The coronavirus has caused governments to shut down whole cities and financial markets to plunge. As of Thursday, there were over 96,000 reported cases worldwide and more than 3,300 deaths, according to Johns Hopkins University.
Public health officials, including the Centers for Disease Control and Prevention (CDC), have urged people to sneeze into their bent elbows, avoid touching their eyes, hands, and mouths, and most importantly, wash their hands with soap and water for at least 20 seconds.
But there’s handwashing and there’s handwashing. A recent study by Poets&Quants’ Professor of the Week, Christos Nicolaides of the MIT Sloan School of Management, suggests an increase in strategic handwashing at ten major international airports that serve as key transit hubs could dramatically reduce the virus’s spread.
AIRPORTS PLAY A KEY ROLE IN THE SPREAD OF A DISEASE LIKE CORNOAVIRUS
The paper, “Hand‐Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network,” was published in December in the journal Risk Analysis. Nicolaides’ co-authors included Demetris Avraam of the University of Cyprus, Luis Cueto-Felgueroso of Universidad Polytechnical de Madrid, Marta C. González of UC Berkeley and Ruben Juanes of MIT’s civil and environmental engineering department.
Nicolaides is actually not a professor but a Digital Fellow at MIT Sloan’s Initiative on the Digital Economy, but because of the newsworthiness of this paper, Poets&Quants has given him an unofficial, temporary “promotion” and is publishing his and his co-authors’ findings as a public service.
The researchers begin by noting that transportation hubs such as airports play “a key role in the spread of transmittable diseases,” such as severe acute respiratory syndrome in 2003 and the H1Ni1 virus in 2009.
HOW EPIDEMICS SPREAD
“The transmission is accelerated when dense populations are concentrated in confined spaces, like an airport, with lack of good hygiene and efficient air ventilation,” Nicolaides and his co-authors write. Plus, airports have many open surfaces easily exposed to contamination that are then touched by passengers.
“Self-service check-in screens, gate bench armrests, water fountain buttons and door handles at airports, as well as seats, tray tables, and handles of lavatories in aircraft, are all known to have high microbial contamination,” the researchers note. This combination of enclosed spaces, contaminated surfaces, and dispersion of passengers to far-flung destinations is a toxic brew in which epidemics can spread.
One way to ameliorate that is by frequent handwashing, which can reduce contamination from 44% of individuals in public places to only 8% after washing with plain soap and water. An estimated 70% of travelers wash their hands after using airport bathrooms, but many of them do not follow CDC recommendations of extended washing with soap and water. So, the researchers developed a computational model that simulated the spread of an infectious disease and the movement of passengers through the air-transport system. Using Monte Carlo simulations (a technique used to measure risk and uncertainty), they assessed the impact of enhanced handwashing rates on the early stages of a disease spreading under four different mitigation strategies…
HOW TO DECREASE THE IMPACT OF THE DISEASE BY 8% TO 37%
One of those strategies focused on ten key airports—those that not only get a lot of traffic but at the same time can be “super spreaders” of a disease across the globe themselves. Those ten, according to the ranking, were: London Heathrow; Los Angeles International (LAX); John F. Kennedy International in New York;; Paris Charles de Gaulle; Dubai International, Frankfurt am Main; Hong Kong International; Beijing Capital International, San Francisco International, and Sydney Kingsford Smith International.
Concentrating handwashing in these ten airports, the researchers found, would be the most cost-effective strategy, decreasing the impact of the disease spreading by 8% to 37%.
There are barriers to putting this strategy into practice. “The capacity of hand‐washing facilities in crowded places including airports, is limited only to washbasins at restrooms,” Nicolaides and his co-authors write. “It is not known, however, if increased capacity would enhance hand‐washing engagement by air travelers.”
Still, Nicolaides and the other researchers offer at least one approach public health officials could try as coronavirus spreads further with each day.
In addition to his research position at MIT Sloan, Nicolaides, 34, is a lecturer at the University of Cyprus’ Business School. A physicist by training, he got his BSc in physics from Aristotle University in Thessaloniki, Greece, his masters in applied mathematics from University College London, and his Ph.D. in civil and environmental engineering from MIT.