(A225) Lessons Learned at the Commonwealth Games: A Mass-Gathering Sporting Event in New Delhi, India

Mass gatherings can be religious, political, socio-cultural, or sporting events, and vary in the form of processions, car races, conferences, fairs, etc. New Delhi hosted the 2010 Commonwealth Games, a mass gathering spread over a duration of 10 days with different venues and a high density of participants, spectators, security personnel, volunteers, and high-profile guests. Various organizations were involved in the planning and implementation of the games which called for a collaborative and coordinated effort to make the event a success. Security coverage was required for 23 sporting, 32 training, and seven non-sporting venues. Security arrangements were of utmost importance and required training, mobilization, and deployment of army, police, and other emergency workers, as well as establishing Standard Operating Procedures for responses to chemical, biological, radioactive, and nuclear events and availing specialized equipment. Areas of public health interventions in mass gathering include mass-casualty preparedness, disease surveillance and outbreak response, safety of water, food, and venues, health promotion, public health preparedness and response, pest and vector control, coordination and communication, healthcare facility capacity, and medical supplies. Methods adopted for the study included interviews with the stakeholders of the Commonwealth Games and use of secondary data to cite examples and support arguments. Existing knowledge must be documented and made available for use in planning for future mass gatherings. The size, duration, and interest of such events demands special attention toward preparedness and mitigation strategies to prevent or minimize the risk of ill health and maximizing the safety of people involved.

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(P2-39) Public Health Safety for Traditional Mass Gatherings in India: A 10-Year Analysis

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11004833 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s148-s148 ◽

Cited By ~ 1

Author(s):

S. Sanyal ◽

A. Madan

Keyword(s):

Violent Behavior ◽

Healthcare Services ◽

Mass Casualty ◽

Sporting Events ◽

Mass Gathering ◽

Health Safety ◽

Crowd Management ◽

Mass Gatherings ◽

Indian Context ◽

The Times

IntroductionIn the past decade, India has witnessed many lapses in crowd safety during mass gatherings. The high casualty rate in stampedes during traditional mass gatherings has prompted the study of these events. Wide variations exist in casualty rates for similar events, and key issues in healthcare services in these special situations were addressed in the Indian context.MethodsFrom 2001–2010, Mass gathering data were collected from news items reported in the archives of newspapers, “The Times of India”, “The Hindu” and “The Indian Express”. The keywords used were: “stampede”, “mass gathering”, “mass-gathering events”, “mass-gathering incidents”, “crowd”, and “crowd management”. The study included triggers for the incident and the number of casualties (dead and injured) in each incident.ResultsIn 27 separate mass gatherings in India, there were 936 dead and 540 injured casualties. The unique characteristics of mass gatherings in India included a predominance of old and vulnerable people in traditional mass gatherings, in contrast to the young and middle-aged groups who gather for music and sporting events elsewhere. Further, alcohol/substance abuse, brawls, and violent behavior were absent at traditional Indian mass gatherings. Non-traditional mass gatherings accounted for a lesser number of incidents in India, and were located in movie theatres and railway stations.ConclusionsIn a populous country like India, traditional mass gatherings predominate, and ensuring the health, safety, and security of the public at such events will require an understanding of crowd behavior, critical crowd densities, and crowd capacities in the Indian context. However, planning for mass gatherings can be developed using the existing body of knowledge of mass-casualty preparedness, food safety, and health promotion.

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What did Syndromic Surveillance Show During London 2012? Lessons for Mass Gatherings

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v7i1.5835 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Dan Todkill ◽

Helen Hughes ◽

Alex Elliot ◽

Roger Morbey ◽

Obaghe Edeghere ◽

...

Keyword(s):

Public Health ◽

General Practitioner ◽

Syndromic Surveillance ◽

Lessons Learned ◽

Surveillance Systems ◽

Mass Gathering ◽

Daily Number ◽

Mass Gatherings ◽

London 2012 ◽

The Impact

This paper investigates the impact of the London 2012 Olympic and Paralympic Games on syndromic surveillance systems coordinated by Public Health England. The Games had very little obvious impact on the daily number of ED attendances and general practitioner consultations both nationally, and within London. These results provide valuable lessons learned for future mass gathering events.

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Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events

The Lancet ◽

10.1016/s0140-6736(19)30501-x ◽

2019 ◽

Vol 393 (10185) ◽

pp. 2073-2084 ◽

Cited By ~ 51

Author(s):

Ziad A Memish ◽

Robert Steffen ◽

Paul White ◽

Osman Dar ◽

Esam I Azhar ◽

...

Keyword(s):

Public Health ◽

Sporting Events ◽

Mass Gathering ◽

Health Issues ◽

Mass Gatherings

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Coordinated Enhanced Surveillance with Healthcare Entities for Mass Gathering Events

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7678 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Erin E. Austin

Keyword(s):

Public Health ◽

Syndromic Surveillance ◽

Lessons Learned ◽

Surveillance Systems ◽

Mass Gathering ◽

Functional Requirements ◽

Specific Field ◽

Mass Gatherings ◽

Ed Visits ◽

The U.S

ObjectiveTo describe the planning strategies and lessons learned by theVirginia Department of Health (VDH) when conducting enhancedsurveillance during mass gathering events and coordinating withhealthcare entities to distinguish event-related emergency department(ED) visits from community-related ED visits.IntroductionMass gatherings can result in morbidity and mortality fromcommunicable and non-communicable diseases, injury, andbioterrorism. Therefore, it is important to identify event-related visitsas opposed to community-related visits when conducting publichealth surveillance1. Previous mass gatherings in Virginia havedemonstrated the importance of implementing enhanced surveillanceto facilitate early detection of public health issues to allow for timelyresponse2.MethodsBetween June 2015 and September 2015, VDH coordinatedwith two healthcare entities representing six acute care hospitalsto conduct enhanced surveillance for the 2015 World Police andFire Games and 2015 Union Cycliste Internationale (UCI) RoadWorld Championships. VDH established initial communicationwith each healthcare entity between 1 week to 2 months before theevent start date to discuss functional requirements with technical,informatics, and clinical staff. Requirements included: 1) health careentity identifying gathering attendees during the ED registration, 2)capturing a standardized mass gathering indicator within the patient’selectronic health record (EHR), and 3) transmitting the gatheringindicator to VDH through existing electronic syndromic surveillancereporting processes. ED visit records with the gathering indicator wereanalyzed by VDH using the Virginia Electronic Surveillance Systemfor the Notification Community-based Epidemics (ESSENCE) andfindings were incorporated in daily VDH situational reports. Thissame methodology will be applied for the upcoming U.S. VicePresidential Debate in October 2016.ResultsThe duration of the two gatherings in 2015 ranged from 9 to 10 daysand the locations were categorized as urban. The population densityof the gathering location ranged from 1,950 to 2,889 populationper square mile. The estimated number of attendees ranged from45,000 to 400,000. Attendees were defined as having attended at leastone day of the mass gathering event. The mass gathering indicatorcaptured during the ED registration included the gathering acronymor a gathering specific field with a drop down menu containingtrue/false options. VDH utilized ESSENCE to identify 42 ED visits(0.5%) with the gathering acronym out of 8,768 total ED visits duringthe 2015 World Police and Fire Games and 60 ED visits (2.6%)with the gathering specific field out of 2,296 total visits during the2015 UCI Road World Championships. The results of the U.S. VicePresidential Debate in October 2016 are pending.ConclusionsIn 2015, VDH partnered with two healthcare entities to conductenhanced surveillance during two mass gatherings. Although VDHroutinely uses syndromic surveillance data to identify issues of publichealth concern, it has previously lacked the ability to identify EDvisits specific to mass gatherings. Prior to collaboration with VDH,the healthcare entities did not capture gathering-specific ED visitsusing their EHR systems. The two healthcare entities successfullymodified their business procedures and EHR system to capture andtransmit a gathering indicator for ED visits despite some challenges.These challenges include constraints with customization of theEHR and syndromic surveillance systems, lack of standardizedtraining among ED registration staff for interpreting and applyingthe gathering indicator, and limited functionality testing prior tothe event. Lessons learned from this coordinated effort are to: 1)initiate the planning phase and identification of requirements as earlyas possible to ensure they are well defined and understandable, 2)implement frequent communications with the healthcare entity,and 3) customize requirements for the specific gathering as muchas possible while balancing the burden and benefit to public healthand the healthcare entity. The coordinated enhanced surveillanceefforts provided both VDH and the healthcare entities with improvedsituational awareness and capacity building during mass gatheringevents. The strategies and lessons learned from these two events willbe applied to improve enhanced surveillance of public health issuesduring future mass gatherings, including the U.S. Vice PresidentialDebate in October 2016.

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Methodology for assessment of public health preparedness and response synergies between institutional authorities and the community

10.21203/rs.3.rs-24278/v1 ◽

2020 ◽

Author(s):

Daniel H. de Vries ◽

John Kinsman ◽

Judit Takacs ◽

Svetla Tsolova ◽

Massimo Ciotti

Keyword(s):

Public Health ◽

Data Collection ◽

Methodological Approach ◽

Effective Means ◽

Field Work ◽

Lessons Learned ◽

Outbreak Response ◽

Study Approach ◽

Rich Data

Abstract Background: This paper describes a participatory methodology that supports investigation of the collaboration between communities affected by infectious disease outbreak events and relevant official institutions. The core principle underlying the methodology is the recognition that synergistic relationships, characterised by mutual trust and respect, between affected communities and official institutions provide the most effective means of addressing outbreak situations. Methods: The methodological approach and lessons learned were derived from four qualitative case studies including (i) two tick-borne disease events: Crimean-Congo haemorrhagic fever in Spain, and tick-borne encephalitis in the Netherlands (2016); and (ii) two outbreaks of acute gastroenteritis (norovirus in Iceland, 2017, and verocytotoxin-producingEscherichia coli [VTEC] in Ireland, 2018). These studies were conducted in collaboration with the respective national public health authorities in the affected countries by the European Centre for Disease Prevention and Control (ECDC). Results: An after-event qualitative case study approach was taken using mixed methods. Lessons highlight the critical importance of collaborating with national focal points during preparation and planning, and interviewer reflexivity during fieldwork. Field work for each case study was conducted over one working week, which although limiting the number of individuals and institutions involved, still allowed for rich data collection due to the close collaboration with local authorities. The analysis focused on the specific actions undertaken by the participating countries’ public health and other authorities in relation to community engagement, as well as the view from the perspective of the community. Conclusions: The overall objective of the assessment to identify synergies between institutional decision-making bodies and community actors and networks before, during and after an outbreak response to a given public health emergency. The methodology is generic and could be applied to a range of public health emergencies, zoonotic or otherwise. The methodology emphasises reflexivity among fieldworkers, a relatively short time needed for data collection, potential generalisability of findings, insider-outsider perspectives, politically sensitive findings, and how to deal with ethical and language issues.

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A US metropolitan county health department’s response to a measles outbreak in a childcare facility – challenges faced and lessons learned

Perspectives in Public Health ◽

10.1177/1757913920955201 ◽

2020 ◽

pp. 175791392095520

Author(s):

Diane Meyer ◽

Marc Trotochaud ◽

Lisa Ferguson ◽

Jennifer Vines ◽

Russell Barlow ◽

...

Keyword(s):

Public Health ◽

Health Department ◽

Lessons Learned ◽

Outbreak Response ◽

Public Health Community ◽

Local Public Health ◽

Measles Outbreak ◽

Health Community ◽

Childcare Facility ◽

Measles Outbreaks

Aims: In June 2018, the Multnomah County Health Department located in Portland, Oregon, US, responded to a measles exposure in a local childcare facility. This analysis describes lessons learned and challenges encountered during this measles response that may inform public health policy and help other local public health authorities prepare for measles outbreaks. These lessons will become increasingly important as measles cases continue to increase in both the US and abroad. Methods: A semi-structured videoconference interview was conducted with nine health department staff who were directly involved in the health department’s response to the measles outbreak. Interview notes were iteratively discussed between all authors to identify those outbreak response challenges and lessons learned that were generalizable to the broader public health community. Results: Some of the key challenges and lessons learned included the need for increased provider recognition and reporting of measles cases, difficulty in determining which staff and children to exclude from attending daycare during the 21-day postexposure monitoring period, determining who would be prioritized to receive immunoglobulin, and the need for childcare staff vaccine status requirements. Conclusion: Lessons from this response highlight important considerations for public health practitioners and policy makers. Given the relative severity of measles and the potential for spread in facilities that serve infants and young children, the public health community must continue to address key gaps through planning and policy.

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Mass-gathering Events: The Public Health Challenge of the Kumbh Mela 2013

Prehospital and Disaster Medicine ◽

10.1017/s1049023x15005245 ◽

2015 ◽

Vol 30 (6) ◽

pp. 621-624 ◽

Cited By ~ 4

Author(s):

Suresh Dwivedi ◽

Mudera P. Cariappa

Keyword(s):

Public Health ◽

Low Cost ◽

Health Planning ◽

Sporting Events ◽

Mass Gathering ◽

Publication Type ◽

Health Security ◽

The Public ◽

Health Challenge ◽

Public Health Challenge

AbstractMass-gathering (MG) events pose challenges to the most adept of public health practitioners in ensuring the health safety of the population. These MGs can be for sporting events, musical festivals, or more commonly, have religious undertones. The Kumbh Mela 2013 at Allahabad, India may have been the largest gathering of humanity in history with nearly 120 million pilgrims having thronged the venue. The scale of the event posed a challenge to the maintenance of public health security and safety. A snapshot of the experience of managing the hygiene and sanitation aspects of this mega event is presented herein, highlighting the importance of proactive public health planning and preparedness. There having been no outbreaks of disease is vindication of the steps undertaken in planning and preparedness, notwithstanding obvious limitations of insanitary behaviors and traditional beliefs of those attending the festival. The evident flaw on post-event analyses was the failure to cater adequately for environmental mopping-up operations after the festival. Besides, a system of real-time monitoring of disease and morbidity patterns, harnessing low cost technology alternatives, should be planned for at all such future events.DwivediS, CariappaMP. Mass-gathering events: the public health challenge of the Kumbh Mela 2013. Prehosp Disaster Med. 2015;30(6):621–624.

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(P2-43) Utilizing a Unified Health Command Structure for Mass Gathering Preparedness and Response: Lessons Learned from the 2008 Pacific Arts Festival

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11004870 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s149-s150

Author(s):

D.B. Bouslough ◽

S. Lemusu ◽

F. Avegalio

Keyword(s):

Public Health ◽

Interpersonal Violence ◽

Hospital Setting ◽

Respiratory Illness ◽

American Samoa ◽

Lessons Learned ◽

Surveillance Data ◽

Population Increase ◽

Mass Gathering ◽

Arts Festival

BackgroundThe Pacific Arts Festival is a mass-gathering event occurring every four years in Oceania. The 10th festival in American Samoa, July 20 to August 2, 2008, brought 2200 performers and 2500 tourists (a 15% population increase) from 27 Pacific nations to the island. Anticipated healthcare concerns included hospital surge (175% in 2004), HIV/STI transmission, imported/communicable diseases, food/water/sanitation-borne illness, interpersonal violence, and healthcare resource utilization.ObjectiveTo describe the preparedness and response efforts for this mass gathering event by emergency medical services, the hospital, and the department of health.MethodsA retrospective review of after-action reports, public health and emergency department surveillance records, and key-informant interviews was conducted. Descriptive statistics were used to evaluate data.ResultsA Unified Command structure was utilized for pre-/post-event response. Patient surveillance data was collected daily. During the festival 217 participants (42% female, 58% male, Average age 36) sought medical care. Acute illness (n = 166), injury (n = 39), other (n = 15), routine follow up (n = 9), chronic conditions (n = 6), mental health (n = 1), OB/GYN (n = 1) were complaints addressed. Predominant acute illnesses included headache (n = 49, 23%), respiratory illness (n = 30, 14%), musculoskeletal pain (n = 26, 12%), and gastroenteritis (n = 17, 8%). One fatality occurred among delegates. No public health outbreaks were reported. Visits per healthcare venue demonstrated a decentralization of patient surge from the hospital setting (37.4% venue aid stations, 28.1% delegation medical staff, 24% DOH clinic, 10.6% hospital).ConclusionA unified health command structure was effective in responding to this mass gathering event. Surveillance data was rapidly gathered and utilized to direct healthcare resources. Efforts to decentralize healthcare from the hospital were successful. Public health emergencies were avoided.

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Lessons learned from China’s mitigation strategies in fighting COVID-19

E3S Web of Conferences ◽

10.1051/e3sconf/202129203088 ◽

2021 ◽

Vol 292 ◽

pp. 03088

Author(s):

Sijiang Liu ◽

Mingyuan Wan

Keyword(s):

Public Health ◽

Risk Mitigation ◽

Arctic Region ◽

Lessons Learned ◽

Mitigation Strategies ◽

World Health ◽

Mitigation Measures ◽

The Arctic ◽

Health Complications ◽

Health Organization

In late 2019, the first SARS-CoV-2 case was reported in Wuhan, China. It has been known as a deadly virus that could cause many severe health complications, particularly respiratory illnesses. With its extraordinary ability to transmit between humans, the coronavirus disease 2019 (COVID-19) has spread worldwide, including Antarctica and the Arctic region. On 11th March 2020, the World Health Organization (WHO) declared the COVID-19 as a public health emergency worldwide (global pandemic) to raise global awareness of the dangerous virus. With immediate and efficient public health interventions, progress has been seen in many countries such as China and New Zealand. Therefore, in this review, we summarized the important public health risk mitigation measures applied in China.

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