Nov 30, 2022

This World Cup is different – what we’ve learned about promoting healthier mass gatherings

Written by: Kaidi Liu, Epidemiologist at BlueDot

Why a strong defense goes beyond the field at the World Cup

Is the world finally returning to normal? This summer, we wrote about the return of international air travel and mass gatherings and how we considered the risks involved. Most regions worldwide have lifted their COVID-related restrictions, and people are once again growing comfortable gathering in large numbers. The World Cup, a 29-day tournament taking place in Qatar, is one of the largest sporting events in the world – presenting a unique opportunity to promote a healthier global event.

While any gathering that brings together a million visitors from around the world will create opportunities for diseases to spread, we've learned some valuable lessons about preventing outbreaks from mass gatherings that can prepare us for the “unprecedented” and strengthen our outbreak response.

So what’s different about this World Cup?

This World Cup is the largest single sporting event to date since the beginning of the pandemic. While the Tokyo and Beijing Olympics involved more participants and countries, this is the first event of this size being held at full capacity. However, more diseases than ever have the potential to become epidemics in new regions. Whether they are newly carried to the host country and surrounding areas, or brought home by returning travelers, select diseases have a high risk of immediate transmission during a large sporting event. There are also no travel-related COVID restrictions for this event (e.g., a negative test is no longer mandatory for entering the country).

Quick facts:

  • Qatar is the least populated country to ever host the World Cup, with a population of 2.9 million people.
  • Qatar is also the smallest country to ever host the World Cup at approximately 11,586 km². For reference, Sydney, Australia (12,368 km²) is larger.
  • Nearly 3 million World Cup tickets were sold, with 1.2 million international visitors estimated to attend from around the world. For reference, 1.5 million tickets were sold for the Arab Cup in 2021, the last large sporting event that took place in Qatar since the beginning of the pandemic.

What are the current disease trends to watch out for?

Not every disease is an immediate concern. Based on the current trends and event-specific context, our in-house subject matter experts have identified the top disease threats to mass gatherings in Qatar. Here are our top three:*

  • COVID-19 – Vaccinations are effective in reducing COVID-19 health risks. Without vaccination requirements for spectators to attend and enter the country, regions with the lowest vaccination coverage are at an increased risk for outbreaks, particularly if there are also suboptimal vaccination rates among attendees. Rising infections in the region should be anticipated, with subsequent impacts on healthcare.
  • Influenza – Countries with the highest ticket sales to the World Cup such as Qatar, US, Saudi Arabia, and UAE are experiencing a heavy volume of flu cases. Given how easily the flu circulates – it is likely to be even more easily transmissible among populations with lower immunity, due to little exposure to these strains in the past two years. 
  • Respiratory syncytial virus (RSV) – Similarly for RSV, Canada and the US, #2 in ticket sales, are seeing above-peak levels compared to pre-pandemic years and is a highly transmissible disease among susceptible populations. Respiratory syncytial virus is the second most common infectious agent causing infant death. 

    *As of November 20, 2022, the start of the World Cup.

Did you know? BlueDot’s AI-powered infectious disease intelligence leveraged its in-house subject matter expertise to not only identify, but also categorize a list of infectious diseases relevant to the Beijing and Tokyo Olympic Games, by risk level.

What have we learned from previous large gatherings?

International events of such density have the potential to amplify disease spread between international travelers who normally would not be in contact with one another. However, the ongoing stream of bite-sized news reports and patchwork array of official reports often don’t give the full picture.

Stay ahead of the game – whether you are an event attendee, organizer, health agency, or support staff around the event, staying informed on the current disease risks and trends can help guide a plan of action for protecting your people.

Staying informed requires having the right context at the right time – not only the local public health context around the host country, but also travel context around the event, disease context around the visiting countries, transmissibility context around relevant diseases, and other policies that impact how groups of people might interact with one another.

Did you know? These factors combined tie into the concept of population mixing – a term that epidemiologists use to approximate how the unique characteristics of people and their behaviours affect the spread of infectious diseases.

The world population has now reached a new high of 8 billion people – and continues to climb. With the return to mass gatherings and international travel increasing back to pre-pandemic levels, more infectious diseases can now spread around the globe faster than ever.

Infectious disease intelligence, however, can spread even faster. As the world becomes increasingly connected, we have the tools to empower our disease outbreak responses, promote healthier sporting events, and ultimately, build our resilience to the possibility of future pandemics. We just have to use them.

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