Public transport etiquette for infection-free commute

As London announces it is cleaning the Tube, experts warn against using buses and trains at peak times

Transport for London joined dozens of cities across the world yesterday in announcing an “enhanced cleaning regime” for trains and buses. New York, Madrid and Los Angeles are also “deep cleaning” their transport systems.

Sadiq Khan, the Mayor of London, said that “cleaning across the Tube and bus network now includes additional substances that kill viruses and bacteria on contact” to cut the risk of the virus spreading,

The reaction of most Londoners will no doubt be that this was long overdue even without coronavirus. The Tube is grimy even at the best of times.

Government advice, based as it is on balancing economic with health concerns, is that there is nothing to fear from using public transport.

“I want to reassure Londoners and visitors that the advice from experts is to continue with our daily lives as normal, including using public transport,” said Mr Khan.

It is true that there are bigger risks associated with catching the virus than travelling by bus, train or plane.

David Nabarro, a World Health Organisation coronavirus adviser, said on Monday that although public transport was an important thing to look at, the evidence suggested that the kind of “fleeting contacts” people have when travelling together did not, so far, seem to be the “most important source of transmission”.

He’s right. Most academic literature to date suggests the virus is mainly spread among people in their homes or workplaces where contacts are closer, more frequent and sustained.

Nevertheless, Jens Spahn, the German health minister, urged people to walk or cycle rather than use public transport if possible. He said it was less of a priority than avoiding big events but said “residents of bigger cities should think about walking or cycling to work when the weather allows it rather than using public transport”.

This is also good advice. Most of us would benefit from more exercise, and walking or cycling to work (assuming the roads and pavements are not packed) present less of a virus risk than a busy bus or train.

A study, published in BMC Infectious Diseases in 2011, found those using public transport in flu outbreaks were up to six times more likely to pick up an acute respiratory infection.

This is especially true in densely populated cities. The Underground is a particular hot spot, according to a paper published in the journal Environmental Health in 2018.

The study “suggests a link between public transport use and infectious diseases transmission” and found risk was highest for those who have long journeys or use busy interchange stations, as they come into contact with more shared surfaces and people.

There is also evidence those who exercise more report fewer respiratory infections than the sedentary.

Prof Lucy Yardley, the co-director (research) for the Centre for Doctoral Training in Digital Health and Care at the University of Bristol, said: “One study looking at more than a thousand people aged 18-85 compared people who spent a lot of time sitting down and did very little activity with people who were active for 20 minutes a few times each week. The active people had fewer days of being ill with respiratory infections and their symptoms were not as bad if they got these illnesses. The more active people were, the more benefit they got.”

But what if you can’t walk or cycle? What’s the best way to reduce the risk of catching the virus on a bus or train?

The most important thing is to understand how the virus is thought to spread – via droplets. They fall on surfaces and are picked up on hands. You risk infection if you then bring them to your eyes, nose or mouth.

It’s also possible for airborne contamination at close quarters – a metre or two.

Experts say you can reduce your risk in public transport by avoiding peak hours, reducing close contacts with people and surfaces and making sure you wash your hands before, during and immediately after travel.

“Sit or stand as far away from other people as you can, especially if they have a dry cough,” said Prof Yardley. “Open windows if possible and avoid touching surfaces more than you need to – but not at the risk of falling over.”

Prof Yardley also recommended the free-to-use Germdefence website of the University of Southampton.