While most of the world is avoiding air travel during the coronavirus outbreak, many pilots have no option but to continue to show up for their trips, putting them at high risk of exposure to the virus. If you are in a high-risk or vulnerable category (over the age of 60 and/or have underlying conditions such as heart disease, kidney disease or diabetes, or are immunocompromised for any reason), please speak to your employer about being excused from work and consult with your health care provider about protective measures you should be taking during this time.
Consider packing disinfectant wipes for wiping down surfaces in the cockpit and around the airport that you will be touching. If you can find it, also bring along hand sanitizer, and use it after contact with another person, after using the restroom, after coughing or sneezing or after touching any surface that others have touched. The FDA recently permitted compounding of hand sanitizer by pharmacists, so we may see more options arise for purchasing hand sanitizer during the shortage. When possible, choose washing your hands for 20 seconds with warm water to avoid overuse of hand sanitizer. You'll want to bring hand moisturizer, as well. The constant sanitizing and hand washing will dry out your skin.
Please avoid purchasing and using N95 masks during your trip. Personal protective equipment, including these masks, are in dire need at our healthcare facilities. If it makes you more comfortable, you may wear a regular surgical mask to avoid spreading or contracting infection, but ensure your area is not experiencing a shortage of these masks for first responders and healthcare workers before purchasing them for yourself. Some evidence shows that wearing a mask can help to reduce transmission of diseases, but masks must NOT take the place of frequent hand-washing. It goes without saying to avoid handshakes or physical contact with other people and, whenever possible, keep a distance of at least six feet between yourself and others.
**Update: The CDC now recommends wearing cloth face coverings in public to prevent the spread of the virus.
Should you come down with symptoms of coronavirus infection, or typical cold and flu symptoms, you should be prepared with some over-the-counter medication. The hallmark symptoms of coronavirus infection include cough, shortness of breath and fever. Other common cold and flu symptoms are possible, as well. Less typical symptoms include loss sense of smell and gastrointestinal upset. If you develop symptoms of coronavirus, contact your healthcare provider by phone. Do not go to their office or the hospital unless your symptoms are severe. Your healthcare provider will take the proper steps to determine if you should be tested for coronavirus. Also, contact your employer if you develop symptoms of coronavirus. It is important that you do not fly if you have symptoms of the illness in order to prevent the spread of disease.
Fever reducing medications, like non-steroidal anti-inflammatory drugs or NSAIDs (ibuprofen, naproxen, etc.) and acetaminophen can help to reduce your fever and make you more comfortable. Keep in mind that a fever is a function of your body's immune system to fight the infection. If your fever is mild and tolerable, you may want to avoid fever-reducing medications. In serious and advanced illness, fever and inflammation become harmful and should absolutely be treated. Consult with your healthcare provider if you have any questions.
Recently, claims have been made that NSAIDs can actually advance coronavirus infection rather than helping. The thought is that these medications increase an enzyme that help the virus enter human cells. However, the evidence on this is limited. In response to this, the World Health Organization has formally declared that they do NOT recommend against the use of NSAIDs at this time. In other words, if you are taking an NSAID for another condition, you can continue to take it. Furthermore, the FDA states that they are unaware of scientific evidence linking NSAIDs to worsening COVID-19 symptoms. They will continue to investigate this issue and communicate any new developments with the public.
If you wish to avoid NSAIDs but need relief from pain or fever, opt for acetaminophen. Acetaminophen has an entirely different mechanism of action than NSAIDs, and it is safer for people with underlying conditions, like heart and gastrointestinal conditions or kidney disease. Always understand that any medication, including over-the-counter cough and cold medications, are never without potential side effects. Acetaminophen can be taxing to the liver and should never be taken at higher than the recommended dose. Read the Drug Facts Label on OTC medications prior to use.
Cough medications can help calm your cough, which in turn helps to lower the transmission of disease. However, many cough medications are on the FDA No-Go List for flying. Please review the list HERE before purchasing and using ANY cough and cold medication if you plan to fly.
Other immune-boosting supplements to consider bringing on your trip are Vitamin C, Zinc, Vitamin D3 and probiotics. When choosing a probiotic, ensure that it does not require refrigeration if you plan to take it on a trip. One option is made by Raw Probiotics, but many good options exist. Keep in mind that probiotics are also in fermented foods such as kombucha, kefir, sauerkraut, kimchi and many yogurts.
The vitamins and supplements listed here are often found in combination. Please read the label and pay attention to what you're taking so you avoid doubling up on any one ingredient. While limited evidence exists to the benefit of these vitamins and supplements in fighting coronavirus, they have shown efficacy as immune boosters in other situations.
Elderberry syrup, a natural product commonly used as an immune enhancer, has been called into question for use in COVID-19 infection. The concern is that since elderberry syrup increases inflammatory cytokine production, it could potentially lead to a dangerous and sometimes fatal condition called Cytokine Release Syndrome (CRS) during coronavirus infection. Simply put, we do not have enough evidence to determine whether or not elderberry syrup causes an elevated risk of CRS. If this concerns you, or if you have ever reacted negatively to elderberry, then avoid it.
Of course, the best thing you can do to defend yourself against the coronavirus, or any illness, is to take care of your body. Stay hydrated, eat a balanced diet that includes plenty of fruits and vegetables, manage stress, exercise regularly, avoid alcohol and other substances and get plenty of rest.
New information regarding the guidelines surrounding the coronavirus is being released every day. We will work hard to keep you up-to-date as the situation progresses. Please let us know if you have any further questions or concerns, and we will do our best to provide with you timely and accurate information.
-Lindsey Palmer, PharmD, MBA
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