Linda Bauld: Mass events are back but can we make them safer?

Public opinion has also changed. A poll from YouGov has been tracking views on measures to address coronavirus since the start of March 2020. It found that eight in ten adults in the UK supported the government requiring large events to be cancelled in late March 2020 when Covid restrictions were first introduced. This dropped to just over half of adults during the summer of last year as cases fell, but rose again to a similar levels during the peak of the second wave this January. Now it is at its lowest levels since the polling started, with just a third of people agreeing that mass events should be cancelled or postponed.

A research programme has been underway in England to examine the risk of virus transmission during such events and look at measures to improve safety. This has included the World Snooker championships, football matches, award ceremonies, conferences, music festivals and nightclubs. The programme has not been without controversy, including questions from the scientific community about transparency of methods and how results have been interpreted. Last week saw the publication of new findings.

The paper, which hasn’t yet been peer-reviewed, reports results from groups of events that took place in June and July including cricket and football matches, a motorsport festival, horse racing, golf, tennis, opera and a music festival. The researchers drew on contact tracing data collected from telephone interviews and questionnaires with those attending. They compared the number of positive cases around each event in two categories – those who attended while infectious (attended in the period from two days prior to symptoms or a positive test) and those who might have become infected at the event (symptoms or a positive test three to seven days afterwards).

This approach has a whole range of limitations including not being able to prove where someone picked up the virus. But other data was also reviewed and overall community prevalence at the time provided for comparison.

The study found that far more cases were associated with the eight EURO 2020 matches at Wembley included in the study than any of the other events in the research, even after taking into account the numbers attending. This amounted to 6,376 people who became infected at or around the time of the matches and 3,036 who attended while likely infectious. There were more cases associated with the semi-final and final in the tournament than other matches.

The study concluded that the EURO 2020 matches generated a level of Covid-19 transmission over and above what would be commonly associated with large crowds attending an outdoor sporting event, even with mitigations in place such as a requirement to show proof of a negative test or vaccination to get in.

The researchers attributed this to big differences in behaviour between those attending the football compared with other events, including singing, shouting and close contact between fans. They also suggeted that crowd management efforts in and around Wembley made the situation worse, with large numbers of people in concourse areas resulting in carbon dioxide levels higher than those at other events. There were public disorder offences with people without tickets getting in. This led to officials abandoning checking vaccine/testing certification for the final.

The EUROS were unusual for a whole variety of reasons outlined in the paper. This has already been discussed in Scotland and we know there were cases associated with fans travelling together to and from matches plus people gathering in hospitality venues and homes to watch the matches. What this suggests is that not all mass gatherings pose the same infection risks, and that it is a whole raft of activities associated with large events that make them risky, not just what happens at the venue.

What can event organisers do in general to reduce the risk of infections occurring at mass events? Findings from the Event Research Programme suggest measures and we can also look at other research.

An obvious first step is for authorities to do a risk assessment, looking at the pros and cons of events going ahead and carefully considering the infection levels in the community at the time. Efforts can also be made to try and reduce the number of people attending who could become very unwell if infected at the event. This means trying to ensure those attending are vaccinated or at least promoting vaccination as part of information about the event, even if the concept of ‘vaccine passports’ for such gatherings is something governments are not currently implementing.

It also means highlighting the importance of attendees taking up regular asymptomatic testing. This can reduce the risk that someone unknowingly carries the virus with them to a venue. Organisers should also provide practical advice to attendees about what to do if they develop symptoms while at an event.

It’s also clear that extra efforts need to be made to manage the number of people in any one place at a time, particularly avoiding crowding at entry and exit to venues and around food and drink concessions. Providing increased provision of toilets and facilities to allow attendees to wash or sanitise their hands. Requiring attendees to wear face coverings where appropriate.

For indoor spaces, the role of ventilation is key and other studies have found that an effective ventilation system can substantially reduce the risk of infection in indoor mass gatherings. None of this is rocket science, and it’s all present in existing guidelines. These measures won’t remove the risk of mass events contributing to the ongoing spread of Covid-19. But they will help them to continue more safely.

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