Death-rate study informing TfL bus recommendations

A new study into higher than average death rates from COVID-19 among London’s bus drivers is being used to inform TfL’s recommendations on its bus network.

The Office for National Statistics (ONS) reported bus and coach drivers have elevated mortality rates from COVID-19. Death rates from the virus among bus drivers in London exceeded death rates for London as a whole in the majority of weeks from early April to early May. With this the case, the UCL Institute of Health Equity was tasked by TfL to explore the pattern of infection with, and deaths from, coronavirus in the capital’s bus worker population. The findings would be used to inform recommendations on any additional occupational health measures that should be put in place to protect them.

The report’s findings include:

  • Many of the London bus drivers who died from coronavirus were suffering with underlying health conditions particularly high blood pressure.
  • Among the bus drivers who died, most stopped work in the ten days either side of lockdown on 23 March, suggesting most of them became infected before lockdown. The report finds that after lockdown, death rates came down among drivers reinforcing evidence that lockdown was an effective measure in saving lives.
  • A high proportion of drivers who died had a number of personal characteristics which enhanced their risk to coronavirus, such as their ethnicity, and living in areas with above average levels of deprivation in London boroughs with the highest coronavirus death rates in April 2020.

According to the UCL Institute of Health Equity, additional risks of COVID-19 related mortality for bus drivers include: age, living in areas characterised by deprivation, having a high proportion of members of Black, Asian, and Minority Ethnic (BAME) groups; and the presence of underlying health conditions – hypertension, cardiovascular disease and diabetes – which are associated with increased likelihood that infection with COVID-19 becomes fatal. The Institute says it is impossible at this stage to establish which of these risks is greatest. However, it claims there is evidence that among those bus drivers aged 65 and over, those from BAME backgrounds and those with pre-existing hypertension are at higher risk of COVID-19 mortality and this should be taken into account in efforts by TfL and bus companies to reduce risks.

Lilli Matson, TfL’s Chief Safety, Health and Environment Officer, said: “We have been devastated by the tragic deaths of our colleagues during this pandemic. We commissioned this independent study so we could urgently understand what more we can do to reduce the risk of others contracting coronavirus. It’s clear that frontline workers across the country have disproportionately suffered from coronavirus, which is why we worked closely with all London bus operators to introduce measures to help keep the capital’s drivers safe.

“This included enhanced daily cleaning using hospital-grade disinfectant in the drivers’ cabs, the parts of the bus regularly touched by customers and in staff welfare facilities, as well as providing more separation from passengers. This was done, firstly, by taking the seats nearest a driver out of use and sealing up holes in the partition between drivers and passengers, and then by introducing middle-door boarding so passengers didn’t need to stand for any length of time next to drivers.

“The recommendations in this report provide a roadmap for action to further protect bus drivers. It is clear from this piece of work and others that there are certain characteristics that make people more vulnerable to coronavirus. We will work with our bus operators to ensure that they consistently carry out risk assessments and appropriate support is given to those that need it. We know that those with underlying health conditions, such as hypertension and cardiovascular disease, are at higher risk. In response we will extend wellbeing initiatives, such as the Health Bus, to reach more drivers. And we will work with the bus operators to prepare a response plan to help us make immediate, consistent interventions in the event of further outbreaks.”

Previous separate work by UCL’s Centre for Transport Studies and the Department of Civil, Environmental & Geomatic Engineering assessed the risk to drivers in their cabs. The analysis found that the steps that TfL has taken – by adding a film layer to screens and sealing off gaps around the screen as a whole, including around the Oyster reader – substantially reduced the risk to drivers of contracting coronavirus from customers.

From 17 March TfL started funding enhanced sick pay for bus staff who were suffering from coronavirus symptoms, or had to self-isolate for up to 14 days because someone in their household has symptoms. This was to ensure drivers didn’t feel forced to attend work for financial reasons when they shouldn’t. This arrangement remains in place.

Senior Assistant General Secretary at trade union RMT, Mick Lynch, said: “This report is an indictment of the Government’s sluggish and irresponsible initial responses to the COVID-19 pandemic.

“While the timing of actions by most companies was similar, the majority of actions were probably initiated after most of the drivers who died had become infected. Bus companies need to be more proactive in understanding existing health conditions of bus drivers, supporting better health and identifying those most at risk of COVID-19 mortality.

“BAME staff, especially those living in poorer areas , are more at risk of becoming severely ill and dying from COVID-19. The recommendations in PHE’s recently published report ‘Beyond the data: Understanding the impact of COVID-19 on BAME groups’ should be implemented.

“In particular that employers should have strategies to create healthy and supportive workplaces – within and outside the health service – that have zero tolerance for discrimination and empower BAME staff to raise concerns about occupational risk and safety.”

  • UCL Institute of Health Equity’s full report can be found here.

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