Can I fly with COVID?

Why shouldn't I fly while I have COVID?

CDC's air travel guidance says people with a confirmed or suspected respiratory infection should delay travel until they are no longer thought to be contagious. The reason is simple: on a plane you sit close to strangers for hours.

Cabin air is cleaner than you might expect. CDC says cabin air is replaced 20 to 30 times an hour, and recirculated air passes through HEPA filters that trap 99.97% of particles 0.3 microns and larger. But CDC also notes that sitting close to other people raises the risk of airborne spread, and that ventilation can be off during boarding, deplaning, de-icing, and runway delays. Spread of the COVID virus on flights has been documented.

• Close seating: CDC says the close proximity of passengers raises the risk of person-to-person spread.
• Boarding, deplaning, and delays: the ventilation system may be off, and CDC says masks matter most during boarding and deplaning.
• Congestion: CDC notes that people with severe congestion or ear, nose, or sinus infections might choose to postpone flying.

When is it OK to fly after COVID?

CDC's current guidance for respiratory viruses, which its travel guidance applies to COVID, says to stay away from others until at least 24 hours after both of these are true:

• Your symptoms are getting better overall.
• You have had no fever, and you are not using fever-reducing medicine to keep it down.
• If you get a fever or feel worse after that, CDC says to go back to staying away from others and start the count again.

What should I do on the plane if I'm still recovering?

Even after you meet the 24-hour line, you may still spread the virus. CDC says to take added precautions for the next 5 days when you are around other people. After that, most people are much less likely to be contagious, though people with a weakened immune system can stay contagious longer.

If a flight falls inside those 5 days, these steps lower the risk to people near you:

• Wear a high-quality, well-fitting mask or respirator for the whole trip. CDC says this matters most during boarding and deplaning.
• Wash or sanitize your hands often, especially after the restroom and before eating.
• Keep distance where you can, for example by waiting away from the crowd at the gate.
• Bring a few rapid tests. CDC's travel guidance suggests carrying several antigen tests, but notes most need to be stored between 36°F and 86°F, so don't leave them in a hot car or checked bag.

What if I'm traveling with someone at high risk?

Take this part seriously. CDC says added precautions are most important around people at higher risk of severe illness. For COVID, that includes adults over 65 (risk starts rising from age 50), people with a weakened immune system, people with chronic conditions such as lung or heart disease, and pregnant people. NHS guidance goes further and advises avoiding people who are more likely to get seriously ill for 10 days after a positive test.

If your travel companion is high risk, think about sitting apart if you can, masking the whole trip, and planning a separate room at your destination. CDC's travel guidance tells travelers to plan for a place to stay away from companions who are not sick.

If you are the high-risk person and you test positive or get symptoms, contact a clinician right away, even if symptoms are mild. COVID antivirals have to start early: Paxlovid and molnupiravir within 5 days of the first symptoms, and remdesivir within 7. Don't let a travel day push you past that window.

Do airlines or other countries have their own COVID rules?

They can, and rules change. Airlines and countries may have their own rules for sick travelers, so check your airline and your destination's official health or entry pages shortly before you leave. CDC's travel guidance also suggests having a plan for where you would get care if you test positive abroad, which includes knowing whether your health insurance or travel insurance covers it.

If you need to cancel, call your airline and check any travel insurance you have. Policies on refunds and change fees for illness differ, so ask before you assume.

If you have a negative rapid test but still have symptoms, don't treat it as a pass. CDC notes a single negative antigen test can't rule out COVID, and FDA recommends a second antigen test 48 hours later if you have symptoms.