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Washington, May 27: Most viruses and other germs do not spread easily on flights, the US Center for Disease Control and Prevention has said in its COVID-19 guidelines which do not recommend following social distancing between two passengers inside a plane or keeping the middle seat unoccupied.

As a result of coronavirus pandemic, air traffic inside the US has come to a near halt. Air traffic is said to be down to about 90 per cent. For all travellers coming from overseas, the Center for Disease Control and Prevention (CDC) has recommended 14 days quarantine.

"Most viruses and other germs do not spread easily on flights because of how air circulates and is filtered on aeroplanes," the CDC has said in its set of COVID-19 guidelines for air travellers.

However, it noted that the air travellers were not risk-free especially in the time of the coronavirus pandemic and recommended Americans to avoid travel as far as possible.

"Air travel requires spending time in security lines and airport terminals, which can bring you in close contact with other people and frequently touched surfaces," it said.

"Social distancing is difficult on crowded flights, and you may have to sit near others (within six feet), sometimes for hours. This may increase your risk for exposure to the virus that causes COVID-19," the CDC said.

But instead of recommended social distancing inside commercial planes, the CDC has advised a series of preventive and hygienic measures to be taken by the airlines pilot and crew to prevent the spread of coronavirus.

The US Department of Transportation and Federal Aviation Administration in its latest safety alerts for operators on May 11 said that air carriers and crews conducting flight operations having a nexus to the US, including both domestic and foreign air carriers, should follow CDC's occupational health and safety guidance.

The CDC issued its guidelines in first guidelines for the airlines and airline crew on March and again in May.

The CDC, which has issued an exhaustive social guideline measures in various sections, is silent on keeping the middle seat of a plane unoccupied so as to maintain the six feet distance between two passengers.

It calls for the plane crew to report to the CDC a traveller with specific COVID-19 symptoms like fever, persistent cough, difficulty in breathing and appearing unwell.

Asking the airlines and cabin crew to review infection control guidelines for cabin crew, the CDC recommends several measures for cabin crew to protect themselves and others, manage a sick traveller, clean contaminated areas, and take actions after a flight.

Prominent among them include washing hands often with soap and water for at least 20 seconds, particularly after assisting sick travellers or touching potentially contaminated body fluids or surfaces and use of alcohol-based hand sanitizer (containing at least 60 per cent alcohol) if soap and water are not available.

Airlines should consider providing alcohol-based hand sanitizer to cabin and flight crews for their personal use, it said.

The CDC guidelines do not recommend following social distancing inside a plane between two passengers or keeping the middle seat unoccupied. But it asks to minimise contact between passengers and cabin crew and the sick person.

"If possible, separate the sick person from others (by a distance of 2 meters or 6 feet, ideally) and designate one crew member to serve the sick person. Offer a facemask, if available and if the sick person can tolerate it. If a facemask is not available or cannot be tolerated, ask the sick person to cover their mouth and nose with tissues when coughing or sneezing," said the CDC guidelines.

If no symptomatic passengers were identified during or immediately after the flight, the CDC recommends airlines to follow routine operating procedures for cleaning aircraft, managing solid waste, and wearing PPE.

"If symptomatic passengers are identified during or immediately after the flight, routine cleaning procedures should be followed, and enhanced cleaning procedures should also be used," it said.

Clean porous (soft) surfaces (e.g, cloth seats, cloth seat belts) at the seat of the symptomatic passengers and within 6 feet of the symptomatic passengers in all directions, it added.

The death toll in China's coronavirus rose sharply to 425 with 64 deaths on Monday alone while 3,235 new confirmed cases were reported, taking the number of those infected with the deadly disease to 20,438, Chinese health authorities said on Tuesday.

The 64 people who died on Monday were all from the Hubei province, the epicentre of the virus, China's National Health Commission said.

Also, 3,235 new confirmed cases of novel coronavirus infection were reported, a big increase in a day.

Another 5,072 new suspected cases were reported on Monday, said the commission, adding that 492 patients became seriously ill.

The commission said that 2,788 patients remained in severe condition and 23,214 people were suspected of being infected with the virus, a pointer that it is increasingly turning virulent.

The overall confirmed cases on the Chinese mainland had reached 20,438 by the end of Monday, the commission said, noting that a total of 425 people had died of the disease.

A total of 632 people had been discharged from hospital after recovery, state-run Xinhua news agency reported As the virus spreads from human to human, 221,015 close contacts had been traced, with 171,329 others still under medical observation.

By the end of Monday, 15 confirmed cases had been reported in Hong Kong, eight in the Macao and 10 in Taiwan.

The Philippines reported the first overseas death from the virus on Sunday while 148 cases have been reported from abroad.

India has reported three cases of the coronavirus. All the three patients from Kerala recently returned from the affected Wuhan city.

Currently, 647 Indians and seven Maldivians who have been evacuated from Wuhan and Hubei are in 14-day quarantine at a medical camp in Manesar, near Delhi.

As the virus continued to spread at an alarming rate, Chinese President Xi Jinping on Monday warned officials of punishment if they shirked responsibility in tackling the virus outbreak.

On Monday, China has opened a 1,000-bed hospital built in record nine days in Wuhan city and started trials for new drug to contain the virus and is set to open another 1,300 bed hospital next to it on Wednesday.

The ruling Communist Party of China on Monday held its political bureau meeting presided by President Xi to review the steps being taken on various fronts to halt the spread of the deadly virus.

The outcome of the epidemic prevention and control directly affects people's lives and health, the overall economic and social stability and the country's opening-up, Xi said.

"Those who disobey the unified command or shirk off responsibilities will be punished," Xi was quoted as saying by the state-run Xinhua news agency.

Xi said that the party and government leaders supervising them would also be held accountable in severe cases.

Chinese armament firms, including those building aircraft carrier and military aircraft, have postponed planned work in order to concentrate on controlling the risk of coronavirus, state-run Global Times reported.

Noted Chinese health expert Zhong Nanshan has said that based on the fresh evidence, the novel coronavirus, which is spreading rapidly in China and the world, may reach its peak in the next 10 to 14 days, contrary to earlier estimates of climaxing sooner.

This means that the cases would drastically increase in the next two weeks before slowing down.

Also, China has begun clinical trials to test a drug to treat the patients of the coronavirus which till now has no cure.

Currently, patients are being treated with a combination of antivirals and other measures, as scientists race to find a vaccine.

Some reports said drugs to treat HIV too was being tried to treat the patients.

The experimental antiviral drug, Remdesivir, to be tested in field trials is developed by US-based Gilead Sciences. It is aimed at treating infectious diseases such as Ebola and SARS, South China Morning Post reported.

It was given to the first US patient last week - a 35-year-old man whose condition appeared to improve within a day, it said.

May 20: The novel coronavirus is behaving differently in patients in northeast China who have contracted it recently compared with early cases, indicating it is changing as it spreads, a prominent doctor said.

China, which has largely brought the virus under control, has found new clusters of infections in the northeastern border provinces of Jilin and Heilongjiang in recent weeks, raising concern about a second wave.

Qiu Haibo, an expert in critical care medicine who is part of a National Health Commission expert group, said the incubation period of the virus in patients in the northeast was longer than that of patients in Wuhan, the central city, where the virus emerged late last year.

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"This causes a problem, as they don't have any symptoms. So when they gather with their families they don't care about this issue and we see family cluster infections," Qiu told state broadcaster CCTV in a programme broadcast late on Tuesday.

Patients in the northeastern clusters were also carrying the virus for longer than earlier cases in Wuhan, and they were taking longer to recover, as defined by a negative nucleic acid test, he said.

Patients in the northeast also rarely exhibited fever and tended to suffer damage to the lungs rather than across multiple organs, he said.

He said the virus found in the northeastern clusters was probably imported from abroad, which could account for the differences.

He did not say where he though they might have come from but both Jilin and Heilongjiang border Russia.

China reported five new coronavirus cases on Wednesday, down from six a day earlier.

Four of the new cases were local transmissions and one was imported by a traveller coming from abroad, the commission said in a statement, compared with three imported cases reported the previous day.

China's total number of coronavirus infections stands at 82,965, while the death toll 4,634.