Dutch Discussion on Public transport

On 12 June, the Dutch Government decided that airline travel could commence operations as usual, based on scientific advice from the Dutch Ministry of Health. The advice had 3 main references:

1. COVID-19 Aviation Health Safety Protocol. Guidance for the management of airline passengers in relation to the COVID-19 pandemic. Issue no: 1.1 Issue date: 21/05/2020.
2. European Centre for Disease Prevention and Control. Considerations for travel-related measures to reduce spread of COVID-19 in the EU/EEA. ECDC: Stockholm; 2020.
3. RAGIDA MERS-CoV.

ECDC Technical Report

Reference 2 clearly states the travel-related risks for COVID19: “ Travel and tourism could lead to an increased risk of SARS-CoV-2 transmission amplification in at least two ways. The first is related to mobility of people and the risk of transmission following arrival at the point of destination, and the second to the gathering of people at various venues such as airports, resorts and similar settings. Public health measures applied specifically to or within the travel sector are intended to minimise the likelihood of COVID- 19 transmission on board various conveyances, at sites of embarkation/disembarkation and at destinations.” This means that

• ECDC recognizes the increased COVID19 risk due to:
  • gathering people at airports
  • transmission on board
  • transmission at sites of embarkation and disembarkation
  • transmission risk at destinations

The document continues: “Travel-related introduction and tourism-related spread within the EU/EEA and the UK contributed substantially to the transmission across and within countries during the early phase of the COVID-19 pandemic” Since the Netherlands is returning to the containment phase, with an aim to reduce endemic transmission as much as possible (though this has never been defined as the strategic goal by the Dutch governing coalition), travel related introduction and tourism related spread are again to be expected becoming substantial contributors to COVID19 transmission.

Indeed, this is specifically acknowledged by ECDC, as the report continues: “In a situation where some Member States have decreased transmission to very low levels, while in others the virus is still circulating, the role of tourism and travel-related transmission may become significant due to the possibility of the virus being re-introduced at multiple sites, causing further spread. Furthermore, a high level of tourism- related activities may increase the risk of over-crowding in certain areas or during tourist events, which in turn may increase spread.”

What are the risks?

• “SARS-CoV-2 is believed to be transmitted mainly via respiratory droplets and by direct contact. However, indirect contact with contaminated fomites is also believed to play a role in transmission. Moreover, transmission through aerosols cannot be excluded.”

In order to reduce these risks, ECDC repeats the relevant interventions: “ Standard non-pharmaceutical countermeasures are the most important approach for controlling the spread of COVID-19 in all settings, including during travel. Such measures include physical distancing, hand hygiene and respiratory etiquette, as well as other infection prevention and control (IPC) measures (e.g. cleaning and disinfection of frequently touched surfaces and toilets, use of face masks, etc).” This list of interventions is not a ‘choose what you prefer’ list. It does not mean that each single intervention item can replace the others. Masks alone are not a good replacement for the lack of physical distancing. To make this explicit, ECDC states clearly in this technical report: “ travel service providers should still optimise physical distancing to the extent possible (e.g. by leaving an empty seat between passengers.”

The issue in many discussions will be: what is ‘to the extent possible’? Airlines might argue: this is not possible, or else we must double (or triple) the prices of tickets.

So what do you do as government? Well, that is a political choice. But please, do not cherry-pick scientific advice and then use science as an excuse for your choice. Be transparent. The public (your voters) deserve this, since you represent them.