When those in my city began noticing, in early-March, New York City Transportation Authority employees had already experienced 41 deaths from Covid-19, and literally 6,000 workers were out on sick-leave. One suspects a significant percentage of them were infected with the virus. Otherwise, those ill with something else were likely more worried about it then they would have been during the Old Abnormal.
The high percentage of bus and motorcoach drivers infected or killed by the virus does not sim- ply reflect their early exposure to a broad cross-section of largely (if not mostly) economically-deprived passengers packed, without masks, into moving petri dishes-on-wheels. The Covid-19-related prob- lems in public transportation are deeply-rooted in plenty of other things we are only now beginning to acknowledge. As did others, I recognized many of these problems decades ago. But they are of increasing importance to members of the public transportation community now, just as they are to our population in general. The underlying issue is the important of fundamental health and its relation- ship to vulnerability from serious viral infections and similar risks.
The Soul of Seoul
In 1988, I was fortunate to attend the Olympic Games in Seoul, Korea. Today, South Korea is a significant benchmark for measuring the effects of Covid-19 in the U.S. That is because both nations effectively discovered the existence of the virus on the same day. South Korea’s population of roughly 52 million is a bit less than one-sixth of ours. Yet at the time South Korea had experienced its 260th death from the virus, we had experienced roughly 90,000. The fact that the South Koreans had con- ducted 305 tests for the same percentage of their population to whom we had administered merely five does not tell the whole story.
My last visit to South Korea was admittedly a good while ago. I am certain this nation now has its share of fast food restaurants and other ills scarce or absent three decades ago. During the two weeks I spent there, I do not recall observing a single fat person. Not one. Among tens of thousands I saw relatively up close, and far more I saw at a distance — in stadiums, arenas, crowded streets and all- night bazaars. To be fair, eating dog meat was common in South Korea then, and may still be for all I know. (Dog meat was eliminated from every restaurant’s menu during the Games.) Yet South Korean diets contained hardly any sugar; finding a sweet desert was a challenge. They ate little or no wheat; their noodles and other pastries were largely rice-based. And they ate zero dairy. One found ice cream nowhere. And apart from finding virtually no slightly-overweight natives, I saw hundreds who had to be 110 to 120 years old, most of them ambulatory, albeit walking around gingerly with canes. Needless to say, I never saw a fat bus driver, taxi driver, conductor, trainman or motorman.
Health and Professional Drivers
In sharp contrast, the typical U.S. bus or coach driver is in poor health, and often obese – to a greater proportion than the general population, a full third of whom are obese. Obesity correlates with, and causes, countless health problems. Those who are obese are likely to be unhealthy in ways even unrelated to their obesity. But the sedentary jobs which drivers occupy do not entirely explain their conditions and vulnerabilities.
For starters, think about their diets: Largely fast-food, dominated by saturated fats, grease, wheat, sugar and high cholesterol. As a high schooler, I hated the boring cafeteria food, with its over- cooked vegetables, small portions of meat (or fish on Fridays), largely fruit for desert, and milk or juice. Ecch. I wanted soda and candy. Catering to the whims of today’s harder-to-manage students, many schools have closed their cafeterias and, instead, contract out lunch service to fast food franchises. In 1963, every male high schooler was subjected to testing according to the “fitness goals” of President Kennedy’s Counsel on Physical Fitness. A passing score was 250. A mediocre athlete, I scored only 248. We were being toughened up, of course, “to fight the enemy.” Regardless, far fewer of today’s youth could pass such a test, whatever its goals might be.
Fast forward these students to adults, with much slower metabolisms. One well-respected nutritional expert, Dariush Mozzaffarian, claims that, beyond obesity, only 12 percent of Americans are “metabolically healthy.” His definition is surprisingly narrow and simple: A normal waist circumfer- ence, normal levels of cholesterol and glucose, and normal levels of hypertension. If one adds low pay, high levels of anxiety and stress, and a sedentary job to the lack of these things, one can understand why Covid-19 infections and deaths are so high among bus and coach drivers.
Interestingly, even with their mediocre diets and health hazards and inequality, deaths of New York City residents from Covid-19 among those age 1 to 18 are .64 per 100,000 people. (See https://www.statista.com/statistics/1109867/coronavirus-death-rates-by-age-new-york-city/.) In contrast, there are roughly 20.57 deaths per 100,000 people between age 18 and 44. At the other end of the spectrum lie those 75 years of age or older: 1566.8 deaths per 100,000 persons. Only the most obvi- ous part of these statistics reflects sheer age. The hidden segment reflects the impact of worsening health over multiple decades from a far-inferior diet, compounded by less exercise (and increasingly less time for it) and other factors which lie beyond the scope of this brief analysis.
A parallel barometer of ill-health among bus, coach and truck drivers has been well-document- ed by their high incidence of Obstructive Sleep Apnea – which several studies have found roughly half of all bus and truck drivers in the U.S. and Australia to possess. Roughly half of this subpopulation is also obese. The sedentary nature of professional driving does not fully account for their possession of OSA – just as it does not fully account for their vulnerability to Covid-19.
Stop-Gap versus Long-Term
After a rude wake-up call, we have begun to protect our bus and coach drivers quite effective- ly. (See “Transit Survival in the Age of Covid-19” in NATIONAL BUS TRADER, July, 2020). Just the same, the vulnerabilities which our bus, truck and motorcoach drivers have to Covid-19, and the vulnerabil- ity which the U.S. population in general has toward it, is also not simply an age factor, despite the large correlation of age with vulnerability. The fundamental core of this vulnerability lies in our poor gen- eral health. Bus, coach and truck drivers are just an extreme example of it. Obviously, those who are older are significantly more vulnerable.
We cannot fix these underlying health problems in a massive short-term swoop. But we can chip away at them meaningfully, particularly within our own industry. Ensuring that drivers are at least marginally fit is hardly a novel or controversial idea. Many states’ school bus drivers are required to undergo and pass a “drag-and-drop” test: They must be able to drag several 50-pound bags of sand from one end of the passenger aisle to the other, and down the stepwell, in a short span of time. This requirement is not designed to help them “fight the enemy.” It is designed to provide school buses
with drivers who can help evacuate the injured and/or disabled in an emergency. But it also helps keep these drivers alive longer. And it helps keep them healthier along the way.
Most interestingly, making meaningful improvements in one’s health is not a multi-year proj- ect. Some medical professionals, like Dr. Mozzaffarian, believe that most individuals can regain meta- bolic health in six weeks.
Hope and Heed
The Statue of Liberty does not say, “Send us your fatsos, your winded and your lazy, yearning to sit on the couch and eat bad food.” But if we wish to become a magnet for Covid-19 infections and deaths, this inscription might be appropriate. After all, our nation contains the very conditions which make us so vulnerable to pandemics, politics aside.
The history of the World is paved with plenty of foolish choices. Some matter more than others, depending on what is at stake. Clearly those nations whose citizens feast on dogs and bats are doing much better in the pandemic than we are. They have plenty of bad habits, many of which compromise their health. But their diets contain far less dairy, wheat or sugar than our diets do. And even while increasing numbers of them work seated in front of computer screens, fatsos are rare.
As many economic and safety problems as our public transportation systems may have, these blunders do not completely prohibit us from hiring healthy drivers and ensuring that they remain that way as a condition of their continued employment. The major constraint is, of course, the low wages and constant driver shortages our industry has experienced for decades. But with the extraordinary unemployment we now have, which is likely to become worse as our corporate leviathans exploit the pandemic to eliminate even more jobs (driverless vehicles, virtual medicine, etc.), hiring and retaining healthy drivers should be much easier (unions notwithstanding).
Having healthy drivers will go a long way in helping to keep the passengers safe. Along with other measures (see the previous three articles on this subject in NATIONAL BUS TRADER’S May, June and July issues), they will go a long way toward restoring our industry. Of course, getting the passengers and the rest of Americans healthy may be a long road we never take. But at least our drivers can trav- el along it. Doing so will help us get back on the road again.
The opinions expressed in this article are that of the author and do not necessarily represent the opinions of NATIONAL BUS TRADER, Inc. or its staff and management.