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You asked: What’s safer during covid — a long flight or layovers?

In this week’s By The Way Concierge, we tackle the risks of long-haul flights during the pandemic.

(Cynthia Kittler for The Washington Post)

Traveling has always come with complications, but the coronavirus pandemic has made it more challenging than ever. Our By The Way Concierge column will take your travel dilemmas to the experts to help you navigate the new normal. Want to see your question answered? Submit it here.

I am 59, vaccinated and boosted, and scheduled to go to Nepal in March for two months — a trip that’s been fully paid for and postponed twice. I feel fairly confident of covid safety on the trip itself, but I am leery of the 15+ hour flight. How risky are long-haul flights with omicron? — Jasmine, Tetonia, Idaho

The thought of spending 15 hours in a confined space with strangers during a pandemic does sound questionable. But if we’re vaccinated and boosted and not at risk for severe infection, should we be worried about taking long-haul flights? We’ve gotten several questions about this, so I took your concerns to doctors and epidemiologists.

Let’s start with the good news: For fully immunized travelers, experts feel confident in the efficacy of ventilation and air circulation systems on airplanes. With that technology, plus mask mandates, “I think the risk is really low,” says Mark Gendreau, an expert in aviation medicine and chief medical officer of BILH Beverly and Addison Gilbert hospitals.

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Gendreau says he feels comfortable flying at this point in the pandemic for a handful of reasons, such as the drop in cases from the colossal omicron spike.

“The second reason: I’m fully vaccinated and that includes the booster,” he says. “If you’ve had a booster within four months, you’ve got a significant level of neutralizing antibodies that are going to really reduce your chances of catching covid.”

But is a long flight riskier than breaking it up into shorter flights? Maybe not.

While there will be risks any time you’re in crowded places, “I don’t personally think that the risks on a long-haul flight are necessarily that much greater than a shorter flight,” says Emily Hyle, an infectious-disease specialist at Massachusetts General Hospital.

If you can get a direct flight, even better. Alexander Rodgers, an assistant professor at the Charles R. Drew University of Medicine & Science in Los Angeles, says a trip with fewer stops would reduce the number of people you have contact with.

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“Just by probability, you decrease the number of chances you’re exposed to somebody who is positive for covid,” Rodgers says.

Of course, there’s no guarantee you will be fully protected from an infection.

“You still need to be cautious because you are in close proximity to multiple people,” says Susan Hassig, an epidemiologist at the Tulane University School of Public Health and Tropical Medicine.

Every expert encourages wearing a well-fitting N95 or KN95 mask throughout travel, removing them sparingly and strategically.

For example, Hyle tells patients to stagger when they eat or drink with other passengers. Once you feel comfortable, don’t fully remove your mask and linger over your refreshments. Instead, “pull your mask down to take a sip, and pull it right back up,” says Anthony Harris, chief executive and medical director of HFit Health.

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If you’re not used to N95 or KN95 masks for long periods of time, Hassig recommends preparing yourself by practicing. Pack a supply of them so you can swap them out when they get swampy.

“After a 12-hour flight … you’re going to want to throw that mask away,” Hassig says.

Aside from being mindful of eating and drinking situations, Gendreau says, travelers can open the air vent above their seat to further reduce their risks.

Gendreau’s biggest concern for travelers is deplaning. Citing a study on infectious-disease mitigation in airports and on planes, getting off is the riskiest part of a flight.

“As you hear that ‘ding,’ everybody jumps up and crowds the aisle,” he says. “You’re there for sometimes 10 minutes or longer, and you are incredibly close to a lot of people.”

Gendreau recommends waiting until it is your row’s turn to exit and the aisle is clear ahead of you before you grab your bags and go. (Beyond a coronavirus mitigation strategy, this is also just good plane etiquette.)

The other major risks of your long-haul trip take place before and after your flight.

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Hyle says you also have to think about risks to and from the airport and inside. “So wearing a high-filtration and well-fitting mask during those periods of time are every bit as important,” she says.

For concerns about bringing an infection back to loved ones upon returning home, Rodgers says, people will have different approaches depends on their risk tolerance.

Because Rodgers’s wife is immunocompromised, he would assess the coronavirus rates where he traveled and proceed accordingly. “Anything above moderate, I would be considering a quarantine of at least five days and take a PCR or rapid test at the end [before going home],” he says.

Hassig also encourages travelers to be aware of the coronavirus situation in both the arrival and departure destination, particularly if you or your loved ones are high risk. Even with a promising drop in cases, “omicron is still circulating very, very widely,” she says. “Practically the entire United States is still red.”

Have a travel dilemma for By The Way Concierge? Submit it here.