Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
28 C H A P T E R 5 Pandemics produce two operational burdens on local transportation organizations: widespread absenteeism across all sectors and infection pre- vention. Since both can have a substantial impact on the ability to provide services, transportation agencies must identify their essential functions and strategies for reallocating resources to maintain those essential functions if possible. It is likely that for many residents without access to personal vehicles, the services provided by their local transportation organization are their most reliable and accessible option for transportation. This makes it even more important that small urban and rural transportation organizations prepare for potential service changes in advance of a pandemic. To best meet demand with the constraints caused by pandemic or other highly infectious disease outbreaks, it is critical that transportation agencies (ahead of time) identify essential services, project how services can be impacted by outbreaks, and establish policies/procedures for managing these events, including potentially transporting symptomatic individuals. A checklist on providing services during a pandemic is provided in Chapter 7 (see Exhibit 21). Identifying Essential Functions Essential functions are those functions (primary services and supporting services) that the organization must continue even in the event of an emergency. Non-essential functions are still important but can be deferred with minimal consequences until additional resources become available. Identifying essential functions is part of the continuity of operations planning process (see Exhibit 22). These essential functions serve as part of the foundation for a local transportation agencyâs Continuity of Operations Plan (COOP). Essential functions may encompass those activities that are at the core of the organizationâs mission, but may also include activities that are deemed essential due to the nature of the outbreak (e.g., providing transportation to medical providers). By pre-identifying those functions that a transportation organization must continue or are the last to be curtailed if services are suspended in a pandemic, a large burden is lifted from decision makers trying to address multiple response issues during an outbreak. It will be useful to get insights from the partners (agency and nonprofit stakeholders and rider representatives) identified in Chapter 3 when discussing and determining essential functions. Organizations are reminded that pre-emergency projections should be re-evaluated prior to implementation to ensure decisions take into account actual circumstances. Providing Services During a Pandemic This chapter outlines the process for defining essential functions and determining how services may be utilized differently. Exhibits in this Chapter 21 Providing Services During a Pandemic Checklist 22 Additional Resources for Identifying Essential Functions 23 Considerations for Service Utilization Changes that may Impact the Organization and Other Services 24 Services for Sick Riders: Direct and Indirect Disease Transmission
Providing Services During a Pandemic 29 Exhibit 21. Providing services during a pandemic checklist. This tool is included on page 48 of Chapter 7. Purpose: Provide a checklist of service-related issues transportation agencies should address during the planning phase for pandemics. This checklist is designed to provide a starting point and is not exhaustive of all possible actions. Directions: Use the chart to plot progress. Continuity of Operations (COOP) Planning Guidelines for Transportation Agencies A comprehensive guide on how to identify essential functions (in coordination with developing a COOP) can be found in the NCHRP Report 525, Volume 16: Continuity of Operations (COOP) Planning Guidelines for Transportation Agencies. The worksheets provided at the end of that guide provide a detailed process, examples, and forms for identifying essential functions. Access the document online at: http://onlinepubs.trb.org/onlinepubs/nchrp/nchrp_rpt_525v8.pdf Developing Partnerships between Transportation Agencies and the Disability and Underrepresented Communities TCRP Research Results Digest 107: Developing Partnerships between Transportation Agencies and the Disability and Underrepresented Communities provides guidance on addressing the needs of special needs populations. Access the document online at: http://onlinepubs.trb.org/onlinepubs/tcrp/tcrp_rrd_107.pdf Exhibit 22. Additional resources for identifying essential functions.
30 A Guide for Public Transportation Pandemic Planning and Response This process is vital to being able to respond to long-term absenteeism in a strategic and orga- nized fashion. Determining essential functions can be difficult because staff and others may incorrectly presume that any function that is not selected as essential is not important. Service Utilization Changes Based on the nature of a pandemic, the demand for transportation services could either be reduced or increased. Both scenarios, while temporary, bring challenges that can be addressed through the planning process (see Exhibit 23). During a pandemic, normal ridership will likely diminish due to: â¢ Workforce absenteeism. â¢ Reduced commerce. â¢ Fear of exposure to infection in a public setting. â¢ Directives from public health and/or emergency management. Conversely, riders who would normally not use transportation organizations may change their travel patterns during an infectious disease outbreak. The rural and small urban com- munities may also see an influx of persons without personal vehicles migrating from more densely populated areas. Services for Ill Passengers It is highly probable that passengers who normally rely on public transportation and who may be exhibiting symptoms of the infectious disease will try to use the services of the transportation organization in order to get to work, school, medical appointments, or other locations. In order to best protect the serviceability of vehicles and the safety of other individuals on board, trans- portation agencies should establish clear safety protocols for providing reasonable accommoda- tion to potentially contagious individuals while best protecting uninfected workers and riders. Safety protocols should: â¢ Make worker protection the highest priority. â¢ Be mindful of the provisions of the Americans with Disabilities Act (ADA). â¢ Recognize that pandemics involve relatively untested and unfamiliar tasks. â¢ Take into account fear, uncertainty, and mental health issues. â¢ Recognize that there will likely be levels of rider and staff noncompliance. Pandemic diseases are transmitted in various ways. The most significant for transportation organizations are through both direct and indirect means, as described in Exhibit 24. Not all methods of disease transmission are discussed in this guide. Exhibit 23. Considerations for service utilization changes that may impact the organization and other services. Service Considerations Fixed routes and on demand Based on route of transmission, modify service model Commuter Services Suspend or curtail Peripheral Routes Reduce frequency, change to on demand, revamp with contiguous or complementary transit service providers Non pandemic related community events participation Suspend
Providing Services During a Pandemic 31 Multiple options are available to transportation organizations to minimize the spread of disease to riders, surfaces, and transit workers. Transportation agencies should incorporate some or all of the actions above when consistent with the recommendations of their local public health department or OSHA and the CDC. Note: Activating safety protocols is an example of decision making by organization leaders. Exhibit 24. Services for sick riders: direct and indirect disease transmission. DIRECT TRANSMISSION INDIRECT TRANSMISSION How it Spreads Airborne/droplet. Spread by breathing (or other routes of entry such as the eyes) the agent that has been released from someone talking, sneezing, coughing, and (less so) breathing. Physical contact. Spread by touching a surface that becomes contaminated with the disease (i.e., fomites) that can remain infectious outside the body. Examples of illnesses spread this way Bacterial meningitis, chickenpox, common cold, inï¬uenza, tuberculosis, measles, rubella, whooping cough, SARS. Inï¬uenza, norovirus, clostridium diï¬cile, Staphylococcus aureus, shigellosis. Preventative Actions Deny service or provide reasonable accommodation. Require sick rider to wear a surgical mask. Transit worker wears N95 or equivalent. Transit worker wears gloves and/or other PPE. Social distancing enforced. Use environmental controls such as physical barriers or stand oï¬ zones. Hand sanitizer provided. Vehicle and structure disinfection. Deny service or provide reasonable accommodation. Require sick rider to wear a surgical mask. Require sick rider to wear gloves. Transit worker wears gloves and/or other PPE. Social distancing enforced. Hand sanitizer provided. Vehicle and structure disinfection.