Health experts weigh in on air travel, latest vaccines and ways to combat COVID-19

Alaska Airlines recently hosted a virtual conversation with some of the world’s leading COVID-19 experts from Fred Hutchinson Cancer Research Center and UW Medicine. Our goal was to share the latest vaccine research and vaccine developments, how to protect yourself and others during the pandemic and what we’re doing to keep guests safe when they travel.

Guests from across the country joined in and asked nearly 1,000 questions for the medical experts, which included topics like what the best kind of mask is to wear, and how long the virus lasts in your system and where we’re at with the latest vaccine.

Check out the full recap of the one-hour virtual event and responses to some of the top unanswered questions below.

Watch the full discussion

Rising to the Challenges of a Pandemic: A Conversation with Experts from Alaska Airlines, Fred Hutch, UW Medicine

The conversation was hosted by Luke Burbank of Live Wire and brought to you by Alaska Airlines.

Questions & Answers

Is air travel safe?

Yes. At Alaska, we believe air travel is safe. Recent studies have found airplanes are among the most low-risk indoor environments in the world. And with our Next-Level Care, Alaska Airlines is prepared to give you the safest, cleanest and most enjoyable travel experience from start to finish. Alaska’s Next-Level Care includes 100+ ways to maintain the highest standard of safety throughout your travels, including mask requirements, enhanced cleaning, hospital-grade high efficiency particulate air filters on board and no change fees.

Is Alaska Airlines considering requiring flyers to vaccinate before they fly?

No. Several recent scientific studies about air travel concluded that it is safe to fly by following a layered approach using masks, hand sanitizer and air filtration. With more than 100 safety protocols in place, including mandatory masks, enhanced cleaning between flights, HEPA air filtration and touch-free technology, we believe it’s safe to fly and will not require guests to vaccinate before they fly on Alaska Airlines at this time.

Is the air onboard filtered during boarding and deplaning and while the plane is taxing at an airport? What about during deicing?

The sophisticated air filtration system and HEPA filters on our aircraft are actively working during the boarding and deplaning process. During cold weather, when we need to deice the plane, the system exchanges air through our HEPA filters the entire time while also preventing deice fluid fumes from entering the aircraft.

Is the air you breathe on a plane the same air from takeoff to landing? No. Our aircraft exchange fresh air from outside and through hospital-grade HEPA filters every 2 to 3 minutes. The entire cabin air is completely refreshed about every 6 minutes. The filters onboard remove 99.9% of airborne contaminants. Read more about Alaska’s HEPA filtration process.

How effective are masks and social distancing? What types of masks are acceptable: disposable paper, cloth, home-made, nose closure or not (bendable wire)?

Masks are one of the most important ways we can protect ourselves and others from infection, which is why Alaska has its strict mask policy—no mask, no travel. Fred Hutch researcher Dr. Josh Schiffer’s work suggests that if both an infected and an uninfected person are wearing masks, the risk of transmission drops by 40% to 80%, depending on the effectiveness of the mask.

The CDC recommends that masks have two or more layers of breathable fabric that completely cover the nose and mouth and snugly fit around the sides of one’s face. The denser the weave of the fabric, the better, as these create a better filter for droplets and aerosols. Read more about Dr. Schiffer’s opinion in the New York Times.

How long is a person contagious before they test positive for the virus?

How soon after infection a person can test positive for the virus, and when they become contagious, depends on the initial amount of virus that triggered the infection.

Sophisticated models by researchers like Dr. Josh Schiffer at Fred Hutch show that people are most infectious from about two days before they start to show symptoms until a day or so after they show symptoms. That three- to four-day window is when people are most infectious and likely represent the earliest time point at which they would return a positive PCR sample.

How long does the antibody remain in your body? Would an antibody test today be able to tell if I had COVID-19 in March?

This is an open question that researchers are still investigating. While there have been anecdotes about re-infection, an outbreak at a Wisconsin summer school retreat provides a little more cause for optimism. Interestingly, the outbreak was seeded by one student who received a negative COVID-19 test one week before camp but tested positive shortly after arriving and developing symptoms. During the retreat, 118 of the 152 attendees tested positive or had COVID-19 symptoms. However, 24 of the 34 who did not contract the disease had previously been infected and recovered, suggesting some level of protection.

Researchers around the world, including Dr. Jesse Bloom at the Hutch, have been studying the persistence of antibodies over time following infection and will know more as more data becomes available.

When will we know more about the long-term impacts of COVID-19, especially its effects on blood clotting?

Given that COVID-19 emerged less than a year ago, scientists have made astounding progress understanding the disease. However, it’s too soon for us to fully understand the long-term impacts, even as we hear stories about long-haulers. A study by Fred Hutch’s Dr. Julie McElrath is following people after infection to learn more about long-term impacts and the factors that might predispose people to these effects.

When viruses or other pathogens mutate, do they generally become more or less virulent? And what about COVID in particular?

While it is true that some viruses mutate rapidly, making vaccines tricky, that does not appear to be the case for SARS-CoV-2, the virus that causes COVID-19. Since the start of the pandemic, Fred Hutch researcher Dr. Trevor Bedford has been tracking tiny changes to the virus’s genetic code (mutations) as it moves from person to person . Based on this tracking, we know that SARS-CoV-2 is not changing as rapidly as other viruses, including flu and HIV. Crucially, only one mutation that has emerged has successfully propagated, and it is located at a site in the genome where it is unlikely to interfere with antibodies the vaccine will produce. Read more about Dr. Bedford and his award-winning open-source software, Nextstrain, in Vanity Fair.

The virus’s history, of course, does not predict its future. Hutch researchers are cognizant that mutations could emerge that affect the region that vaccines target: the virus’s spike. With that in mind, Dr. Jesse Bloom has measured how virtually every possible mutation to the spike region would affect the virus’s ability to escape detection from vaccines and other antibody-based treatments without compromising its ability to infect cells. His work will inform future treatments and vaccines.

If a person has one type of COVID-19 vaccine, would it be okay to have a different type of COVID-19 vaccine later?

If different types of vaccines are found to have equivalent safety and efficacy profiles, this idea could be an intriguing one. Researchers would need to design studies carefully to determine the right order to ensure an optimal immunity boost. This will need careful study before researchers are able to recommend whether, and in what order, people should get two different vaccines.

Do the vaccines alter your own RNA?

The short answer is no: Messenger RNA (mRNA) is short-lived and cannot be incorporated into our genetic code. The first few vaccines that are likely to be approved — made by Pfizer, Moderna, AstraZeneca, and Janssen —use a few different mechanisms to deliver mRNA which elicits an immune reaction to fight the virus.

Are there any treatments that our doctors can easily prescribe that minimize the impact of the disease if we get Covid?

Currently, treatments such as remdesivir (an antiviral drug), dexamethasone (an anti-inflammatory), and monoclonal antibodies such as those given to President Trump (virus blocking and targeting) are being prescribed to people with severe disease, and they appear to have some effect. There is, however, a need for treatments that can be prescribed earlier in the course of the disease, and there is no proof that the same treatments will work then. To expand the treatments available for patients, Fred Hutch launched the COVID-19 Clinical Research Center, the nation’s first freestanding facility dedicated to studying early coronavirus interventions. The goal with these treatments is to interrupt the disease early, reducing the severity and preventing hospitalization. We are currently enrolling patients for several clinical trials of promising therapies.

Would volunteering for the vaccine trial require a drive to Seattle?

No. You can learn more about the vaccine trials at preventcovid.org.

I assume mRNA vaccine will translate spike proteins in cells throughout the body, not just the lungs. What danger is there of triggering an unexpected cytokine/inflammation response?

All vaccines go through three phases of human testing before being approved by the FDA and distributed to the public.

• Phase 1 clinical trials show if a vaccine is safe in humans and measure how the immune system responds to it.
• Phase 2 trials enroll hundreds of volunteers and show whether the biological signals of effectiveness show up in those assigned randomly to a vaccine instead of a placebo.
• Phase 3 trials enroll large numbers of people — 30,000 and 60,000 in the U.S. and worldwide — to prove that the vaccine reduces the risk of infection or serious illness to protect individuals and communities from COVID-19.

Data from these studies are assessed by an independent Data Safety and Monitoring Board to confirm the safety of the vaccines. If volunteers experience serious health problems, researchers investigate to determine whether they were caused by the vaccine. If these vaccines trigger an adverse response in any way, these trials will catch them and pause, as they did with AstraZeneca and Janssen, to determine if they were caused by the vaccine.

Meet the panel:

Josh Nice is the Director of Quality Assurance at Alaska Airlines. With more than 25 years of experience in roles managing safety training and compliance, Josh is a member of the Alaska Airlines COVID-19 Safety Team that is responsible for identifying and reducing the risks related to COVID-19 across our operation, both for guests and Alaska employees. He also leads the effort to audit COVID-19 safety measures at airports and Alaska’s corporate workspace.

Dr. Michele Andrasik is one of the directors of the Hutch-based HIV Vaccine Trials Network where she focuses on HIV prevention and social and structural factors that cause health inequities. She is drawing on her expertise to ensure that communities of color who are hardest hit by the coronavirus are adequately represented in vaccine trials hosted by the Coronavirus Prevention Network.

Dr. Keith Jerome is a virologist at Fred Hutch and director of the University of Washington’s Molecular Virology Laboratory. Thanks to his team’s quick work to develop a test for COVID-19, the Virology Lab at the UW School of Medicine which has done more than a million COVID-19 tests since early March. His group continues to improve testing, including developing rapid point-of-care tests.

Dr. John Lynch is an associate professor of medicine at the University of Washington School of Medicine and an associate medical director at Harborview Medical Center. Dr. Lynch oversees the hospital’s Infection Prevention & Control, Employee Health and Sepsis Programs and is currently leading the clinical team for UW Medicine’s COVID-19 Emergency Operations Center. His focus is on the prevention of infections within healthcare settings.

Emcee, Luke Burbank is an American radio host and podcaster who hosts the Portland, Oregon-based syndicated variety show Live Wire Radio and the Seattle-based former radio program and current podcast Too Beautiful to Live.