The following statement was issued by The Colleges of Medicine of South Africa
30thJune 2020
The College of Public Health Medicine Task Team for evidence-based COVID-19 guidance released a guidance documentary in the epidemic on the 22ndMarch 2020 regarding public transport. The Task Team was established to conduct rapid reviews of key priorities for evidence to inform public health recommendations to reduce the spread of COVID-19. Based on careful process using standard methodologies for rapid reviews, the Task Team provided a set of recommendations for infection prevention and control measures at transport hubs and within vehicles, be it taxi, bus or train. These latter measures included:
- ensuring ventilation by opening windows on both sides of a vehicle or conveyance to allow air to ventilate through;
- no more than 50% of carrying capacity for vehicle (subsequently increased to 75%in the regulations, possibly to accommodate the concerns of taxi drivers regarding economic viability);
- regular cleaning of window ledges, handles and backs of seats;
- conductors to open and close doors to reduce passengers touching handles
- passengers to clasp hands in front of them when entering and exiting vehicles to avoid touching surfaces
Subsequent to issuing the guidance, national adoption of a regulation that members of the public must wear cloth masks also applies to passenger and drivers of taxis.
It must therefore be noted that, contrary to public statement that there is no expert opinion that filling taxis to 100% capacity was unsafe “if passengers were sanitised and wore masks”, the CPHM recommendations, released more than three months ago, do indeed indicate that it is dangerous to fill taxis to capacity. This is based on a careful and systematic review of evidence by an expert task team of the public health medicine specialty in South Africa.
The role of public transport in spreading infectious disease has been widely investigated in the scientific literature. For example, South Africa researchers investigating indoor and outdoor pathways for TB transmission noted that “the increasing use of crowded transport
… with general population mixing and low levels of ventilation indicates that transport use offers high potential for maintaining TB transmission.” Given that COVID-19 is far more infectious than TB, we should be concerned to reduce risks of transmission in our public transport systems. There is therefore a strong evidence base for restricting mixing inside taxis, trains and buses and, while the economic plight of the taxi industry is a matter of public concern, it should not override the critical need to minimise transmission and the risk of morbidity and mortality from COVID-19.
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Signed by: Professor Eric Buch Chief Executive Officer: Colleges of Medicine of South Africa
Dr Flavia Senkubuge President: Colleges of Medicine of South Africa
Professor Leslie London President: College of Public HealthMedicine
For questions, contact Professor Leslie London; email: leslie.london@uct.ac.zaor 0791896368