Riders Who Avoided Public Transit During COVID-19 Personal Burdens and Implications for Social Equity

Problem, research strategy, and findings Millions of North Americans stopped riding public transit in response to COVID-19. We treat this crisis as a natural experiment to illustrate the importance of public transit in riders' abilities to access essential destinations. We measured the impacts of riders forgoing transit through a survey of transportation barriers completed by more than 4,000 transit riders in Toronto and Vancouver (Canada). We used Heckman selection models to predict six dimensions of transport disadvantage and transport-related social exclusions captured in our survey. We then complemented model results with an analysis of survey comments describing barriers that individuals faced. Lack of access to alternative modes is the strongest predictor of a former rider experiencing transport disadvantage, particularly neighborhood walkability and vehicle ownership. Groups at risk of transport disadvantage before COVID-19, particularly women and people in poorer health, were also more likely to report difficulties while avoiding public transit. Barriers described by respondents included former supports no longer offering rides, gendered household car use dynamics, and lack of culturally specific or specialized amenities within walking distance. Takeaway for practice Policymakers should plan for a level of redundancy in transportation systems that enables residents to access essential destinations when unexpected service losses occur. Designing communities that enable residents to walk to those essential destinations will help reduce the burdens faced by transit riders during crises that render transit unfeasible. At the same time, planners championing active travel as an alternative to transit during such crises also need to devise solutions for former transit riders for whom active travel is ill suited, for example, due to physical challenges with carrying groceries or needing to chaperone children.

Cytokine storm syndrome in coronavirus disease 2019: A narrative review.

Cytokine storm syndrome (CSS) is a critical clinical condition induced by a cascade of cytokine activation, characterized by overwhelming systemic inflammation, hyperferritinaemia, haemodynamic instability and multiple organ failure (MOF). At the end of 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, and rapidly developed into a global pandemic. More and more evidence shows that there is a dramatic increase of inflammatory cytokines in patients with COVID-19, suggesting the existence of cytokine storm in some critical illness patients. Here, we summarize the pathogenesis, clinical manifestation of CSS, and highlight the current understanding about the recognition and potential therapeutic options of CSS in COVID-19.