabin. A 2007 investigation by The Wall Street Journal revealed that most airlines cleaned their blankets every five to 30 days, and only did a "deep cleaning" of the cabin once a month. Obviously that doesn't seem very promising for the removal of bacteria and viruses... 
But I love traveling! What can I do to stay healthy?
Things to be skeptical of:
  • Tray Table
  • Pillow and Blankets
  • Water
  • Seat Pocket
  • Lavatory
The number one rule is to not touch your eyes, mouth or the inside of your nose. This is a HUGE ask, especially on a long haul flight. Unless you have otherworldly discipline your best bet is to make sure that when you do touch your face your hands are clean. You should be using hand sanitizer or wipes throughout the flight, especially before and after going to the lavatory and touching your face. Ideally, before you get comfortable in your seat (if that's possible), you should also wipe down as many surfaces as you can with the antibacterial gel or wipes, such as the remote control, tray table, TV screen and armrests.
Drink (water, not wine)
Stay hydrated. Drinking a lot of water will not only counter the overall dehydrating effects of air travel, which can lead to headaches, stomach problems, cramps, fatigue and more, but can actually fortify your preemptive natural immune mechanisms to function considerably better. However, since caffeine and alcohol have a diuretic effect (causing more urine to be produced), it is wise to limit consumption of such beverages during long flights.
Guy washing hands in sink..jpeg
Wash your hands as soon as you land:
This is far and away the easiest and most effective thing you can do to keep yourself healthy. To ensure you don’t take away any unwanted germs, find the closest toilet once you get off the plane and make sure you use anti-bacterial soap and warm water to wash your hands. Below is the Red Cross recommendation for proper handwashing technique:
"Wet your hands with warm water, apply soap; Rub your hands together in a soapy lather, between your fingers and under your fingernails too, counting to 15 – away from the running water – (sing the ABC’s or Happy Birthday song); Rub all the surfaces of your hands: backs, insides and wrists; Rinse your hands off counting to 10; Pat your hands dry with paper towel or use a warm air dryer; If possible, turn off the taps with the paper towel; Dispose of the paper towel by putting it in the garbage near the sink."
If you're feeling sick when you get off the plane, don't wait to consult a doctor
Make sure you take the time to see a doctor. This will allow you to recover properly and not let the cold or flu drag on longer than it needs to. If you're traveling or are looking for a more convenient option to address your cold or flu symptoms you can consider a telemedicine service like RingMD to speak with a doctor online.
Wherever you are in the world, we wish you health and happiness. And if you're not feeling well, we're here to support you.

Consult A Doctor Now

We're trying to make healthcare more accessible and convenient for everyone. In some places, like Singapore, this means making your primary care experience more convenient. In other places, such as rural India, this means helping people see doctors for the first time in their lives. We think this is important stuff. We're always looking for ideas that could help more people. If you have any cool ideas, we'd love to hear from you! And when you're sick and need a doctor, remember that RingMD is here for you, wherever you are. 

We're also focusing on increasing access to mental healthcare. If you're thinking "I need a therapist near me" but don't know where to start, try the RingMD therapist directory. We will help you find the right therapist for YOU!

Lastly, if you're a doctor or wellness expert considering offering virtual care services, here are some arguments to consider. Thousands of people a month, in Singapore alone, search for things like "doctors near me" or "gp near me", if you're looking to grow your practice this is a great way to do it.