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      Results of the enhanced COVID-19 surveillance during UEFA EURO 2020 in Germany

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          Abstract

          In general, mass gatherings might pose a risk to the public health (PH). The UEFA EURO 2020 tournament (EURO 2020) was one of the first mass gathering events since the start of the coronavirus disease 2019 (COVID-19) pandemic in Germany. To allow early detection and response to any EURO 2020-associated impact on the COVID-19-related epidemiological situation, we initiated enhanced surveillance activities using the routine surveillance system in collaboration with the regional PH authority of Bavaria. Several preventive measures regarding the attendance of football matches and public viewing were implemented according to state regulations. We describe the results from the enhanced surveillance during the EURO 2020. In total, five cases who had attended a football match in the stadium of Munich, nine cases, who attended a football match in a stadium outside of Germany, and 123 cases in association with public viewing events were identified by enhanced surveillance. Concluding, the EURO 2020 seems to not have had a major impact on the COVID-19 pandemic development in Germany. Health measures for stadium visitors and the restriction of large public viewing events may have potentially contributed to the low case numbers detected, emphasising the need of appropriate PH surveillance and regulations to limit the potential risk to PH during mass gathering events.

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          Incubation period of COVID-19: a rapid systematic review and meta-analysis of observational research

          Objectives The aim of this study was to conduct a rapid systematic review and meta-analysis of estimates of the incubation period of COVID-19. Design Rapid systematic review and meta-analysis of observational research. Setting International studies on incubation period of COVID-19. Participants Searches were carried out in PubMed, Google Scholar, Embase, Cochrane Library as well as the preprint servers MedRxiv and BioRxiv. Studies were selected for meta-analysis if they reported either the parameters and CIs of the distributions fit to the data, or sufficient information to facilitate calculation of those values. After initial eligibility screening, 24 studies were selected for initial review, nine of these were shortlisted for meta-analysis. Final estimates are from meta-analysis of eight studies. Primary outcome measures Parameters of a lognormal distribution of incubation periods. Results The incubation period distribution may be modelled with a lognormal distribution with pooled mu and sigma parameters (95% CIs) of 1.63 (95% CI 1.51 to 1.75) and 0.50 (95% CI 0.46 to 0.55), respectively. The corresponding mean (95% CIs) was 5.8 (95% CI 5.0 to 6.7) days. It should be noted that uncertainty increases towards the tail of the distribution: the pooled parameter estimates (95% CIs) resulted in a median incubation period of 5.1 (95% CI 4.5 to 5.8) days, whereas the 95th percentile was 11.7 (95% CI 9.7 to 14.2) days. Conclusions The choice of which parameter values are adopted will depend on how the information is used, the associated risks and the perceived consequences of decisions to be taken. These recommendations will need to be revisited once further relevant information becomes available. Accordingly, we present an R Shiny app that facilitates updating these estimates as new data become available.
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            Indoor versus outdoor transmission of SARS-COV-2: environmental factors in virus spread and underestimated sources of risk

            Graphic abstract The first case of Coronavirus Disease 2019 (COVID-19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), in Europe was officially confirmed in February 2020. On 11 March 2020, after thousands of deaths from this disease had been reported worldwide, the WHO changed their classification of COVID-19 from a public health emergency of international concern to a pandemic. The SARS-CoV-2 virus has been shown to be much more resistant to environmental degradation than other coated viruses. Several studies have shown that environmental conditions can influence its viability and infectivity. This review summarizes current knowledge on the transmission pathways of the novel coronavirus, and directs attention towards potentially underestimated factors that affect its propagation, notably indoor spread and outdoor risk sources. The contributions of significant indoor factors such as ventilation systems to the spread of this virus need to be carefully ascertained. Outdoor risk sources such as aerosolized particles emitted during wastewater treatment and particulate matter (PM), both of which may act as virus carriers, should be examined as well. This study shows the influence of certain underestimated factors on the environmental behavior and survival of the SARS-CoV-2 virus. These aspects of coronavirus propagation need to be accounted for when devising actions to limit not only the current pandemic but also future outbreaks.
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              Mass Gatherings and the Spread of Respiratory Infections. Lessons from the Hajj

              The mass gathering of people is a potential source for developing, propagating, and disseminating infectious diseases on a global scale. Of the illnesses associated with mass gatherings, respiratory tract infections are the most common, the most easily transmitted, and the most likely to be spread widely beyond the site of the meeting by attendees returning home. Many factors contribute to the spread of these infections during mass gatherings, including crowding, the health of the attendees, and the type and location of meetings. The annual Hajj in the Kingdom of Saudi Arabia is the largest recurring single mass gathering in the world. Every year more than 10 million pilgrims attend the annual Hajj and Umrah. Attendees assemble in confined areas for several days. People with a wide range of age, health, susceptibility to illness, and hygiene sophistication come in close contact, creating an enormous public health challenge. Controlling respiratory infections at the Hajj requires surveillance, rapid diagnostic testing, and containment strategies. Although the Hajj is without equal, other mass gatherings can generate similar hazards. The geographic colocalization of the Zika virus epidemic and the 2016 Summer Olympic Games in Brazil is a current example of great concern. The potential of international mass gatherings for local and global calamity calls for greater global attention and research.
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                Author and article information

                Journal
                Epidemiol Infect
                Epidemiol Infect
                HYG
                Epidemiology and Infection
                Cambridge University Press (Cambridge, UK )
                0950-2688
                1469-4409
                2022
                03 March 2022
                03 March 2022
                : 150
                : e60
                Affiliations
                [1 ]Department for Infectious Disease Epidemiology, Robert Koch Institute , Berlin, Germany
                [2 ]Bavarian Health and Food Safety Authority (LGL) , Oberschleißheim, Germany
                Author notes
                Author for correspondence: Helena Heese, E-mail: heeseh@ 123456rki.de
                [*]

                Shared first authorship.

                Author information
                https://orcid.org/0000-0002-7617-0714
                https://orcid.org/0000-0002-5807-8092
                Article
                S0950268822000449
                10.1017/S0950268822000449
                8924559
                35236530
                196e49b1-4a2c-4f42-ba3f-34fcc0f0c4e6
                © The Author(s) 2022

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                : 14 October 2021
                : 11 February 2022
                : 25 February 2022
                Page count
                Figures: 3, Tables: 1, References: 18, Pages: 7
                Categories
                Transformations
                Original Paper

                Public health
                enhanced surveillance,public health,covid-19,infectious disease epidemiology,mass gathering events

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