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

Severo, Mílton; Ribeiro, Ana Isabel; Lucas, Raquel; Leão, Teresa; Barros, Henrique

doi:10.3389/fpubh.2021.611565

Cited by 16 publications

(12 citation statements)

References 33 publications

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“…There was a crude association of public transportation with risk of infection, but it was largely attenuated after adjustment for sex, age, education, and citizenship. These results are in line with a previous ecological study in the same geographical setting, which underlined the role of socioeconomic aspects rather than the use of public transportation ( 22 ). Similarly, dining areas or other commercial spaces did not increase the risk of infection, even after adjustment for education or citizenship.…”

Section: Discussionsupporting

confidence: 92%

A Case-Control Study of Contextual Factors for SARS-CoV-2 Transmission

Leite

Leão

Soares

et al. 2021

Front. Public Health

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Background: Knowledge on the settings and activities associated with a higher risk of SARS-CoV-2 transmission is essential to inform decision-making. We thus designed a case-control study to identify relevant settings for community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Portugal.Methods: We evaluated 1,088 cases, identified through the national surveillance system, and 787 community controls, recruited using random digit dialing. Sociodemographic characteristics, individual protective measures, and activities or visited settings were obtained through telephone interview. We report sex-, age-, education-, and citizenship-adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).Results: Household overcrowding (aOR = 1.47; 95% CI 1.14–1.91) and work in senior care (4.99; 1.30–33.08) increased while working remotely decreased the risk of infection (0.30; 0.22–0.42). Going to restaurants/other dining spaces (0.73; 0.59–0.91), grocery stores (0.44; 0.34–0.57) or hair salons (0.51; 0.39–0.66), or the use of public transportation did not present a higher risk of infection (0.98; 0.75–1.29), under existing mitigation strategies. Lower education ( ≤ 4 years vs. tertiary education: 1.79; 1.33–2.42) and no Portuguese citizenship (5.47; 3.43–9.22) were important risk factors.Conclusions: The utilization of public transportation, restaurants, and commercial spaces was not associated with increased risk of infection, under capacity restrictions, physical distancing, use of masks, and hygiene measures. Overcrowding, foreign citizenship, low education and working on-site were positively associated with SARS-CoV-2 infection.

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Section: Discussionsupporting

confidence: 92%

A Case-Control Study of Contextual Factors for SARS-CoV-2 Transmission

Leite

Leão

Soares

et al. 2021

Front. Public Health

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“…According to Team and Manderson (2020) The percentage of people commuting to the municipality to work or study is an important factor across the country, but assumes particular importance in the municipalities around the Lisbon Metropolitan Area. Despite the measures taken to diminish the capacity of public transportation and to promote the usage of mask in public spaces, daily commuting through public transportation is perceived as a favourable factor for the spread of virus (Troko et al, 2011) as it promotes risk contact (Kang et al, 2020;Severo et al, 2021). According to Lai et al (2020), in the future, places will need to ensure that residents may work and study in the same municipality where they live.…”

Section: Discussionmentioning

confidence: 99%

Spatial inequalities of COVID-19 incidence and associated socioeconomic risk factors in Portugal

Almendra

Santana

Costa

2021

BAGE

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COVID-19 hit the world in a sudden and uneven way. Scientific community has provided strong evidence about socioeconomic characteristics of the territory associated with the geographical pattern of COVID-19 incidence. Still, the role played by these factors differs between study areas. Geographically Weighted Regression (GWR) models were applied to explore the spatially varying association between age-standardized COVID-19 incidence rate in 2020 and socioeconomic conditions in Portugal, at the municipality level. The spatial context was defined as a function of the number of neighbours; the bandwidth was determined through AIC. Prior, the validity of the GWR was assessed through ordinary least squares models. Border proximity, proportion of overcrowded living quarters, persons employed in manufacturing establishments and persons employed in construction establishments were found to be significant predictors. It was possible to observe that municipalities are affected differently by the same factor, and that this varying influence has identifiable geographical patterns, the role of each analysed factor varies importantly across the country. This study provides useful insights for policymakers for targeted interventions and for proper identification of risk factors.

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“…The average S-SDS value from Week 5 of 2020 to Week 5 of 2021 was significantly lower than the previous two years. In addition, the incidence of other respiratory virus infections during the COVID-19 pandemic was also significantly lower than the previous four-year mean cumulative incidence in the preintervention period (24.5%) in the Republic of Korea [ 16 ]. As a bundle of non-pharmaceutical public health interventions, mask-wearing, hand hygiene, contact tracing, and social distancing have been emphasized, social activity has decreased.…”

Section: Discussionmentioning

confidence: 99%

Correlation between the Level of Social Distancing and Activity of Influenza Epidemic or COVID-19 Pandemic: A Subway Use-Based Assessment

Seong

Hong

Hyun

et al. 2021

JCM

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Social distancing is an effective measure to mitigate the spread of novel viral infections in the absence of antiviral agents and insufficient vaccine supplies. Subway utilization density may reflect social activity and the degree of social distancing in the general population.; This study aimed to evaluate the correlations between subway use density and the activity of the influenza epidemic or coronavirus disease 2019 (COVID-19) pandemic using a time-series regression method. The subway use-based social distancing score (S-SDS) was calculated using the weekly ridership of 11 major subway stations. The temporal association of S-SDS with influenza-like illness (ILI) rates or the COVID-19 pandemic activity was analyzed using structural vector autoregressive modeling and the Granger causality (GC) test. During three influenza seasons (2017–2020), the time-series regression presented a significant causality from S-SDS to ILI (p = 0.0484). During the COVID-19 pandemic in January 2020, S-SDS had been suppressed at a level similar to or below the average of the previous four years. In contrast to the ILI rate, there was a negative correlation between COVID-19 activity and S-SDS. GC analysis revealed a negative causal relationship between COVID-19 and S-SDS (p = 0.0098).; S-SDS showed a significant time-series association with the ILI rate but not with COVID-19 activity. When public transportation use is sufficiently suppressed, additional social mobility restrictions are unlikely to significantly affect COVID-19 pandemic activity. It would be more important to strengthen universal mask-wearing and detailed public health measures focused on risk activities, particularly in enclosed spaces.

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

Cited by 16 publications

References 33 publications

A Case-Control Study of Contextual Factors for SARS-CoV-2 Transmission

A Case-Control Study of Contextual Factors for SARS-CoV-2 Transmission

Spatial inequalities of COVID-19 incidence and associated socioeconomic risk factors in Portugal

Correlation between the Level of Social Distancing and Activity of Influenza Epidemic or COVID-19 Pandemic: A Subway Use-Based Assessment

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