The moral dilemma of travelling if you are sick with COVID

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This was published 1 year ago

The moral dilemma of travelling if you are sick with COVID

By Siobhan Downes
In theory, airlines shouldn't let you fly if you're unwell.

In theory, airlines shouldn't let you fly if you're unwell.Credit: iStock

Your flights are booked, your bags are packed. Then the night before your holiday, you feel a sore throat coming on. What do you do?

Of course, you're supposed to take a COVID-19 test. If it's positive, here in New Zealand, you're still required to isolate for seven days (though this measure is set to be reviewed this month).

But that little devil on your shoulder – the one who is really looking forward to spending some time by the pool with a cocktail – might be whispering, "what if I just ignore my symptoms, and don't take the test?"

It's a scenario that would have been next to impossible a few months ago, when many countries still required negative pre-departure tests to be able to board a flight.

And it would have been unthinkable a year ago. There was outrage in New Zealand when a British DJ broke the isolation rules, travelled to Waiheke Island and went clubbing in Auckland before he got his test results back – which turned out to be positive?

"If I hear somebody arrives in New Zealand, tests positive and then goes out in the community – maybe they go on a trip to Waiheke Island, they don't wear a mask and don't take any precautions – I have to say, my sense of outrage would be no less [now]," says Dr Marco Grix, a lecturer in philosophy at Massey University.

But the context now is very different to a year ago. Back then, we were all about the team of five million. These days, avoiding COVID-19 is largely a personal responsibility. We've had the opportunity to be vaccinated and boosted, which reduces the likelihood of severe illness and death. We also have tools like antiviral medications, for those who are most at risk.

Still, there's that seven-day isolation requirement – which New Zealand's Acting Minister for COVID-19 Response Chris Hipkins said last month was continuing to prove effective in "dampening the impact of the virus on the health system and in protecting the most vulnerable".

In New Zealand, travelling after testing positive – or neglecting to test when you know there's a good chance it will be positive – is pretty obviously the wrong thing to do, as it's breaking the law.

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But what about countries like Australia or the UK, where isolation is no longer mandatory? If you catch COVID there, can you feel ok about carrying on with your sightseeing plans?

As Grix points out, it then becomes a "purely ethical question".

"It might not be illegal to go out and spread the virus, if you're so inclined, but there's a reason why we do have that isolation period in this country," he says.

"It's a very straightforward reason – we want to prevent the spread, even in a place like ours where vaccination rates are so high.

"Why would that same rule, ethically speaking, not also apply somewhere else?"

This ethical question comes into play when there is no punishment for doing the "wrong" thing, but also, when there is no reward for doing the "right" one.

While earlier in the pandemic, many travel operators offered customers the opportunity to change their travel dates for free, hold their booking in credit, or even get a full refund, these days, standard cancellation policies are likely to apply to your COVID sob story.

Grix said that's not surprising, considering people are now well aware of the risks, and should be taking them into account in their trip planning, such as by purchasing travel insurance.

But another good idea, says University of Otago public health professor Michael Baker, would be to do whatever you can to avoid getting sick in the first place, whether it be by staying away from crowded places or wearing a high-quality face mask in the week before your trip.

Ideally, this would be out of concern for your fellow passengers – but "from a purely selfish perspective", there are plenty of reasons why you wouldn't want to have COVID when travelling.

"It may just ruin your trip... you may feel miserable the whole time you're away."

In the worst cases, COVID could put you at increased risk of blood clots, that could lead to life-threatening heart attacks, strokes or pulmonary emboli. Baker says this can be even more dangerous on a plane, when you're already at increased risk of deep vein thrombosis.

In theory, airlines shouldn't let you fly if you're unwell. Jetstar said if a passenger was showing symptoms of illness – they described this as "vomiting or visibly contagious" – staff would deny them boarding.

But as anyone who has ever found themselves stuck beside a sneezing, coughing passenger knows, this is not always enforced – leaving a grey area for travellers.

This was a conundrum Stuff Travel journalist Brook Sabin was recently faced with. Two days before he was due to fly home from a holiday in the Maldives, he developed a sore throat, which progressed to a cough. The day he was due to fly home, he was feeling at his worst.

Credit: Brook Sabin/Stuff

He'd taken COVID tests, which were negative, and was confident it was just a cold – something that a few years ago, he wouldn't have given a second thought.

"I would have just got on the plane."

Sabin's insurance looked like it would only cover disruption if he was declared medically unfit to fly. He debated going to a doctor – but that would have involved travelling from the island he was staying on to the capital, Male. There were also limited available flights back home.

"It seemed like too much complexity to deal with."

He ended up carrying on with his travel plans, but took precautions by wearing a quality face mask, which he only removed about four times over the 26-hour journey to eat.

If Sabin had returned a positive result in the Maldives – which like New Zealand, still has a seven-day isolation requirement – there would have been no question.

"Isolating at a resort in the Maldives courtesy of the insurance company wouldn't have been the worst thing in the world," he said.

"I personally wouldn't fly with COVID."

Stuff.co.nz

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