TORONTO -- With March break around the corner many Canadians are rethinking their travel plans amid the global COVID-19 pandemic.

Those that do travel can take extra hygiene steps in a bid to stave off the risk of catching the new coronavirus while flying or on other transport.

CTVNews.ca has compiled a round-up of advice from health and travel professionals so travellers can do as much as they can to keep the disease at bay.

“I just came back from the U.S. and I’ve never been on a cleaner plane in my life,” travel expert David Choi told CTV’s Your Morning March 12.

“Everyone was wiping it down, they were spraying Purell in the air, I practically bathed in the stuff.”

Healthy habits

Dr. Melissa Lem, a Vancouver-based family physician, said one thing travellers often forget to do when preparing for their vacation is to take care of themselves.

“People are often really busy with work and different things before they leave on vacation. Prioritize your healthy habits like sleep, exercise, and a good diet to keep your immune system strong,” she told CTVNews.ca during an interview last year. 

What to pack

Beatrix Morrallee, the nurse manager for Passport Health Canada, which operates dozens of travel health clinics across the country, said hand sanitizer and disinfectant wipes can be useful additions to pack.

Both Lem and Morrallee said Canadians should ensure they have travel medical insurance before they leave on their trip.

“It’s essential to buy travel health insurance anytime you leave your home country because medical expenses, especially if you get seriously ill, can pile up very quickly,” Lem explained.

En route

Travellers should clean off any hard surfaces, such as their seatbelt and tray table, before they sit down.

But the most important thing both Lem and Morrallee advised vacationers do is practice proper hand washing. Passengers should frequently wash their hands with soap and water throughout the trip. If soap and water isn’t readily available, use an alcohol-based hand sanitizer instead.

“Viruses can stay on cold surfaces for several days,” Morrallee said. “They need to wash their hands every time they touch a hard surface.”

Selecting a window seat can also decrease exposure to other passengers who are passing by the aisle, according to Lem. She also recommended using a nasal lubricant to protect the mucous membranes from viruses and bacteria.

Morrallee added that using a paper towel to open the bathroom door after handwashing is also a good idea.

Lastly, Lem and Morrallee said staying hydrated, eating well, and getting plenty of sleep during the voyage will go a long way in ensuring travellers remain healthy when they arrive at their destination.

A U.S. study from 2018 found the 11 people sitting closest to a person with a cold or flu are at the highest risk of getting sick themselves.

Meanwhile, testing has shown that seat pockets are the most likely places on an airplane for E. coli fecal indicators to be found.

Researchers at Drexel University in the U.S. say other in-flight germ hotspots include tray tables, bathrooms, blankets, pillows, touch-screen entertainment systems and in-flight magazines.

"If you want to kill bacteria, you've got to put sanitizer on, leave it for a set amount of time, let it work, and you don't get that with alcohol wipes," Keith Warriner of the University of Guelph told CTVNews.ca.

Warriner's recommendations for any flyers concerned about germs include: keeping food out of seat pockets, using sanitizing towels when touching latches and fixtures in airplane washrooms, and wearing facemasks with the white side facing outward.

Airline steps

Canadian airline WestJet has expanded and increased the frequency of its sanitation procedures, in light of coronavirus concerns. In addition to regular cleaners, airline staff are now also using hospital-grade disinfecting wipes and spray.

"These new products are used on tray tables as well as general seating areas to ensure all guest contact surfaces are thoroughly disinfected," WestJet said in a statement..

"The Clorox and (regular) Sanicide products are used to accomplish the cleaning of our galleys, lavatories, tray tables, seat armrests and headrests, seatbelt buckles, the PSU panel (above seats with lights and call buttons), overhead bin door latches and lavatory door handles."

Official advice from the U.S. Centers for Disease Control and Prevention shows that due to the way air circulates and is filtered on airplanes, "most viruses and other germs do not spread easily," but that travellers are still advised to "avoid contact with sick passengers and wash their hands often with soap and water for at least 20 seconds or use hand sanitizer that contains 60%-95% alcohol."

Christian Rooney, manager of JetWash Aero, a specialist aviation cleaning company based in the U.K., told CNN that the cleaning process varies depending on the schedule of the aircraft.

"We have seen an uptick in the requirements and levels of disinfection, spraying and fumigation of the cabin, as the airlines look to address concerns over the coronavirus," he said.

Normal cleaning procedures

If turnaround time is tight, Rooney explained that cabin crew will do “very straightforward cleaning” at the end of the previous flight to remove passengers’ trash.

"A basic but more thorough cabin clean is usually carried out at night -- or when there is more downtime -- and it includes the cleaning of toilets, wiping down and disinfecting of trays, cleaning galleys, [overhead bins], seats etc. This may take up to an hour or longer," explains Rooney.

"An airline will also always schedule a 'deep interior clean' every month or six weeks. This clean takes several hours and is extremely thorough."

Cleaning products and disinfectants are approved by aircraft manufacturers, says Rooney.

"Some of the disinfectants we use are effective against a wide range of pathogens and are known to inactivate complex viruses with similar properties to SARS, E. coli, avian flu, MRSA etc," he adds.

These offer antimicrobial protection for up to 10 days, he said.

Stephanie Biron, a retired flight attendant who used to work for American Airlines, told CNN that, in her experience, standards of aircraft cleaning vary.

"Sometimes you come on and you have to go out and tell the agent, 'look, the plane looks terrible. We need somebody to come on and redo it,'” she said.

“It just varies all the time. Sometimes you come on in the morning and they deep cleaned the whole thing, or at least they told you they have."

Infectious disease

Dr. William Schaffner, a professor of medicine in Vanderbilt University's division of infectious diseases, told CNN he doesn't think there's much more carriers can do to prevent the spread of coronavirus.

Because transmission most often occurs person-to-person, the inanimate environment of the airplane isn't really the problem, Schaffner said.

It's still wise, he says, to wipe down surfaces -- but ultimately it's handwashing that is the most important preventative step.

"Even if there is virus in the inanimate environment, it's not going to jump off the seat and bite you in the ankle. You've got to touch it, and then touch your nose or your mouth," Schaffner explains.

"So it's those hands we have that are the important intermediary -- and that's where I would put the emphasis. Use those wipes on your hands. That's the important thing."

Dr Paulo Alves, who attended IATA's Aviation Resilience Health workshop in Singapore, which is working to address the overall impact of COVID-19, agreed with Schaffner.

"It seems reasonable to wipe the tray table surface, where it is more likely for droplets to land after someone coughs or sneezes,” he said.

“Travellers should maintain good personal hygiene on board flights, before flights and after flights and avoid touching their face."

Airports

Toronto's Pearson International Airport has added extra hand sanitizer stations in its arrivals area and is more frequently cleaning those spaces, including kiosks and bathrooms, according to The Canadian Press. High-traffic areas are regularly disinfected, the airport authority said.

Ferries

Canada's chief public health officer, Dr. Theresa Tam, has recommended Canadians avoid travelling on all cruise ships, which have seen several outbreaks.

Travel advisories

Travellers are urged to check the government’s online travel advisories, which are updated hourly.

"March break is coming up and if you're travelling, we recommend you check out travel advisories from @TravelGoC. We also encourage you to use the Registration of Canadians Abroad service to receive important updates before & during your travel," Prime Minister Justin Trudeau tweeted on Tuesday.

Canadians are expected to monitor themselves for symptoms when they return home and report to public health if they suspect they may have been infected.

Ontario's chief medical officer of health, Dr. David Williams, told The Canadian Press that said Canadians with international travel plans during March break should do a "precautionary assessment."

"Do you need to go on the trip? Where are you going on the trip? What are your risk factors of you going on the trip? Do you have health conditions? What's the risk factor of taking your children on the trip? What kind of behaviour are you going to be involved with at that end? What kind of ability are you going to have to limit your social distancing in those settings?" he said.

"It's one thing to be in a very crowded international venue versus you're just going down and have an AirBnB somewhere and sit on the beach with your kids."

Schaffner notes that, from the passengers' point of view, the ultimate way to avoid infections on aircraft is to stay home.

"And there will come a time perhaps -- and some of that is happening already -- where we are being urged to social distance ourselves," he says. "People are reconsidering whether they wish to fly at the moment."

With files from CTVNews.ca’s Jackie Dunham, Ryan Flanagan and The Canadian Press