Spring 2020 COVID-19 community transmission behaviours around New York City medical facilities

BACKGROUND: Epidemiological studies have long been used for infection transmission prevention, but exact patterns of touch behaviours and transportation choices [contributors to community spread of coronavirus disease 2019 (COVID-19)] were previously unknown. AIM: To investigate individual risk behaviour levels with respect to local COVID-19 infection levels. METHODS: A longitudinal field study recorded behaviours of individuals leaving medical facilities following the New York State's PAUSE order. A subset of those data was analysed herein (4793 records, 16 facilities, 23(rd) March–17(th) May 2020). Touched objects and transportation choices were compared over time using Chi-squared tests (P<0.05 significance threshold). FINDINGS: In Week 1, 64.1% of subjects touched at least one environmental object [such as a building door handle (21.8%); traffic light, railing or parking meter (5.6%)]; shared object [such as a vehicle door handle (19.7%)]; personal object [such as a cell phone (4.2%)]; or themselves (0.4%). By Week 8, <35% of subjects touched at least one object, where the greatest reduction was in touching environmental objects. The frequency of touching increased slightly during the observation period for some personal objects such as cell phones. The use of public transportation remained steady (approximately 20%) throughout the study period; for-hire vehicle usage increased from 0% in Week 1 to 7% in Week 8, mirroring a 7% decrease in the use of personal vehicles (from 34% to 27%). Touching and transportation patterns varied significantly by facility. CONCLUSIONS: While this study observed a decline in touch patterns and use of shared modes of transportation, the persistence of many risk-related behaviours suggests that more effective public health policies, including cleaning regimens for public environmental objects and the removal or relocation of frequently touched objects, could help limit the spread of COVID-19.