Abstract
BackgroundMass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies.DiscussionNot all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards.Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure.Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action.SummaryOne-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event.
Highlights
Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation"
Summary: One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event
Mass gatherings have been defined by the World Health Organisation [1] as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation"
Summary
When does a 'mass gathering' require enhanced public health planning and response? Sydney has an international reputation as a "party city [14]" and hosts mass gatherings of over 200,000 people at least semi-annually (including Sydney's New Year's Eve and Gay and Lesbian Mardi Gras celebrations [15]). The Sydney 2007 APEC event occurred in a world with heightened security concerns, post the September 11 terrorist attacks in the United States In this environment, the need for key public health staff to hold appropriate national security clearances so as to be adequately briefed on the risk of bioterrorism or other attacks became apparent at inter-agency planning meetings. During the current response to the pandemic (H1N1) 2009 the previous experience of mass gatherings in Sydney has enabled NSW Health to quickly implement a formal incident control system, establish a state-wide Public Health Emergency Operations Centre within 24 hours and utilised the near-real time surveillance system to provide daily reports, seven days a week, on Emergency Department activity for influenza-like-illness. Whilst finding adequate funding for such investments can be challenging, the long term preparedness and response benefit for future mass gatherings or large scale public health emergencies, such as pandemic influenza, could offer a large return on investment to the city, state or nation
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