Taking a long-haul flight? These are a doctor’s tips for avoiding illness
With European summer in full swing, more of us are looking to take a long-haul flight to escape Australia’s winter chill. Do this to lower your chance of getting sick before you even arrive.
On a recent long-haul flight, I failed miserably at every single step I usually take to stay well.
Typically, I will take a mask and hygienic wet wipes in my carry-on bag for emergencies, and pack my own reusable drink bottle to stay hydrated.
This time though, I was a complete mess. I ran out of time to pack so ended up throwing a bunch of random clothes and supplies into a suitcase and handbag before scrambling to the airport and hoping some of what I had shoved in a bag would be useful. Most of it was not.
I packed a pair of shoes without any insoles and forgot my wet wipes and mask too.
Then came the flight.
I was in economy, it was a full plane, we would be flying for a little over 14 hours on this stretch alone and there were episodes of turbulence that meant whenever the seatbelt sign came off everyone needed to use the bathrooms at once and it seemed like there was a constant line.
It meant I could only reasonably reach two of the cubicles. An hour into the flight, I discovered one of those two toilets had no soap in the dispenser.
A little while later, I discovered the other had no water coming out of the tap. Sadly for me, I only discovered this after smugly dispensing soap into my hands and beginning the lathering process.
Due to the full flight, turbulence, and me being towards the back of the fully loaded cattle pen, it also took a long time for rubbish to be collected. At one stage, I had to handle the used food tray of another passenger (who was a stranger and not in their seat) so that I could get past their tray table and visit said loo with no water to wash my hands.
So, I did what any rational person would do and stopped drinking liquids and tried to sleep solidly through the rest of the flight. Meaning, I was also not hydrating or moving around.
I was essentially goading an illness to come on holidays with me. I have since given myself a stern talking to and vowed to do much better in the future.
That vow made me wonder about what we should actually be doing to avoid getting sick on a plane. Clearly, I have lost my privileges to comment on this subject with any authority whatsoever. So, I called Dr Brooke Ah Shay.
She is the chairman of Aerospace Medicine with the Royal Australian College of General Practitioners and has her private pilot’s licence.
Her special interest is in keeping pilots, passengers and even astronauts well during aviation and space travel.
In 2022 she became a Designated Aviation Medical Examiner.
“It’s a designation given by CASA (Civil Aviation Safety Authority) that allows a doctor to do a medical examination on a pilot,” Dr Ah Shay says.
“If a commercial pilot wants to get their medical done, and they have to get them done regularly, they cannot simply just go to a GP or a random doctor. They have to go to a doctor who has this qualification.”
Safe to say, when it comes to staying well in the skies, Dr Ah Shay knows what she is talking about.
How to avoid illness on your next long-haul flight
Prepare for your flight
“The best protection on a long flight actually starts before you board,” Dr Ah Shay says.
“The number one thing I am going to say is vaccinations. Of course, I’m a doctor and I love vaccinations. I encourage anyone to make sure that they are up to date with the latest flu vaccination and their latest Covid booster.”
Take important medications in your carry-on and if you wear contact lenses, consider wearing spectacles instead to make your eyes more comfortable.
Dr Ah Shay says planning shorter legs in a long journey may be helpful.
“I think it’s great if people can try to plan their flight itinerary to break up long flights so that they don’t have to be sitting on a plane for 14 hours, ideally, if that’s possible,” she says.
Dr Ah Shay recommends that people with a heightened risk of blood clots should also consult with their GP before flying to understand whether they should be taking additional measures such as medication, or wearing compression stockings to reduce their chance of developing deep vein thrombosis.
“The overall risk of getting a clot on a flight is very low, but it does happen and the longer you fly the greater your risk. There are some people who have medical conditions that do put them at increased risk when flying,” she says.
Some of those conditions include people with clotting disorders, those with cancer, and people who have had recent surgery.
What to do to stay well on-board
Dr Ah Shay advises people to pack their carry-on luggage appropriately and identifies hand sanitiser as the single most useful thing you can take with you on board.
“One study found we touch our face about 20 times an hour, mostly subconsciously,” she says.
“Our hands touch surfaces on a plane and then, of course, it ends up in our nose and mouth. That’s why hand hygiene is really the most effective thing that you can do before eating and after touching any high-contact areas, like toilets and tray tables and seat buckles.”
Depending on your circumstances, you may want to pack a mask too. This can be particularly handy if you sit near someone who is coughing and spluttering: “I would certainly put a mask on in that situation!”
If you’re feeling unwell, especially with an upper respiratory illness, you may also be the culprit, and Dr Ah Shay says you should avoid travelling in the first place. That’s not only for the safety of others, but also to ensure changes in cabin pressure do not cause you further ear and sinus pain.
“Modern aircraft cabins are a lot safer than people realise in terms of infectious disease risk, because there are HEPA filters that remove airborne viruses and bacteria and the cabin air is refreshed every couple of minutes,” she says.
“But it’s still a very enclosed space. And, unfortunately, most modern planes involve squishing as many people as possible into a long metal tube, which absolutely can increase your risk of getting sick.
“Really, hand hygiene is your best defence against getting sick on a flight.”
Other tips for general wellness on board include drinking plenty of water to offset the dry, low-humid air of the cabin, and to move around and try to stretch from time to time.
What not to do on-board
Cabin pressure, altitude and that lack of humidity in the cabin also affects your blood and oxygen levels, and can increase the impact of alcohol and raise the risk of adverse effects. It’s why doctors recommend limiting or entirely avoiding alcohol when flying.
As mentioned earlier, don’t fly if you’re unwell. The pressure could worsen your condition and, if you’re infectious, you’re a potential hazard to others.
What you eat also matters. Dr Ah Shay recommends avoiding eating a heavy meal prior to or during your flight.
“When we talk about the change in cabin pressures, that also applies to our gut because our gut is full of air, which is why you fart a lot more on planes. So, don’t eat anything too bad or heavy,” she says.
What about post flight and jet lag?
There is not a lot you can do after the fact if you have been exposed to pathogens during a flight and have not taken any of the preventive measures. But there are some things you can do to feel better in other ways once you land.
Drinking plenty of water will help to rehydrate you, while taking a walk in the fresh air could also help to make you feel more refreshed.
As for lowering the effects of jet lag, Dr Ah Shay says your preparation should start on board. She recommends against sleeping for the entire flight and instead suggests timing naps to help reset your body clock in line with the time zone of your destination.
“You want to make yourself as comfortable as possible on the flight to help you get to sleep, if that’s what you want to do to reset your body clock,” she says.
“If you need to sleep while you’re flying, think about bringing an eye mask and earplugs and a neck pillow and noise-cancelling headphones to give yourself the best chance of rest.”
If you arrive at your destination at night, try to rest at a normal bedtime. If you arrive during the day, hold off sleeping and try to instead aim for an early night to increase your chance of waking the next day feeling refreshed.
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