Maogui Hu1, Hui Lin2, Jinfeng Wang1, Chengdong Xu1, Andrew J Tatem3, Bin Meng4, Xin Zhang5, Yifeng Liu2, Pengda Wang2, Guizhen Wu6, Haiyong Xie2,7, Shengjie Lai3,8. 1. State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China. 2. China Academy of Electronics and Information Technology, Beijing, China. 3. WorldPop, School of Geography and Environmental Science, University of Southampton, UK. 4. Beijing Union University, Beijing, China. 5. Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, China. 6. Chinese Center for Disease Control and Prevention, Beijing, China. 7. University of Science and Technology of China, Hefei, China. 8. School of Public Health, Fudan University, Shanghai, China.
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.
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-19infections (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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