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The Airline Conundrum Of Flying Sick Passengers

This article is more than 2 years old.

The Wall Street Journal published a piece this week about airlines carrying sick passengers, and how this issue has become more important in today’s pandemic-sensitive world. The column rightly points out that airlines face a difficult choice here: let sick passengers travel as they had originally planned or open a pandora’s box of problems by letting anyone change their ticket because they say they are too sick to fly.

No one, including the airlines, wants passengers onboard a plane that could transmit diseases to other passengers and crew. Yet airline rules essentially encourage this behavior by creating an economic penalty for passengers who must change their flight because of illness. Is there a time when airlines should give in and allow a flight change for no penalty?

Removal Of Change Fees Helps, But Doesn’t Solve The Problem

The recent removal of change fees from many tickets would seem to help, and it does. Changing a ticket used to have a cost in two ways: the fee to change itself, and the difference in price between the flight originally purchased and the new flight requested. This second fee is often called the “add-collect”, and for sick passengers this is the biggest economic challenge. If a passenger is sick and wants to fly on a later date, it is most likely that the price of the newly requested flight on the day the illness is recognized is higher than the original flight. That’s because, again most likely, the purchase is being made closer to the departure date. Not additionally charging a fee just to make the change removes some of the economic penalty, but keeping the add-collect leaves the airlines in the tough spot of essentially asking someone to fly sick.

Sick And Contagious Aren’t The Same Thing

“Sick” is a broad term and can even mean different things to different people. What airlines really should try to prevent is putting contagious people onboard. Many illnesses are not contagious, and not all contagious people show signs of illness initially. This creates a likely unsolvable problem for airlines, unless the world can produce an economically efficient fast test that shows if you are or aren't contagious with something that could harm others. Without this, airlines will continue to unknowingly board contagious but seemly healthy passengers. Without clear guidelines of what visible symptoms suggest contagion risk, just feeling or looking sick isn't enough to say “we’ll waive the add-collect”.

Going To Work Versus Flying

When do you stay home from work if sick? Presumably for the same kind of reasons you might think it’s better not to fly. But if you stay home from work, one of two things happens. For some jobs, another person has to step in and do it for you while you are out. For others, you can stay home but are still expected to complete your work over a period of time even if some of that time is not in the office. Neither of these cases works for airline — they can’t likely re-sell the seat you give up if you decide just before flight time that you are too sick to travel. Flying later, like completing all of your work, fills a seat on a different flight but the airline loses the revenue from the current flight forever. Airline seats spoil, as I have written before, and this means an economic penalty is paid if the customer must change at the time of the flight. The question becomes who pays this penalty — the customer, the airline, or the other passengers on the flight who might be exposed?

Going To School Versus Flying

Schools have faced the issue on when to let sick kids come to class for centuries. Like an airplane, schools don't want students in a classroom if they will make everyone else there sick also. Most schools follow a simple guideline of when to keep a child home from school: fever, diarrhea, vomiting, heavy cough, pinkeye, or rashes. Stomachaches, general discomfort, runny nose, and ear infections aren’t a reason for most students to stay home. Translating this to airline passengers, hangovers wouldn’t apply, along with many other things that make us, as adults, generally feel like not working or flying. The challenge for airlines is how to check for these conditions and what to do if they are present. Again this is likely an unsolvable problem without some real-time quick test.

Why Letting Customers Decide Won’t Work

Allowing customers to change at will, which is what would happen if airlines let customers decide if they are too sick to travel, would create an untenable situations for airlines. Overbooking would increase, as the likelihood for a confirmed passenger not showing up would increase. This activity would be hard to predict although forecasting would get better over time. Still, the industry would face more empty seats (the problem from not overbooking enough) and more situations of involuntary denied boardings (the problem from overbooking too much). In either case, the only tool the airlines would have to cover these increased costs would be higher fares, and that is exactly what more customer flexibility would create. Higher fares means less overall air traffic, as air traffic is highly price elastic.

Insure, Or Self-Insure

Insurance is available to help cover costs incurred if you get sick while traveling. This isn't free and must be purchased in advance, and it is likely that most customers will not find it useful to insure every flight in case of illness. The alternative is to self-insure, meaning to recognize that when you actually are sick, you will pay something as a consequence of the illness. Over time, this would be much cheaper than purchasing insurance for each flight.

Trust In Your Fellow Man Or Woman — And Take Care Of Yourself

The word “conundrum” is the head line is accurate — this is truly a confusing and difficult problem to solve. You cannot go to a grocery store and be free from contagious customers who chose to shop at the same time. You can eat at a restaurant and be seated next to table with someone who was too sick to go out to eat, but went anyway. The point is that we trust people we don't know all the time to behave in ways that won’t hurt us. And, most of us have the sensibility and empathy to not pass our troubles to others. It may cost you something to change your flight when you are sick, but if that is the right thing to do, you should do it if you can. It’s no different than choices we make in other parts of our life when we get sick — we recognize that we must act differently for a while and we live with those consequences. This trust is the only practical thing we have in the case of flying sick passengers. We can also take care of ourselves, including continuing to wear a mask when we aren’t feeling well and are around other people. One of the positive cultural outcomes of this pandemic is that we all have masks and no one looks odd wearing them. They can keep us safe from spreading colds and other diseases too, so let’s keep using them when it makes sense. There is no quick test for contagion, and no economic reality to let customers make the call. When you step back and think about this, it isn't so bad. We trust people all the time, and should be willing to in these cases also, while doing what we can to stop spreading diseases.

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