Robert T. Babbitt PLLC
Issue 7, Article 1
COVID 19, AS TRANSIT RIDERS RETURN, ARE THE FEARS SERIOUS OR IRRATIONAL?
By any measure, New York City has been a center of the infection spread in this difficult disease. Yet the data prove that proof of causation is often difficult, and this pandemic has brought about a great deal of imperfect assessments. The obvious connection between dense neighborhoods, areas with subway access and high rates of infections in New York City led MIT researcher, Jeffrey Harris, to publish findings in April that the subway was “…a major disseminator-if not the principal transmission vehicle…” in the NYC outbreak. Though this was written by a talented economist, it was not correct.
Janet Sadik-Khan and Seth Solomonow recently offered several errors in this research.
A more objective researcher would have tested this reasonable theory against many data points around the globe. For example, if this theory had been correct, several other cities of similar scale would exhibit the same tendencies. But Hong Kong carries over 12 million riders per day and Hong Kong has recorded fewer positive cases than the state of Kansas.
The careful social scientist would have noticed that Hong Kong riders almost universally rode with facial coverings, and few if any were loudly talking while on the train. Similarly, if the MIT economist wished to prove the theory it would have possible to find patterns of positive cases hotspots. That economist never bothered with this important step. Paris researchers did bother to measure the patterns of hotspots. They found several patterns in the city, but none were traced to the Paris Metro.
The precise analysis would have asked if the basic pattern of zip-codes with high infection rates would hold up after the infection data were converted to infections per 1,000 residents. That would have proven that the borough with the least transit use, Staten Island, had higher infection rates than Manhattan.
As our riders return, there will be apprehensiveness on the part of operators and customers. It is vital that we understand the basics of the science of the transmission of Covid-19. Being on the same bus as riders who are not coughing, sneezing, or exhibiting any symptoms and who are all wearing facial coverings is not a high-risk condition. The riders can further reduce their personal risk by avoiding riders who are loudly speaking with no facial covering, riding shorter trips and avoiding the most crowded trips.
Transit managers can support these returning customers by providing and encouraging facial coverings, posting many reminders about the health safety issues, and reporting those who create health risks immediately to the appropriate personnel. These steps, in combination with the exceptional cleaning procedures, operator clear barriers, and offerings of hand sanitizers can restore confidence in the safety of all.
Issue 7, Article 2
COVID 19, RESTARTING FULL-SERVICE CAN BE ACCOMPLISHED SAFELY
One of the more unusual cases in the country took place in Skagit County, Washington in March.
We have known that certain tendencies are clear: avoid close contact for extended periods with positive cases. But in the case of a 2.5-hour choir practice in Skagit County, 32 of the 61 persons became infected (32 confirmed, 20 probable). Three of these cases required hospitalization and two cases were fatal. Over the course of these infections, 91% experienced a cough; 76% had a fever; and 61% had a headache.
What systematic factors were present, and how do we avoid this type of exposure?
As Skagit County Public Health investigated, they found that the full-voiced singing was a probable transmission factor; that the 150 minute duration of the practice was a probable factor; seating arrangement of 20 person rows with less than 11 inches between chairs was a probable factor; and the median age of 69 for the confirmed cases was a probable factor.
Few if any transit systems will ever have a choir practice, but many transit systems have older team members, many were accustomed to conducting frequent safety meetings with rows of seating close to one another, and some have meetings that take over ninety minutes.
We do not yet have proof of the factors that lead to a single individual infecting these many cases.
While we continue to learn more about the exact movement of exhaled breath that contains the virus, we already know that the droplets move a greater distance in cooler, drier conditions. We know that if we can use outdoor settings or change our air-handling systems to incorporate a great deal of fresh air, the infection rates are lowered.
Eventually we will learn why some positive cases involve an individual who infects far more persons than expected. Expanded testing and tracing will lead to this important finding.
But, at the moment, we know that not conducting meetings with close seating, not allowing untested team members to speak with one another without using facial coverings or not spaced over 6 feet apart is important. Reminding all team members of the hand hygiene, health reporting protocols and health safety metrics of the organization are vital to the health and reputation of our transit systems. Hong Kong has managed an impressive safety record in transit related cases of Covid-19 transmission. The choir practice in Skagit is a reminder of how a few risk factors can complicate the infection rate and transmission rate rapidly.
For more details: Morbidity and Mortality Weekly Report, CDC (May15, 2020)
Issue 7, Article 3
COVID 19, AS WE AWAIT A VACCINE, HOW USEFUL WILL THE NEW THERAPIES BE?
There are over two dozen vaccine candidates expected to reach clinical trial testing phase this summer. Three of the frontrunner candidates have published partial results and partnered with other firms to manufacture millions of doses.
But the safety testing of one or more of these vaccines will take several more months, even in the optimistic scenarios.
We are learning every day how to “cope” with the compromised solutions between social distancing in an almost open economy. Either herd immunity will be accomplished by 70% to 90% of the population receiving the new vaccines or by that number surviving the virus and producing appropriate antibodies.
The short term is not without promise of therapies that are safe and proven.
Remdesivir mimics the genetic material of the virus and replaces the building blocks of the virus. The result is a brake pedal in the speed of the infection. It appears to slow and interfere with the worst impacts of Covid-19.
Existing antiviral medications might be repurposed to fight the virus. Many labs have tested an array of existing drugs. The HIV drugs lopinavir and ritonavir have been at the forefront of testing news. The results are mixed. The next step is expected to combine drugs like remdesivir with these HIV medicines to test the safety and efficacy in treatment.
Perhaps the fastest breakthroughs could come in the form of a medicine to calm the cytokine storm found in very serious cases.
The immune system can, under certain conditions, become our own worst enemy. Cytokines play important roles in normal immune response. If the severe immune reaction causes the body to release too many into the blood rapidly, the reaction can lead to multiple organ failure.
The overabundance of the response leads to scavenger cells called macrophages inflaming the lungs. In the Covid-19 cases that are fatal, this is often the climax.
The clearest path seems to be the use of survivor plasma. The scientific logic has solved many immune issues. Take plasma from survivors of the disease, refine the results and inject in those who need prevention from the infection.
None of these solutions are ready for millions of treatments today. But several of these paths leading to solutions that at least prevent fatalities is great news for the nation and the transit profession.
Issue 7, Article 4
COVID 19, AFTER OUR SYSTEM RETURNS TO FULL SERVICE, WHAT HAPPENS NEXT?
In smaller transit systems, the nature of the trips will gradually return to the mix served before the pandemic, but the volume will take an uncertain period to return. Riders have delayed routine trips to the doctor and medical clinics. Those facilities are currently reporting a slow surge in patients.
Many school trips seem to be returning in September. Yet many school districts and colleges are making preparations for fall openings, with contingency plans in case of a surge in the infected case rates.
One trend for our transit systems seems clear: the express routes will be slow to recover. Many of the riders of these services in Houston, Dallas, San Antonio, Austin, Fort Worth, and El Paso have autos available and are expected to gradually shift back from single occupancy vehicles to transit after being convinced that the transit system health safety features are rigorous and the traffic congestion that had disappeared is now returning.
Another system impact that will be improbable to avoid is the increase in questions. Expect the website to receive more hits, expect the customer service phone process to be overwhelmed at times. Expect the public hearings at your council or commission meetings to be enlivened by public requests and suggestions.
One impact that is certain to occur is the local option sales tax will be lower this year than last. Whether your system is a direct recipient of dedicated funding or not, local governments losing revenue will lead to important budget decisions in 2021. Governor Abbott ordered state agencies and related organizations to prepare to reduce their budgets by 5%, compared to a normal small increase.
We will need to be prepared with accurate ridership trends on each of our routes and service types. The last three months have already proven that transit is one of the more essential services in a community. Our leadership in designing solutions for the challenging budget year ahead will be a measure of our value.
For more details see: Statesman.com (May 20, 2020)
Issue 7, Article 5
COVID 19, AFTER MORE CLEANING AND MASKS WHAT CAN WE DO TO IMPROVE THE RIDE?
The need to clean our vehicles more thoroughly is understood by all. The need to encourage facial coverings is understood by almost all. The need to provide cough shields or barriers for the operators and at customer service windows is easy to communicate.
But what else should we be considering that allows our revenue vehicles to be safe and effective in this new environment?
Broome County Transit is a medium size system south of Syracuse, New York. It will be interesting to watch the results of their newest strategy in this battle against the virus. They are installing negative ion systems in the HVAC systems on buses. The negative ions can trap particulates including viruses, bacteria and pollen.
Certainly, if proven, the news will focus on the potential impacts in the Covid-19 fight. But the negative ion system has the potential to safely improve the transit vehicle “indoor” air as a defense against any influenza also. Broome County Transit is also announcing plans to follow the lead of MTA in New York City as they implement UV disinfection equipment inside the railcars.
Bay Area Rapid Transit is one of several transit agencies that have implemented electrostatic spraying or misters to disinfect more effectively. The 2018 EPA evaluation of these sprayers proved that the electrostatic process allows greater efficiency in waste flow: the waste generation for a backpack sprayer was 45%, compared to the waste generation of the electrostatic sprayer of 10%.
Systems around the nation are evaluating strategies to collect fares in a “no-touch” method. The technology exists using tap cards or mobile devices including cell phones to pay a transit fare as simply as a Starbucks coffee. Be prepared to answer important questions regarding Title VI. There are ways to implement these strategies in an equitable manner, but the needs of all our customers, including those without bank accounts or smartphones must be considered and resolved.
For more details see: EPA/600/R-18/283 and wbng.com (June 12, 2020)