Methodology
The literature search for quantitative and qualitative studies revealed five papers that fit the inclusion criteria. Of the five, two used the susceptible exposed infected removed (SEIR) model for social distancing protocols (Prem et al., 2020; Wilson et al., 2020), while the others conducted their studies using the stochastic agent-based model (Shi et al., 2020), survey (Quaife et al., 2020), and a systematic literature review. Note that due to technical difficulties, the cost of conducting surveys (such as finding participants) and their unreliability forced the researcher to consider conducting a systematic literature review over a study. First, the systematic literature review would introduce evidence from different populations and countries, giving the findings and conclusions stronger internal validity; thus, increasing their generalizability. Secondly, a survey would involve an insignificant number of participants, and air travel has yet to pick up. Therefore, finding air travelers to participate in the survey would not only be costly but also put the researchers at unnecessary risks when going out to recruit them at airports.
On the other hand, the measures taken to control the spread of the pandemic are not limited to the aircraft's only. For instance, social distancing measures and regulations requiring everyone to wear a mask when outdoors to reduce the risk of spreading or acquiring the infection is common to the public domain. Therefore, if the measures are effective in the public domain, they will be effective in aircraft. There are a few exceptions, however. First, measures like airliner cabin air filtration are unique to aircraft only because the systems are not applied elsewhere. Furthermore, the current state of these systems is that they are proprietary, and no one the researchers contacted for the survey was willing to provide information on their effectiveness. The following section outlines the findings of the systematic literature review with respect to the research question.
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Findings
Prem et al. (2020) used the SEIR model to determine the effectiveness of social distancing measures using data from ground zero of the pandemic: Wuhan. The model used synthetic location-specific contact patterns and adjusted them for changes in behavioral patterns as different measures were taken in Wuhan to curb the virus, such as school and workplace closures and reduced mixing in the community. Prem et al. (2020) also simulated the effect of a staggered return to work in phases where limitations were gradually lifted. The model results indicated that the social distancing measures were effective in curbing the spread of the virus, and if the restrictions were slowly lifted, the number of infections would be halved by mid-2020 and eradicated by the end of the year.
Another study by Quaife et al. (2020) conducted a social contact survey with 213 participants from Nairobi, Kenya, to determine the impact of the social distancing measures introduced by the government a month earlier. The results indicate that the measures imposed by the government reduced physical contact by up to 62% and non-physical contact by up to 67%, which had a significant impact on the spread of the pandemic in the country.
Another study by Shi et al. (2020) used the stochastic agent-based model to establish the effectiveness and cost-effectiveness of several measures implemented to control the pandemic. These measures, especially the cost aspect, are essential to establishing the economic cost of the interventions by the airlines and airport authorities. Shi et al. (2020) used the model in two scenarios: the importation of one and four cases, respectively. The model predicted in both cases that isolation and quarantine measures averted 1696 and infected 1990 individuals at the cost of $12,428 and $58,555. A combination of personal protection and quarantine procedures significantly reduced these numbers. The model also predicted that in cases where the quarantine probability was 0.25, and the delay was more than 5 days, the risk of an outbreak increased significantly. Shi et al. (2020) predicted that while quarantine was the most cost-effective intervention, personal protection and quarantine were optimal.
The final study included was conducted by Wang et al. (2020). The study is a systematic literature review of the effectiveness of wearing a mask. This is significant as masks are currently the most common personal protective measure employed against COVID19. According to Wang et al. (2020), previous studies had established masks as an effective measure against the spread of respiratory viruses, especially influenza, MERS, and SARS. Wang et al. (2020) also cited a study by Barasheed et al. (2016), which concluded from a sample of 12,710 samples from over 50 countries that masks reduced the transmission of respiratory infections from public places by 20%. Wang et al. (2020) also noted that a combination of hand washing and wearing a mask would significantly reduce the risk of an outbreak, especially if a vaccine for the virus or bacteria has yet to be developed.
Analysis
This paper set out with a research question on examining the relationship between COVID-19 safety precautions implemented in the aviation industry. Its purpose is to address the concern about the role the aviation industry has played in spreading the pandemic. It also aims to determine if the precautions implemented are enough for air transport to resume to its previous numbers. Therefore, the paper set out to examine an alternative hypothesis that there is a relationship between the safety precautions being implemented by the aviation industry and the number of COVID-19 cases reported in the industry.
The results from the literature findings are consistent and confirm the alternative hypothesis. In other words, within the constraints of the assumptions and limitations of the methodology of the paper, there is a relationship between the safety precautions being implemented by the aviation industry and the number of COVID19 cases reported in a country. For instance, mandatory measures requiring passengers to wear their masks all the time, combined with a handwashing regimen, would significantly reduce the spread of the virus. Note that masks should be worn by everyone, infected (symptomatic or asymptomatic), or healthy. On the other hand, quarantine procedures, mandatory testing, and prevention of physical and non-physical contact were established to reduce the spread of the pandemic, using survey results and model predictions.
This, therefore, validates the measures taken in airports where all passengers are screened, undergo medical check-ups, and quarantine procedures for suspected cases. The findings also indicate the urgent need for contactless technology to maximize the safety of the passenger, airport staff, and every one the general public. There is a limitation, however. The results from the literature search were consistent in their findings. However, they were conducted in limited settings, such as in particular countries where a case in a country yet to implement the changes is yet to be reported. After all, it would be unrealistic to assume that the other countries and stakeholders, such as airlines, have adhered strictly to the letter and spirit of these measurement.
Other factors, like financial restraints, politics, and environmental challenges might influence some of the stakeholders to lag behind. Furthermore, while the measurements have been established to prevent the spread of the virus today, no data is available on their effectiveness in the long-term. For instance, these measures are new and are changing practice in the industry. While adoption is high due to the enthusiasm, it is unclear if the protections will remain long-term or if the stakeholders will slowly return to their previous practices.
On the other hand, the findings from the literature led to the rejection of the null hypothesis, which posited that there is no relationship between the safety precautions being implemented by the aviation industry and the number of COVID-19 reported cases. The study conducted by Wilson et al. (2020) provided quantitative evidence to reject the null hypothesis, especially the study used statistics from New Zealand. The study was also significant because while Prem et al. (2020) used the SEIR model to simulate the effectiveness of social distancing in reducing the spread of the virus, Wilson et al. (2020) applied it specifically to aircraft and international travel, factoring in the impact of each intervention.
At the time Wilson et al. (2020) were conducting their research, New Zealand was yet to report any cases. The model predicted that if no interventions were taken, then an outbreak would occur in 1.7 years (average) with a 95% uncertainty interval. On the other hand, if the country implemented several interventions, the risk of an outbreak is reduced to 29.8 years. The interventions included entry and exit screening, wearing masks on the aircraft, two PCR tests (3 and 12 days after arriving in New Zealand), self-reporting of symptoms, and contact tracing. If, on the other hand, passengers used masks but were not subjected to PCR testing, the risk of an outbreak changed to 14 years (Wilson et al., 2020). However, the best intervention was a mandatory 14-day quarantine, which reduced the risk of an outbreak to 34 years.
Limitations
The findings of the literature review are limited by the methodology used. As explained in an earlier section, the number of papers included for findings and analysis is very small. However, the quantity is compensated by the quality of the papers. Each of the papers selected discussed the research question and performed studies using different models and methods. Furthermore, some of the congruent models complemented each other. For instance, while Prem et al. (2020) applied the SEIR model to the general population, Wilson et al. (2020) applied it in a case congruent to the research method. Both findings were consistent with each other. The second limitation is that there was no data to test the effectiveness of other interventions specific to aircraft operations. For instance, there was no data to establish the effectiveness of the cabin air filtration systems installed to reduce the risk of spreading the virus in pressurized cabins.
Conclusion
In conclusion, implementing several measures, individually and in concert, has been shown to play a significant role in reducing the aviation industry's contribution to the continued spread of the pandemic. The measures have been implemented to contain the pandemic by targeting and protecting both the passengers and workers through proper social distancing measures, cabin air filtration systems, regular cleaning and disinfecting of aircraft, screening and mandatory wearing of face masks, and quarantine procedures for suspected cases. Furthermore, it was recognized that contactless technology was applied, the physical and non-physical contact reduced significantly, which helped contain the spread of the virus.
Recommendations
The recommendation for future work is further research into the possible applications and implementation of contactless technologies, both in the aviation industry and the general public alike. Existing studies have shown their effectiveness in reducing contact, physical and non-physical. The airports are ingress and egress locations, which makes them strategic locations to prevent the virus from entering the country or leaving it to spread it further. While it might be possible to care more about the virus coming in more than it goes out to other countries, especially to competing or enemy states, such view is simplistic and short-sighted at best. If the virus leaves a territory, its destination becomes a sink, where it goes to spread and potentially return, resulting in the pandemic happening in waves.
It is also recommended that future research look into the long-term effectiveness of the measures implemented to stop the spread of the virus. Current research has failed to consider external factors that might result in the protective measures being ignored. For instance, stakeholders could start to return to their previously normal operations without considering the pandemic, or follow the procedures in writing only. If the aviation industry is expected to recover to its former levels, the current protective measures need to be evaluated, especially if they are effective in the long-term.
References
Barasheed, O., Alfelali, M., Mushta, S., Bokhary, H., Alshehri, J., Attar, A. A., ... & Rashid, H. (2016). Uptake and effectiveness of facemask against respiratory infections at mass gatherings: a systematic review. International Journal of Infectious Diseases , 47 , 105-111.
Prem, K., Liu, Y., Russell, T. W., Kucharski, A. J., Eggo, R. M., Davies, N., ... & Abbott, S. (2020). The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. The Lancet Public Health .
Quaife, M., van Zandvoort, K., Gimma, A., Shah, K., McCreesh, N., Prem, K., ... & Edmunds, J. (2020). The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements. medRxiv .
Shi, N., Wang, Q., Huang, J., Cui, T., Yang, L., Ai, J., ... & Jin, H. (2020). Effectiveness and cost-effectiveness of public health measures to control COVID-19: a modelling study. medRxiv .
Wang, J., Pan, L., Tang, S., Ji, J. S., & Shi, X. (2020). Mask use during COVID-19: A risk adjusted strategy. Environmental Pollution , 115099.
Wilson, N., Baker, M. G., & Eichner, M. (2020). Estimating the Impact of Control Measures to Prevent Outbreaks of COVID-19 Associated with Air Travel into a COVID-19-free country: A Simulation Modelling Study. medRxiv .
