SEPTA’s ridership won’t rebound for a long time. Fear of contracting COVID-19 is partially to blame.

Through the fall, Jerry Fagliano, associate clinical professor and chair at Drexel University’s Dornsife School of Public Health, was one of SEPTA Regional Rail’s lone riders.

He commuted on the Chestnut Hill East Line one or two days a week. Since that’s how he had gotten to work before the COVID-19 pandemic, he continued using SEPTA during the pandemic. Fagliano wore a mask, and social distancing was fairly easy, considering SEPTA’s depressed ridership.

“It really was not a difficult decision for me to make at the time,” Fagliano said.

While telecommuting will continue to keep riders off SEPTA, which is still losing about $1 million a day, so will the general stigma of uncleanliness attached to public transportation. The misperception of mass transit being a hotbed for COVID-19 transmission could contribute to a push for private cars for those who can afford one, clogging roads, creating further funding woes, and deteriorating service for riders who depend on transit most.

To be clear, there is potential risk of getting infected on transit, according to a half-dozen health experts who spoke with The Inquirer, but it’s a manageable risk like going into a store or dining outdoors. Safety measures, such as mask-wearing, must be in place, they said, but taking public transportation isn’t an activity to be avoided at all costs. For many people, that’s not an option.

“As far as mass transit being a substantial source of spread, compared to some of the settings that we do know are high risk, like bars,” Fagliano said, “there’s pretty good confidence that mass transit is not going to be a major source of spread when people take the proper precautions.”

Before the pandemic, cleanliness was identified as an area “where SEPTA must improve” in a 2018 customer satisfaction survey. More recently, a SEPTA COVID-19 Travel Survey released in September showed riders felt safer going to a grocery store or visiting family than riding SEPTA. Mask enforcement was listed as the top concern.

While “we’re much less worried about surfaces than we were six months ago,” said Henry Fraimow, infectious-disease specialist at Cooper University Health Care, SEPTA has continued enhanced cleaning protocols since March. COVID-19 is most commonly spread through close contact with others, according to the Centers for Disease Control and Prevention, and good ventilation is a helpful risk-mitigation measure.

» READ MORE: Wiping surfaces is fine for the coronavirus, but the main risk is through the air. How to tell if your ventilation is OK.

“One thing that I think most people don’t appreciate is that there is good air exchange in public transit,” Fraimow said.

SEPTA vehicles experience 15 to 20 full air exchanges every hour, said Jim Fox, assistant general manager of SEPTA’s system safety division. The authority is also replacing air filters more frequently.

“It’s a frustrating struggle for us in the industry,” Fox said, “... a lot of the public is either still on their old beliefs or really not taking advantage of updated research, information that’s out there to support the position of how transit is not this super spreader that everyone believes it to be.”

For some people, getting onto a crowded bus even after vaccines are widely distributed is difficult to imagine. Transit agencies, which have received emergency relief to help stem COVID-19 losses, will “have to budget and plan for a pretty significant lag to get back to full ridership,” said Ben Fried of TransitCenter, a New York-based advocacy group for public transit.

“The public health agencies should say something to dispel some of this negative stigma that attaches to transit,” Fried said. “If the health agency thinks it’s safe for people to be dining indoors, then they should make it clear that it’s also safe to be riding buses and trains.”

» READ MORE: SEPTA union is considering legal action over COVID-19 quarantine policy

Ron Goren, who specializes in infectious diseases at Nazareth Hospital in Northeast Philadelphia, concurs.

“We’ve done nothing to try to change those fears,” he said.

Last month, SEPTA announced a partnership with Drexel to research COVID-19 on mass transit, including the effects of mask-wearing, ventilation, and cleaning. When making the announcement, SEPTA general manager Leslie Richards said: “Studies during the pandemic have shown that public transportation is safe, and there have been no direct links between riding SEPTA and contracting the coronavirus.”

In an unrelated news conference this past fall, Mike Carroll, the city’s deputy managing director for the Office of Transportation, Infrastructure, and Sustainability, said: “There’s no outbreaks that we can trace to the use of mass transit.” A report commissioned by the American Public Transportation Association “based on a comprehensive review of United States and global research regarding COVID-19 transmission and public transit” found “no direct correlation.”

While some health experts found the information encouraging, Mike Levy, associate professor of epidemiology in the Perelman School of Medicine at the University of Pennsylvania, had reservations.

“When I see any study that says, ‘There is no evidence of transmission in blank,’ my first question is ‘How do they know?’” he said. “... It’s probably obvious to everyone that doing contact tracing on public transportation is extremely difficult, and it, frankly, probably does not happen very often.”

» READ MORE: A year without a commute for many in the Philadelphia region

About 960 SEPTA employees have contracted COVID-19, according to self-reported figures from SEPTA, and about 560 have since returned to work. Nine SEPTA workers have died of COVID-19. The authority has a partnership with the Black Doctors COVID-19 Consortium to voluntarily test employees.

The city doesn’t “really have any good data conclusively linking travel on SEPTA or other public transit to cases of COVID” and “it’s difficult to tell if riding public transit took place as a possible exposure or if it happened while they were infectious,” said Jim Garrow, health department spokesperson.

Asked whether the Pennsylvania Department of Health’s contact tracing efforts have linked any COVID-19 cases with the use of public transportation in Pennsylvania, a spokesperson said: “Information collected during the case investigation process is not shared publicly unless doing so would help the department in its efforts to stop the spread on a broader scale.”

In a reply outlining that evidence of a definite link between contracting COVID-19 and public transportation would aid in helping to slow COVID-19′s spread, the department said: “We do know that traveling does increase a person’s risk of exposure to the virus. If an individual reveals to public health professionals that they used public transportation while infectious, the information is used to identify and inform all close contacts.”

» READ MORE: COVID-19 contact tracing hobbled by distrust, partisanship, and phone etiquette, Pew study finds

There’s a careful balance to maintain, said Thomas Fekete, chair of the department of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University.

“A bus that’s empty is ultimately safer for you, but not sustainable for society,” he said. “A bus that’s crowded is sustainable from an economic perspective, but not from a health perspective. So, something in the middle is probably the sweet spot for right now.”

Although mask compliance and crowd sizes are legitimate concerns to consider, a generalized fear is not, said Goren, of Nazareth Hospital.

“The whole problem with all this is everybody’s afraid of stuff they shouldn’t be afraid of and not afraid of things they should be afraid of,” he said. “They’re willing to go to a bar and drink, but they’re afraid to get on a bus.”