Three's a crowd? Examining evolving public transit crowding standards amidst the COVID-19 pandemic

The COVID-19 pandemic dramatically affected public transit systems around the globe. Because transit systems typically move many people closely together on buses and trains, public health guidance demanded that riders should keep a distance of about two meters to others changed the definition of "crowding” on transit in 2020. Accordingly, this research examines how U.S. public transit agencies responded to public health guidance that directly conflicted with their business model. To do this, we examined published crowding standards before the COVID-19 pandemic for a representative sample of 200 transit systems, including whether they started or changed their published standards during the pandemic, as well as the reasons whether agencies publicize such standards at all. We present both descriptive statistics and regression model results to shed light on the factors associated with agency crowding standards. We find that 56% of the agencies surveyed published crowding standards before the pandemic, while only 46% published COVID-19-specific crowding standards. Regression analyses suggest that larger agencies were more likely to publish crowding standards before and during the COVID-19 pandemic, likely because they are more apt to experience crowding. Pandemic-specific crowding standards, by contrast, were associated with a more complex set of factors. We conclude that the relative lack of pandemic standards reflects the uncertainty and fluidity of the public health crisis, inconsistent and at times conflicting with the guidance from public health officials, and, in the U.S., a lack national or transit industry consensus on appropriate crowding standards during the first year of the pandemic.

Residual antimicrobial coating efficacy against SARS-CoV-2.

AIMS: This study evaluated the residual efficacy of commercially available antimicrobial coatings or films against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on non-porous surfaces. METHODS AND RESULTS: Products were applied to stainless steel or ABS plastic coupons and dried overnight. Coupons were inoculated with SARS-CoV-2 in the presence of 5% soil load. Recovered infectious SARS-CoV-2 was quantified by TCID50 assay. Tested product efficacies ranged from <1.0 to >3.0 log10 reduction at a 2-h contact time. The log10 reduction in recovered infectious SARS-CoV-2 ranged from 0.44 to 3 log10 reduction on stainless steel and 0.25 to >1.67 log10 on ABS plastic. The most effective products tested contained varying concentrations (0.5%-1.3%) of the same active ingredient: 3-(trihydroxysilyl) propyldimethyloctadecyl ammonium chloride. Products formulated with other quaternary ammonium compounds were less effective against SARS-CoV-2 in this test. CONCLUSIONS: The residual antimicrobial products tested showed varied effectiveness against SARS-CoV-2 as a function of product tested. Several products were identified as efficacious against SARS-CoV-2 on both stainless steel and ABS plastic surfaces under the conditions evaluated. Differences in observed efficacy may be due to variation in active ingredient formulation; efficacy is, therefore, difficult to predict based upon listed active ingredient and its concentration. SIGNIFICANCE AND IMPACT: This study highlights the formulation-specific efficacy of several products against SARS-CoV-2 and may inform future development of residual antiviral products for use on non-porous surfaces. The identification of antimicrobial coatings or films showing promise to inactivate SARS-CoV-2 suggests that these products may be worth future testing and consideration.

Efficacy of chemical disinfectants against SARS-CoV-2 on high-touch surface materials.

AIMS: This study aimed to provide operationally relevant SARS-CoV-2 surface disinfection efficacy information. METHODS AND RESULTS: Three EPA-registered disinfectants (Vital Oxide, Peroxide, Clorox Total 360 (C360)) and one antimicrobial formulation (CDC Bleach) were evaluated against SARS-CoV-2 on material coupons and were tested using Spray (no-touch with contact time) and Spray & Wipe (wipe immediately post-application) methods immediately and 2 hours post-contamination. Efficacy was evaluated for infectious virus, with a subset tested for vRNA recovery. Efficacy varied by method, disinfectant and material. CDC Bleach solution showed low efficacy against SARS-CoV-2 (Log Reduction < 1.7), unless applied via Spray & Wipe. Additionally, mechanical wiping increased the efficacy of treatments against SARS-CoV-2. Recovery of vRNA post-disinfection suggested vRNA may overestimate infectious virus remaining. CONCLUSIONS: Efficacy depends on surface material, chemical, and disinfection procedure, and suggests that mechanical wiping alone has some efficacy at removing SARS-CoV-2 from surfaces. We observed that disinfectant treatment biased recovery of vRNA over infectious virus.

Vehicle access and falling transit ridership: evidence from Southern California.

We examine pre-COVID declines in transit ridership, using Southern California as a case study. We first illustrate Southern California's unique position in the transit landscape: it is a large transit market that demographically resembles a small one. We then draw on administrative data, travel diaries, rider surveys, accessibility indices, and Census microdata for Southern California, and demonstrate a strong association between rising private vehicle access, particularly among the populations most likely to ride transit, and falling transit use. Because we cannot control quantitatively for the endogeneity between vehicle acquisition and transit use, our results are not causal. Nevertheless, the results strongly suggest that increasing private vehicle access helped depress transit ridership. Given Southern California's similarity to most US transit markets, we conclude that vehicle access may have played a role in transit losses across the US since 2000.

Three's a crowd? Examining evolving public transit crowding standards amidst the COVID-19 pandemic

The COVID-19 pandemic dramatically affected public transit systems around the globe. Because transit systems typically move many people closely together on buses and trains, public health guidance demanded that riders should keep a distance of about two meters to others changed the definition of "crowding " on transit in 2020. Accordingly, this research examines how U.S. public transit agencies responded to public health guidance that directly conflicted with their business model. To do this, we examined published crowding standards before the COVID-19 pandemic for a representative sample of 200 transit systems, including whether they started or changed their published standards during the pandemic, as well as the reasons whether agencies publicize such standards at all. We present both descriptive statistics and regression model results to shed light on the factors associated with agency crowding standards. We find that 56% of the agencies surveyed published crowding standards before the pandemic, while only 46% published COVID-19-specific crowding standards. Regression analyses suggest that larger agencies were more likely to publish crowding standards before and during the COVID-19 pandemic, likely because they are more apt to experience crowding. Pandemic-specific crowding standards, by contrast, were associated with a more complex set of factors. We conclude that the relative lack of pandemic standards reflects the uncertainty and fluidity of the public health crisis, inconsistent and at times conflicting with the guidance from public health officials, and, in the U.S., a lack national or transit industry consensus on appropriate crowding standards during the first year of the pandemic.

Pandemic transit: examining transit use changes and equity implications in Boston, Houston, and Los Angeles

While the COVID-19 pandemic upended many aspects of life as we knew it, its effects on U.S. public transit were especially dramatic. Many former transit commuters began to work from home or switched to traveling via private vehicles. But for those who continued to work outside the home and could not drive—who were more likely low-income and Black or Hispanic—transit remained an important means of mobility. However, most transit agencies reduced service during the first year of the pandemic, reflecting reduced ridership demand, increasing costs, and uncertain budgets. To analyze the effects of the pandemic on transit systems and their users, we examine bus ridership changes by neighborhood in Boston, Houston, and Los Angeles from 2019 to 2020. Combining aggregated stop-level boarding data, passenger surveys, and census data, we identify associations between shifting travel patterns and neighborhoods. We find that early in the pandemic, neighborhoods with more poor and non-white households lost proportionally fewer riders;however, this gap between high- and low-ridership-loss neighborhoods shrank as the pandemic wore on. We also model ridership change controlling for multiple factors. Ridership in Houston and LA generally outperformed Boston, with built environment and demographic factors accounting for some of the observed differences. Neighborhoods with high shares of Hispanic and African American residents retained more riders in the pandemic, while those with higher levels of auto access and with more workers able to work from home lost more riders, all else equal. We conclude that transit’s social service role elevated during the pandemic, and that serving travelers in disadvantaged neighborhoods will likely remain paramount emerging from it. Supplementary Information The online version contains supplementary material available at 10.1007/s11116-022-10345-1.

Testing for SARS-CoV-2 in Symptomatic Vaccinated and Unvaccinated Health Care Workers During the Delta Variant Surge.

BACKGROUND: Infection with SARS- CoV- 2 in health care workers (HCWs) challenges employee health services. METHODS: We analyzed telephone Coronavirus Disease 2019 (COVID-19) hotline data over 8 weeks in 2021 during SARS- CoV- 2 Delta variant surge. We calculated COVID-19 case rates among persons-under-investigation (PUIs) for illness at two health care centers (HCs). RESULTS: There were 41 COVID-19 cases among the 285 PUIs (14.4%) at the study HC and 549 (16.9%) of 3244 at the comparison HC. At the study HC, 11.7% of vaccinated PUIs versus 36.6% of unvaccinated PUIs were COVID-19 positive. The COVID-19 positivity rates among vaccinated and unvaccinated PUIs at the comparison HC were 16.1% and 33.3%, respectively. DISCUSSION: In the SARS-CoV-2 Delta variant surge, COVID-19 test positivity rates among unvaccinated symptomatic HCWs are dramatically elevated. Aggressive testing of HCW PUIs is particularly critical during periods of disease upsurge.

Relationship-centered consultation skills for audiologists: Remote and in-person care

To compound the problem of low uptake of hearing aids, recent data suggest untreated hearing loss is linked to several other conditions that erode a person's overall quality of life, especially as they age. One popular approach geared to better meet the needs of persons with hearing loss is to practice patient-centered care. Something that is easy to talk about (ask any audiologist and they say that they do it) but challenging to implement. Patient-centered care might seem like a recent advance, but the term has been around for more than 30 years. Relationship-centered communication acknowledges the clinician's expertise and judgment, while respecting the person's preferences, perspectives, and ultimately his or her ability to decide what intervention is best. Recently, Wallhagen, Strawbridge, and Tremblay (2021) proposed that audiologists should work within the 4M's framework. The 4M's framework suggests that what Matters is relationship-centered communication, and it needs to be combined with being mindful of Medication that might impact the individual's overall wellbeing and communication ability, along with Mobility (maintaining overall daily physical functioning) and Mentation (sustaining good cognitive and emotional health). The 4M's framework reminds us that hearing loss is not independent of other health conditions and the ability to capture the full totality of the individual's situation is built on a foundation of holistic, empathic communication. This book intends to provide some practical guidance, based on scientific principles, around this foundation of holistic communication. Furthermore, it shows that relationship-centered communication is not confined to in-person visits;that strong professional relationships can be forged in the virtual world-something that should interest all stakeholders as we move into the post-COVID era of tele-audiology and remote care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Temporal Trends in COVID-19 Incidence in Two Healthcare Worker Cohorts.

BACKGROUND: Health care workers (HCWs) experience increased occupational risk of contracting COVID-19, with temporal trends that might inform surveillance. METHODS: We analyzed data from a Veterans Affairs hospital-based COVID-19 worker telephone hotline collected over 40 weeks (2020). We calculated the proportion of COVID-19+ cases among persons-under-investigation (PUIs) for illness compared to rates from a nearby large university-based health care institution. RESULTS: We observed 740 PUIs, 65 (8.8%) COVID-19+. Time trends were similar at the study and comparison hospitals; only for the first of 10 four-week observation periods was the ratio for observed to expected COVID-19+ significant (P < 0.001). DISCUSSION: These data suggest that employee health COVID-19+ to PUI ratios could be utilized as a barometer of community trends. Pooling experience among heath care facilities may yield insights into occupational infectious disease outbreaks.

Rating the composition: Deconstructing the demand-side effects on transit use changes in California

Transit use in the U.S. has been sliding since 2014, well before the onset of the COVID-19 pandemic. The largest state, California, was also losing transit riders despite substantial public investment and increased service in the pre-pandemic period. This downturn prompted concern among transit managers and planners interested in service-side interventions to reverse the decline. However, relatively little is known about changes in the demand for public transit and how shifts in demand-side factors have affected patronage. Drawing on California data from the 2009 and 2017 National Household Travel Surveys, we quantify demand-side changes as a function of two factors—changes in ridership rates of various classes of transit riders (“rate effects”) and changes in the composition of those rider classes (“composition effects”). Statewide, we find that while shifts in the population composition were in some cases associated with lower levels of ridership, the largest declines in transit patronage were associated with falling ridership rates. Specifically, those with limited automobile access and Hispanic travelers rode transit far less frequently in 2017 compared to 2009. Transit ridership rates and rider composition in the San Francisco Bay Area were relatively stable during the study period, while both rate and compositional changes in the Los Angeles area were associated with much lower levels of total ridership. Overall, our findings demonstrate the important role of demand-side factors in understanding aggregate transit use, and suggest that planners and managers may have limited policy tools at their disposal when seeking to bolster ridership levels.