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'7 commandments' for public transport will reduce risk of virus spread -- medical experts

A group of medical experts, including two former Health secretaries, backed a proposal to increase public transport capacity as it recommended "seven commandments" to minimize the risk of spreading the novel coronavirus disease.

"We cannot build back the economy without increasing public transport capacity, which has been operating at only 20-30% of pre-pandemic levels due to understandable fears of outbreaks arising from congested public transport spaces," the group said in a statement released Tuesday.

The signatories are former Health chiefs Manuel Dayrit and Esperanza Cabral, UP Manila College of Public Health dean Vicente Belizario Jr., special advisor to the National Task Force against COVID-19 and former Health Undersecretary Teodoro Herbosa, UP Manila Department of Environmental and Occupational Health chairman Michael Hernandez, Philippine College of Surgeons Cancer Commission director Manuel Francisco Roxas, Eye Bank Foundation of the Philippines CEO Ma. Dominga Padilla, and infectious disease specialist Rontgene Solante.

The group's so-called seven commandments for public transportation, which it presented to the Inter-Agency Task Force on Emerging Infectious Diseases Monday, are as follows:

- Wearing of proper face masks;

- Wearing of face shields;

- No talking and no eating;

- Adequate ventilation;

- Frequent and proper disinfection;

- No symptomatic passengers; and

- Appropriate physical distancing

"We believe that the combination of these measures will be among the most comprehensive in the world, based on our consultation with international experts. By imposing these strict measures, we believe we can gradually relax social distancing rules, in order to double or even triple our current public transport capacity, without compromising public health," the group said.

A recent study from Duke University showed surgical masks reduce droplet transmission by up to 99 percent, and the simple act of not talking can reduce droplet count by up to four times.

A meta-analysis published in The Lancet, leading international medical journal, shows that face masks and face shields can independently reduce the chance of viral transmission by up to 5-fold and 3-fold, respectively.

The medical experts noted that COVID-19 cases remain manageable in countries such as China, Japan, Korea, Singapore, Taiwan, Vietnam, among others, where passengers wear face masks while sitting side-by-side in trains, while COVID cases remain manageable. 

And while the World Health Organization recommends keeping a distance of one meter from other passengers, it allows for adjustments based on context, the group said.

"Given our other recommended health interventions, we propose the gradual reduction of the physical distancing norm during transit to 0.5 meters or lower. Based on our review of the scientific literature and the policies and experiences of neighboring countries, we believe the evidence shows physical distancing can be maintained below 1 meter, so long as other health measures are also implemented."

The group of medical experts also called for wider discussion on the issue of the "overall increase of the supply of safe public transportation such as rail, buses, jeepneys, motorcycle taxis, and Transport Network Vehicle Services (TNVS), and the use of other options such as cycling, walking, and private shuttles."

The group said it will seek further dialog with the IATF, medical and transportation experts, and other stakeholders about its proposal.

"The comparative toll on Filipinos from a further prolonged recession is much more devastating than the manageable risks entailed in our plan. We believe that there is a way forward that carefully balances a careful reopening of public transport capacity, with public health, while allowing purposeful flexibility to re-adjust measures based on actual and evolving data from the ground."

"The success of this plan is by no means guaranteed. Critically, it requires the education of the public, who must take full responsibility for compliance with the 7 Commandments," the group said. 

Topics: World Health Organization , COVID-19 , Transportation , Transport Network Vehicle Services , Inter-Agency Task Force on Emerging Infectious
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