Mass Gatherings Research Articles

Emergency pharmacy workforce views and experience related to the provision of pharmaceutical care during mass gathering events: the FIFA World Cup Qatar 2022™ experience.

This study aimed to explore emergency pharmacy workforce perspectives and experiences in providing pharmaceutical care during mass gathering events (i.e., FIFA World Cup Qatar 2022™). A qualitative methodology was employed using focus groups discussions. Emergency pharmacists across Hamad Medical Corporation were invited to participate using a combination of purposive and snowball sampling. Focus groups were audio-recorded, transcribed verbatim, and validated. Inductive thematic analysis was undertaken to generate key themes and subthemes. Four focus groups were conducted which included 21 participants and generated five major themes. Whilst participants had mixed opinions in relation to their preparedness to practice during the World Cup, they perceived their experience as successful and smooth. The primary perceived facilitators were management support, mobile medical units, and high public health awareness. The main highlighted barriers were related to staff insufficiency, medications availability, and cultural and language challenges. Participants recommended pharmacist's role identification in mass gatherings, development of pharmacy action plan, and offering simulation training and pharmacy-specific training. Despite the perceived barriers, pharmacists reported positive views in relation to their experience in providing pharmaceutical care during mass gatherings. Future research should focus on the development of theory-driven action framework for pharmacy departments to adopt during mass gatherings.

Drug-related deaths at Australian music festivals

BackgroundIllicit drug use is overrepresented in music festival attendees compared with the general population. Drug use often involves a wide range of substances with the potential to cause drug toxicity. Law enforcement-centred strategies intended to deter drug use and supply at these mass gatherings have been implemented throughout Australia. However, many have been criticised for their lack of effectiveness, with evidence suggesting that they can inadvertently increase the risk of drug harm. Drug deaths are often multifactorial, providing added challenges in the development of prevention strategies. This study aimed to determine the frequency of deaths involving alcohol and other drugs at music festivals in Australia and to identify potential risk factors that may inform future harm reduction strategies. MethodsA descriptive case series study was conducted using the National Coronial Information System (NCIS) to investigate drug-related deaths at music festivals throughout Australia between 1 July 2000 (Queensland from 1 January 2001) and 31 December 2019, using a list of keywords comprising music festival names and terms. ResultsThere were 64 deaths, of which most involved males (73.4%) aged in their mid-20s (range 15-50 years). Drug toxicity was the most common primary cause of death (46.9%) followed by external injuries (37.5%). The drug most commonly detected or reported as being used was MDMA (65.6%), followed by alcohol (46.9%) and cannabis (17.2%), with most cases reporting the use of two or more drugs (including alcohol) and 36% reporting a history of drug misuse in the coroner's findings. Most deaths were unintentional, with less than a fifth of cases (17.2%) involving intentional self-harm. Clinical intervention was involved in 64.1% of cases and most festivals occurred in inner city locations (59.4%). ConclusionsThe findings suggest that drug-related deaths at music festivals in Australia typically involve young people using multiple illicit substances in combination with alcohol. Most are unintentional and could potentially be prevented through the implementation of a range of harm reduction strategies, including mobile medical care, drug checking services, and increased consumer education and awareness.

Genetic diversity and molecular analysis of human influenza virus among pilgrims during Hajj

The risk of transmission of respiratory tract infections is considerably enhanced at mass gathering (MG) religious events. Hajj is an annual Islamic MG event with approximately 3 million Muslim pilgrims from over 180 countries concentrated in Makkah, Saudi Arabia. This study aimed to investigate the genetic diversity of influenza viruses circulating among pilgrims during the Hajj pilgrimage. We performed a cross-sectional analytical study where nasopharyngeal swabs (NPs) from pilgrims with respiratory tract illnesses presenting to healthcare facilities during the 2019 Hajj were screened for influenza viruses. Influenza A subtypes and influenza B lineages were determined by multiplex RT–PCR for positive influenza samples. The phylogenetic analysis was carried out for the hemagglutination (HA) gene. Out of 185 nasopharyngeal samples, 54 were positive for the human influenza virus. Of these, 27 were influenza A H1N1 and 19 H3N2, 4 were untypable influenza A, and 4 were influenza B. Phylogenetic analysis revealed that the H1N1 and H3N2 strains differentiated into different and independent genetic groups and formed close clusters with selected strains of influenza viruses from various locations. To conclude, this study demonstrates a high genetic diversity of circulating influenza A subtypes among pilgrims during the Hajj Season. There is a need for further larger studies to investigate in-depth the genetic characteristics of influenza viruses and other respiratory viruses during Hajj seasons.

Фізична реабілітація при коронавірусній інфекції та постковідному синдромі у санаторно-курортних установах України

This article is devoted to the problem of physical rehabilitation of patients who have suffered coronavirus infection and suffer from post-Covid syndrome. The authors consider the possibilities and advantages of physical rehabilitation in sanatorium and resort institutions of Ukraine in the context of updating physical and psychological health. The article highlights effective methods of physical therapy, physical education and rehabilitation procedures that help improve the condition of patients and improve the quality of life after infection with coronavirus. The results of the article may be useful for specialists in the field of medicine and rehabilitation, as well as for patients who are looking for optimal methods of recovery after COVID-19. Taking into account the restrictions providing for a quarantine regime and other measures to slow down the spread of viral infection, we examined exactly how they affected the sanatorium and resort institutions of Ukraine, because in a pandemic, any mass gatherings are dangerous to health due to the risks of spreading the infection. The actions and influence of viruses from the family were studied Coronaviridae and their mode of transmission. The clinical manifestations of COVID-19, its spread, forms and possible complications are analyzed. Statistics are provided on the number of patients and deaths among them. To date, it has not yet been clarified why patients continue to experience symptoms after treatment, so this condition has been called post-Covid syndrome. The symptoms of post-Covid syndrome, its prerequisites, course and impact are described. Rehabilitation methods that can be used for COVID-19 and post-Covid syndrome are presented. The direction of therapeutic physical culture is characterized as a means that can be started in the first stage of rehabilitation. The feasibility of using massage, physiotherapy and hydrotherapy in combination with exercise has been proven. It has been established that Ukraine has good climatic and natural resource potential, which stimulates the development of the sanatorium and resort industry. The problems of recreation that lead to damage in the health resort industry and threaten its existence are examined. It is proposed to pay attention to the need for resorts, sanatoriums, boarding houses and other health institutions, where rehabilitation for coronavirus infection and post-Covid syndrome will help patients speed up recovery and shorten the period of incapacity.

Effect ofthe NFL's Super Bowl on emergency department visits for assault-related injuries.

Through its associations with mass gatherings, alcohol consumption, emotional cues, and gambling, the Super Bowl (SB) has been implicated in increased rates of interpersonal violence and assaults. This study endeavors to investigate the relationship between assault-related injuries, especially intimate partner violence (IPV) and SB. A retrospective review of prospectively collected data from the National Electronic Injury Surveillance System (NEISS) spanning 2005 to 2017 was conducted. Assault-related injuries were examined in relation to (1) the 4-day Super Bowl weekend (Friday-Monday), (2) Super Bowl Sunday, and (3) the Super Bowl week (Friday-Thursday) for all years, following the loss of the projected winning team (underdog victories), and losses despite a significant point spread favoring one team (upset losses). National estimates of injuries and associated variables were derived using the SUDAAN software. While there were no significant differences in the overall number of assaults or assault types during the SB weekend (5.6% vs 5.5%; p = 0.31), relative decreases were observed for altercations (21.1% vs 24.8%; p < 0.01), sexual assault (3.4% vs 4.0%; p < 0.01), and IPV (8.3% vs 12.5%; p < 0.01) on the Friday preceding SB, and robbery incidents on SB Sunday (2.1% vs 3.5%; p = 0.01). No changes in the incidence of assault-related injuries were found based on the favored or underdog status of the teams, including upset losses. Contrary to expectations, SB was not associated with increased assault-related injuries. This study underscores the need for year-round structural changes in addressing violence rather than relying solely on heightened awareness during specific events.

Modelling and accelerating the passenger evacuation process in a bi-modal system with bus and e-hailing modes after mass gathering events

After mass gathering events, passenger trip demand surges immediately within a small area. While organized bus bridging services would be usually offered in such circumstances to speed up passenger evacuation, many people prefer the more comfortable e-hailing service to leave the area. However, the use of e-hailing services for speedy passenger evacuation is a double-edged sword. On the one hand, e-hailing vehicles supplement to buses by offering more transportation supplies; on the other hand, the large inflows of e-hailing vehicles and the time-consuming passenger-driver (offline) searching process would lead to a huge vehicle accumulation within the area, thus lower vehicle speed and reduce bus evacuation efficiency. This paper proposes a mathematical model to depict the dynamic passenger evacuation rates and traffic conditions in a bi-modal system with both bus and e-hailing services for passenger evacuation. Numerical examples show that e-hailing service could significantly deteriorate the evacuation process when the arrival rates of e-hailing vehicles are high. Thus we further propose two feedback based perimeter control strategies that control the total inflow rates of e-hailing vehicles and background traffic, based on the vehicle accumulation and the number of parked vehicles within the area respectively. As shown by simulation experiments, both perimeter control strategies can effectively improve evacuation efficiency in the presence of e-hailing vehicles, especially when bus frequency is low, passenger demand is high, and/or the number of parking spaces is limited.

EDUKASI PENCEGAHAN COVID-19 DENGAN METODE 5M PADA REMAJA DESA SIDOREJO KABUPATEN SUKOHARJO

Covid-19 can be transmitted from one individual to another through coughing/sneezing droplets (droplets). Besides that, people can also be infected by touching surfaces that have been contaminated with the Covid-19 virus and then touching their faces (eg eyes, nose and mouth). Through the implementation of physical distancing such as staying away from gatherings or crowds, avoiding mass gatherings, and keeping a distance from other people, you can reduce the risk of being infected with Covid-19 (or what we know as 5M (wearing masks, washing hands, keeping your distance, staying away from formulas, reducing mobility). The purpose of this service is to provide information to adolescents in preventing Covid-19, while the problems encountered in adolescents are not all adolescents know what prevention of Covid-19 is with the 5M method. Solutions offered increase knowledge and empower youth in preventing Covid-19, the method used used socialization and assistance to adolescents in preventing Covid-19 the results of the behavior of preventing covid-19 washing hands properly by 92.5%, wearing masks by 90%, maintaining distance by 87.5%, reducing mobility by 80% and avoiding crowds by 85% Conclusion Most of the 60% of teenagers are &lt;20 years old, most of the teenagers are 70% with vocational/high school education, the behavior of preventing covid-19 is washing hands properly by 92.5%, wearing masks by 90%, keeping a distance by 87.5%, reducing mobility 80% and stay away from the crowd by 85%

Improving public safety in events of mass gathering: The 2022 Kanjuruhan Stadium Disaster in Indonesia

AbstractThe Kanjuruhan tragedy has caused tremendous sorrow for Indonesia and its football history. The incident happened during the match between the Arema and Persebaya football teams that was followed by a chaotic stampede due to supporters’ anarchy. The incident caused 135 deaths due to a stampede in the chaotic stadium. However, it has also brought into the limelight several violations and depravity of safety measures that have been neglected by the Indonesian officials and its football association. Despite being banned by FIFA's Safety and Security Regulations, the use of crowd‐control gas is hypothesized as one of the key driving factors for the stampede. There were also violations of the evacuation plan with overloaded stadium capacity, lack of safety protocol, and no regard for the disaster management command chain needed in such a situation. Inappropriate security plans, lack of safety officers, lack of a contingency plan in the event of a stampede, and lack of appropriate safe infrastructure contributed to the severity of this incident. We discuss the incident with the possible causes and notable issues in the management of mass gatherings, as well as the might‐be solution and precaution for all parties involved, from the evaluation of the use of crowd‐control gas, reassessment of safety protocol, and infrastructure to the appropriate response for stampede or any similar situations. The Kanjuruhan tragedy is heart‐wrenching, with various issues involved, showing the lack of regulations by the Indonesian government and its football association. However, it might also be an opportunity to learn and inspect all parties to achieve a peaceful and safe football in Indonesia.

Role of emergency teleradiology in a mass motorcycle event: the experience of the 2021 International Six Days of Enduro (ISDE).

Provision of healthcare support at mass gathering sporting events is of paramount importance for the success of the event. Many of such events, like motorsports, have been increasingly taking place in remote and austere environments. In these settings, the use of first-line diagnostic tools, such as point of care ultrasound and portable X-ray, could aid in definitive care on the field for patients with minor trauma while also ensuring fast access to the appropriate level of care for patients requiring hospitalization. As part of the ISDE 2021 medical response plan, a field hospital equipped with portable digital X-ray and telemedicine was established. Data on patient admission, triage, treatments, diagnostics, and outcomes were collected for analysis. During the 6-day competition, 79 patients sought medical care at the field hospital, with traumatic injuries accounting for 77% of cases. Of these, 47 were athletes and 32 were non-athletes. The majority (91%) arrived spontaneously, while 9% were transported directly. Upon admission, 68 patients were triaged as non-urgent (code 3) and 11 as urgent (code 2). Of those admitted, 69 received treatment and were discharged at the field hospital, while 10 were transferred elsewhere. Notably, four patients had major trauma, two had isolated fractures, and one needed a CT scan after losing consciousness. Overall, 29 missions were conducted on the race field, including 13 primary transports to local hospitals and 6 to the field hospital. Primary transport was primarily due to major trauma. Among 31 patients who had radiological exams, 11 (35.5%) had traumatic injuries. Of these, 5 were treated with braces and casts and discharged without hospitalization, 3 were advised for post-event care, and 3 were hospitalized. In contrast, patients with negative X-rays received on-site treatment, with 7 able to continue competing. In summary, the successful implementation of portable X-ray machines and teleradiology at remote and austere high-risk sporting events holds great promise for enhancing on-site medical capabilities, allowing clinicians informed decisions, avoiding unnecessary hospitalization, and allowing athletes to continue with their competition. Provided that challenges related to cost, safety, connectivity, and power supply are effectively addressed.

Characteristics and Outcomes of Conditions Encountered in Primary Care During FIFA World Cup 2022 in Qatar - A Cross-Sectional Study

The FIFA World Cup, a massive football event, presents significant challenges to healthcare systems. Primary healthcare plays a crucial role in patient-provider interactions and serves as a cornerstone of the system. This study aimed to assess the frequency, characteristics, and outcomes of conditions treated in primary care facilities during the FIFA World Cup Qatar 2022. A cross-sectional study was conducted from November 15 to December 20, 2022. All patients visiting the 29 governmental primary healthcare facilities in Qatar were included. Anonymous patient data, including age, sex, nationality, diagnosis, treatments, visit date, consultation type, and outcomes, were extracted from electronic medical records. A total of 401,962 patients were seen in primary care, with an average age of 34.50 ±19.3 years. Less than 1% held Hayya Visa (n=3120, 0.8%), and roughly 2% were referred to secondary care (8494, 2.1%). The most prevalent diagnoses were Type 2 diabetes mellitus (n=59670, 7.7%) and upper respiratory tract infection (n=47364, 6.2%). Paracetamol was the most frequently prescribed medication (n=69,960, 11.9%). Elderly patients (OR=1.23), non-Qatari patients (OR=1.25), and male patients (OR=1.17) were more likely to be referred to secondary care. Hayya cardholders were about twice as likely to be transferred (OR=2.40). Primary healthcare services operated efficiently during the FIFA World Cup 2022 in Qatar. The majority of cases involved managing chronic diseases and minor respiratory infections. Football enthusiasts and non-Qatari individuals were more often referred to secondary healthcare. These findings can guide policymakers in enhancing primary healthcare services for future mass gatherings.

Disaster preparedness of health professionals at mass gatherings: a scoping review

Mass gathering disasters involving large numbers of casualties can adversely affect the performance of healthcare systems. This scoping review aims to explore the current literature on the preparedness of health professionals for disasters during mass gathering events. Four databases were searched to identify papers examining health professionals' disaster preparedness during mass gatherings between 2011 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews was applied to undertake this review. A total of 2024 articles were identified, of which 18 qualified for inclusion in the scoping review. Some studies reported the level of professionals' preparedness for disaster management, while others reported strategies to enhance preparedness and challenges associated with disaster preparedness during mass gatherings. More studies are needed in this field to better understand the level of disaster preparedness of health professionals to improve response and management of potential disasters during mass gathering events.

Adoption and Discontinuance of Innovation Packages: A Longitudinal Study of Transitions in COVID-19 Mitigation

ABSTRACT The past decades have seen growing interest and application of interventions targeting the change of multiple behaviors at once. We advance this work by using the diffusion of innovations theory (DOI) to consider constellations of behaviors as innovation packages: multiple innovations that are logically related, interdependent in their use or effects, and often promoted as a set (Rogers, 2003). In addition, we embraced DOI’s focus on behavioral decisions as a continual process that can include adoption and discontinuance over time, especially as new innovations (e.g., COVID-19 vaccine) appear. To that end, we conducted a latent transition analysis of COVID-19 mitigation behaviors (N = 697; 97% received a COVID-19 vaccine) across three time points in the pandemic: initial outbreak; a secondary, record-breaking rise in cases; and after the CDC recommended that fully vaccinated adults could discontinue wearing masks. This analysis allowed us to identify latent classes based on shared behavioral patterns and transitions between classes over time. The results showed evidence of three possible packages: (a) a package of traditional, symptom-management behaviors (covering coughs and sneezes, staying home if ill, and seeking medical care), (b) a package of just-novel COVID-19 behaviors (wearing masks, keeping six feet apart, and avoiding mass gatherings), and (c) a package of all COVID-19 mitigation behaviors. Movement between classes exemplified adoption and discontinuance of different packages, as well as widespread discontinuance with the replacement innovation: COVID-19 vaccines. Additional analyses showed that increases in hope were associated with sustained and delayed adoption; decreases in social approval were associated with discontinuance. Future directions in theorizing around innovation packages are discussed.

Genetic analysis of human parainfluenza type 2 virus in Riyadh, Saudi Arabia.

The extensive mass gathering of pilgrims from all over the world, as well as the constant flow of foreign workers via country entry crossings, raises the likelihood of respiratory virus outbreaks spreading and evolving in Saudi Arabia. Here, we report the sequence and phylogenetic analysis of the human parainfluenza type-2 (HPIV-2) in nasopharyngeal aspirates (NPAs) collected from Riyadh, Saudi Arabia, from 2020/21 to 2021/22 seasons. RNA was extracted from the clinical samples and subjected to RT-PCR analysis for the detection of IAV and IBV. The full-length HN gene of HPIV-2 was amplified and sequenced. Multiple sequence alignments (both nucleotides and deduced amino acids) were aligned using Clustal W, MegAlign program of Lasergene software, and MEGA 7.0. HPIV-2 was found in (4; 2% of 200) NPAs. Sequence and phylogenetic analysis results showed that indicated a genotype shifting from G3 to G4a with 83% sequence homology 62-M786 from Japan, which was prominent throughout the winter seasons of 2008/09. Multiple amino acid sequence alignment revealed 25 sites of possible difference between G3 genotypes and G4a. A total of twenty- two of these locations were shared by the other G4a genotypes, whereas three positions, 67V, 175S, and 377Q, were exclusively shared by G3. Only eight conserved N-glycosylation sites were found at amino acids 6(NLS), 286(NTT), 335(NIT), 388(NNS), 498(NES), 504(NPT), 517(NTT), and 539(NGT) in four Riyadh isolates. Our findings also revealed that the G4a genotype of HPIV-2 predominated in our samples population during the winter seasons of 2020/21 and 2021/22. Further research with a larger sample size covering numerous regions of Saudi Arabia throughout different epidemic seasons is needed to achieve an improved knowledge of HPIV-2 circulation.

Emergency exit layout planning using optimization and agent-based simulation

Evacuation preparedness includes ensuring proper infrastructure, resources and planning for moving people from a dangerous area to safety. This is especially important and challenging during mass gatherings, such as large concerts. In this paper, we present the Emergency Exit Layout Problem (EELP) which is the problem of locating a given number of emergency exits and deciding their width such that the time it takes to evacuate the crowd from an arena is minimized. The EELP takes into account the geography of the arena and its surroundings, as well as the number of pedestrians in the crowd and the distribution of these within the arena. The EELP is formulated as a two-stage stochastic mixed integer linear program to handle the uncertainty related to the location of the possible incidents and the distribution of the pedestrians. Two cases are studied, a large concert planned at the Leangen trotting track in Trondheim and a smaller indoor arena. For each case, the EELP is solved for different scenarios, and the suggested layouts are evaluated using an agent-based simulation model. In particular, the potential of incorporating detailed assessment regarding the location and probability of specific incidents and the distribution of pedestrians are investigated. The computational study shows that making a more detailed risk assessment has little effect on the large concert, but a significant impact on the location of the emergency exits for the smaller indoor case. The results also indicate that it is more important to consider the location and probability of specific incidents rather than the pedestrian distribution.

Long COVID Prevalence and the Impact of the Third SARS-CoV-2 Vaccine Dose: A Cross-Sectional Analysis from the Third Follow-Up of the Borriana Cohort, Valencia, Spain (2020-2022).

In March 2020, a COVID-19 outbreak linked to mass gathering dinners at the Falles Festival in Borriana, Spain, resulted in an estimated attack rate of 42.6% among attendees. In June 2022, we conducted a cross-sectional follow-up study of 473 adults aged 18 to 64 who attended the dinners at the Falles Festival in 2020, examining the cumulative experience after SARS-CoV-2 infection and vaccination responses. Data included demographic details, lifestyle habits, medical history, infection records, and vaccinations from a population-based vaccine registry. Blood samples were analyzed for SARS-CoV-2 antibodies and cellular immunity. We employed a doubly robust inverse-probability weighting analysis to estimate the booster vaccine dose's impact on long COVID prevalence and symptom count. A total of 28.1% of participants met the WHO criteria for long COVID, with older individuals showing higher rates. Long COVID diagnosis was less likely with factors including O blood group, higher occupational status, physical activity, three vaccine doses, strong SARS-CoV-2-S-reactive IFNγ-producing-CD8+ response, and infection during the Omicron period. Increased age, high or low social activity, underlying health conditions, a severe initial COVID episode, and reinfection were associated with higher long COVID likelihood. A booster dose, compared to one or two doses, reduced long COVID risk by 74% (95% CI: 56% to 92%) and symptom count by 55% (95% CI: 32% to 79%). Long COVID was prevalent in a significant portion of those who contracted COVID-19, underscoring the need for sustained follow-up and therapeutic strategies. Vaccinations, notably the booster dose, had a substantial beneficial effect on long-term infection outcomes, affirming the vaccination's role in mitigating SARS-CoV-2 infection consequences.

Exploring attitudes towards health preparedness in the Middle East and North Africa against chemical, biological, radiological, and nuclear threats: A qualitative study

AbstractSince 1970, Middle East and North African (MENA) countries have witnessed evolutionary industrial development and long‐running terrorist and inter‐country conflicts. Additionally, the risk of accidental, deliberate or natural chemical, biological, radiological, and nuclear (CBRN) threats has also increased, requiring a collaborative review of the health sectors’ preparedness for potential CBRN risks within the region. This study aimed to explore the opinion of multidisciplinary experts interested in disaster management research in MENA about perspectives and challenges on readiness for potential CBRN incidents.A modified interview online link was sent to the participants. A qualitative thematic analysis was performed on the responses using Nvivo®12 software, following semi‐structured modified interviews using the Phonic® application.A total of 29 participants were sufficient to reach the data saturation. Through an inductive coding approach, five themes were identified: ‘CBRN‐Related Incidents are a Threat’, ‘Inadequate National Practice and Policy’, ‘Need for International Cooperation’, ‘Importance of Better Mass Gathering Management’, and ‘Ineffective Hospital Preparedness’.With the assistance of the World Health Organization, there is a consensus on the need for cooperation between the MENA countries to ensure adequate healthcare preparedness for CBRN threats. Suggested measures should be considered, such as creating a unified database and liaison officer designation.

Targeted community wastewater surveillance for SARS-CoV-2 and Mpox virus during a festival mass-gathering event

Wastewater surveillance has emerged recently as a powerful approach to understanding infectious disease dynamics in densely populated zones. Wastewater surveillance, while promising as a public health tool, is often hampered by slow turn-around times, complex analytical protocols, and resource-intensive techniques. In this study, we evaluated an affinity capture method and microfluidic digital PCR as a rapid approach to quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mpox (formerly known as monkeypox) virus, and fecal indicator, pepper mild mottle virus (PMMoV) in wastewater during a mass-gathering event. Wastewater samples (n = 131) were collected from residential and commercial manholes, pump stations, and a city's wastewater treatment plant. The use of Nanotrap® Microbiome Particles and microfluidic digital PCR produced comparable results to other established methodologies, with reduced process complexity and analytical times, providing same day results for public health preparedness and response. Using indigenous SARS-CoV-2 and PMMoV in wastewater, the average viral recovery efficiency was estimated at 10.1 %. Both SARS-CoV-2 N1 and N2 genes were consistently detected throughout the sampling period, with increased RNA concentrations mainly in wastewater samples collected from commercial area after festival mass gatherings. The mpox virus was sporadically detected in wastewater samples during the surveillance period, without distinct temporal trends. SARS-CoV-2 RNA concentrations in the city's wastewater mirrored the city's COVID-19 cases, confirming the predictive properties of wastewater surveillance. Wastewater surveillance continues to be beneficial for tracking diseases that display gastrointestinal symptoms, including SARS-CoV-2, and can be a powerful tool for sentinel surveillance. However, careful site selection and a thorough understanding of community dynamics are necessary when performing targeted surveillance during temporary mass-gathering events as potential confirmation bias may occur.

Football Saturday: are collegiate football stadiums adequately prepared to handle spectator emergencies?

Mass gatherings are a commonly occurring event, especially on college campuses. Any mass gathering gives rise to possible small- or large-scale emergencies. Mass gathering medicine is an integral part of emergency medical services (EMS). An assessment was performed to see if collegiate stadiums possess capabilities for advanced medical care when emergencies arise among attendees. A standardized survey was sent by a single researcher to all National Collegiate Athletic Association (NCAA) Division I programs regarding medical services they currently have in place at their stadiums during Saturday football games. A follow-up inquiry was made at each local community office of emergency management (OEM) to confirm responses or obtain missing data. Only 21.5% (N.=17) of stadium facilities reported having physicians solely dedicated to the care of fans and other support staff. Most stadiums (N.=70, 88.6%) offered ALS services for their fans, with the remaining ALS services provided by paramedics (N.=46, 58.2%) or registered nurses (N.=7, 8.9%). The remaining stadiums only offered BLS services (N.=6, 7.6%) or basic first aid (N.=3, 3.8%). One stadium offered athletic trainer services to its fan in addition to the ALS care. Given the potential for a large influx of patients at sporting events, almost all stadiums have some degree of prehospital emergency care on site. More than a 10% of stadiums lacked ALS services and very few stadiums have physicians on site. Many stadiums were unaware of the resources available during these events. The ability to have ALS services on site who can provide rapid, advanced care to spectators is important due to likely delays in 911 response. At a minimum ALS services should be available within the stadium with consideration of physician coverage as well.

Detecting Land Surface Temperature Variations Using Earth Observation at the Holy Sites in Makkah, Saudi Arabia

During Hajj, Muslims throughout the globe assemble at the holy sites in Makkah, Saudi Arabia. The Saudi government aims to increase the number of pilgrims. To ensure the pilgrims’ safety from the impact of surface urban heat island (SUHI), a scientific approach using artificial intelligence and Earth observation (EO) is recommended for crowd management and human health. SUHI is usually measured using satellite LST data. UHIs impact the walkability of cities in hot climates. The development of digital technologies has provided researchers with a better understanding of crowd management modeling to control such a mass gathering, especially within the summer season and in drought regions. In this study, an approach was used to detect the UHI in holy sites and understand the factors causing them. To achieve this goal, EO data were used to calculate the LST using the Landsat 8 thermal band (TIRS) and calculating the surface emissivity and Normalized Difference Vegetation Index (NDVI). Then, UHIs were identified by adding the mean of the LST to half of its standard deviation. Based on the results of this study, LST had a strong correlation with NDVI (negative) in Arafah. In addition, the strength of the correlation became much weaker within Mina and Muzdalifah. As for the correlation of LST and elevation, the strength appeared to be weak but negative in Arafah, but stronger in Muzdalifah and Mina. The results show that there is a certain correlation between LST, NDVI, and NDBI and elevation in the study area. Using Earth observation technologies can help in studying climate change.

Implications of the COVID-19 pandemic on athletes, sports events, and mass gathering events: Review and recommendations.

Since the coronavirus disease 19 (COVID-19), which caused several respiratory diseases, was formally declared a global pandemic by the World Health Organization (WHO) on March 11, 2020, it affected the lifestyle and health of athletes, both directly through cardiorespiratory and other health related effects, and indirectly as the pandemic has forced the suspension, postponement, or cancellation of most professional sporting events around the world. In this review, we explore the journey of athletes throughout the pandemic and during their return to their competitive routine. We also highlight potential pitfalls during the process and summarize the recommendations for the optimal return to sport participation. We further discuss the impact of the pandemic on the psychology of athletes, the variance between the team and individual athletes, and their ability to cope with the changes. Moreover, we specifically reviewed the pandemic impact on younger professional athletes in terms of mental and fitness health. Finally, we shaded light on the various impacts of mass gathering events and recommendations for managing upcoming events.