Reduce the spread

Epidemiology principles

Fundamentally, we need to reduce exposure risk for Covid-19 by:

• Reducing proximity between people to limit the transmission of the disease through microdroplets in the air

• Reducing direct contact, such as hand-to-hand contact, to limit direct transmission from person to person

• Increasing/improving cleaning and hygiene to reduce the risks from fomites – transmission via handles and surfaces

How intense interventions should be depends on underlying transmission rates, locally or in the area of origin for arrivals. Risk is determined by:

• The time spent in the facility itself

• The degree of social mixing/person-density

• The level of hygiene and sanitation

If exposure can be sufficiently reduced using evidencebased measures, the public can be reassured that the risk of travel is no greater (or could even be lower) than the risk of normal daily tasks in public places.

International vs domestic

As countries emerge from lockdown, decisions on what is opened up and when will be determined by the ability of health services to handle new infections and the need to kickstart economic activity without having to revert to stringent lockdowns. Opening up domestic aviation would be part of the same risk analysis, so ensuring a risk-controlled environment is critical both to allowing widespread travel and to giving passengers confidence that risks are as low as possible.

Restriction of international aviation is one of the primary controls on the spread of the virus across borders – and one that can be turned on or off on a unilateral basis. Aviation needs to demonstrate that it has controlled risks both to receiving countries and to passengers. The industry can reduce risks further if certain non-pharmaceutical interventions are adopted.

Guiding principles of non-pharmaceutical interventions (NPIs)

• Keep passengers informed, so they can carry out any necessary preparation before travelling to the airport

• Screen out symptomatic passengers prior to entry

• Reduce time in the terminal: the less time spent in the airport, the less time exposed

• Reduce the density and contact points in the terminal

• Provide what is necessary to minimise transmission risk, such as hand sanitiser, face masks and personal protective equipment (PPE) for staff

• Reduce potential for cross-flight contamination in the terminal

• Remove non-essential staff, processes and access to facilities

• Do the ‘brilliant basics’ of cleaning, process and maintenance thoroughly

• Include all key stakeholders in core decision-making

• Use the latest evidence, as it emerges, to refine interventions and select those (or combinations) are most effective