Abstract
Globally, little evidence exists on transmission patterns of COVID-19. Recommendations to prevent infection include appropriate and frequent handwashing plus physical and social distancing. We conducted an exploratory observational study to assess compliance with these recommendations in selected transportation stations in Ghana. A one-hour audit of 45 public transport stations in the Greater Accra region was carried out between 27th and 29th March 2020. Using an adapted World Health Organization (WHO) hand hygiene assessment scale, the availability and use of handwashing facilities, social distancing, and ongoing public education on COVID-19 prevention measures were assessed, weighted and scored to determine the level of compliance of stations. Compliance with recommendations was categorized as "inadequate" "basic", "intermediate" and "advanced", based on the overall score. Majority (80%) of stations in Accra have at least one Veronica Bucket with flowing water and soap, but the number of washing places at each station is not adequate. Only a small minority (18%) of stations were communicating the need to wash hands frequently and appropriately, and to practice social/physical distancing while at the station. In most stations (95%), hand washing practice was either not observed, or only infrequently. Almost all stations (93%) did not have alcohol-based hand sanitizers available for public use, while social distancing was rarely practiced (only 2%). In over 90% of the stations, face masks were either not worn or only worn by a few passengers. Compliance with COVID-19 prevention measures was inadequate in 13 stations, basic in 16 stations, intermediate in 7 stations, and advanced in 9 stations. Compliance with COVID-19 prevention measures in public transportation stations in the Greater Accra region remains a challenge. Awareness creation should aim to elevate COVID-19 risk perception of transportation operators and clients. Transport operators and stations need support and guidance to enforce hand washing and social distancing.
Highlights
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by coronaviruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2]
The Accra Metropolitan Assembly had the highest number of public transportation stations included among those observed (22.2%)
Ghana was identified among African countries with the highest vulnerability, as well as limited capacity to respond to the COVID-19 pandemic [18,19] Public transportation is an indispensable service that must continue during a COVID-19 outbreak situation
Summary
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by coronaviruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2]. COVID-19 is a highly transmissible disease with a basic reproductive number estimated to be higher than that of Severe Acute Respiratory Syndrome (SARS), which only affected 26 countries and caused about 8,000 deaths in 2002 [5,6]. The virus has been shown to survive outside a host for durations that depend on the nature of the surface. It can survive in the air for up to 3 hours, on copper surfaces for up to 4 hours, on cardboard for up to 24 hours, and plastic and stainless steel, for up to 72 hours [8]. Neither is there any vaccine for prevention in vulnerable populations [2]
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