Attitudes and behaviors of international air travelers toward pandemic influenza

Evaluating the Impact of the Pandemic Crisis on the Aviation Industry

This paper investigates the intellectual structure of the literature addressing "epidemic/pandemic" and "aviation industry" through a bibliometric approach to the literature from 1991 to 2021. The final count of 856 publications was collected from Web of Science and analyzed by CiteSpace (version 5.8.R1) and VOS Viewer. Visualization tools are used to perform the co-citation, co-occurrence, and thematic-based cluster analysis. The results highlight the most prominent nodes (articles, authors, journals, countries, and institutions) within the literature on "epidemic/pandemic" and "aviation industry." Furthermore, this study conceptualizes and compares the growth of literature before theCOVID-19 pandemic and during the COVID-19 ("hotspot") era. The conclusion is that the aviation industry is an engine for global economics on the road to recovery from COVID-19, in which soft (human) resources can play an integral part.

Higher education responses to COVID-19 in the United States: Evidence for the impacts of university policy

With a dataset of testing and case counts from over 1,400 institutions of higher education (IHEs) in the United States, we analyze the number of infections and deaths from SARS-CoV-2 in the counties surrounding these IHEs during the Fall 2020 semester (August to December, 2020). We find that counties with IHEs that remained primarily online experienced fewer cases and deaths during the Fall 2020 semester; whereas before and after the semester, these two groups had almost identical COVID-19 incidence. Additionally, we see fewer cases and deaths in counties with IHEs that reported conducting any on-campus testing compared to those that reported none. To perform these two comparisons, we used a matching procedure designed to create well-balanced groups of counties that are aligned as much as possible along age, race, income, population, and urban/rural categories-demographic variables that have been shown to be correlated with COVID-19 outcomes. We conclude with a case study of IHEs in Massachusetts-a state with especially high detail in our dataset-which further highlights the importance of IHE-affiliated testing for the broader community. The results in this work suggest that campus testing can itself be thought of as a mitigation policy and that allocating additional resources to IHEs to support efforts to regularly test students and staff would be beneficial to mitigating the spread of COVID-19 in a pre-vaccine environment.

Exploring the impacts of COVID-19 on travel behavior and mode preferences

Various measures were recommended or imposed by the governments to control the spread of COVID-19. Travel behaviors are significantly influenced due to such measures. However, people have various travel needs ranging from grocery shopping to work. This study examines the changes that occurred in travel behavior due to the COVID-19 pandemic. Data were collected through an online questionnaire survey that included questions on trip purpose, mode choice, distance traveled, and frequency of trips before and during COVID-19. 1203 responses were collected from various countries around the world. Results explained that trip purpose, mode choice, distance traveled, and frequency of trips for the primary travel were significantly different before and during the pandemic. Further, the majority of trips were made for shopping during the pandemic. There was a significant shift from public transport to private transport and non-motorized modes. People placed a higher priority on the pandemic related concerns while choosing a mode during the pandemic as compared to the general concerns. Gender, car ownership, employment status, travel distance, the primary purpose of traveling, and pandemic-related underlying factors during COVID-19 were found to be significant predictors of mode choice during the pandemic. Outcomes of this study could be useful in transport planning and policymaking during pandemics based on the travel needs of people. In particular, government authorities could utilize such knowledge for planning smart and partial lockdowns. Service providers, e.g., taxi companies and retailers, could use such information to better plan their services and operations.

Role of Transport during Outbreak of Infectious Diseases: Evidence from the Past

The outbreak of infectious diseases affects people’s lifestyles significantly, as they undertake fewer outdoor activities as a protective measure and to follow government orders of restricted movements. This paper reviewed the scientific literature related to transport and infectious diseases to gain insights into managing such circumstances. The outcomes indicate that the transport sector has a two-fold role during the outbreak of infectious diseases: controlling the spread of infection and assessing the impact of reduced outdoor activities on the transport sector. It was found that local and international travel restrictions, if applied at the initial stages, are effective in controlling the spread of infectious disease; at a later stage, behavioral changes become prominent in limiting the spread. Further, the outbreaks resulted in a significant reduction in mobility, altering traffic patterns with lower peaks and improving traffic safety. The public transport mode share reduced considerably and people preferred cars and active modes. These changes also showed positive impacts on air pollution and water pollution. Further, the air transport and tourism sector were noted to be the hardest hit and will recover slowly. The outcomes from the review will be useful for planners and administrators in managing future emergency conditions better.

Usefulness and applicability of infectious disease control measures in air travel: a review

BACKGROUND

Air travel has opened up opportunities for world transportation, but has also increased infectious disease transmission and public health risks. To control disease spread, airlines and governments are able to implement control measures in air travel. This study inventories experiences and applicability of infectious disease control measures.

METHODS

A literature search was performed in PubMed, including studies between 1990 and 2013. Search terms included air travel terms and intervention terms. Interventions were scored according outcome, required resources, preparation, passenger inconvenience and passenger compliance.

RESULTS

Provision of information to travelers, isolation, health monitoring, hygiene measures and vector control reportedly prevent disease spread and are well applicable. Contact tracing can be supportive in controlling disease spread but depend on disease characteristics. Exit and entry screening, quarantine and travel restrictions are unlikely to be very effective in preventing disease spread, while implementation requires extensive resources or travel implications.

CONCLUSIONS

Control measures should focus on providing information towards travelers, isolation, health monitoring and hygiene measures. Appropriateness of measures depends on disease characteristics, and the required resources. As most studies analyze one type of measure in a particular situation, further research comparing the effectiveness of measures is recommended.

An analysis of influenza prevention measures from air travellers' perspective

BACKGROUND

The influenza A virus is easily transmitted through airborne saliva droplets disseminated by unprotected coughing or sneezing, particularly in a crowded, enclosed space.

AIM

The purpose of this study was to analyse the knowledge, attitudes and practices of air travellers regarding influenza A preventive measures and to examine any significant differences in perceptions among different types of traveller groups.

METHODS

This study used a 5-point Likert scale questionnaire and surveyed 1684 passengers at Taoyuan International Airport in Taiwan. The frequencies, mean score and ranking of descriptive analyses were used to evaluate respondents' demographic profiles. t-Test, one-way analysis of variance and Scheffe post hoc analyses were used to evaluate the relationship among knowledge, attitudes and practices, and respondents' characteristics.

RESULTS

There were significant differences in the knowledge, attitudes and practices measures among groups with different types of trip purposes and among occupation groups. Most passengers expressed common knowledge regarding influenza A; however, their attitudes and their degree of perception were not consistent with their prevention practices.

LIMITATIONS

This research is limited because it only examined surveyed air travellers in Taiwan.

CONCLUSION

Air travellers could benefit greatly if the government and airlines were to implement a health policy that includes education on the importance of influenza prevention measures, such as frequent hand washing, to citizens. Nurses could be involved in this important health promotion activity.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Schools should implement a health education policy to communicate the importance of prevention measures. Nurses can consider how they can be involved in emphasizing the importance of prevention and health promotion regarding this. Airlines should also include basic preventive measures as a component of flight attendant training.

Timeliness of contact tracing among flight passengers for influenza A/H1N1 2009

BACKGROUND

During the initial containment phase of influenza A/H1N1 2009, close contacts of cases were traced to provide antiviral prophylaxis within 48 h after exposure and to alert them on signs of disease for early diagnosis and treatment. Passengers seated on the same row, two rows in front or behind a patient infectious for influenza, during a flight of ≥ 4 h were considered close contacts. This study evaluates the timeliness of flight-contact tracing (CT) as performed following national and international CT requests addressed to the Center of Infectious Disease Control (CIb/RIVM), and implemented by the Municipal Health Services of Schiphol Airport.

METHODS

Elapsed days between date of flight arrival and the date passenger lists became available (contact details identified - CI) was used as proxy for timeliness of CT. In a retrospective study, dates of flight arrival, onset of illness, laboratory diagnosis, CT request and identification of contacts details through passenger lists, following CT requests to the RIVM for flights landed at Schiphol Airport were collected and analyzed.

RESULTS

24 requests for CT were identified. Three of these were declined as over 4 days had elapsed since flight arrival. In 17 out of 21 requests, contact details were obtained within 7 days after arrival (81%). The average delay between arrival and CI was 3,9 days (range 2-7), mainly caused by delay in diagnosis of the index patient after arrival (2,6 days). In four flights (19%), contacts were not identified or only after > 7 days. CI involving Dutch airlines was faster than non-Dutch airlines (P < 0,05). Passenger locator cards did not improve timeliness of CI. In only three flights contact details were identified within 2 days after arrival.

CONCLUSION

CT for influenza A/H1N1 2009 among flight passengers was not successful for timely provision of prophylaxis. CT had little additional value for alerting passengers for disease symptoms, as this information already was provided during and after the flight. Public health authorities should take into account patient delays in seeking medical advise and laboratory confirmation in relation to maximum time to provide postexposure prophylaxis when deciding to install contact tracing measures. International standardization of CT guidelines is recommended.