By Dr. George Jacob

Kochi, May 22, 2020: After the lockdown lull, people have started travelling once again, or will travel in larger numbers very soon. Trains have started chugging again, and flights will resume operations on May 25. Buses too have resumed operations in some states.

But travelling will never be the same as it was before the Corona virus made its presence felt in India. A number of changes will have to be enforced while travelling within a country still in the grip of COVID-19. These changes are dictated by the virus’ modes of spread, which are:

• Through the respiratory route- the virus spreads from human to human when the virus colonizing the body fluids in the respiratory passages of the infected is released forcefully in large numbers through coughing, sneezing, blowing the nose, and , according to some scientists, even through speaking. This calls for physical distancing and use of masks.

• Through fomites (substances) – the virus spreads from person to person through fomites, or physical material exchanged by infected hands, or through gestures like shaking hands, or hugging. This calls for people to limit the load of the contagion by frequent hand washing using soap and water, or by using hand sanitizers.

Other concerns of this viral infection are largely scientific, those that continue to baffle and have healthcare providers on a slippery slope of uncertainty and admittedly, a certain degree of helplessness. These make promulgating modifications while travelling in the ‘Covidian’ times pertinent.

These concerns are:
• Dearth of vaccine to confer herd immunity within the community till an effective treatment is unraveled.
• Lack of effective and targeted treatment, though a lot of modalities viz; Convalescent Plasma Therapy, combinations of anti-virals and use of hyfroxychloroquine, which still remains controversial, and about which the last word hasn’t been said yet.
• Vagaries of manifestation of the viral infection, which is bracketed within a wide spectrum ranging from asymptomatic (without symptoms) to multi-organ failure and death. It is now known that those above 60 years, the immunocompromised, those with co-morbidities like cardiovascular diseases, renal and hepatic diseases, obesity, hypertension, diabetes, and the pregnant are the ones who fare badly.

Evidently, the trick to dodge the Corona Virus is to prevent transmission. This is achieved by:

• Physical distancing- to maintain at least a meter between individuals.
• Avoiding coughing and blowing noses publicly, and by coughing into a handkerchief, or into the shirt sleeve.
• Use of masks.
• By ideally limiting exchange of articles between people. There is no better instance when these are to be observed religiously than during travel, which involves a captive group of people, likely to interact within the confines of a vehicle.
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Based on the above facts, travel has to be modified in these ‘Covidian’ times to prevent transmission, whatever the mode of transport might be:

• Physical distancing must be maintained. This can be achieved by limiting passengers occupying long seats, especially in buses and trains. Travelling by standing in buses must be banned. Travel in crowded conditions in vehicles must not be allowed under any circumstance.
• Buses, especially in the private sector which will entail huge losses of income through the above measure must be supported by the government financially.
• Touch-free hand sanitizer dispensers, either foot-operated or sensor-operated should be made available extensively inside railway stations, airports and bus stations, and within vehicles as well. Hand-washing facilities also must be provided liberally. Only liquid soap dispensed by sensor operated technology must be used. Hands must be dried either with disposable paper napkins or warm air blowers.
• Wearing of masks must be made compulsory for passengers and staff manning modes of transport.
• Use of physical articles that need to be exchanged between people like boarding passes, tickets and ID proof must be limited. Electronic Travel cards can be used instead of tickets.
• The use of gloves by personnel involved in security check at airports must be banned. Gloves, while protecting the user, in fact transmit the virus if used without changing them between passengers. Instead, use of hand sanitizers must be encouraged between individual passengers.
• Web check-in must be encouraged to avoid transaction, crowding and queuing before check-in counters at airports. Flight Tickets must be confirmed on computers at check-in counters, use of mobile phones to confirm tickets must be limited.
• Functioning of Doors within and those allowing entry into airports, railway and bus stations must be made automatic using sensor-operated, or visual-operated technology.
• Physical frisking by security personnel at airports must be minimized, and use of walk-through metal detectors and X-Ray screening of luggage and passengers must be made foolproof and more effective by having more alert personnel than the somnolent ones, often seen manning screening stations!
• Airhostesses must welcome passengers into flights with a squirt of hand sanitizer, apart from the usual smile and namastes.
• Luggage must be sanitized by targeted fogging at every possible instance, especially on conveyer belts.
• An alternative must be discovered for boarding passes for flights, which change many hands.
• Number of Counters and staff strength at facilities like airports, bus and railway stations must be increased substantially to minimize queuing and crowding.
• Food counters at the above facilities must address physical distancing and hygiene.
• Trash cans must be placed more liberally in public utilities.
• Visitors who flock to see off and receive passengers must voluntarily limit themselves, or their entry limited by security personnel at the gates of public utilities.
• Medical aid posts at airports, bus and railway stations must be adequately manned and equipped to test suspected Covid cases, and to provide symptomatic treatment.
• It would be ideal if dedicated and well-maintained lodging facilities are made available at airports, railway and bus stations to quarantine people, if need demands.