I am just an ophthalmologist. I have no special training in hygiene or tropical medicine,
and I am not reporting on a special case or treatment but on a layman’s observation
on hygiene in airports. As anybody going on holiday to Southeast Asia, I just took
the usual precautions: antibiotics in case of diarrhea, disinfectants, masks, etc.
Nothing was known about the 2019 novel coronavirus disease (COVID-19) at that time
when the journey was planned. Time went on, and then came the COVID-19 outbreak in
China. People were astonished and curiously watching hospitals being erected in China
within 2 weeks on TV. But here in Europe, people were relaxed. It was all far away.
Fear only grew as more and more news about the outbreak of COVID-19 reached the world.
People were canceling their holidays not only to China but also to other countries.
Warnings concerning economic growth were issued worldwide as the virus spread. Suddenly,
people became aware how vulnerable they would be in a world where infectious particles
could spread in 24 hours by plane.
The less it was known about the disease, the more fantastic the stories spread. For
example, many of the Cambodians I met believed that the virus could not survive more
than 30°C. This was why they were safe, whereas the Chinese were in danger in Wuhan
because the climate there would be much colder. But why would our authorities calm
the public that the disease was not that dangerous, while one could see quarantine
and other measurements being taken up at the same time and while the daily death toll
in China and other countries kept rising?
Anyway, we decided not to cancel the trip. Coming from Europe, we had no special treatment
to expect when landing in Bangkok. All passengers had to pass an infrared camera to
single out febrile passengers. But the camera was not positioned at the gate where
we disembarked, but at the junction of several terminals where passengers form all
over the world were passing by to find their way either to the exit or to a connecting
flight. We passed the infrared camera very fast in a single line. Some people were
wearing facial masks—nothing uncommon for Asia. No questions were asked. Nobody was
stopped. Anyway, the shear mass of passengers passing by would have clogged up the
capacities of the controlling personnel in my view.
What struck me more was the frequent control of documents. Personal security and terrorism
obviously played a bigger role in the authorities’ minds than health. I counted four
different passport and boarding pass checks, where my documents were physically handled
before the connecting flight. All of the security personnel took my passport and boarding
pass, as well as those of hundreds of other passengers, in their bare hands. There
seemed to be a strong need for a haptic control of documents.
I felt a bit uneasy. It was reported at that time that China was collecting and disinfecting
old banknotes to prevent the spread of COVID-19. The mode of transmission of the disease
still was partly in the dark: could there be smear infection as well? When I asked
to be allowed to use one of the few disinfectant dispensers, a friendly officer pushed
the pump on the dispenser with her bare hands.
Finally, we made the connecting flight. Several times it was announced that the flight
attendants were required by their airline to wear facial masks to inhibit the spread
of the virus. They only had very simple masks, just good enough to avoid a direct
hit of big droplets if somebody sneezed. As soon as the attendants were seated themselves,
they took the masks off and put them on again when serving the passengers. I thought
about what I knew about air conditioning in planes. Not very much. Do they use fresh
air or is air kept in circulation? What filters do they use?
Landing in Siem Reap was no different. The procedure of obtaining a visa on arrival
was like a flashback to past times. Passengers were lining up in front of a huge desk
with uniformed officers looking fierce. There were about 10 in a line. The procedure
was simple. You handed in your passport and paperwork to the first officer and paid
your dues. Then, you advanced along the desk at the same time as your passport was
handed from one officer to the other being processed. The lack of machinery made this
process a quite efficient and fast way to issue the visa—and spread particles. And
yes, you would guess right that documents were manipulated by bare hands and there
was no disinfection of said hands to be noticed.
Cambodia is a beautiful country with a wealth of cultural sights. I had it mostly
for myself as tourists were rare at the time when the Westerdam crisis occurred. You
might remember, the Westerdam was a cruise liner suspected to carry passengers being
infected with the SARS-CoV-2. It was turned away from several countries before being
allowed to dock in Cambodia. The passengers were allowed to leave and apparently had
insufficient medical screening before being allowed to go on their way. As a result,
Thai authorities raised vigilance for arrivals from Cambodia. I already thought that
I was going to get stuck in the Bangkok airport on my way back.
But none of that happened. I thought that health controls would now take place right
at the gate of the docking plane. But I was wrong. Again, we passed an infrared camera
at the juncture of several terminals. Multiple times my passport and boarding pass
were checked in the manner described earlier, but this time I had to give fingerprints
at the immigration checkpoint. Laser scanners were used to this purpose, and I had
to put all fingers and thumbs on a glass screen to be scanned.
The glass screens were full of fingerprints of previous passengers and even remnants
of food, I guessed. A sign told passengers that the fingerprint screens were cleaned
every hour. I was trying to figure out how many passengers would put their fingers
on such a fingerprint scanner within 1 hour when I was suddenly stopped at the exit
of the control unit.
It was now that the authorities became aware that I was arriving from Cambodia after
having traversed half of the airport. I was asked to wait separately with two or three
other passengers having the same fate. My passport was once again scrutinized manually
by several officers. There was excitement, and it seemed that they did not quite know
what to do with me, and while there was some discussion among the officers, other
passengers slipped through the controls simply because there was nobody at the desks.
Finally, after some time, an officer returned to me with my passport, handed it over,
and asked me whether or not I had passed the infrared camera. She was very polite
and apologized for the inconvenience. When I confirmed, I was free to go.
Now, why would one tell such a story, which is—after all—not extraordinary for the
readers of this journal. It is certainly not to blame authorities at airports. This
could be happening at any airport anywhere in the world.
This trip made me think that humankind is simply not prepared for the COVID-19 outbreak.
The next virus or infectious particle is sure to come. It might be much worse. In
addition to the need for scientific progress in this field, we also have to change
some of our habits, and we need to educate. Precaution, understanding, and hygienic
habits must become the rule for everybody. Otherwise, quarantine and other measures
of enforcement will not be sufficient to limit future outbreaks.