Use of Personal Protection Equipment by Moscow Subway Passengers under Conditions of COVID-19 Pandemic

The Subway is the most important means of transport in Moscow. The active flows of passengers in the metro can contribute to the spread of infectious diseases with airborne and contact mechanisms of transmission, including the coronavirus infection COVID-19. The aim of the study was to assess the level of adherence to the use of personal protective equipment (facial masks, gloves) by passengers of the Moscow Subway. Materials and methods. A prospective study based on a visual assessment of passengers in a rolling stock of the Moscow subway, with division into cohorts of those using masks and gloves (K1), using only masks (K2), using masks in violation of the rules of use (K3) and not using personal protection equipment (K4) was conducted. Observations were carried out during the 42^nd and 43^rd weeks of 2020 in various subway clusters with a division in time into morning, afternoon and evening hours. Additionally, passengers were ranked into groups by occupation during the trip. Statistical processing included the identification of frequencies, their 95 % confidence intervals. To compare the significance of differences in the prevalence of features in paired groups, the methods of 4-field tables (χ2 Pearson) were used. Results and discussion. 18053 observations were validated, covering 61.3 % of stations. Men accounted for 54.7 % (9867). During the observation period, the following shares were established: K1 – 5.2 % (95 % CI 4.9–5.5), K2 – 51.9 % (95 % CI 51.2–52.7), K3 – 26.9 (95 % CI 26.2–27.6), K4 – 16 % (95 % CI 15.4–16.6). The level of adherence to the proper use of PPE is significantly lower among men. Land lines have the lowest proportion of passengers using PPE. Among passengers using electronic devices and paper media, a higher proportion of those wearing masks with violation of the rules of use, compared to passengers without activities, was established. Among passengers using electronic devices, the proportion of those using gloves is the lowest. Within two weeks of follow-up, a significant increase in the frequency of PPE use was revealed.

1. Van Doremalen N., Bushmaker T., Morris D.H., Holbrook M.G., Gamble A., Williamson B.N., Tamin A., Harcourt J.L., Thornburg N.J., Gerber S.I., Lloyd-Smith J.O., De Wit E., Munster V.J. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N. Engl. J. Med. 2020; 382(16):1564–7. DOI: 10.1056/NEJMc2004973.

2. Ahn J.Y., An S., Sohn Y., Cho Y., Hyun J.H., Baek Y.J., Kim M.H., Jeong S.J., Kim J.H., Ku N.S., Yeom J.-S., Smith D.M., Lee H., Yong D., Lee Y.-J., Kim J.W., Kim H.R., Hwang J., Choi J.Y. Environmental contamination in the isolation rooms of COVID-19 patients with severe pneumonia requiring mechanical ventilation or high-flow oxygen therapy. J. Hosp. Infect. 2020; 106(3):570–6. DOI: 10.1016/j.jhin.2020.08.014.

3. Yamagishi T., Ohnishi M., Matsunaga N., Kakimoto K., Kamiya H., Okamoto K., Suzuki M., Gu Y., Sakaguchi M., Tajima T., Takaya S., Ohmagari N., Takeda M., Matsuyama Sh., Shirato K., Nao N., Hasegawa H., Kageyama Ts., Takayama I., Saito Sh., Wada K., Fujita R., Saito H., Okinaka K., Griffith M., Parry A.E., Barnetson B., Leonard J., Wakita T. Environmental sampling for severe acute respiratory syndrome Coronavirus 2 during a COVID-19 outbreak on the Diamond Princess cruise ship. J. Infect. Dis. 2020; 222(7):1098–102. DOI: 10.1093/infdis/jiaa437.

4. Zhou Y., Zeng Y., Chen C. Presence of SARS-CoV-2 RNA in isolation ward environment 28 days after exposure. Int. J. Infect. Dis. 2020; 97:258–9. DOI: 10.1016/j.ijid.2020.06.015.

5. Mizumoto K., Kagaya K., Zarebski A., Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020; 25(10):2000180. DOI: 10.2807/1560-7917.ES.2020.25.10.2000180.

6. Prather K.A., Wang Ch.C., Schooley R.T. Reducing transmission of SARS-CoV-2. Science. 2020; 368(6498):1422–4. DOI: 10.1126/science.abc6197.

7. Goscé L., Johansson A. Analysing the link between public transport use and airborne transmission: mobility and contagion in the London underground. Environmental Health. 2018; 17(1):84. DOI: 10.1186/s12940-018-0427-5.

8. Furuya H. Risk of transmission of airborne infection during train commute based on mathematical model. Environ. Health Prev. Med. 2007; 12(2):78–83. DOI: 10.1007/BF02898153.

9. Hu M., Lin H., Wang J., Xu C., Tatem A.J., Meng B., Zhang X., Liu Y., Wang P., Wu G., Xie H., Lai S. Risk of COVID-19 transmission in train passengers: an epidemiological and modeling study. Clin. Infect. Dis. 2021; 72(4):604–10. DOI: 10.1093/cid/ciaa1057.

10. Tian H., Liu Y., Li Y., Wu C.H., Chen B., Kraemer M.U.G., Li B., Cai J., Xu B., Yang Q., Wang B., Yang P., Cui Y., Song Y., Zheng P., Wang Q., Bjornstad O.N., Yang R., Grenfell B.T., Pybus O.G., Dye C. An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China. Science. 2020; 368(6491):638–42. DOI: 10.1126/science.abb6105.

11. [Moscow Metro – 85 years old]. (Cited 25 Oct 2020). [Internet]. Available from: https://www.mos.ru/city/projects/metro85.

12. [Subway System in Figures]. (Cited 15 Nov 2020). [Internet]. Available from: https://mosmetro.ru/press/digits.

13. When to wear gloves. (Cited 07 Nov 2020). [Internet]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/gloves.html.

14. Coronavirus disease (COVID-19): Masks. (Cited 07 Nov 2020). [Internet]. Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-masks.

15. Chu D.K., Akl E.A., Duda S., Solo K., Yaacoub S., Schünemann H.J. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020; 395(10242):1973–87. DOI: 10.1016/S0140-6736(20)31142-9.

16. Matuschek C., Moll F., Fangerau H., Fischer J.C., Zänker K., van Griensven M., Schneider M., Kindgen-Milles D., Knoefel W.T., Lichtenberg A., Tamaskovics B., Djiepmo-Njanang F.J., Budach W., Corradini S., Häussinger D., Feldt T., Jensen B., Pelka R., Orth K., Peiper M., Grebe O., Maas K., Bölke E., Haussmann J. Face masks: benefits and risks during the COVID-19 crisis. Eur. J. Med. Res. 2020; 25(1):23. DOI: 10.1186/s40001-020-00430-5.

17. Liang M., Gao L., Cheng C., Zhou Q., Uy J.P., Heiner K., Sun C. Efficacy of face mask in preventing respiratory virus transmission: A systematic review and meta-analysis. Travel Med. Infect. Dis. 2020; 36:101751. DOI: 10.1016/j.tmaid.2020.101751.

18. On the effectiveness of using PPE in the spread of acute respiratory viral infections. (Cited 20 Nov 2020). [Internet]. Available from: https://www.rospotrebnadzor.ru/about/info/news/news_details.php?ELEMENT_ID=15472.