The impact of public transportation on the transmission of COVID-19 in Rwanda

Abstract

Introduction: The onset of the COVID-19 pandemic has placed a significant burden on healthcare systems worldwide, particularly in sub-Saharan regions where healthcare resources are limited. The transmission of SARS-CoV-2 is facilitated by the movement of people from place to place. Therefore, implementing measures that restrict movement of people and contacts is crucial in controlling the spread of the disease. Following the identification of the first COVID-19 case in Rwanda, the government implemented stringent measures, including a complete nationwide lockdown, border closures, curfews, reduced capacity in public transportation and businesses, and mandatory testing. This study aims to assess epidemiological trends in COVID-19 cases in relation to changes in population mobility within the public transportation system.

Methods: A descriptive analysis using publicly available data on COVID-19 epidemiological indicators (cases, deaths, vaccinations, and stringency index) and mobility data was conducted.

Results: The results reveal a strong correlation between mobility in public transportation and other activities, underscoring Rwanda's reliance on its public transportation system. The study also identifies a pattern where increases in transit station mobility preceded spikes in COVID-19 cases, suggesting that the subsequent rise in public transportation usage may contribute to higher infection rates.

Discussion: Therefore, this study emphasizes the importance of ongoing vigilance and regulatory measures regarding public transportation during infectious disease outbreaks.

Keywords: COVID-19; SARS-CoV-2; disease transmission; epidemiological trends; public transportation.

Figure 1

Epidemiological characteristics of COVID-19 outbreak in Rwanda from 14/03/2020 to 15/10/2022. (A) Epidemiological curve for weekly new COVID-19 cases (blue) and deaths (red); Including the date when the first case was ever reported in Rwanda on for the Wuhan strain (14/04/2020), Alpha, Delta, and Omicron Variants of Concern periods. (B) Trend of weekly total number of the people tested for COVID-19 (blue) and positive rate (red). (C) Cumulative number of COVID-19 vaccine doses administered; Dose1 represents the cumulative number of people who received at least one dose of COVID-19 vaccine, and Dose2 represents the cumulative number of people who received at least two doses of COVID-19 vaccine.

Figure 2

The impact of COVID-19 restrictive measures on the mobility flow. The change in mobility flow during the COVID-19 outbreak at different locations. (A) Retail and recreation, (B) Grocery and Pharmacy, (C) Workplaces, (D) Transit stations, (E) Parks, (F) Residential. The change in mobility is in percentage where 0% represent no change in mobility flow compared to the baseline. The baseline represents the mobility flow for the pre-pandemic period from 3 January 2020 to 6 February 2020. (G) Represents the change in the stringency index during COVID-19, (H) represents curfew restrictions imposed during COVID-19 outbreak.

Figure 3

The relationship between the outdoor mobility trend and COVID-19 cases. This figure illustrates the relationship between the outdoor mobility flow (red line) and the epidemiological trend for COVID-19 cases (blue line).