The role of aviation in the spread of epidemics in the 21st century has been recognized by the scientific community for many years. Yet instead of limiting flights as much as possible from the start of the COVID-19 epidemic, the International Civil Aviation Organization, an advocacy agency of the United Nations that is headquartered in Montreal, lobbied to delay the adoption of health measures that could harm air traffic.
In a Feb. 4 statement on COVID-19, the International Civil Aviation Organization warned governments about imposing “additional health measures that may significantly impede international [air] traffic.” By then the first cases of infection had already been declared two to three weeks earlier in travellers who came from China, most of them by plane.
The organization was wrong to urge governments not to limit air traffic as the virus began to spread outside of China, according to a French expert.
“Frankly, it was not the right message to have,” says Alain Barrat, director of research at the French National Center for Scientific Research and co-author of an article entitled “The role of the airline transportation network in the prediction and predictability of global epidemics,” published in 2006 in the Proceedings of the National Academy of Sciences.
“Global air traffic networks play a key role in the global importation of emerging infectious diseases,” notes a group of of researchers that includes individuals from the University of Virginia’s Biocomplexity Institute & Initiative in a Feb. 25 article on the current COVID-19 epidemic. (Authored by more than 30 people, the article is available online prior to approval for publication.)
In recent years, airplanes have been involved in many cases of transmission of contagious diseases such as severe acute respiratory syndrome (SARS), influenza, smallpox and measles, reports Alexandra Mangili of the Tufts University School of Medicine in Boston.
As winter ends, COVID-19 is already well established in many countries and is now spreading within communities, said Barrat during a Skype interview with Ricochet from Marseille, France, on March 12. But at the start of winter, planes were a very important carrier of the virus and the aviation industry could not ignore it. The International Air Transport Association, which represents most of the world’s major airlines and is also based in Montreal, participated in a study by Barrat and his colleagues on the role of airplanes in the spread of infectious diseases.
Epidemics have regularly erupted over the centuries, notably the plague in the Middle Ages, but they spread more slowly, said Barrat. With airplanes, the flow and the speed are much greater: “We have numbers of people who are displaced every day over great distances,” he said. Today, epidemics, like SARS or COVID-19, “are spreading along the aviation network,” which “completely changes the dynamics.”
The researchers at the University of Virginia’s Biocomplexity Institute & Initiative and their co-authors also report in their article that the coronavirus quickly spread outside of China via the air network. Wealthier people travel by plane, and the study notes that countries reporting COVID-19 cases are mainly developed countries, such as Italy and South Korea.
Iran, a less affluent country also affected, is a special case, but here too aviation is at issue, suggests Dr. Amir Khadir, a specialist in medical microbiology at Pierre-LeGardeur Hospital in the suburbs of Montreal. COVID-19 first appeared in the holy city of Qom, and hundreds of Chinese students of Islamic studies regularly make roundtrip flights there from their hometowns. “There is a lot of travel and trade between Iran and China,” said Dr. Khadir, who is of Iranian origin. “When the Iranian government became aware of the epidemic in China, it took no steps to limit trade and air travel.”
And it seems no government could count on the International Civil Aviation Organization to get it right. On another issue — that of the climate crisis — this United Nations agency has been regularly accused of not defending the public interest and instead serving as a lobby for the powerful aviation industry.
The fact that planes spread epidemics very quickly has a major impact on public health networks, as it leaves governments little time to take action, said Barrat.
“Governments are machines that respond slowly to a crisis,” he said. “With regard to an epidemic, we know that we are going to have exponential growth, which at first seems slow and which becomes very fast. And when you start having a lot of cases … we have to take the measures that are being taken, but it would have been better if we had done it before.”
Barrat is not surprised that the International Civil Aviation Organization, which has a mandate to support civil aviation, did not want rapid and radical measures that could have hampered air traffic at the start of the epidemic.
“It is obvious that the first concern when the number of cases [of infection] is still low is to say ‘well, we must not kill the economy too much.’ But then we realize that it might have been nice if we had been a little more reactive before.” If they act in time, authorities can limit the spread of the virus and ultimately avoid taking catastrophic measures that hurt all aspects of the economy. In hindsight, the call by the International Civil Aviation Organization not to hinder air traffic at the start of the epidemic was not the right message.
On March 9, the International Civil Aviation Organization’s council finally adopted a declaration affirming “the urgent need to reduce the public health risk of the spread of COVID-19 by air transport,” but the damage was already done. The statement also said that organization is concerned “about the economic impact of the COVID-19 outbreak on air transport and civil aviation.”
