Health

Avoid Infection During Holiday Travel
Dr. Pat’s Flight Routine

Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

We celebrated Christmas Eve last weekend, which gave us holiday time to travel to California this coming week for a once in a lifetime celebration and to share Christmas with our West Coast sons, both of whom live in the Los Angeles area. Our son and daughter-in-law, who live with a lively German short-haired pointer in a small house in West Hollywood, have invited us for Christmas Eve dinner. The professional athlete will make Christmas Day breakfast in his home high on a hill behind Malibu with majestic views of the Pacific. Not bad. I want to be there but I don’t want to travel to get there.

Christmas Eve dinner will be spent here.

Gunner, the highly active dog.

 

Christmas Day breakfast will be spent looking at this West Coast view.  

 

I have been saving my Amex miles for years and The Husband and I are using these to fly first class for this trip. I dress as though I am going somewhere important even though I don’t like flying, especially on commercial planes. I really don’t like flying during the Christmas week. I hate flying across the country over the Rocky Mountains with all that nasty turbulence. I also hate flying because I don’t want to acquire an infection due to long hours in close confinement with people who have respiratory infections and poor cough technique in the setting of airplane interior surfaces that are teeming with germs.

As part of my training to become a board certified physician, I did a year’s fellowship in infectious disease and I became a slight germaphobe after this special training. I tell you this to both explain and share my airline travel routine. After all, you fellow travelers are also at risk for the diseases to be found in the cabins of airplanes. Infectious diseases are one of the leading causes of death worldwide and respiratory infections occur in up to 20% of all travelers. Viral pathogens are the most common cause of respiratory infection in travelers and include rhinoviruses, respiratory syncytial virus, influenza virus, parainfluenza virus, human metapneumovirus, measles, mumps, adenovirus, and coronaviruses. Other causes are bacteria, including tuberculosis. Air-pressure changes during ascent and descent of aircraft can facilitate the development of sinusitis and otitis media (ear infection).

Of course, I have all my immunizations up to date. And, I check to see if there have been any reported carriers of tuberculosis, bird flu or Ebola recently on the Delta flights to and from from JFK to LAX. This was easier to do when the CDC had enough funding to update the travel warnings.

Packing list for the flight:
1. Non-latex gloves
2. Clorox wipes
3. Hand sanitizer
4. White cotton gloves
5. Plastic to cover the seat (bed bug prevention)
6. My personal washable blanket and pillow
7. N-95 face masks to prevent airborne infectious agents .
8. Boroleum ointment to insert into the nasal openings. (It traps viruses that pass under my mask and prevents them from taking up residence in my sinuses. It moisturizes the nasal mucosa, preventing easy access for germs.)
9. Take one Aspirin one hour before flight with food and wear compression stockings. (I believe both of these will decrease the risk of blood clot formation during long airline flights.)
10. EarPlanes ear plugs to prevent ear barotrauma from the pressure change that occurs during flights
11. Afrin nasal spray and Sudafed to prevent Eustachian tube swelling and ear and sinus pain after the flight or worse the development of sinusitis to mar an otherwise lovely holiday.
12. Moisturizer. (I will use one of those wonderful new moisturizing face masks for this trip. After all, I am flying to the city where no one ever ages.

On the flight:
1. After I board the plane, I put on a pair of disposable latex free gloves and start to work with the Clorox wipes, cleaning every surface in sight including the call button and those for air and light along with the window shade.
2. Cover the seat with plastic.
3. Remove and discard first pair of latex free gloves.
4. After settling in I finish my pre-flight routine:

    • Purell to hands followed by moisturizer.
    • Put on white cotton gloves.
    • Apply moisturizing sheet mask that has holes cut out for eyes, nose and mouth on face.
    • Place N-95 face mask around nose and mouth and tie securely.

Rules that I follow:
1. Avoid touching eyes, nasal opening or mouth with hands. These are the areas of entry for infectious agents.
2. Never ever touch those filthy back of the seat magazine pouches. You do not want to know what has been cultured from those places.
3. Bring my own food. The last time I ate food on a plane was a morning flight from Denver to Newark. I was starving and I ate bacon and eggs and a croissant with jam and two cups of coffee. Twenty minutes into the car ride to NYC from Newark and I realized that I had “food poisoning” from a toxin in poorly handled airline food. Nothing else makes anyone this sick this quickly. I will spare you the details. I don’t have to learn that lesson again.
4. Airplane lavatory survival: remove white cotton gloves. Replace with non-latex gloves. Before leaving the lavatory, remove and discard gloves and scrub hands with soap and water for 30 seconds. Use Kleenex to open the bathroom door. Discard Kleenex. Return to seat and replace white cotton gloves.

5. Drink lots of bottled water but avoid the nasty ice picked up by unwashed hands.  Room temperature water is fine.

6. Avoid alcohol and caffeine.

I will bring extra masks and many small containers of Purel and Kleenex to give as Christmas gifts to the lucky passengers who are willing to make eye contact with me. At this point, I know that I am not a pretty sight but my preparation for air travel and adherence to this pre-flight checklist have worked well since the Denver experience. While many of you just hope to land on a runway at the end of your holiday airline experience, I urge you to set your sights higher: hope to land without any infectious disease to take with you to your destination and to pass on to unsuspecting friends and family.

I send you best wishes for the holidays and safe travel wherever you are going.

Dr. Pat

Join the conversation

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  • Roz Warren February 6, 2018 at 10:46 pm

    This is absolutely wonderful. It makes so much sense and yet most folks, even knowing that it would keep them healthy, wouldn’t do it because it would set them apart from the fellow travelers who are breathing in germs, handling schmutzic magazine pouches and eating tainted food. You are inspiring. I am totally doing this on my next cross country flight.

    Reply
    • Patricia Yarberry Allen, M.D. February 7, 2018 at 10:09 am

      Dear Roz,
      Always glad to hear from you. So far these measures have kept me free from infections on planes.
      I obviously don’t care how I appear to the other passengers. Health first.

      Reply
  • Andrea December 19, 2017 at 12:07 am

    Dearest Pat
    I would sit next to you on a plane,train or automobile
    I believe some of our readers are “germ shamers”
    Don’t listen! No one want to get sick and I applaud your extreme approach to staying germ free. If you bring germs to your families on the West Coast they will never invite you back! So do what you need to do!
    Safe travels and happy holidays!

    Reply
  • Patricia Yarberry Allen, M.D. December 18, 2017 at 10:46 pm

    Dear Elizabeth,
    The Husband does wear compression socks and takes an asparin before longer flights. He does not use chlorox wipes. However, he is very interested in my moisturizing face masks!
    Dr Pat

    Reply
  • Patricia Yarberry Allen, M.D. December 18, 2017 at 10:40 pm

    Janet, thank you for bringing up your concerns about chlorox fumes.
    I use only one chlorox wipe to clean the small hard surface around the seat on my plane. And, I do not think that people who won’t carry kleenex and use them, will begin to carry a chlorox wipe to clean the dirty surfaces around them!
    Safe travels,
    Dr Pat

    Reply
  • Florence W. December 18, 2017 at 7:46 pm

    Dr. Pat,
    This is absolutely amazing. Your fund of knowledge continues to amaze me and your attention to detail is refreshing. The protocol is spot on. Please continue to share your other “routines” with us in the future. I appreciate the genuine concern you have to enlighten your subscribers.

    Reply
  • Elizabeth Turner December 18, 2017 at 6:26 pm

    Does The Husband follow the same protocol?

    Reply
    • Karen Coc January 29, 2018 at 8:05 am

      Excellent! If everyone would just wipe down hard surfaces on planes and cough into elbows it would help. And isn’t it sad airlines no longer thoroughly clean planes between shorter flights?

      Reply
  • Julia December 18, 2017 at 4:59 pm

    No. Just no. There are many risks in life, and each person has to make a decision which ones are worth it. I don’t worry much (not zero) about germs and figure that if I ever get anything serious, so be it. Unless it kills me, the amount of time I would be sick has got to be less than the time I would used up over my life being a germophobe.

    Reply
    • Patricia Yarberry Allen, M.D. December 18, 2017 at 10:47 pm

      Dear Julia,
      Each of us can choose what makes us most comfortable.
      Dr Pat

      Reply
    • Roz Warren February 6, 2018 at 10:52 pm

      The last time I flew, the woman in the woman seat, if she didn’t have the flu, clearly had something very close to it. She sneezed and wheezed and coughed throughout the five hour flight. I felt very very sorry for the person who was going to sit in that seat on the plane’s next flight. (And I plan to emulate Dr. Pat in the future.) We all take risks but that’s not one I’m going to take without some effort to protect myself.

      Reply
  • Susan B December 18, 2017 at 2:24 pm

    I hope I get to sit next to you someday. I will (and do) happily clorox everything in site. You’re on your own with the face mask though. 😉

    Reply
    • Dr Pat December 19, 2017 at 9:46 am

      Dear Susan,
      The Husband read yesterday’s post and said if I wore the moisturizing mask on the plane he would sit in the back of the plane and give his seat to someone else! Harsh words. More later
      Happy Christmas
      Dr Pat

      Reply
  • Patricia Yarberry Allen, M.D. December 18, 2017 at 12:00 pm

    Dear Kristyn,
    Thanks for astute observation. Unfortunately, I work more than full time so I do not have the longed for luxury of a drive across the country to spend only a week with adult children and friends I do not see frequently. We are fortunate that we have this option to travel so far, so quickly. I just wish I didn’t hate the process.
    I wish you very happy holidays and do encourage you to comment frequently.
    Dr. Pat

    Reply
  • Kristyn Appleby December 18, 2017 at 11:42 am

    You used your miles to fly first class and are doing all of this? What a waste. Next time maybe you should drive. Just saying.

    Reply
    • Janet December 18, 2017 at 12:02 pm

      It might not be a problem if you are the only one using Clorox bleach wipes to disinfect surfaces in and around your seat, but if even 5% of the people on the flight did this, it would make it hard for me to breathe. If your recommendation caught on, there would have to be a regulation to disallow it, for the health of all passengers.

      Reply
  • LK December 18, 2017 at 8:09 am

    Something you forgot to mention is that, because you have performed the ritual described above, no one will be willing to sit next to you on the plane, so you also have that adjacent seat available for healing naps!

    Reply