Transmission of SARS-CoV-2 in Public Transportation Vehicles: A Case Study in Hunan Province, China

Luo, Kaiwei; Lei, Zhao; Hai, Zheng; Xiao, Shanliang; Rui, Jia; Yang, Hao; Jing, Xinping; Wang, Hui; Xie, Zhengshen; Luo, Ping; Li, Wanying; Liu, Qiao; Tan, Huilu; Xu, Zicheng; Yang, Yang; Hu, Shixiong; Chen, Tianmu

doi:10.1093/ofid/ofaa430

Cited by 93 publications

(96 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The evidence available thus far is from Chinese studies, where airport or high-speed railway station travel was found to be associated to the speed of the infection spread ( 15 ). In particular, a strong association between travel by train to six major Chinese cities and the number of SARS-CoV-2 cases has been found ( 16 ); and an important SARS-CoV-2 outbreak in public transportation (bus) has also been reported ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Severo

Ribeiro

Lucas

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Introduction: The large number of passengers, limited space and shared surfaces can transform public transportation into a hub of epidemic spread. This study was conducted to investigate whether proximity to railway stations, a proxy for utilization, was associated with higher rates of SARS-CoV-2 infection across small-areas of the Lisbon Metropolitan Area (Portugal).Methods: The number of SARS-CoV-2 confirmed infections from March 2 until July 5, 2020 at the parish-level was obtained from the National Epidemiological Surveillance System. A Geographic Information System was used to estimate proximity to railway stations of the six railway lines operating in the area. A quasi-Poisson generalized linear regression model was fitted to estimate the relative risks (RR) and corresponding 95% confidence intervals (95%CI).Results: Between May 2 and July 5, 2020, there were a total of 17,168 SARS-CoV-2 infections in the Lisbon Metropolitan Area, with wide disparities between parishes. Overall, parishes near any of the railway stations of the Sintra line presented significantly higher SARS-CoV-2 infection rates (RR = 1.42, 95%CI 1.16, 1.75) compared to parishes located farther away from railway stations, while the opposite was observed for parishes near other railway stations (Sado and Fertagus lines), where infection rates were significantly lower than those observed in parishes located farther away from railway stations (RR = 0.66, 95%CI 0.50, 0.87). The associations varied according to the stage of the epidemic and to the mitigation measures enforced. Regression results also revealed an increasing influence of socioeconomic deprivation on SARS-CoV-2 infections.Conclusions: No consistent association between proximity to railway stations and SARS-CoV-2 infection rates in the most affected metropolitan area of Portugal was observed, suggesting that other factors (e.g., socioeconomic deprivation) may play a more prominent role in the epidemic dynamics.

show abstract

Section: Discussionmentioning

confidence: 99%

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Severo

Ribeiro

Lucas

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…On the first 2.5 hour leg on a larger bus, 7 of 48 riders were infected, including riders ~4.5 m away; on the second 1-hour leg on a smaller bus, 2 of 12 riders were infected [24] . (3) In February 2020, clusters of coronavirus transmission in aerobic dance exercise classes were found, in Korea, this time due to sick instructors [25] .…”

Section: Background and Motivationmentioning

confidence: 98%

“…Also in January 2020, an index patient in Wuhan, China took two different buses on a single trip. On the first 2.5 hour leg on a larger bus, 7 of 48 riders were infected, including riders ∼4.5 m away; on the second 1-hour leg on a smaller bus, 2 of 12 riders were infected [24].…”

Section: Background and Motivationmentioning

confidence: 99%

Superspreading Events Without Superspreaders: Using High Attack Rate Events to Estimate N_º for Airborne Transmission of COVID-19

Prentiss¹,

Chu²,

Berggren³

2020

Preprint

View full text Add to dashboard Cite

We study transmission of COVID-19 using five well-documented case studies : a Washington state church choir, a Korean call center, a Korean exercise class, and two different Chinese bus trips. In all cases the likely index patients were pre-symptomatic or mildly symptomatic, which is when infective patients are most likely to interact with large groups of people. An estimate of N 0 , the characteristic number of COVID-19 virions needed to induce infection in each case, is found using a simple physical model of airborne transmission. We find that the N 0 values are similar for five COVID-19 superspreading cases (~300-2,000 viral copies) and of the same order as influenza A. Consistent with the recent results of Goyal et al , these results suggest that viral loads relevant to infection from presymptomatic or mildly symptomatic individuals may fall into a narrow range, and that exceptionally high viral loads are not required to induce a superspreading event [1,2] . Rather, t he accumulation of infective aerosols exhaled by a typical pre-symptomatic or mildly symptomatic patient in a confined, crowdedspace (amplified by poor ventilation, particularly activity like exercise or singing, or lack of masks) for exposure times as short as one hour are sufficient. We calculate that talking and breathing release ~460 N 0 and ~10 N 0 (quanta)/hour, respectively, providing a basis to estimate the risks of everyday activities. Finally, we provide a calculation which motivates the observation that fomites appear to account for a smallpercentage of total COVID-19 infection events.

show abstract

“…Of concern, a recent case study has identified buses resulting in a high transmission rate, R0, where 24 of 68 people became infected after riding one a bus with one infectious person (Shen et al 2020). Other studies describe a single person transmitted SARS-CoV-2 to 12 other individuals on two bus rides on a single day (Luo et al 2020). In addition, there have been transmission to almost 900 workers during the pandemic within a bus transportation organization, resulting in 8 deaths (Herguth and Hurley 2020).…”

Section: Introductionmentioning

confidence: 99%

Reducing COVID-19 Airborne Transmission Risks on Public Transportation Buses: An Empirical Study on Aerosol Dispersion and Control

Edwards

Widrick

Wilmes

et al. 2021

Preprint

View full text Add to dashboard Cite

This study is one of the first COVID-19 related bus studies to fully characterize cough aerosol dispersion and control in the highly turbulent real-world environment of driving regular bus routes on both a school bus and a transit bus. While several other bus studies have been conducted, they were limited to clinical contact tracing, simulation, or partial characterization of aerosol transmission in the passenger areas with constraint conditions. When considering the risk of transmission of SARS-CoV-2 (COVID-19) and other highly infectious airborne diseases, ground based public transportation systems are high-risk environments for airborne transmission particularly since social distancing of six feet is not practical on most buses. This study demonstrates that wearing of masks reduced the overall particle count released into the bus by an average of 50% or more depending on mask quality and reduced the dispersion distance by several feet. The study also demonstrates an 84.36% reduction in aerosol particles and an 80.28% reduction in the mean aerosol residence time for some test cases. We conducted 84 experimental runs using nebulized 10% sodium chloride and a mechanical exhalation simulator that resulted in 78.3 million data points and 124 miles of on-the-road testing. Our study not only captures the dispersion patterns using 28 networked particle counters, as well as quantifies the effectiveness of using on-board fans, opening of various windows, use of face coverings or masks, and the use of the transit bus HVAC system. This work also provides empirical observations of aerosol dispersion in a real-world turbulent air environment, which are remarkably different than many existing fluid dynamics simulations, and also offers substantial discussion on the implications for inclement weather conditions, driver safety, retrofit applications to improve bus air quality, and operational considerations for public transportation organizations.

show abstract

Transmission of SARS-CoV-2 in Public Transportation Vehicles: A Case Study in Hunan Province, China

Cited by 93 publications

References 8 publications

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Superspreading Events Without Superspreaders: Using High Attack Rate Events to Estimate N_º for Airborne Transmission of COVID-19

Reducing COVID-19 Airborne Transmission Risks on Public Transportation Buses: An Empirical Study on Aerosol Dispersion and Control

Contact Info

Product

Resources

About

Transmission of SARS-CoV-2 in Public Transportation Vehicles: A Case Study in Hunan Province, China

Cited by 93 publications

References 8 publications

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Urban Rail Transportation and SARS-Cov-2 Infections: An Ecological Study in the Lisbon Metropolitan Area

Superspreading Events Without Superspreaders: Using High Attack Rate Events to Estimate Nº for Airborne Transmission of COVID-19

Reducing COVID-19 Airborne Transmission Risks on Public Transportation Buses: An Empirical Study on Aerosol Dispersion and Control

Contact Info

Product

Resources

About

Superspreading Events Without Superspreaders: Using High Attack Rate Events to Estimate N_º for Airborne Transmission of COVID-19