Guidelines for public and mass transport, and COVID control

Guidelines for public and mass transport, and COVID control

29 Jun 2020
Measures against Epidemics

Guidelines for public and mass transport, and COVID control

19, 06, 2020 - # COVID-19 #SafeTransport

From the Collaborative Modeling Group of COVID and Mobility in Colombia (see authors, affiliations and logos below) we will describe changes in transportation to continue returning to normal. The main purpose has been to investigate how to increase the operational capacity of public transport in Colombia while maintaining adequate infection control.

Although there is strong evidence of a powerful correlation between mobility and COVID effective reproductive number, particularly in situations of high restriction, there is also growing evidence of a potential de-correlation when other sufficiently effective measures of personal protection and infection control are implemented. This would allow better balance between infection control and “reopening” of daily activities and economic sectors.

Even so, there is also evidence of super-propagation events in mass transportation systems, so measures must be taken to avoid them. Something very relevant is the fact that a large part of these super-propagation events are initiated by people in an asymptomatic or pre-symptomatic state.

It should be noted that the transparent and open management that various institutions have had towards the data they generate in their daily activities has served to provide decision-makers, academia and the general public with an increasingly precise idea about the changing reality of COVID-19 and its relationship with transportation. The appearance of public databases with information that a few years ago would have been almost impossible to access (e.i. geo-localized epidemiological and population information, disaggregated data on use in public transport systems or information on mobility trends), are now tools with which we can face the emergency more and more effectively.

After reviewing different technical reports and publications, we have compiled a series of specific recommendations for infection control in public transport.

Users upon entering the station:

• Wear a mask permanently covering the mouth and nose simultaneously; it is for your protection and of the people around you. Remember that the mask should be changed at least daily or whenever it potentially becomes contaminated.

• Try to keep distance of more than 1 meter from the other passengers.

• Do not greet with kisses, hugs, or hands.

• Do not eat or drink inside the station.


Users during the trip:

• Avoid touching your face while traveling. Your hands can become contaminated with surfaces of the transport system and touching your face can infect you.

• If you need to cough or blow your nose, cover your nose and mouth with your forearm and use disposable tissues, then wash your hands or apply glycerinated alcohol.

• Avoid being around people with flu-like symptoms (fever, cough, sneezing).

• Try to keep distance of more than 1 meter or a chair in between with other passengers.

• Avoid talking on the bus (do not sing, do not talk, preferably keep silent).

• Avoid eating or drinking on the bus.

• Avoid interaction with the driver as much as possible.

Users when leaving the station:

• Carry out handwashing with soap and water when you reach your destination and have contact with the soap for at least 20 to 30 seconds.

• Clean electronic devices when leaving the transport station if they have been used (cell phone, tablet, watches, among others).


Vehicles and facilities conditions:

1. It is recommended that vehicles do not have recirculating air conditioning. Natural air circulation is preferred.

2. To promote physical distance, it is recommended to have visual indications in chairs and on the floor both outside and inside the transport system. These signs must be at least one meter apart.

3. Strengthen measures to avoid the formation of crowds and lines. If lines are unavoidable, consider rearranging station flows and internal layout in order to maintain secure lines that preserve physical distance.

4. Strengthen and intensify cleaning programs for transport facilities and vehicles with which the public transportation service is provided. Particularly, disinfecting surfaces and elements that are frequently touched.

5. Clean the vehicles as often as possible, at least daily and at the end of the work.

6. Install handwashing stations within the system with the indication of ideal handwashing before boarding the bus and in case of transfer.

7. Promote automatic door opening in all seasons to avoid the need to press buttons.

System operation:

1. Promote electronic payment systems to reduce crowding at payment points.

2. Promote the staggering of schedules in companies and trades, teleworking and, as far as possible, trips on foot and by bicycle.

3. If the vehicle has windows, they must all be open.

4. Encourage changing the position of chairs when they are facing each other.

5. Monitor occupancy in entrances, stations, and vehicles permanently.

6. Carry out an inventory and strict monitoring of symptoms to personnel who work in this means of transport because they are in continuous contact with users.

7. Strengthen mechanisms for physical distancing and safe transportation for people with disabilities.

8. Promote the investigation of potential super-propagation situations in transport


About symptoms in stations and buses:

If upon entering the station or during the trip you experience symptoms such as dry cough, fever, sore throat, shortness of breath, fatigue or extreme tiredness, diarrhea, alteration of taste or smell, confusion of recent appearance, WATCH OUT! You must contact personnel designated by the system and participate in the registration system that is defined. It is important that you return home and depending on how you feel during the day, you should contact the emergency numbers in your city. If your health condition worsens and you have not received medical attention, you should go to the emergency department with all personal protection measures.

These recommendations are based on research where outbreaks have been documented, indicating that the measures listed here substantially reduce the risk of contagion. A consultation was also made from various sources in countries where the mechanisms of contagion have been better understood and public transport and its risks of contagion have been valued.

These data have also been validated by researchers from the National University and simulations performed for the Medellín Metro case.

The individual recommendations are based on the guidelines and recommendations of the Ministry of Health and Social Protection, the National Institute of Health and the Colombian Association of Infectious Diseases.

Collaborative Modeling Group Colombia COVID19 – Transport

Authors of this document: Andrea Ramirez Varela, Catalina González Uribe, Andrés Burbano, Alejandro Calderón (Universidad de los Andes); Rafael Hurtado Juan David García, (Universidad Nacional de Colombia - Bogotá); Zulma M. Cucunubá (Imperial College London); Jairo José Espinosa Oviedo, Daniel Ramírez Corrales y César Augusto Gómez (Universidad Nacional de Colombia - Medellín), Silvana Zapata Bedoya (Gobernación de Antioquia - DAP); Diego Zapata Córdoba (Alcaldía de Medellín); José David Pinzón Ortiz (Arquitectura, Territorio & Ciudad); Carlos F. Pardo (NUMO Alliance); Dario Hidalgo, PhD (Investigador en Transporte Sostenible y Seguridad Vial)

Acknowledgments for data submitted for analysis: Transmilenio SA. y Metro de Medellín

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Relevant links:


Publications in Colombia

Alejandro Tirachini: How about we stop repeating that public transport is risky?

https://medium.com/@alejandro.tirachini/y-si-dejamos-de-repetir-que-el-transportep%C3%BAblico-es-riesgoso-7f05615c0eec

TUMI initiative (thread with links to various cases)

https://twitter.com/TUMInitiative/status/1266662574453673985?s=20

Editorial Journal of Transport and Health: evidence does not support the effectiveness of suspending public transport as a preventive measure, despite the relevance of public transport for individual risk of infection, there is a greater threat in exposure at home

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174824/

Although it was found that the use of crowded public transport vehicles can be associated with the acquisition of infectious diseases, it can be argued that these findings do not support the effectiveness of suspending mass urban transport systems as a pandemic countermeasure aimed at reducing or slowing population spread because, whatever the relevance of public transport is to individual-level risk, household exposure most likely poses a greater threat (Williams et al., 2010; Cooley et al., 2011).

The Conversation: Suggestions to Limit Infection in Several Countries

https://theconversation.com/to-limit-coronavirus-risks-on-public-transport-heres-what-wecan-learn-from-efforts-overseas-133764

Public transport in our cities is highly vulnerable to disease outbreaks such as the global coronavirus (COVID-19) pandemic. However, public transport is the lifeblood of our cities, so it’s desirable to keep services running as long as possible. Australia can learn from what has been done overseas, especially in China, where concrete strategies to reduce the spread of the virus on public transport helped eventually to contain the disease.

The Atlantic, Fear of Public Transportation Ahead of Evidence:

https://www.theatlantic.com/ideas/archive/2020/06/fear-transit-bad-cities/612979/?utm_%20source=feed

Many have blamed subways and buses for coronavirus outbreaks, but a growing body of research suggests otherwise. Janette Sadik-Khan, Seth Solomonow

France (no evidence of contagion on trains, subways or planes)

(Of 150 detected French coronavirus “clusters” (at least three people sickened) outside of homes and nursing homes from May 9 to June 3, none of them occurred on trains, metros, or airplanes. Mask wearing has been mandatory since May 11)

Japan (mass transportation is not linked to contagion)

https://www.sciencemag.org/news/2020/05/japan-ends-its-covid-19-state-emergency

(Reassuringly, they did not trace any clusters to Japan’s notoriously packed commuter trains. Oshitani says riders are usually alone and not talking to other passengers. And lately, they are all He says Japan would have seen large outbreaks traced to trains if airborne transmission of the virus was possible)

Austria (no evidence of contagion on public transport)

https://www.ages.at/service/service-presse/pressemeldungen/epidemiologische-abklaerung-am-beispiel-covid-19/

(Out of 297 local clusters, none was related to public transport)

Singapur (meetings and social interactions show greater risk)

https://www.linkedin.com/posts/shreya-gadepalli-9a48591b_lawrence-wong-co-chair-of-singapore-ministerial-activity-6675929081944543232-IxFg

“Lawrence Wong co-chair of Singapore Ministerial Covid19 Task Force: ‘We have evidence that the risk of spreading the virus in gatherings and social interactions is much higher than in public transport where people wear masks, don’t talk and travel in disinfected vehicles for a short time’”

New York

https://www.nydailynews.com/opinion/ny-oped-our-covid-response-could-worsen-unrest-20200608-af5nwbg66nawffu77kkvurhq6q-story.html

Analysis from Sam Schwartz. “A survey in early May of 1,300 patients admitted into NYC hospitals for the virus in early May showed just 4% had used transit. Transit just doesn’t show up as a comorbidity “condition.””

X-ray of three outbreaks: this is how they spread and how we can avoid it

Different studies in Japan and other countries show that means of transport are not places where large contagions occur if users maintain hygiene and protection standards, especially the use of masks, which prevent the expulsion of contagious particles into the environment. , as happened in the case of patient 0 of the coach. In addition, it is suggested to establish specific protection measures for transport drivers, improve ventilation and increase the regularity of coaches and trains to reduce crowds as much as possible.

https://elpais.com/ciencia/2020-06-06/radiografia-de-tres-brotes-asi-se-contagiaron-y-asi-podemos-evitarlo.html?ssm=TW_AM_CM

Recommendations of the United Kingdom (Environmental and Scientific Advisory Group Modeling Group Emergency: Duration of exposure and ventilation are very important)

https://www.gov.uk/government/publications/emg-transmission-and-control-of-sars-cov-2on-public-transport-18-may-2020

EMG: Transmission and Control of SARS-CoV-2 on Public Transport, 18 May 2020

Paper prepared by the Environmental and Modelling group (EMG) for the Scientific Advisory Group for Emergencies (SAGE).

As risk of transmission is associated with the duration of exposure, improved ventilation is most likely to be of greatest benefit to those who spend the most time on-board vehicles including transport workers and long distance passengers.

There is high confidence that increasing ventilation rates in poorly ventilated vehicles will mitigate against transmission through aerosols. There is some evidence that ventilation flow patterns also have an effect, but this is not as strong as the evidence for ventilation rate.

While there are not explicit guidelines for what constitutes good ventilation in public transport vehicles, it would be reasonable to assume that the guidance for buildings holds, which recommends 8-10 l/s/person of fresh air, avoiding recirculation of air. In general, most public transport vehicles have high air change rates because they are designed for high occupancy.

From Paul White:

One, an op-ed in the Daily News by Sam Schwartz: “Transit: Safe and Vital to Reopen” and the other by Christina Goldbaum in the Times, “As riders prepare to start riding the trains again during New York City’s initial reopening, the safety of public transit is a big question.”

Ms. Goldbaum and Sam (whom I spoke with recently) sync, however, about micromobility being a critical way to help manage demand, especially during the peak:

‘Commuters should also think about using alternative modes of transportation — preferably those that keep them outside where the risk of transmission is lower than indoors.

“I would recommend thinking about alternatives that are feasible and realistic, especially active modes like walking or biking that are outdoors and means avoiding being in an enclosed crowded space,” said Krystal Pollitt, an assistant professor of epidemiology at the Yale School of Public Health.

#publictransport #micromobility #urbanmobility #covid #transit #epidemiology

https://www.nytimes.com/2020/06/08/nyregion/mta-subway-riding-health-coronavirus.html

https://twitter.com/AleTirachini/status/1269646374766817280?s=20

(This article was first published in Spanish by Universidad de Los Andes)

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