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Ask An Epidemiologist: How To Stay Safe From COVID While Riding The Subway

Beginning Monday, subways will be open for 22 hours a day, as part of Governor Andrew Cuomo’s “phased reopening” of the nation’s largest transit system. There will be a two-hour closure 2 a.m. to 4 a.m. each night—slightly expanding the 20-hour schedule that has been implemented since May.

The two-hour window retains the continued efforts to clean subway cars and stations overnight—aimed at reducing surface transmission of the coronavirus despite a growing amount of scientific evidence showing the primary pathways of catching the germ is through close contact and airborne droplets. Critics have called the cleaning efforts “hygiene theater” and discrimination against homeless New Yorkers.

When justifying the cleaning, the MTA cites federal guidance encouraging regular surface cleaning as well as an agency survey showing three in four riders felt safer because of the cleaning. NYC Transit Interim President Sarah Feinberg said on WABC-7 Sunday morning the agency cleans the system at all hours of the day, but “during those overnight hours, when there are no customers in the system, we’re really efficient.”

Theater or not, many may be nervous about riding the train, though some industry reports and academic studies suggest the spread of the coronavirus as well as influenza is not linked to subway riding. Others may just be lucky enough to mostly stay at home. MTA’s recent figures show ridership is down overall 60% to 70% compared to the middle of February last year. But subways can still be seen packed with essential workers:

With nearly a year of this pandemic behind us, we checked in with epidemiologist Dr. Jessica Justman for updates on safety practices for riding the subway. Some of the tips you’ve heard for months now. Wear a mask, wash your hands, and stay six feet apart when possible.

Justman, an associate professor of medicine in epidemiology at Columbia Mailman School of Public Health, said eye protection and double masking are now a good idea, too, especially if you have no choice but to board a crowded train.

Here’s what else she had to say:

What do you feel like is the one thing around subway riding and COVID risks that has changed the most since a year ago?

A year ago, we had an inkling that this was spread through respiratory transmission, but there was more uncertainty about how important surface transmission might be. Now a year later, it’s abundantly clear that the respiratory droplets in the aerosols play the most important role in transmission. Contamination of surfaces with the coronavirus virus really is of minimal importance.

A lot of people are still nervous about riding the subway right now. Governor Cuomo is still closing the trains for a couple of hours overnight for surface cleaning of cars and stations. So, does this policy help?

In thinking about the subways, I would want to separate out the cleaning of the surfaces from the physical experience of being in a subway that might be crowded at rush hour with a lot of people. Because cleaning surfaces, it doesn’t clearly reduce the spread of SARS-CoV-2.

But people feel more comfortable when they’re in a clean place, and especially if they have concerns or anxieties about germs. It’s reassuring to see that people are paying attention and cleaning all the surfaces. It just instills confidence so that people are more likely to take the subway and I don’t want to underplay that. Feeling more confident in what you’re doing is always helpful.

Well if that’s true, do people still need to wash their hands?

Hand washing does remain important. When coming out of the subway, it’s good to use hand sanitizer right away. It helps in case you accidentally rub your eyes or touch your nose or touch your mouth. And at least your hands will be cleaner than they would have been right when you came out of a place where there are a lot of people.

What about ventilation on subways? Does that matter?

Ventilation is important. It’s more important than cleaning all the surfaces.

As people start to ride the subways more often, what should they do if there is a crowded platform or a crowded train car?

The ideal is to wait for a different train, or try and walk to the front or the back of the train and get onto a car that’s less crowded. The days of riding during rush hour on a completely packed subway where everybody’s packed in like sardines—I certainly don’t want to do that anytime soon.

Eye protection is a good idea. If you’re wearing something over your eyes, you’re less likely to touch your eyes. It becomes a barrier.

As long as I can be on a subway car; keep a reasonable distance approximately six feet away from other people; I’m wearing a mask or double mask; and other people are wearing masks, then it’s fine.

If you happen to notice that somebody who’s near you is coughing or sneezing, I would try to move away.

It’s still those key principles again, of physical distancing, masking, and hand washing.

This may be a matter of personal preference‚ but how crowded is too crowded? If it’s standing room only or to sit next to someone versus stand and face them? A subway can be standing room only but still feel relatively spacious if it’s just all the seats are full.

You’re absolutely right. This is subjective. I think that if all of the seats are full, that is a very full train. I probably would have second thoughts about that. That’s my personal opinion. Having every single seat full, to me, that’s a little too crowded from my own comfort.

Most Americans wear masks now. But what should people do if there is someone without a mask near them on a train?

I would try very hard to stay more than six feet away from the person who’s not wearing a mask. If you really have to take the subway to get somewhere, and you don’t have time to wait and wait, and all the seats are full, that’s when I would be really focused on double masking, wearing eye protection, and working really hard to not touch your face. Then use hand sanitizer, or wash your hands when you come out of the subway.

Because sometimes people don’t have a choice. I recognize that. You don’t always have the luxury of saying, ‘Oh, I’ll just wait for five more trains to go by.’ You might have to really get somewhere.

In other words, maximize your protective measures if you really have to be on a full subway train.

At first, the NYPD was enforcing social distancing regulations, which backfired, leading to a policy shift. The MTA made a rule where officers can issue $50 fines if a rider refuses to wear a mask, which led to few summonses. What’s the best way to make sure people are taking these precautions?

Public service announcements that are encouraging and saying, ‘wear a mask, to protect yourself and protect others.’ Make sure it really covers your nose, mouth, and chin.

Making masks available at stations for people who don’t have them is a great idea if it’s feasible.Provide or sell masks at least at some of the stations, near the Metrocard machines.

I would not encourage the MTA to use attendants to ‘police’ adherence to social distancing. It would not be well received. It would not be feasible to do this in a uniform manner. It will never work well for us to take a punitive approach to enforcement. I think that would really backfire.

The MTA says it is doing many of these activities. The agency says it has distributed 440,000 masks between July and January through its “mask force,” and that subway mask compliance is 97%. Starting this month, celebrities are making a new set of COVID PSAs, and subway ads posted inside train cars are telling people the correct way to wear a mask. Is it enough?

Of course, these measures will not be effective unless there is enough space on the trains for people to spread out enough. It would be very helpful if MTA had attendants to identify which trains—the specific lines, the day of week, and the time of day—are crowded in order to then adjust the length (number of cars) and frequency of the trains.

Editor’s note: This interview has been edited for clarity and brevity.

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