Living with COVID-19: mass gatherings and minimizing risk

Maximum proportion of masks worn: Collaborative efforts in Japanese professional football

Mass gathering events in Japan have gradually mitigated their novel coronavirus disease (COVID-19) control regulations, along with a minimum infection risk. The Japan Professional Football League (J.League) conducted pilot surveys on holding events with chant cheers. In this commentary, we introduce the collaborative efforts based on scientific knowledge among experts, J.League, and their fans. We performed risk assessment in advance, by updating a previously developed model. We further observed the average proportion of masks worn, chant cheering time of participants, and CO2 levels in the stand. The number of new COVID-19 cases in an event with 5,000 chant cheering participants and 35,000 non-chant cheering participants was estimated to be 1.02 times of an event, with 40,000 non-chant cheering participants. The average proportion of masks worn during the game was 98.9 %, for chant cheer participants. The chant cheering participants spent 50.0-51.1 % of their time chant cheering. Monitored average CO2 levels were ≤ 540 ppm, suggesting high ventilation rates in the stand. The high proportion of masks worn represents the willingness of norm-conscious fans to cooperate in regular recovery of the sport. This has proved to be one of the successful models for future mass gathering events.

COVID-19 prevention and control measures and experiences during the 14th National Games of China: a qualitative interview study

Background

The 14th National Games was the first sporting mass gathering to be held in China in the context of the COVID-19 pandemic. It may increase the risk of severe acute respiratory syndrome coronavirus 2 transmission. In order to reduce the spread of the virus during the 14th National Games, the Chinese government took a series of public health measures, and ultimately no confirmed cases were found in the 14th National Games venues.

Objective

This study aimed to discuss preventive and control measures used to respond to the COVID-19 pandemic during the 14th National Games.

Methods

Five experts were selected for this study using a snowball sampling method, and semistructured and in-depth interviews were conducted. Based on grounded theory, the transcriptions were analysed and coded using Nvivo 12 software.

Results

A theoretical model of the COVID-19 prevention and control measures at the 14th National Games of China was constructed. The model contains seven main components: the health risks of mass gatherings, crowd management, emergency medical care, allocation of emergency medical resources, pandemic emergency drills, the pandemic prevention and control management platform (Quanyuntong app), and emergency response plans.

Conclusion

The study showed that the deployment of emergency medical resources was the most important for mass gatherings. This study not only expanded the applications of grounded theory but also serves as a reference for future scholars when conducting more in-depth empirical studies on public health countermeasures for mass gatherings and can inform organizers when holding mass gatherings.

Case study of the Beijing 2022 Olympic Winter Games: Implications for global mass gathering events amidst the COVID-19 pandemic

Objective

This study aimed to evaluate the public health countermeasures against coronavirus disease 2019 (COVID-19) that are important for organizing mass gathering events (MGEs) during a pandemic and to identify the practices suitable for application at future MGEs.

Methods

This study analyzed data from the Beijing 2022 Olympic Winter Games. The aforementioned analysis was conducted from the viewpoints of overseas stakeholders and Chinese residents. The comprehensive set of countermeasures established to prevent the transmission of the COVID-19 pandemic comprised the bubble strategy, the three-layer testing strategy (pre-departure testing, testing at the airport, and daily screening), the mandatory wearing of N95 masks, and mandatory vaccination.

Findings

A total of 437 positive cases within the bubble were reported during the Games, of which 60.6% were detected through screening at the airport and 39.4% were detected through routine screening. Nearly, 92.0% of the positive cases were detected within 7 days of arrival in China, and 80.8% of the cases had already been identified before the Opening Ceremony of the Games. Outside the bubble, no Games stakeholders were infected and no spectator contracted COVID-19. The bubble strategy, the three-layer testing strategy, the mandatory wearing of N95 masks, and mandatory vaccination are promising countermeasures to prevent the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during MGEs.

Conclusion

Public health countermeasures introduced during the Beijing 2022 Olympic Winter Games were proven to be useful. The success in delivering and organizing the Games instills confidence and leaves a public health legacy for future MGEs amid the pandemic of COVID-19 or future emerging infectious diseases.

Tourism Vulnerability Amid the Pandemic Crisis: Impacts and Implications for Rebuilding Resilience of a Local Tourism System in Vietnam

Despite the devastating impact of the COVID-19 crisis on the global tourism industry, a few countries have attempted to foster their local tourism economies’ recovery by offering distinctive mechanisms which facilitate their safe tourism destinations to restart domestic tourism operations during the pandemic waves. However, there has been little research investigating how different sectors of a local tourism system, particularly in a developing country, seriously suffer from the pandemic crisis but gain encouraging revitalization from the pandemic shocks. Therefore, this study employed Can Tho city as a case study to examine the holistic impact of COVID-19 on different sectors of the local tourism industry and explore the key factors/players contributing to the resilience empowerment and adaptive recovery of the local tourism system. As such, a semi-structured interview approach was employed in this study to collect both quantitative and qualitative data. The study recruited 40 representatives of tourism-related authorities at different levels and 280 managers of different tourism sectors in the local tourism industry. The findings generally reveal the disastrous impacts of the pandemic on the local tourism industry across all tourism sectors but show an unexpected recovery of tourism businesses during the pandemic crisis. The integrated findings also highlight the pivotal role of local governments in crisis governance and destination recovery support during and after the pandemic waves. Similarly, the proactive engagement of local enterprises was found critical toward rebuilding their organizational resilience, and such adaptive transformations were essential for tourism business recovery in new normal conditions. The economic policy response and effective financial schemes were common expected measures toward the tourism industry’s recovery in the post-pandemic crisis.

Assessment of COVID-19 risk and prevention effectiveness among spectators of mass gathering events

There is a need to evaluate and minimize the risk of novel coronavirus infections at mass gathering events, such as sports. In particular, to consider how to hold mass gathering events, it is important to clarify how the local infection prevalence, the number of spectators, the capacity proportion, and the implementation of preventions affect the infection risk. In this study, we used an environmental exposure model to analyze the relationship between infection risk and infection prevalence, the number of spectators, and the capacity proportion at mass gathering events in football and baseball games. In addition to assessing risk reduction through the implementation of various preventive measures, we assessed how face-mask-wearing proportion affects infection risk. Furthermore, the model was applied to estimate the number of infectors who entered the stadium and the number of newly infected individuals, and to compare them with actual reported cases. The model analysis revealed an 86-95% reduction in the infection risk due to the implementation of face-mask wearing and hand washing. Under conditions in which vaccine effectiveness was 20% and 80%, the risk reduction rates of infection among vaccinated spectators were 36% and 96%, respectively. Among the individual measures, face-mask wearing was particularly effective, and the infection risk increased as the face-mask-wearing proportion decreased. A linear relationship was observed between infection risk at mass gathering events and the infection prevalence. Furthermore, the number of newly infected individuals was also dependent on the number of spectators and the capacity proportion independent of the infection prevalence, confirming the importance of considering spectator capacity in infection risk management. These results highlight that it is beneficial for organisers to ensure prevention compliance and to mitigate or limit the number of spectators according to the prevalence of local infection. Both the estimated and reported numbers of newly infected individuals after the events were small, below 10 per 3-4 million spectators, despite a small gap between these numbers.

Development of a Method for Evaluating Social Distancing Situations on Urban Streets during a Pandemic

In the New Normal era of “Living with COVID-19”, we need a measure of the safety of street spaces. Social distancing during a pandemic is considered an effective safety measure, but the current binary threshold approach to social distancing is clearly inadequate for evaluating and monitoring the risk of infection on urban streets. This study is to propose a social distancing indicator that can quantitatively evaluate the level of exposure to viral infection for pedestrians using urban streets during a pandemic, and to develop a statistical model to estimate the proposed indicator from simulations of pedestrian activity on urban streets. We assumed that the risk of infection on urban streets has a direct relationship with distance between pedestrians. The social distancing indicator was based largely on the findings of past studies. We developed a statistical model to relate the proposed indicator to three other explanatory variables: pedestrian density, clumpiness, and directional heterogeneity. We used pedestrian simulation to generate the raw data for these explanatory variables. The social distancing indicator demonstrated a statistically significant relationship with input variables and can be used to evaluate pedestrians’ social distancing on urban streets. We measured the relationship between different levels of pedestrian density, clumpiness, and directional heterogeneity and related the results to the potential level of exposure to viral infection. Health agencies can use the findings to develop appropriate policies for monitoring and improving the social distance between pedestrians on urban streets during a pandemic.

The Statistical Analysis to Find Correlation Between Mass Gathering Event and COVID-19 Pandemic Outbreak: The Prayagraj Magh Mela 2021 Experience

Magh mela, a smaller form of Kumbh mela, organize every year in Prayagraj. With the emergence of novel corona virus, there is worldwide discussion to find out the effective way to organize or cancel the mass gathering events. The present study assesses the challenges in organization of mass gathering events like Magh mela held at Prayagraj, India in 2021. The correlation between increased cases of COVID-19 and Magh mela-2021 has been highlighted through statistical analysis and growth curves using the available data. The study finds that there is a correlation between the Magh mela-2021 mass gathering event and increased rate of COVID-19 infections. After the Magh mela 2021, the average daily increase in the COVID-19 cases started to increase. It was found 4.25%, 6.28% and 2.73% in India, Uttar Pradesh and Prayagraj, respectively.

COVID-19 and other respiratory tract infections at mass gathering religious and sporting events

PURPOSE OF REVIEW

Mass gathering (MG) religious events provide ideal conditions for transmission and globalization of respiratory tract infections (RTIs). We review recent literature on COVID-19 and other RTIs at recurring international annual MG religious and sporting events.

RECENT FINDINGS

Due to the COVID-19 pandemic organizers of MG religious and sporting events introduced risk-based infection control measures that limited transmission of RTIs. The 2020 and 2021 Hajj were conducted with limited numbers of pilgrims compared to the annual millions of pilgrims. The Tokyo 2020 Olympic and Paralympic Games were cancelled and held in 2021. The success of the COVID-19 countermeasures at the 2021 Hajj and 2021 Tokyo Olympics was based on implementing good public health and social measures alongside a comprehensive testing strategy.

SUMMARY

MG events are associated with transmission of a range of bacterial and viral RTIs. Introducing risk based a multitude of public health interventions can reduce transmission of SARS-CoV-2 and other RTIs.

Pilot evaluation of risk assessment and enhanced protocols regarding contacts at an international professional golf event

Objectives

The aim of this study was to assess whether a risk assessment and managed risk approach to contact tracing was practical and feasible at the Gran Canaria Lopesan Open 2021 and could inform further pilot work regarding disease transmission during elite sporting events.

Methods

This prospective cohort study included all international attendees. All participants required a minimum of one negative reverse transcriptase PCR (RT-PCR) test prior to travelling to each tournament. High-risk contacts were isolated for 10 days. Moderate-risk contacts received education regarding enhanced medical surveillance, had daily rapid antigen testing for 5 days, with RT-PCR day 5, mandated mask use and access to outside space for work purposes only. Low-risk contacts received rapid antigen testing every 48 hours and PCR testing on day 5.

Results

A total of 550 persons were accredited and were required to undergo RT-PCR testing before the event. Two of these tests were positive (0.36%). Of these, case 1 had 1 high, 23 moderate and 48 low-risk contacts. Case 2 did not have any significant travel history within 2 days of positive test and had one high-risk contact. There were no further positive tests on site in the wider cohort of attendees, from a total of 872 RT-PCR and 198 rapid antigen tests.

Conclusions

This pilot study showed it is practical, feasible and well accepted to provide enhanced (daily) virus testing and risk-mitigating measures at a professional golf event. Further study is required to assess the efficacy of these interventions; however, no transmission was found in this pilot study.

The Association between Wearing a Mask and COVID-19

With the widespread and increasing number of cases of Coronavirus Disease (2019) globally, countries have been taking preventive measures against this pandemic. However, there is no universal agreement across cultures on whether wearing face masks are an effective physical intervention against disease transmission. We investigated the relationship between mask wearing and COVID-19 among close contacts of COVID-19 patients in the Hiroshima Prefecture, Japan. In the Hiroshima Prefecture, a COVID-19 form adapted from the reporting form, “Japanese Surveillance in Post-Extreme Emergencies and Disasters”, was developed to collect data from COVID-19 patients’ close contacts under active epidemiological surveillance at Public Health Centers. The relative risk of COVID-19 for mask users versus non-mask users was calculated. A total of 820 interviewees were included in the analysis and 53.3% of them responded that they wore masks. Non-mask users were infected at a rate of 16.4%, while mask users were infected at a rate of 7.1%. Those who wore masks were infected at a rate of 0.4 times that of those who did not wear masks. (RR = 0.4, 95%CI = 0.3–0.6; Adjusted RR = 0.6, 95%CI = 0.3–0.9). These findings implied that COVID-19 could be avoided to a certain degree by wearing a mask.