Through Covid-19 lockdown and distancing measures, transport suffered a historic stop and metamorphosis, quickly raising many questions: will people use public transport in a pandemic context? How will public transport be cleaned? How green is a train conveying one passenger every two seats? Already in 1918, Charles W. Berry, pointed out the importance of sanitation in the navy to avoid infections. Later, public transport was defined as a key driver in the spread of epidemic/pandemic or respiratory infections (Alirol et al. 2011; Colizza et al. 2017). Saunders-Hastings and Krewski (2016) even go as far as stating that ‘mobility […] became the primary vector of disease spread’. Then, the World Energy Council encourages including the Epidemic, Pandemic, or Infectious (EPI) risk in future work, such as scenarios, since ‘the world remains poorly prepared to even modest biological threats’ (WEC, 2019). Nevertheless, it is not systematically discussed, even in documents addressing transport health. Khreis et al. (2019) forgot to address it in their conceptual model, which describes the health beneficial and detrimental transport factors. Consequently, are pre-Covid-19 transport scenarios still relevant? Is the EPI risk discussed? The apparent unpreparedness of most transport networks during the Covid-19 peak undermines the idea of an appropriate inclusion of the risk in transport predictive studies. Then, the hypothesis is made that, pre-Covid-19, research and transport players poorly addressed the EPI risk in transport future scenarios.
Were considered as scenarios, peer-review, and grey literature documents that detail a vision of future transports (Paez 2017). English and French keywords were used with 17 search engines (Tables 1, 2), representing 334 requests, without time restriction (Gusenbauer and Haddaway 2020). All transport that can be shared was considered a form of public transport. Documents discussing transport facilities or providing guidance on transport scenario development were qualified. Field-specific, but still broad, documents were accepted (e.g., transport for the elderly).
All documents were categorised according to whether the EPI risk was addressed, mentioned, indirectly mentioned, or not mentioned (Table 3). Guidance documents and transport scenarios had separate criteria to meet the “addressed” category. A guidance document only needed to mention the EPI risk to be considered to address it, while a scenario document had to propose actions and solutions to be considered to address it. The assumption was made that transport cannot be described as comfortable if it lacks cleanliness. Hence, this review considers the discussion of transport’s comfort as an indirect mention of the EPI risk. With both qualitative and quantitative data, a Factor Analysis of Mixed Data (FAMD), using R, was used to explore the variability of the sample and reveal important features. These include potential factors or patterns fostering the discussion of the EPI risk (Pagès 2004).
The 5 dimensions of the FAMD explain 35.91% of the dataset variation (Figure 3). The scree plot (Figure 1, A) shows that dimensions 1 and 2 explain 19.9% of the variation. Despite being the first variable in dimension 1, the discussion of health in documents is extremely low in dimension 2 (Table 6, Figure 1, C, D). Across the two selected dimensions, entity and type are the most contributing variables (Figure 1, B). Figure 2 shows that the more the number of addressed health topics is high, the more the EPI is likely to be addressed, or at least mentioned.
The EPI is addressed in 4 documents, mentioned in 7, and indirectly mentioned in 37. Exclusively on the global and national scales. Public health strategies are always defined by governments, while inter-governmental institutions coordinate nation interactions on global issues (Alexander 2015; Kickbusch et al. 2013). The EPI risk is discussed as complex to integrate into scenarios. This can explain why it is mostly addressed in grey literature, which remains more flexible on methodology. The discussion around the risk is carried out in two stages. First, documents rely on a past event (e.g., the Black Plague, etc.) before expanding their scope. And to remind us that each pandemic brings new parameters and uncertainties. ‘Cleanliness’ and ‘comfort’ are the main references to the EPI risk found among the 37 documents mentioning indirectly the risk.
Health is discussed in 101 documents, with an average of 3.45 health topics discussed per document. The main discussed health topics are those described by Kjellstrom et al. (2003): air pollution, safety, active transport, and noise. Documents addressing or mentioning the EPI risk are among documents that discuss more health topics (respectively 4.00 and 3.57) (Figure 3). The more health topics are addressed, the more the EPI risk will be addressed or mentioned. Documents that mention indirectly the EPI risk explore a smaller range of health topics. Some scenarios provide comprehensive health-related analysis while leaving aside the EPI risk. Over time, the number of health topics discussed increased.
The range of health topics discussed remains context-dependent. Seven documents that aimed to address health in transport provide a poor discussion of the EPI risk. Despite they address more health topics (4.14 on average) than documents discussing transport future through a wider lens. The report ‘Health 2020: Transport and Health’ (WHO, 2015) is particularly disturbing as it does not mention the EPI risk. That, despite the World Health Organisation publishing reports and procedures on pandemic preparedness. With, for example, dedicated web pages on Ebola and zoonotic diseases (WHO, 2020a, 2020b).
The review reveals some transport means are poorly represented. Few or no papers were found addressing future scenarios for maritime passenger transport or lifts. The latter is of critical importance to the EPI risk as they offer a confined space and a control panel touched by all users. Moreover, it is one of the primary shared transport means, with 100 million trips/day only in France (Franceinfo 2016; Fédération des Ascenseurs 2020). In addition, the use of elevators has other health impacts by discouraging the use of stairs (Yang, Sun, and Xu 2007). With most pre-Covid documents being now obsolete, the EPI should be considered in future work, like done by, for example, Schultz et al. (2020) and Cieśla et al. (2021).
I thank Dr. Marin Cvitanovic for his advice, help, support, and supervision of this paper which was part of my MSc thesis. I also thank Dr. Elena Cantarello and Pr. Adrian Newton for their support and valuable lessons throughout the year. I thank the co-working office Le 22 (Castres, France) which welcomed me at the time of my research.