Absence of in-flight transmission of SARS-CoV-2 likely due to use of face masks on board

While there are many reports of patients who were either severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) active patients flying in the last epidemic, there is no evidence to support viral transmission during flights. Recently, it was reported that in flights arriving from endemic areas to Greece and Brunei, asymptomatic rate was as high as 3–5%.^1,2 Recently potential transmission during a flight in Africa was suggested.³ Thus, it would be important to anticipate the risk of such travel. On 20 February Israel repatriated 11 citizens form the Diamond Princesses cruise ship in Japan back to Israel. Those 11 patients had at least 1 negative reverse transcription polymerase chain reaction (RT-PCR) for SARS-Cov-2 before flight boarding. A total of six were women and five men with age ranging from 42 to 76 (median of 70). All were transferred in a dedicated bus directly from the ship to the aircraft. The equipment was a charter Bombardier Galaxy 6000 commercial aircraft. Flight staff included three pilots and one steward, who were instructed to wear filtering facepiece (FFP2) masks. The crew had minimal interaction with passengers that was mainly in the distribution of the meals. This aircraft have two outflow valves that alternate between, and one air mixture unit.