The crowded local train is Mumbai’s lifeline. The city’s supply chain of essential commodities and its residents are heavily dependent on this mode of transport. The local trains, used by more than 7.5 million commuters daily, are being sanitised in a bid to control the spread of coronavirus. Special efforts are being put in to ensure cleanliness and hygiene in all passenger interface areas and components in coaches, including door handles, side handles, grab handles, seats, windows, partitions, etc. In the long-distance trains, disinfection of toilets and washbasins are also being ensured.
That said, travelling in the local trains could be the easiest way to contract the virus. The Mumbai locals, which are known to carry commuters 2.6 times more than its capacity, are famous for people breathing down each other’s necks, literally. An infected person travelling on a local train in Mumbai can potentially infect millions.
What are other countries doing with their mass transit systems? What can we learn from their experience? Is mere disinfection of the trains enough?
In the face of the coronavirus outbreak, health officials are advising citizens to avoid crowds whenever possible, and people are increasingly worried about being in close contact with strangers. For those who use public transit, this concern is top of the mind. Health experts know that Covid-19 causes respiratory problems. This virus is similar to the common cold and other respiratory viruses, which usually spread through exposure to tiny droplets from a sick person’s cough or sneeze. Scientists have been planning for a pandemic for decades and transport hubs are widely regarded as infection hotspots, with virus transmission rates up to six times higher for those using public transport systems. Airplanes, trains and buses (and the stations and airports you must travel through) provide in many respects the perfect environment for droplet-spread diseases such as coronavirus (Covid-19) to thrive.
Most cities with large transit systems, such as in the US, are doubling down on deep cleaning their subway cars, buses, turnstiles, and handrails. The London Underground, which serves roughly 1.2 billion passengers annually, is a particular hotspot. Many mass transit companies have set up pandemic response teams. If the outbreak gets significantly worse, it is up to transit and local officials to use their discretion and shut down the system or reduce service.
Authorities in Wuhan, China, the epicentre of the outbreak, closed all transportation hubs in an unprecedented quarantine, stopping all trains, ferries, buses, and planes from leaving the city when the disease started to take hold in late January. This drastic step, in retrospect, appears to have been most effective in slowing the spread of the virus.
What measures can individuals and companies take to reduce risk and effectively slow the spread of the virus? Individuals can consider commuting during non-peak hours, using transport other than mass transit systems, or working from home. Many major companies have asked employees to work from home or instituted a staggered work-from-home plan. If you feel sick or belong to the category classified as “at higher risk” of contracting the coronavirus (older adults, people with chronic medical conditions, etc), staying at home or self-quarantining is the best thing to do. Generally speaking, close contact with people in crowded spaces (whether that be a subway, airplane, or office) makes a person more susceptible to catching the virus.
Previous research has shown that using public transport can increase a person’s risk of catching a respiratory infection (the flu or common cold), since “buses and [trains] are crowded with people sitting and standing in close proximity” to one another. Herd immunity (we often say that Indians have great immunity) to other infections may not hold true for the coronavirus since it’s a new virus strain.
Preliminary data from China suggests that household contact was an important means of transmission outside of Wuhan — prolonged contact with a sick person increases the risk of transmission. The time spent commuting and the density of people commuting are important factors in assessing if public transportation constitutes a risk for the disease’s transmission. Because public transit naturally requires people to share space with others, it goes against the “social distancing” practices health officials have recommended, such as closing of schools, encouraging remote work, and postponing or cancelling mass gatherings like sporting events, concerts, or religious meetings.
According to a 2005 survey conducted in eight regions affected by the 2003 SARS outbreak, six locales — Hong Kong, Spain, Poland, Denmark, Great Britain, and the Netherlands — deemed public transportation the riskiest place to be in during a pandemic, in comparison to entertainment places, shops, hospitals, workplaces and schools. Countries such as Italy, Iran, Japan, and South Korea have seen a dip in ridership, in part because schools, businesses, and even entire cities have shut down. Cities are still operating some train and bus routes, in addition to thoroughly sanitising them.
Some transit systems are using technology to monitor at-risk individuals. Taiwan’s metro agency installed an infra-red tool to measure people’s body temperature before allowing them to enter a train, barring anyone with a temperature above 38 degrees Celsius (or 100 degrees Fahrenheit) from riding. A Chinese tech firm recently developed an algorithm for Beijing subway officials to identify commuters not wearing a mask or wearing it improperly, and Hong Kong’s railway operator rolled out a robot to disinfect trains, in addition to deploying cleaning staff.
To contain the risk of spread on public transit, Canadian health authorities recommend that users practise impeccable “hand hygiene”. This means using an alcohol hand sanitiser or washing one’s hands afterwards, and being mindful not to touch one’s face. Commuters are also advised to follow “cough hygiene”, which means not to cough directly into one’s hand and then touch things, or to stifle the cough in one’s elbow.
For Mumbai, the pandemic response team on the local trains must use technology and quick response to prevent transmission of the virus. Health workers, police and security, utility and supply chains for food and medicines need to be considered as high priority travellers while travel restrictions could be imposed on others.
This article first appeared in the print edition on March 19, 2020 under the title ‘A travelling spectre’. The writer is vice-chairperson, Piramal Enterprises, and an alumnus of the Harvard School of Public Health