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CMAAO Corona Facts and Myth COVID Train Travel

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Dr KK Aggarwal    10 August 2020

With inputs from Dr Monica Vasudev

1033: The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study; Maogui Hu, Hui Lin, Jinfeng Wang, Chengdong Xu, et all; Clinical Infectious Diseases, 29 July 2020

Despite the trains being one of the commonest modes of public transport across the world, the risk of COVID 19 transmission among individuals traveling by train remains ambiguous.

The study was conducted retrospectively to quantify the risk of spread of COVID 19 on high-speed train passengers. The data was collected from 2,334 index patients and 72,093 close contacts who travelled together for 0-8 hours from 19 December 2019 through 6 March 2020 in China. The researchers analyzed the spatial and temporal distribution of COVID 19 transmission among train passengers to assess the link between infection, spatial distance and co-travel time.

The study findings showed that the attack rate in train travelers on seats within a distance of 3 rows and 5 columns of the index patient varied from 0 to 10.3% with a mean of 0.325, while patients sitting in the same row seat as the index patient had an average attack rate of 1.5%. This was higher than those in other rows, with a relative risk of 11.2. The study clearly showed that patients sitting adjacent to the index patients were at the highest risk. The attack rate reduced directly in proportion with the increasing distance between the seats, but it increased with the increase in co-travel time.

The findings led to the conclusion that COVID 19 has a high infection rate among train passengers, but the risk significantly varies with co-travel time and location of the seat. Based on the study findings, the authors have recommended that during disease outbreaks, when traveling via public transport in restricted enclosures such as trains, adequate measures are necessary to lower the risk of spread of disease. These measures include increasing seat distance, reduced passenger density, and use of personal hygiene as protection.

 

Dr KK Aggarwal

President CMAAO

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