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The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study

The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study
The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study
Background: Train is a common mode of public transport across the globe; however, the risk of COVID-19 transmission among individual train passengers remains unclear.

Methods: We quantified the transmission risk of COVID-19 on high-speed train passengers using data from 2,334 index patients and 72,093 close contacts who had co-travel times of 0–8 hours from 19 December 2019 through 6 March 2020 in China. We analysed the spatial and temporal distribution of COVID-19 transmission among train passengers to elucidate the associations between infection, spatial distance, and co-travel time.

Results: The attack rate in train passengers on seats within a distance of 3 rows and 5 columns of the index patient varied from 0 to 10.3% (95% confidence interval [CI] 5.3% – 19.0%), with a mean of 0.32% (95%CI 0.29% – 0.37%). Passengers in seats on the same row as the index patient had an average attack rate of 1.5% (95%CI 1.3% – 1.8%), higher than that in other rows (0.14%, 95%CI 0.11% – 0.17%), with a relative risk (RR) of 11.2 (95%CI 8.6 –14.6). Travellers adjacent to the index patient had the highest attack rate (3.5%, 95%CI 2.9% – 4.3%) of COVID-19 infections (RR 18.0, 95%CI 13.9 – 23.4) among all seats. The attack rate decreased with increasing distance, but it increased with increasing co-travel time. The attack rate increased on average by 0.15% (p = 0.005) per hour of co-travel; for passengers at adjacent seats, this increase was 1.3% (p = 0.008), the highest among all seats considered.

Conclusions: COVID-19 has a high transmission risk among train passengers, but this risk shows significant differences with co-travel time and seat location. During disease outbreaks, when travelling on public transportation in confined spaces such as trains, measures should be taken to reduce the risk of transmission, including increasing seat distance, reducing passenger density, and use of personal hygiene protection.
1058-4838
Hu, Maogui
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Lin, Hui
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Wang, Jinfeng
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Xu, Chengdong
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Tatem, Andrew
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Meng, Bin
3d4cb30e-afaf-4585-b533-f8fa4a58696b
Zhang, Xin
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Liu, Yifeng
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Wang, Pengda
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Wu, Guizhen
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Xie, Haiyong
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Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Hu, Maogui
f9d52bef-2c40-4831-9b90-72ecd8fe2758
Lin, Hui
3ec28381-8f89-4051-b8d1-76cf314ee778
Wang, Jinfeng
3b2e15d2-baff-451c-8a30-d05c3970059f
Xu, Chengdong
100f216b-ab5b-4030-8cb5-c2757be1ccdd
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Meng, Bin
3d4cb30e-afaf-4585-b533-f8fa4a58696b
Zhang, Xin
82ab4a1f-c1de-4a16-b50d-e5e6a9face3f
Liu, Yifeng
651c679e-c464-4b93-b755-ac6eca502d70
Wang, Pengda
6338cac9-0baa-4da8-8dcc-7e22710fc9fd
Wu, Guizhen
49cbafd0-c91c-40c6-951a-dbe8d2872eb3
Xie, Haiyong
726611ed-645f-4c33-899e-cbef20c03c6d
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001

Hu, Maogui, Lin, Hui, Wang, Jinfeng, Xu, Chengdong, Tatem, Andrew, Meng, Bin, Zhang, Xin, Liu, Yifeng, Wang, Pengda, Wu, Guizhen, Xie, Haiyong and Lai, Shengjie (2020) The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study. Clinical Infectious Diseases. (In Press)

Record type: Article

Abstract

Background: Train is a common mode of public transport across the globe; however, the risk of COVID-19 transmission among individual train passengers remains unclear.

Methods: We quantified the transmission risk of COVID-19 on high-speed train passengers using data from 2,334 index patients and 72,093 close contacts who had co-travel times of 0–8 hours from 19 December 2019 through 6 March 2020 in China. We analysed the spatial and temporal distribution of COVID-19 transmission among train passengers to elucidate the associations between infection, spatial distance, and co-travel time.

Results: The attack rate in train passengers on seats within a distance of 3 rows and 5 columns of the index patient varied from 0 to 10.3% (95% confidence interval [CI] 5.3% – 19.0%), with a mean of 0.32% (95%CI 0.29% – 0.37%). Passengers in seats on the same row as the index patient had an average attack rate of 1.5% (95%CI 1.3% – 1.8%), higher than that in other rows (0.14%, 95%CI 0.11% – 0.17%), with a relative risk (RR) of 11.2 (95%CI 8.6 –14.6). Travellers adjacent to the index patient had the highest attack rate (3.5%, 95%CI 2.9% – 4.3%) of COVID-19 infections (RR 18.0, 95%CI 13.9 – 23.4) among all seats. The attack rate decreased with increasing distance, but it increased with increasing co-travel time. The attack rate increased on average by 0.15% (p = 0.005) per hour of co-travel; for passengers at adjacent seats, this increase was 1.3% (p = 0.008), the highest among all seats considered.

Conclusions: COVID-19 has a high transmission risk among train passengers, but this risk shows significant differences with co-travel time and seat location. During disease outbreaks, when travelling on public transportation in confined spaces such as trains, measures should be taken to reduce the risk of transmission, including increasing seat distance, reducing passenger density, and use of personal hygiene protection.

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20200717-COVID-19-Train - Accepted Manuscript
Restricted to Repository staff only until 20 July 2021.
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Accepted/In Press date: 20 July 2020

Identifiers

Local EPrints ID: 442641
URI: http://eprints.soton.ac.uk/id/eprint/442641
ISSN: 1058-4838
PURE UUID: 0e3790dc-545e-4a4b-918b-265dc9f4ac4d
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 22 Jul 2020 16:30
Last modified: 08 Oct 2020 16:38

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Contributors

Author: Maogui Hu
Author: Hui Lin
Author: Jinfeng Wang
Author: Chengdong Xu
Author: Andrew Tatem ORCID iD
Author: Bin Meng
Author: Xin Zhang
Author: Yifeng Liu
Author: Pengda Wang
Author: Guizhen Wu
Author: Haiyong Xie
Author: Shengjie Lai ORCID iD

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