Flying with Kids During a Pandemic

Who would you give up quarantine for?

What would you leave the safety of your home for, expand your social bubble for, even get on a plane for?

Maybe you, or your kids are totally stir-crazy and need to make that getaway happen before you drive each other insane. Maybe that once-in-a-lifetime trip or event really can’t wait. Maybe you really need the love and support of your family or friend. Or maybe your loved one really needs you …

Whatever your answer – there’s no judgment.

My answer – there’s not much that I would willingly leave the safety of my home bubble for.

Yes, Kenzi and Bodi had COVID in March. But who knows if they’re immune, and how long that immunity will last for. And we still have no idea if Peter and I had it.

We reopened the office on June 1 and to be totally honest, we can’t afford for me to be out of work for potentially weeks on end if I was exposed or sick.

But we can’t live in quarantine forever, and these are all questions we’ll have to answer sooner or later. We need social and physical contact. Our anxiety is at an all time high due to the social distancing that for many has become social isolation. Yet we need to weigh this need against the risks we’re willing, and able, to tolerate. What if we get sick? What if we can’t work for weeks (or months)? What if our kids get sick? What if we get our loved ones sick who may be more vulnerable than us? What if we never see that loved one again because we were too afraid to get them sick?

I weighed all of these questions heavily. We’ve chosen not to put the kids in any summer camps. We’ve created a social bubble with a few families, which gives the kids their so-needed semblance of carefree and joyful pre-COVID days. 

But, I did decide to fly across the country, once with Peter and the kids, and once on my own – both times for my mama.

My mama, who grew up in South Korea during the Korean War where she fought over scraps of chicken meat with her sister, followed the war front peddling chewing gum and whatever she could from the American GI’s, became a high school breaststroke champion, graduated as 1 of only 6 women from the prestigious Yonsei University Medical School, braved her way to the United States to do her OBGYN residency in New York, started her own private practice, and raised 3 children in the suburbs of New Jersey with all the comforts she never had growing up.

I’ll tell you more about my amazing mama some time. But for now, know that there is NO one, right decision.

Every person, every parent, every family must make the decisions that are right for them, and know that what is right for them may change at any moment. I had no intention of flying this summer, and felt my anxiety rise as I got on the plane from Florida, the potential new “epicenter,” where there were very likely passengers with pre-symptomatic or asymptomatic COVID-19. After my experiences flying during this pandemic, I personally would not suggest that anyone fly this summer unless it’s absolutely necessary. Most planes are totally full (one of my flights even asked for volunteers to switch flights because they were oversold), and while some airports have no food and not a drop of coffee to be found, other airports are crazy busy with restaurants and bars open in at least Dallas, Atlanta and Charlotte, And apart from SFO, where face coverings are required inside the terminal, maybe only 1 in 10 people were wearing masks at the other airports I was in. No, I don’t feel that good about flying right now.

(Some photos from my flights in June…)

Despite this, some of you will decide that the risk of flying is worth it. It’s a risk that I chose to take for me and my family. But as I always say – knowledge is power. So make the decision to fly with the knowledge that there are some things that you can do to mitigate the risks. While you can’t do anything about who is on your plane and their actions (like if they’re not wearing their mask the right way), you CAN do something about your, and your kids,’ actions to reduce your risk of contracting COVID-19 while flying and spreading it to someone you love when you get to your destination

Here are my top tips for safe(r) flying during a pandemic:

• Get a Good Night Sleep. Make sure you’ve had a good night’s sleep the night before (and hopefully for the week leading up to your trip!). Security lines may be shorter, but airport travel is still chaotic, especially when you have car seats, strollers, diaper bags, and whining kids to juggle. The emotional stress of travel is enough to wear our immune systems down and make us more vulnerable to our neighbor’s coughing. Optimizing sleep actually supports your white blood cells’ ability to fight infections more efficiently. So get your zzzz’s and start your travels on the right foot!
• Wipe down surfaces around your airplane seat. Anything you or your kids might touch – the tray table, seat buckles, armrests, recline button, touchscreen, overhead light and air vent. SARS-CoV-2 may live on metallic surfaces and plastic for up to 72 hours. And yes, most airlines have implemented more “thorough” cleaning in between flights, but I still prefer to do my own final wipe down.  A study looking at the dirtiest places on airplanes and at airports found that the tray table had the most germs by far of any of the 26 samples tested – almost 10 times as many colony-forming units of bacteria than even the lavatory flush button! Eeeuuuwww! So before you put your child’s snack, iPad, or art project on that tray table in front of you, wipe it down along with the other surfaces that you may touch.
• Stay hydrated, and bring your own water. Wanna know the second germiest place at the airport? Water drinking fountain buttons! And what’s the first thing that kids do after taking a big swill from a water fountain as you’re yelling at them to NOT touch their mouth to the spigot – wipe their wet, dripping mouths with their hands! Staying hydrated is one of the best ways to stay healthy on the road, but bring your refillable water bottles and fill them up on the other side once you’ve passed the security gates at a no-touch, filtered, fill station, or with spring water that you buy. Not only will little hands be exposed to fewer germs from the water fountain button, but you’ll be sure that the water your kids are drinking is clean and safe.
• Bring healthy snacks. Be prepared and pack some healthy snacks that travel well like baby carrots, snap peas, dried fruit, and nuts. Especially because many food establishments may be closed depending on which airport you travel through. As tempting as it may be to “bribe” your child with a pack of M&M’s or a chocolate croissant from Starbuck’s for being “good” on the plane – resist the temptation. Sugar lowers your immune system’s ability to fight off germs by 50% within 20 minutes of consumption – just as the passenger behind you starts hacking away.
• Wash hands frequently, with warm soap and water for at least 20 seconds. Did you know that 30% of people DON’T wash their hands after going to the bathroom? EEEEUUUUWWW! And of those who do wash their hands, only about 50% do it RIGHT? Make sure you and your kids are washing your hands the right way! (READ my article: Handwashing and Coronavirus: Are you doing it the right way? ) If water and soap aren’t available, use a hand sanitizer with at least 60% alcohol. Clean hands BEFORE and AFTER taking your mask on and off mask, and BEFORE and AFTER eating or drinking.
• Keep hands away from your face. Most adults touch their face up to 23 times an hour. Kids probably touch their face even more frequently! And when we touch our faces, it’s typically around our eyes, nose, and mouth – exactly the entry points for SARS-CoV-2.  Instead of nagging your kids constantly to STOP TOUCHING their faces, start with having them be mindful and notice when they ARE touching their face. Frame what they should be doing in a positive way instead of negative. Positive reinforcement always works better than negative reinforcement. Instead of “STOP touching your face”, try “KEEP your hands down.”
• Keep hands away, period. You know how your kids love to rub their hands over the handrail on escalators, moving walkways and stairs? And how they race to be the first to push every elevator button possible? Talk to you kids BEFORE you get to the airport about paying attention to keeping their hands down by their sides and off the handrails when they’re going on escalators, moving walkways and stairs. Show them how to use their knuckles or an object to press buttons – and then properly sanitize.
• Wear a mask or cloth face covering! Masks have been shown in many studies to substantially help prevent the spread of larger virus-containing respiratory droplets that people emit when breathing, talking, coughing or sneezing (I’ve received many questions regarding masks, so be sure you’re signed up for my newsletter to get my new article Masks & Kids coming soon!). These droplets fall to the ground fairly quickly, but smaller aerosolized droplets may stay suspended in the air for up to 8 minutes. When you’re outdoors, the wind typically dissipates these aerosols quickly enough that it’s not a significant risk. But  in an airplane, where you’re in an enclosed space breathing partially recirculated air, the risk is not insignificant, Some studies suggest aerosols have a more limited reach, just two seats on either side and one row in front of and one row behind an infected passenger, but transmission of respiratory infections on airplanes clearly can occur, and you have no idea whether or not the person sitting 2 seats over or 1 seat in front or behind is actually sick. During the pandemic, I believe that wearing a mask is one of the most important ways to prevent the spread of infections from one person to another, especially in enclosed spaces like an airplane. I protect you. You protect me.

PLEASE: Practice wearing a mask with your kids before your flight.

• Practice wearing a mask. Have your kids keep their mask on for increasingly longer periods while they’re at home so they get used to how it feels. Have them practice keeping their hands down, and not fiddling with the mask once it’s on. Acknowledge that it gets hot sometimes, and that it’s not the most comfortable thing. Let them know what an important job they’re doing in keeping the other passengers safe. And teach them how to put their masks on and off the correct way:
  • Wash hands before putting on their mask
  • Do not touch the inside of the mask that goes against your nose and mouth
  • Put the mask on using the straps
  • Cover your mouth AND nose with the mask
  • Pinch the metal nose piece for a secure fit if you have one
  • Wash hands before taking off your mask
  • Take off your mask by the straps being careful to not touch the outside of the mask that may be contaminated
  • Put the mask carefully in a plastic bag until you’re ready to reuse it
• Stay physically distanced, by at least 6 feet – to every extent possible. I’m not seeing much physical distancing going on, whether it’s checking in your luggage, paying for your coffee, sitting at the gate, or waiting to board on the jetway. If you notice someone getting a little too close for comfort, you can try politely asking them to move back, especially if you don’t have anywhere to move and they’re not wearing a mask. Unfortunately, once you’re on the plane, physical distancing is really nothing but a myth. Most planes are completely packed now because airlines are running fewer routes and it’s simply not profitable to run a flight ⅓ empty. And let’s face it – having the middle seat empty between you and a stranger doesn’t really provide much protection, especially if that person is breathing, talking, coughing, or sneezing without a mask on the correct way – over their mouth AND nose. This is where I feel the most vulnerable, because there’s very little to no control you have over this situation – which is why being proactive with all other measures is so important.
• Turn the air vent on. I typically don’t like air blowing on the top of my head – in an airplane or anywhere else. But in this case, I do suggest that you turn the air vent on and point them away from you and your kids. According to the CDC’s travel page, “all commercial jet aircraft built after the late 1980s, and a few modified older aircraft, recirculate 10%–50% of the air in the cabin, mixed with outside air. The recirculated air passes through a series of filters 20–30 times per hour. In most newer-model airplanes, the recycled air passes through high-efficiency particulate air (HEPA) filters, which capture 99.9% of particles (bacteria, fungi, and larger viruses or virus clumps) 0.1–0.3 µm in diameter. Furthermore, air generally circulates in defined areas within the aircraft, thus limiting the radius of distribution of pathogens spread by small-particle aerosols. As a result, the cabin air environment is not conducive to the spread of most infectious diseases.” These systems were implemented when smoking was permitted on flights (remember those days? My dad would sit in the front smoking section and we would sit in the back, pretending like we didn’t smell the smoke wafting from the front). But luckily for us, airplane filtration systems should be effective in limiting the transmission of viral particles, even SARS-CoV-2 with an estimated average particle size of 0.12 µm. So turning on the air vents gives you a constant source of filtered air and also creates an invisible, turbulent-air barrier around you – a  zone of turbulence that blocks respiratory droplets from your neighbors and pushes them away from you and to the ground faster. That being said, the filtration system won’t filter out every particle. And in an enclosed space with no chance of physical distancing, it still comes down to keeping your hands clean and away from your face and wearing a mask.
• It’s good to be last. You know how everyone rushes to be the first on the plane to avoid the dreaded gate check? During times of a pandemic, it’s good to be last. I would much rather have to gate check my carry-on luggage than be the first on the plane while all the other passengers are walking by, breathing on me before the airplane filtration system as had a chance to turn on.
• Consider how long to quarantine before seeing anyone. The incubation period for COVID-19 is estimated to be between 2-14 days. The vast majority of people will get sick 4-6 days after exposure, so if you physically distance for the first week after your arrival before seeing loved ones, you’re likely safe. However, if you have especially vulnerable loved ones, you may want to consider quarantining for the full 14 days.
• Be prepared for the long haul. If you choose to fly, be prepared to stay at your destination for longer than anticipated. If you are exposed to someone with COVID-19, the responsible thing to do is to self-quarantine in that location for 14 days before flying home. And if you contract COVID-19 and get sick, you may be in for the long haul depending on your recovery. 
• Take Oscillococcinum. Oscillococcinum is an amazing homeopathic remedy for colds and flus. Studies have shown that Oscillococcinum can signficantly shorten the duration and severity of influenza and influenza-like illnesses. But did you know that it may also help preventatively? Give yourself and each member of your family 1 vial of Oscillococcinum before getting on that plane to give everyone a quick and easy immune boost.
• Irrigate your nose. Stop those germs from multiplying and taking hold in the first place. Spraying your nose with Xlear nasal spray and blowing out any germs before they can grab hold is one of the easiest and most effective ways to keep from getting sick in the first place! One study found that people who did preventive daily nasal irrigation had significantly fewer episodes of upper respiratory symptoms, shorter symptom duration and fewer days with nasal symptoms compared to those who did not irrigate their nose daily. Xlear comes in a spray for older kids and adults, and in nasal drops for babies, and they’re small enough that you can carry them right on the plane in your TSA-approved, quart-sized liquids bag. Spray and blow (or suck out with a bulb syringe or Nose Frida) throughout your plane ride, or at least as soon as you get off and arrive at your final destination!
• Give your immune system pandemic-fighting punch! For pandemic immune support, I am prioritizing Zinc, Vitamin D, Vitamin C, Quercetin, Glutathione, and Vitamin A. These supplements may help prevent our cells from allowing SARS-CoV-2 to enter and multiply, and significantly reduce our risk of getting sick. To learn more, be sure to WATCH my free Masterclass: A Holistic Pediatrician’s Guide to the Pandemic and READ my Article: A Pediatrician’s Pandemic Immune Support Plan.

And last but not least … be responsible and respectful. Extraordinary times call for extraordinary patience and kindness. Every single one of us is in uncharted waters. Be kind to yourself. Be kind to others. We’re all in this together.

As we re-enter society, with school re-openings just around the corner and all of the added exposure that will bring for you and your kids, it’s so important now, more than ever, to be prepared – without fear. I’m here to support you through re-entry and your FOGO (Fear of Going Out). That’s why I created my online program, Integrative & Functional Medicine Strategies for the Pandemic, where I teach you everything you need to know to strengthen your immune system during the pandemic and what to do if you get sick to minimize serious complications – as a holistic pediatrician who’s cared for children with COVID-19, and a mama who’s had 2 kids recover amazingly well from COVID-19 even after hospitalization, so you can:

💥Stay calm.

💥Be prepared.

Learn more about my program HERE: Integrative & Functional Medicine Strategies for the Pandemic. I’m here to support you and your family.

xo Holistic mama doc – Elisa Song, MD

On June 30, 2020   /   Coronavirus, General, Health Conditions, Immune Health   /   12 Comments