COVID-19: Why mass gatherings are dangerous

Any planned or impromptu event that is attended by a number of people such as the Olympic Games, the Haj or various other major sports, religious, and cultural events. 

According to the World Health Organisation, an event is counted as a mass gathering if it puts any kind of strain on the planning and response resources of the health system due to a large number of people attending the event. Not every gathering can be considered a mass gathering as you need to consider the location and duration of the event as well as the number of participants to judge that. 

For instance, if the event is happening in a small union territory like Lakshadweep (with a population of less than 65,000), 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 it will be considered a mass gathering event.

However, if the same event is being held in a metropolitan city like Delhi or Mumbai with a large, well-resourced health system and lasts a few hours, the event may not be considered a mass gathering.

Mass gatherings not only put a strain on the healthcare system but also increase the chance of spreading an infection rapidly in a community. 

There are certain things which make a mass gathering dangerous especially during an outbreak of infectious diseases, as a large number of people with different immunological status come together in a similar place.

The young and healthy people may not get adversely affected by this virus but the ones with a pre-existing medical condition may be at a higher risk of developing severe complications of the viral disease. The infection can also spread through food and water available in the event.

Mass gatherings should be completely restrained in countries where the spread of the disease has already been started in communities. 

Before planning any mass gathering, countries that are currently not experiencing community transmission of COVID-19 should consider the fact that the planned mass gathering event can substantially increase the risk of the virus entering the country. There is an equal risk to the participants, as they could be importing the infection back to their home countries or regions and further increasing the spread of the disease globally.

Firstly, the local health authorities should talk to the organisers of the events to brief them about the potential risks that event can bear. They should plan on postponing or cancelling the event until the risk of spreading the disease reduces. 

If the event cannot be cancelled or postponed, event organisers should assess the risk of spreading the disease and plan for surveillance during and after the event. These measures can be taken during a mass gathering to avoid the risk of spreading the disease:

• Try to keep the crowd density as low as possible. Make the participation available through video or teleconferencing.
• The organisers should make sure that there are surveillance indicators and systems for early detection and monitoring of diseases. If possible, screen every participant for COVID-19 symptoms (dry cough, fever, malaise) at points of entry to the venue. 
• Organisers should be involved with the local public health agencies.
• Organisers should get all the participants who would be attending the event registered prior to the event.
• Organisers should have appropriate stock of soap, water, disposable tissues and alcohol-based sanitizers for maintaining proper hand hygiene. All the participants of the event should be taught the proper way of washing hands. They should be informed about the precautions they must take in order to avoid getting infected from this infectious disease.
• Organisers should know the details like the profession of the participants as it would help them to know if they have been previously exposed to the disease. The age of participants should be known as elderly people who have co-morbid conditions can be more prone to get seriously affected by the disease. 
• Participants who would be coming from countries or areas affected by the COVID-19 outbreak should be asked to come 14 days before the event. They should be kept under observation and tested for COVID-19 infection. 
• It would be easy to diagnose event-associated cases if the duration of the mass gathering would be longer than the incubation period for COVID-19 infection (14 days) as the event would still be under way. However, if the duration of the event is shorter, there is a possibility that the participants may carry the infection back to their home communities.