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Older Adults' Avoidance of Public Transportation After The healthcare Article Older Adults’ Avoidance of Public Transportation after the Outbreak of COVID-19: Korean Subway Evidence Byungjin Park 1 and Joonmo Cho 2,* 1 HRD Center, Department of Economics, Sungkyunkwan University, Seoul 03063, Korea; [email protected] 2 Department of Economics, Sungkyunkwan University, Seoul 03063, Korea * Correspondence: [email protected] Abstract: With the spread of the coronavirus worldwide, nations have implemented policies restrict- ing the movement of people to minimize the possibility of infection. Although voluntary restriction is a key factor in reducing mobility, it has only been emphasized in terms of the effect of governments’ mobility restriction measures. This research aimed to analyze voluntary mass transportation use after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak by age group to explore how the perception of the risk of infection affected the public transit system. Mass transportation big data of Seoul Metro transportation use in the capital city of Korea was employed for panel analyses. The analysis results showed that in the period with both the highest and lowest number of infections of SARS-CoV-2, users aged 65 years and over reduced their subway use more than people aged between 20 and 64. This study also found that the decrease in subway use caused by the sharp increase of coronavirus disease 2019 (COVID-19) cases was the most prominent among people aged 65 years and over. The results imply that the elders’ avoidance of public transportation affected their daily lives, consumption, and production activities, as well as their mobility. Citation: Park, B.; Cho, J. Older Adults’ Avoidance of Public Keywords: COVID-19; avoidance of infection; social distancing; free tickets for the aged; subway Transportation after the Outbreak of use demand COVID-19: Korean Subway Evidence. Healthcare 2021, 9, 448. https:// doi.org/10.3390/healthcare9040448 1. Introduction Academic Editors: Manoj Sharma and Since the World Health Organization (WHO) declared the coronavirus disease 2019 Kavita Batra (COVID-19) pandemic, the spread of infections around the world has not abated. While the total number of global COVID-19 cases was 0.7 million in March 2020 when the WHO Received: 24 February 2021 announced the COVID-19 outbreak a global pandemic, the number of cases exceeded Accepted: 8 April 2021 Published: 11 April 2021 79.2 million in December 2020 [1,2]. With the incessant outbreaks of community transmis- sion, clusters of cases, and sporadic infections, coronavirus is still spreading throughout Publisher’s Note: MDPI stays neutral the world. with regard to jurisdictional claims in The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infec- published maps and institutional affil- tions was inevitable, even in Korea. Figure1 shows the progress of COVID-19 cases in iations. Seoul, the capital of Korea, between February and September. As of December 24, the num- ber of COVID-19 cases in South Korea reached 53,533, with 756 deaths, and the incidence rate (i.e., the cumulative number of confirmed cases per 100,000 population) was 103.25 [3]. With the spread of the coronavirus worldwide, nations implemented policies restrict- ing the movement of people to minimize the amount of contact between people, as WHO Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. reported that COVID-19 is rapidly transmitted through human contact and respiratory This article is an open access article organs [4]. Asymptomatic “silent spreaders” were found, making it difficult to track the distributed under the terms and routes of transmission [5]. Wuhan, the Chinese city where the pandemic is believed to have conditions of the Creative Commons started, was effectively sealed off from the rest of the country immediately, and movement Attribution (CC BY) license (https:// between regions in China was strictly banned [6]. In Europe, strict restrictions, such as creativecommons.org/licenses/by/ lockdowns, curfews, and permits for movement, were imposed by governments [7]. In 4.0/). the United States, which has the most coronavirus cases worldwide, heightened mobility Healthcare 2021, 9, 448. https://doi.org/10.3390/healthcare9040448 https://www.mdpi.com/journal/healthcare Healthcare 2021, 9, x 2 of 15 Healthcare 2021, 9movement, 448 between regions in China was strictly banned [6]. In Europe, strict restrictions, 2 of 15 such as lockdowns, curfews, and permits for movement, were imposed by governments [7]. In the United States, which has the most coronavirus cases worldwide, heightened mobility restrictions,restrictions, such such as asstay-at-home stay-at-home orders, orders, bansbans on on gathering, gathering, and and travel travel restrictions, re- were strictions, were implemented,implemented, depending dependin ong theon the status status of each of each state [state8]. [8]. Figure 1. NumberFigure of cumulative 1. Number confirmed of cumulative cases confirmed in Seoul cases in 2020. in Seoul The in uppe 2020.r The and upper lower and figures lower figures show show the numberthe of numberinfections of infectionsin February in February and September, and September, respectively. respectively. The Korean governmentThe Korean implemented government implemented social distancing social distancingmeasures measuresinstead of instead strong of strong restrictions on movementrestrictions on to movementcurb the tocontag curbion the contagionof SARS-CoV-2. of SARS-CoV-2. The call The for call social for social dis- distanc- ing is a campaign, guidance, or recommendation of the Korean government to achieve tancing is a campaign, guidance, or recommendation of the Korean government to achieve regulated mobility through citizens’ voluntary cooperation and compliance. In social regulated mobilitydistancing through phases citizens’ 1 and voluntary 1.5, it was cooperation recommended and to compliance. wear a mask, In report social meetings dis- and tancing phases 1events, and 1.5, and it workwas recommended from home for to one-fifth wear a ofmask, each report institution. meetings In phase and 2,events, all meetings and work fromwith home more for thanone-fifth 100 people of each were institution. prohibited, In and phase a third 2, all of employeesmeetings werewith encouragedmore to than 100 people were prohibited, and a third of employees were encouraged to work from home. Furthermore, the use of entertainment facilities was prohibited and the reduction Healthcare 2021, 9, 448 3 of 15 work from home. Furthermore, the use of entertainment facilities was prohibited and the reduction of store operating hours to 9 p.m. was applied. In phases 2.5 and 3, all of the above restrictions applied to more facilities. The mobility restriction policies of countries and voluntary restrictions, which were driven by the fear of the coronavirus infection, have led to a decrease in transit demand. In France, consumer mobility, which was estimated based on the use of payment cards, decreased by 75% during the national lockdown compared to 2019 [9]. According to Google Trend data, mass transit demand in ten countries, including Italy, Brazil, and the United Kingdom, fell sharply since the COVID-19 outbreak [10]. In Mexico, the use of automobiles decreased by 10 to 25% since the outbreak [11]. Seoul has also witnessed a drastic reduction of transit demand amid the pandemic, which can be measured based on the changes in mass transit system use in Seoul, which is among the top ten in the world in terms of efficiency and user satisfaction [12]. The population of Seoul was 9,668,465 as of December 2020, and the number of uses of buses and subways surpassed 100 million each month. Figure2 shows the number of bus and subway rides in 2018, 2019, and 2020. As the number of cases of COVID-19 began to rise in late January 2020, mass transit demand fell dramatically and rebounded after March, but it was still well below the demand recorded in the same periods of 2018 and 2019. Furthermore, in August, the mass transportation demand declined again after the outbreak of cluster infections in Seoul, showing that mass transportation was significantly affected by the pandemic. Statistics on bus and subway use are in Table A1 of the AppendixA. Most studies on the decrease of mass transit demand are focused on the effect of governments’ mobility restriction measures. However, there is a lack of studies on the impact of the voluntary restriction that significantly affected the decrease in transit demand. This may be attributed to the fact that, as many countries are implementing restrictions on mobility, it is difficult to isolate the effect of citizens’ voluntary restraint of movement. Data on subway transit demand in Seoul is useful for studying the voluntary mobility reduction during the pandemic since it has three characteristics that are not found in other cities. First, it is a type of mass transit that carries a high probability of infection. Mass transportation involves very high risks of infection because of the high density, diversity of contacts, and potential presence of patients [13]. Hence, when traveling in the subway, passengers are aware of the risk of infection. Second, the government did not issue any specific restrictions on subway use. Without enforced mobility regulation, subway use reflects the voluntary mobility of people. Third, people aged 65 and over in Seoul can ride a subway for free due to Article 19 of the Welfare of Senior Citizens Act [14]. For the elderly without income earned through economic activity participation, the subway is an essential and the most common means of mass transit for leisure. However, after the COVID-19 outbreak, subways were classified as facilities that carried the highest infection risk, and the age group most prone to fatality because of a SARS-CoV-2 infection is the elderly group. Therefore, though they have free access to the subway, i.e., the most efficient means of movement, the aged cannot ride on a subway train without concern regarding COVID-19’s impact.
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