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Tuesday, September 21, 2021

Is it ethical to travel right now? Experts on flying in the age of Delta

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A new season is here and, with it, seedlings of holiday escape plans to some sun-drenched beach or snowy mountain ski slope. In view of passenger data from the US and the UK, air travel is on its way toward recovering from the slump of a pre-vaccine Covid-19 pandemic – despite the rise of the Delta variant.

But does that mean it’s a good idea to buy that plane ticket, even if you’re vaccinated? And if you’re comfortable assuming some degree of personal risk, is it unethical to do so?

Kelly Hills: The short answer is that it depends on where you live. Are we talking about a country with a relatively successful public health response where 80% or more of the eligible population are fully vaccinated, and there is low overall incidence of Covid-19 both where you live and where you are traveling to? Then no, it isn’t unethical. But that doesn’t describe most of the world.

[As well as] following whatever public health guidance is in place, I think that people need to think in terms of best avoiding ‘moral injury’, which is what we call the psychological damage that happens when you violate your own moral or ethical beliefs. So, is there a risk of physical or moral injury to taking, or not taking, this nonessential travel? I think this more accurately catches the diversity of situations that people can find themselves in.

Thomas Tsai: I view it as less of an ethical question – a right or wrong – and more of a public health question of how best to minimize risk to yourself and to others. As a vaccinated traveler, it’s still important to follow airline and local jurisdiction guidelines around masking, screening and testing (in locations that require it).

To travel unvaccinated puts yourself and others at risk. We’re at a stage of the pandemic where the focus is collectively taking the actions that can reduce transmission to ensure that schools, workplaces and public venues can remain open and minimize the risk of infections from the Delta variant.

Saskia Popescu: I would encourage people to consider where they’re traveling to/from, and the community transmission levels [in both places]. Ensure that you’re prepared to continue practicing infection prevention efforts, like wearing a mask and reducing time unmasked indoors. Moreover, if you’re traveling after an exposure or not feeling well, I would discourage that – we need to be good stewards of public health.

Even though I’m vaccinated, is it wrong for me to travel somewhere that has low rates of vaccination?

Tsai: Again, I would think of it as maximizing the actions that are known to reduce risk of Covid transmission. With over a year and a half of deferred travel due to Covid, there are very real reasons why individuals may want or need to travel even to areas with low rates of vaccination – to see family, for example. As a public health researcher, I view the tradeoffs as one of risk.

Traveling to an area of low vaccination (and high Covid-19 case rates) is inherently risky. While you can’t control the risk to you from the surrounding community, you can control the risk to yourself and the risk to others by ensuring you are vaccinated, wearing masks in appropriate venues, not traveling when symptomatic or if you have a recent exposure and getting tested frequently with antigen tests.

Hills: Should you take a complete for-funsies vacation to a country that has a low vaccination rate because they literally cannot get any vaccines? No, you should not. If that’s not the case, it’s helpful to evaluate the situation in terms of physical and moral risk.

OK. How do I do that?

Hills: You can ask yourself: who is at risk by my travel, in where I am going and where I will return to? What is the risk to the hourly employees within an airport that will be serving me during that travel? Is there a high vaccination rate where I’m going? What is the current rate of Covid-19 infections where I am going and where I am coming from?

Also consider: What sort of risk am I taking when I reach my destination? (Spending time at the family home with your parents is less likely to be risky than spending multiple days at a theme park, for example.) Is this travel that must happen now? How will I protect the people around me while I am on vacation and for the quarantine period when I return?

Asking yourself these kinds of questions and answering them honestly will help you answer the question of if this travel now is ethical for you to take.

If I do decide to travel, are there any activities I should avoid once I’ve reached my destination?

Popescu: I think it’s ideal to avoid crowded indoor settings with inadequate ventilation. I try to focus on doing things outdoors and be aware of the local transmission rates where I may need to take other precautions.

Tsai: The activities depend on the community-level transmission of the place you are visiting. If you are outdoors, generally safer; if you are indoors, generally less safe.

Hills: People should follow the most stringent public health guidance available, regardless of whether or not local public health officials have the same recommendations. If people have decided that they are going to travel, it is on them to take responsibility for their actions, and to do the absolute best they can to minimize the spread of disease.

Now, all that said, I want to emphasize: the only reason that we as individuals are even having to ask whether or not it’s ethical for us to take nonessential flights (or do a lot of other things) is because public health has failed. How to handle a pandemic is not, and should not be, a matter that is up to individuals. It’s in that spirit I even offer guidance for how to ethically make these choices. Because when it comes down to it, these are not the sorts of individual ethical choices we should have to make.

Check your local Covid-19 travel rules here:

US: https://travel.state.gov/content/travel/en/traveladvisories/ea/covid-19-information1.html

UK: https://www.gov.uk/coronavirus

Australia: https://covid19.homeaffairs.gov.au/travel-restrictions

The experts:

  • Kelly Hills is a bioethicist and co-founder of the bioethics consulting firm Rogue Bioethics.

  • Dr Thomas Chin-Chia Tsai is a surgeon and health policy researcher at Brigham and Women’s hospital and Harvard TH Chan School of Public Health

  • Saskia Popescu is an infectious disease epidemiologist and assistant professor at the George Mason University Schar School of Policy and Government

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