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Suspension of Mass Gathering: A Life Saving Measure against COVID-19
The Corona Virus Disease-2019 (COVID-19) has put the world in great worry, confusion and pressure. From its prevailing patterns in past few days, we can estimate the stress which the health care systems and societies are bearing globally. This dreadful COVID-19 pandemic [1WHO. Coronavirus disease (COVID-19) outbreak. 2020. Available from
https://www.who.int/ emergencies/ diseases/ novel-coronavirus-2019 (accessed March 17, 2020).] is infecting uncontrolled number of individuals every single hour. Therefore, the major concern of the present hour is to prevent the further global spread of this pandemic as it has already involved more than 200 countries around the globe. According to the latest WHO reports upto 6th April, there are 12,10,956 total confirmed cases of COVID-19 and approximately 67,594 people have lost their lives all over the world [2WHO. Coronavirus disease (COVID-19) outbreak. Available from
https://www.who.int/ emergencies/ diseases/novel-coronavirus-2019 (accessed April 6, 2020).]. Corona virus (CoV) transmits readily through respiratory droplets and person to person contact, therefore presence at mass gathering event [3WHO. Public health for mass gatherings: key considerations 2015. Available from
https://www.who.int/ ihr/ publications/ WHO_HSE_GCR_2015.5/ en/ (accessed March 17, 2020).] is a major risk for transmission of this infection. The historical data clears the picture that various mass gathering events like sports, religious, musical and political are the major source of the spread of such fatal diseases [4Memish ZA, Steffen R, White P, et al. Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events. Lancet 2019; 393(10185): 2073-84. [http://dx.doi.org/10.1016/S0140-6736(19)30501-X] [PMID: 31106753] ]. Although, on 22nd January 2011; 130th Executive Board Decision declined such health issues caused during the mass gatherings because of advancements in public health measures, collaborative health planning, enhancements in health infrastructures and execution of all the preventive measures to manifest the spread of such infectious ailments at International scale [5WHO. Global mass gatherings: implications and opportunities for global health security. 2011. Available from
https://apps.who.int/iris/handle/10665/23751 (accessed March 18, 2020).]. After this, many mega events with huge mass gatherings were organized successfully even at the times when WHO has declared public health emergencies such as Vancouver Olympics in 2010 & FIFA World Cup in South Africa during H1N1 influenza epidemic, 2015 Africa Football Cup during Ebola infection and Rio Olympics in 2016 during Zika virus disease [6Blumberg L, Regmi J, Endricks T, et al. Hosting of mass gathering sporting events during the 2013-2016 Ebola virus outbreak in West Africa: experience from three African countries. Int J Infect Dis 2016; 47: 38-41. [http://dx.doi.org/10.1016/j.ijid.2016.06.011] [PMID: 27321960] , 7Petersen E, Wilson ME, Touch S, et al. Rapid spread of Zika virus in the Americas—implications for public health preparedness for mass gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis 2016; 44: 11-5. [http://dx.doi.org/10.1016/j.ijid.2016.02.001] [PMID: 26854199] ]. But the sudden emergence of SARS-CoV-2 in China from December 2019 onwards has again recreated the problem of the spread of this respiratory pathogen through mass gathering public events which has now led to a pandemic [1WHO. Coronavirus disease (COVID-19) outbreak. 2020. Available from
https://www.who.int/ emergencies/ diseases/ novel-coronavirus-2019 (accessed March 17, 2020).]. Therefore, several countries have put a stoppage on cultural, religious, sports and political events from the beginning of March 2020. Due to threat of spread of COVID-19, many mega events which were scheduled to take place during the present time were canceled or postponed such as Euro 2020 Football championship, Formula one Grand Prix in China, Rugby Championship in Italy, Olympic boxing qualifying championships, Umrah in Saudi Arabia and IPL in India [8Ebrahim SH, Memish ZA. Saudi Arabia’s measures to curb the COVID-19 outbreak: temporary suspension of the Umrah pilgrimage. J Travel Med 2020.published online Feb 28 [http://dx.doi.org/10.1093/jtm/taaa029] ].
Beyond this, with the progression of March, many countries have closed their boundaries, borders, tourism has been abandoned as well air travel has also been suspended and every day more and more countries are following the same trend. Maximum countries have now adapted and instructed their public to maintain continuous hand hygiene and keep social distancing. WHO has continuously worked with health authorities all over the world on the issue of mass gathering and has framed specific recommendations in order to ensure public health concerns of mass gatherings and these guidelines must be used with consultation of latest technical guidance on COVID-19 along with consideration of risk assessment [9Memish ZA, Zumla A, Alhakeem RF, et al. Hajj: infectious disease surveillance and control. Lancet 2014; 383(9934): 2073-82. [http://dx.doi.org/10.1016/S0140-6736(14)60381-0] [PMID: 24857703] -11WHO. Country and technical guidance—coronavirus disease (COVID-19). 2020. Available from
https://www.who.int/ emergencies/ diseases/ novel-coronavirus-2019/ technical-guidance (accessed March 17, 2020).]. The COVID-19 risk guidelines have been established on the basis of pre-existing recommendations on mass gathering. Some scientists such as Brian McCloskey and colleagues have advocated in their comment about formal risk assessment and a point of view to recommend mass gathering during this time of COVID-19 outbreak [12McCloskey B, Zumla A, Ippolito G, et al. Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma. Lancet 2020 March; 19 [http://dx.doi.org/10.1016/ S0140-6736(20)30681] ]. Re-commendations of mass gathering in such a time, put a misleading message to the public, policy makers as well as businessmen or stake holders. Such recommendations might be valid if the COVID-19 pandemic has limited to isolated portions only, but the situation is more terrible now all over the world. A mass gathering event in such a time can put the lives of millions of people in danger as well as harm the associated countries.
Cancellation of mass gathering events such as Saudi Arabia’s suspension of Umrah has led to protection of several lives, whereas Iran’s allowance to mass gatherings in Mashad and Qom has led to a loss of several lives due to COVID-19 [13Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. BMJ 2020; 368: m1066. [http://dx.doi.org/10.1136/bmj.m1066] [PMID: 32184233] ]. Other facts which support suspension of mass gathering events are morbidity rate in youth, presence and long survival of virus on innate surfaces and continuous progression of infection. It is evident that events like sports, music parties contain most attendees as young people. It is also evident from the reports that old persons or persons with disease are more prone to COVID-19, hence their isolation from the mass gatherings is of utmost importance. By keeping in view public health as a major concern, governments of several countries have declared suspension of all such mass gathering events and declared a “Lock Down” for a specific period of time. The cancellation of such events has a direct impact on individuals as well as national economy, public morale as well as daily individual livelihoods. It should be routinely analyzed that mass gathering cancelation has reduced the COVID-19 spread upto much extent.
Although mass gathering suspension and social distancing is an effective measure to prevent the spread of COVID-19, still there are certain issues particularly with the labour persons whose livelihood runs on daily earnings. Governments of countries are already concerned with this issue, but it needs a collaborative effort in this difficult hour. The public tends to panic in such situations, but this can lead to the only ignition to spread COVID-19 [14Carey B. Complacency, not panic, is the real danger. 2020.https://www. nytimes.com/ 2020/ 03/ 19/health/coronaviruspanic-anxiety.html?referringSource=]. Together we all must put our efforts to fight against this pandemic. Cancellation of mass gatherings may affect the economy in many aspects, but as per the concern of COVID-19 and nature of its virus, the risk of transmission is far much in such gatherings. Therefore we must make the “social distancing” our first and unavoidable choice because no treatment is available to date and it may take several months to be discovered [15WHO. Coronavirus diseases (COVID-19) advice for the public. 2020. Available from
https://www.who.int/ emergencies/ diseases/ novel-coronavirus-2019/ advice-for-public (accessed March 18, 2020).].
Blumberg L, Regmi J, Endricks T, et al. Hosting of mass gathering sporting events during the 2013-2016 Ebola virus outbreak in West Africa: experience from three African countries. Int J Infect Dis 2016; 47: 38-41. [http://dx.doi.org/10.1016/j.ijid.2016.06.011] [PMID: 27321960]
Petersen E, Wilson ME, Touch S, et al. Rapid spread of Zika virus in the Americas—implications for public health preparedness for mass gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis 2016; 44: 11-5. [http://dx.doi.org/10.1016/j.ijid.2016.02.001] [PMID: 26854199]
Ebrahim SH, Memish ZA. Saudi Arabia’s measures to curb the COVID-19 outbreak: temporary suspension of the Umrah pilgrimage. J Travel Med 2020.published online Feb 28 [http://dx.doi.org/10.1093/jtm/taaa029]