Q&A on Mass Gatherings and COVID-19

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High profile international sporting events such as the Olympics or World Cups as well as international religious events such as the Hajj count as mass gatherings. However, lower profile conferences and events can also meet WHO’s definition of a mass gathering. An event counts as a “mass gatherings” if the number of people it brings together is so large that it has the potential to strain the planning and response resources of the health system in the community where it takes place. You need to consider the location and duration of the event as well as the number of participants. For example, if the event takes place over several days in a small island state where the capacity of the health system is quite limited then even an event with just a few thousand participants could place a big strain on the health system and then be considered a “mass gathering” event. Conversely, if the event is held in a big city in a country with a large, well-resourced health system and lasts just a few hours, the event may not constitute a “mass gathering” event.

No. As each international mass gathering is different, the factors to consider when determining if the event should be cancelled may also differ. Any decision to change a planned international gathering should be based on a careful assessment of the risks and how they can be managed, and the level of event planning. The assessment should involve all stakeholders in the event, and in particular the health authorities in the country or community where the event is due to take place. These authorities and stakeholders are in the best position to assess the level of stress the event might place on the local health system and emergency services – and whether this level of stress is acceptable in the current situation.

For countries not currently known to be experiencing community transmission of COVID-19, the priority consideration will be whether the planned mass gathering event substantially increases the risk of the virus entering the country and becoming established, as well as the risk for participants to importing infection back to their home country and further increasing global spread. In making this assessment, the organizers and their national or local health authorities should recognize that the risk of imported cases of COVID-19 is naturally linked to international travel. They should also recognize that it is neither realistic or desirable to aim for zero risk. When organizers and health authorities are determining whether to hold a mass gathering, they should determine what is an acceptable risk and what additional measures should be implemented to mitigate the risks.

For countries where COVID-19 has already started to spread in the community, key consideration will be:

  • aiming at containing or at least slowing down the spread of the virus in the local community/country.
  • preventing participants from other countries being infected with COVID-19

In each case the risk should be considered in the context of the known features of COVID-19, its severity, its transmissibility and the effectiveness of measures to prevent or reduce transmission. The strain already placed on the local health system in responding to COVID-19 outbreak(s), and the additional strain the mass gathering might place on the system also need to be taken into account.

You can find more advice on what to look at in the WHO document Key planning recommendations for Mass Gatherings in the context of the current COVID-19 outbreak of 14 February 2020. See: https://www.who.int/publications-detail/key-planning-recommendations-for-mass-gatherings-in-the-context-of-the-current-covid-19-outbreak

The national and local public health authorities in the country where you plan to hold the mass gathering will most likely know how to conduct a health risk assessment. If there is a WHO Country Office there they may also be able to provide some expert support. So too might the WHO Regional Office in your part of the world. You can find the names and contact details of the WHO Regional Offices at https://www.who.int/about/who-we-are/regional-offices

Promote hand washing, respiratory hygiene and social distancing at the event. Make sure you have emergency contact details for all participants, including where they are staying during the event. You should make it clear to them that this information will be shared with the local public health authorities to enable rapid contact tracing if a participant at the event becomes ill with COVID-19. The event organisers need to have an agreed preparedness plan in case one or more participants become ill with COVID-19 symptoms. This should include rapid isolation of the ill person and their safe transfer to a local health facility. You should consider whether the number of participants at the event could be reduced, making available participation by video or teleconference and possibly screening participants for COVID-19 symptoms (cough, fever, malaise) at points of entry to the venue. You can find advice on how individual participants can protect themselves and their loved ones from COVID-19 at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

WHO has produced guidance and also a training course on how to plan for a mass gathering. The guidance and the course both look at how to conduct a risk assessment, plan for and manage health risks in partnership with the local authorities: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/points-of-entry-and-mass-gatherings  You can find advice to give individual participants on how to protect themselves and their loved ones from COVID-19 at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public