My opinion

By Dr. Deepak Gupta , Dr. Sarwan Kumar , Dr. Berhane Seyoum
Corresponding Author Dr. Deepak Gupta
Wayne State University, - United States of America
Submitting Author Dr. Deepak Gupta
Other Authors Dr. Sarwan Kumar
Wayne State University, Internal Medicine, - United States of America

Dr. Berhane Seyoum
Wayne State University, Internal Medicine, - United States of America


Masks, Flyers, Long-Haul Flights, Hypoxia, Hypoglycemia, High Altitude

Gupta D, Kumar S, Seyoum B. Can Long Straw Sipper Bottle Keep Masked Flyers Calm During Long-Haul Flights? It Maybe Worth Investigating. WebmedCentral PUBLIC HEALTH 2021;12(7):WMC005728

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 22 Jun 2021 11:11:24 PM GMT
Published on: 06 Jul 2021 07:37:12 AM GMT

My opinion

Incidents of bad behavior during flights are growing most likely due to the mandates to wear masks. These badly behaving flyers may blame it all on their intolerance to wearing masks especially during long-haul flights. The critics of these badly behaving flyers may blame it all on these flyers' belief systems preventing them from adhering to mandatory regulation to wear masks. However, the experts should consider exploring [1-14] whether hypoxemia and hypoglycemia are additively or synergistically interfering in mask mandates' adherence among flyers. A simple way to explore and maybe fix this issue can be by providing flyers the option to have personal long straw sipper bottles (Figure 1) filled with either oral rehydration salts' solutions (if available at airports) to keep their plasma electrolyte levels physiological [15-17] or non-alcoholic liquids (freely available at airports) of their choices to keep their behavior levels manageable. Although the old sexist adage "husbands' hearts are routed through husbands' stomachs [18-19]" was designed to school the women in old-fashioned ways, path to all human minds and thus their behaviors originates at their guts because hungry brains are cranking for attention with soaring adrenalines in the bodies tapping into their dwindling energy reserves when those starving bodies are going through survival mode.

The questions to be asked and answered are the following:

  • When high-flying airplanes' cabins are pressurized up to the atmospheric pressure levels as observed at the altitude of 8000 feet above sea-level [20-23], won't pilots and cabin crew demonstrate the chronic effects of living at 8000 feet above sea-level while flyers will be demonstrating the hyper-acute and acute effects of living at 8000 feet above sea-level [1]?
  • If the above-mentioned is true, won't hypobaric hypoxia happening during long-haul flying induce glucose metabolism shifts as seen among lowlanders hyper-acutely or acutely moved to high altitude of 8000 feet above sea-level [1]?   
  • If the above-mentioned is true, won't this hyper-acute and acute hypobaric hypoxic condition-induced glucose metabolism's disarray be worsened among mask-wearing flyers unless this disarray is somewhat attenuated by increasing the high-flying airplanes' cabins' pressures from being equivalent to 8000 feet above sea-level to being equivalent to 5000 feet above sea-level [24]?
  • If the above-mentioned is true, won't flyers need to monitor their plasma glucose level fluctuations by finger-stick blood tests or continuous blood glucose monitors or glycosuria testing by urine dipsticks during their long-haul flights [25-26]?
  • If the above-mentioned is true, won't flyers during long-haul flights find themselves to be hyper-acutely and acutely hyperglycemic as a paradoxical response to hyper-acute and acute exposure to controlled high-altitude conditions within airplanes' cabins unlike, in response to chronic exposures to controlled high-altitude conditions within airplanes, pilots and cabin crew may be demonstrating chronic hypoglycemia which is not so dissimilar to so many other healthcare conditions uniquely demonstrated by pilots and cabin crew [1, 27-29]?
  • If the above-mentioned is true, won't flyers during long-haul flights eventually be in energy-depletion phase at controlled high-altitude conditions within airplanes' cabins unless they actively supplement their energy needs with long straw sipper bottles filled with hydrating and energizing fluids of their choices to be continuously accessible under the masks without the need to doff the masks to replenish the glycogen stores of their bodies [1]?
  • If the above-mentioned is true, won’t long straw sipper bottles replenish the body stores when the preexisting water losses among flyers secondary to cold-temperature induced diuresis at controlled high-altitude conditions inside airplanes’ cabins may get exaggerated by the water losses induced by hot and humid microclimates under flyers’ masks [30-42]?

Summarily, there are many physiological questions to be raised and resolved instead of prematurely and preemptively denouncing flyers' behaviors to be arising from their belief systems against masks and mask mandates.




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  15. Oral Rehydration Salts ORS (50, One Liter Packets/Box) World Health Organization (WHO) New Formula for Food Poisoning, Hangovers, Diarrhea, Electrolyte Replacement.
  16. Maddak Plastic Hydrant Water Bottle, 1-Liter (745820000).
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  25. What Can I Bring With Me on the Plane. https:/ /
  26. Diabetics May Still Put Flying in Their Diets. s-flying.asp
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  28. Mortality from Cancer and Other Causes among Airline Cabin Attendants in Germany, 1960–1997. 6/6/556/152938
  29. Why Do Airline Pilots and Flight Crews Have an Increased Incidence of Melanoma? rnals/jamaoncology/fullarticle/2293944
  30. Effects of metered versus bolus water consumption on urine production and rehydration.
  31. PulmCrit: Myth-busting the fluid bolus.
  32. Cold diuresis during targeted temperature management after cardiac arrest, myth or fact? https://academic.o
  33. Urine Output Changes During Postcardiac Arrest Therapeutic Hypothermia. es/PMC3868285/
  34. Cold and warm infusion of Ringer's acetate in healthy volunteers: the effects on haemodynamic parameters, transcapillary fluid balance, diuresis and atrial peptides.
  35. 10 warning signs of dehydration. And staying hydrated while wearing a mask. atch-out
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  37. The Surprising Reason Why It's Always So Cold On Airplanes (Video). https://www.trav
  38. Why is it so cold on a plane? https://www.telegrap
  39. Once you step on a plane, it's sweats to shivers in five minutes flat. https://www.
  40. Why Is It Colder at the Top of a Mountain Than It Is at Sea Level? https://
  41. Why is it colder at a higher altitude when technically it is closer to the sun? 61
  42. If heat rises, why does the temperature decrease at higher elevations? https://www.scientifica

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