Effects of large gatherings on the COVID-19 epidemic: Evidence from professional and college sports

Munich goes viral: Measuring the impact of the Oktoberfest on COVID-19 infection rates using difference-in-differences

With about 6 million visitors, the 2022 Oktoberfest in Germany has been one of the largest in-person social events following the COVID-19 pandemic. Despite high vaccination rates in Germany at that time, health authorities pointed out the high risk of getting infected at such events. Using a unique dataset, we estimate the causal impact of the Oktoberfest on the spread of infection by applying an event study design. Our results imply a significant increase in the infection rates during and after Oktoberfest, especially in the age cohorts 15-34 and 35-59. However, the case rate drops relatively quickly after Oktoberfest. We also find little to no effect of the fair on the infection rates of the remaining age cohorts below 15 and above 60 years of age. A robustness check using the hospitalization rate as dependent variable confirms those results. Our findings have important implications for regulations of large social events in times of COVID-19, when the share of vaccinated people in the population is already high.

A scoping review of cultural issues concerning institutional quarantine and isolation during major multi-country outbreaks in Africa: 2000-2023

Background and Aims

Infectious disease outbreaks pose significant challenges in Africa due to its ecology, socioeconomic conditions, and weak health systems. Implementing institutional quarantine and isolation (Q&I) measures is crucial for managing major outbreaks. However, the cultural context often determines the success of these measures. This scoping review aims to examine existing evidence on the cultural aspects of institutional Q&I in Africa over the past two decades, focusing on the COVID-19 pandemic and other major multi-country disease outbreaks.

Methods

This scoping review's protocol was registered with the Open Science Framework registry. Nine research databases were systematically searched to retrieve all relevant literature, followed by deduplication and a two-stage screening process using the Rayyan web application. The inclusion of any literature into this review was based on a set of eligibility criteria. Also, manual searching of the reference lists of included literature was done to retrieve any other eligible literature. From the included literature, data were charted, collected, and summarized.

Findings

Out of the 787 articles retrieved from the database searches, this review found only one to be eligible for inclusion. Also, no other eligible article was obtained after manual searching of the reference list for this article. The reviewed article presented empirical findings on the impact of COVID-19 Q&I protocols on traditional burial rites in Ghana. Many Ghanaian families were against their country's protocol because they felt it was insensitive to their traditional values and burial practices. Also, the way the protocol was implemented made some Ghanaian families feel that foreign burial practices were imposed on them, which bred feelings of cultural exclusion and neglect (by the government) among Ghanaians.

Conclusion

Research evidence on the cultural implications of Q&I in Africa is very scanty. More research is needed on this topic of public health interest.

An experienced racial-ethnic diversity dataset in the United States using human mobility data

Despite the importance of measuring racial-ethnic segregation and diversity in the United States, current measurements are largely based on the Census and, thus, only reflect segregation and diversity as understood through residential location. This leaves out the social contexts experienced throughout the course of the day during work, leisure, errands, and other activities. The National Experienced Racial-ethnic Diversity (NERD) dataset provides estimates of diversity for the entire United States at the census tract level based on the range of place and times when people have the opportunity to come into contact with one another. Using anonymized and opted-in mobile phone location data to determine co-locations of people and their demographic backgrounds, these measurements of diversity in potential social interactions are estimated at 38.2 m × 19.1 m scale and 15-minute timeframe for a representative year and aggregated to the Census tract level for purposes of data privacy. As well, we detail some of the characteristics and limitations of the data for potential use in national, comparative studies.

Genomic Epidemiology of a Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in a US Major League Soccer Club: Was It Travel Related?

Background

Professional soccer athletes are at risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). United States Major League Soccer (MLS) uses protocol-based SARS-CoV-2 testing for identification of individuals with coronavirus disease 2019.

Methods

Per MLS protocol, fully vaccinated players underwent SARS-CoV-2 real-time polymerase chain reaction testing weekly; unvaccinated players were tested every other day. Demographic and epidemiologic data were collected from individuals who tested positive, and contact tracing was performed. Whole genome sequencing (WGS) was performed on positive specimens, and phylogenetic analyses were used to identify potential transmission patterns.

Results

In the fall of 2021, all 30 players from 1 MLS team underwent SARS-CoV-2 testing per protocol; 27 (90%) were vaccinated. One player who had recently traveled to Africa tested positive for SARS-CoV-2; within the following 2 weeks, 10 additional players and 1 staff member tested positive. WGS yielded full genome sequences for 10 samples, including 1 from the traveler. The traveler's sample was Delta sublineage AY.36 and was closely related to a sequence from Africa. Nine samples yielded other Delta sublineages including AY.4 (n = 7), AY.39 (n = 1), and B.1.617.2 (n = 1). The 7 AY.4 sequences clustered together; suggesting a common source of infection. Transmission from a family member visiting from England to an MLS player was identified as the potential index case. The other 2 AY.4 sequences differed from this group by 1-3 nucleotides, as did a partial genome sequence from an additional team member.

Conclusions

WGS is a useful tool for understanding SARS-CoV-2 transmission dynamics in professional sports teams.

Opening of hotels and ski facilities: Impact on mobility, spending, and Covid-19 outcomes

This paper investigates how reopening hotels and ski facilities in Poland impacted tourism spending, mobility, and COVID-19 outcomes. We used administrative data from a government program that subsidizes travel to show that the policy increased the consumption of tourism services in ski resorts. By leveraging geolocation data from Facebook, we showed that ski resorts experienced a significant influx of tourists, increasing the number of local users by up to 50%. Furthermore, we confirmed an increase in the probability of meetings between pairs of users from distanced locations and users from tourist and non-tourist areas. As the policy impacted travel and gatherings, we then analyzed its effect on the diffusion of COVID-19. We found that counties with ski facilities experienced more infections after the reopening. Moreover, counties strongly connected to the ski resorts during the reopening had more subsequent cases than weakly connected counties.

Willingness to pay for policies to reduce health risks from COVID-19: Evidence from U.S. professional sports

Airborne transmission of the COVID-19 virus increased the need for health policies to reduce transmission in congregate settings associated with minimal risk before the pandemic. While a large literature estimates tradeoffs between policies designed to reduce negative health outcomes, no empirical research addresses consumer willingness to pay (WTP) for health policies designed to reduce airborne virus transmission. Using survey data from 1381 fans of professional sports, we estimate consumers' WTP for reduced likelihood of coronavirus transmission through mask and social distancing policies using a stated preference approach. The results indicate increased attendance likelihood if the venue requires masks and limits attendance, with significant heterogeneity in WTP across risk scenarios and sports. We characterize consumers as casual fans who prefer a mask requirement but are indifferent to capacity constraints, strong fans who are anti-maskers and prefer capacity constraints, and a second group of casual fans with positive WTP under both mask and limited capacity requirements. For example, casual fans' WTP for masking, $38 per National Basketball Association (NBA) game attended, is more than double their WTP for capacity constraints only. Strong fans' WTP for attending capacity constrained NBA games was $490, more than 400% higher than the pre-pandemic average WTP of $105.

Quantifying the impact of the Tokyo Olympics on COVID-19 cases using synthetic control methods

This paper uses a synthetic control method (SCM) and a Ridge Augmented SCM to estimate the impact of holding the Tokyo Olympic games on the number of newly confirmed COVID-19 cases in Tokyo (Japan). Our analysis with these methods enables us to estimate the causal impact of the Tokyo Olympics on COVID-19 cases by constructing counterfactual COVID-19 cases for Tokyo (Japan) as the optimal weighted average of COVID-19 cases of OECD countries that are not affected by holding the Olympics through a data-driven approach. Based on reliable estimates obtained from different analytical settings, we find that, compared to the counterfactuals, holding the Tokyo Olympics significantly increased the daily average number of COVID-19 cases by 105 to 132 cases in Tokyo (47 to 65 cases in Japan as a whole) per million people. This result suggests that holding the Olympics likely led to the spread of COVID-19 infection in Tokyo (Japan).

Spreading the disease: Protest in times of pandemics

This study analyzes the impact of large anti-lockdown protests on the spread of SARS-CoV-2 in Germany. Since protesters at such large gatherings are very mobile and largely neglect SARS-CoV-2 containment strategies, they may contribute to the regional transmission of the coronavirus. Employing novel data on bus connections of travel companies specialized in driving protesters to these gatherings, and exploiting the timing of two large-scale demonstrations in November 2020, we estimate the causal impact of these protests on the spread of SARS-CoV-2 using an event study framework. Our findings imply sizable increases in infection rates in protesters' origin regions after these demonstrations. A month after the protests, treated areas face a relative increase in infection rates up to 35% compared to non-treated areas. Our results shed light on public health consequences of behavior that ignores potential externalities for the society during a pandemic.

Mass gathering events and the spread of infectious diseases: Evidence from the early growth phase of COVID-19

This paper studies the impact on reported coronavirus 2019 (COVID-19) cases and deaths in Spain resulting from large mass gatherings that occurred from March 6 to March 8, 2020. To study these outcomes, the geographic differences in the planned pre-pandemic major events that took place on these dates were exploited, which is a quasi-random source of variation for identification purposes. We collected daily and detailed information about the number of attendees at football (soccer) and basketball matches in addition to individuals participating in the Women's Day marches across Spain, which we merged with daily data on reported COVID-19 cases and deaths at the provincial level. Our results reveal evidence of non-negligible COVID-19 cases related to the differences in the percentage of attendees at these major events from March 6 to March 8. In a typical province, approximately 31% of the average daily reported COVID-19 cases per 100,000 inhabitants between mid-March and early April 2020 can be explained by the participation rate in those major events. A back-of-the-envelope calculation suggests that this implies almost five million euros (169,000 euros/day) of additional economic cost in the health system of a typical province with one million inhabitants in the period under consideration. Several mechanisms behind the spread of COVID-19 are also examined.

Political violence, risk aversion, and population health: Evidence from the US Capitol riot

This study is the first to explore the impact of the January 6, 2021 Capitol riot on risk avoidance behavior and the spread of COVID-19. First, using anonymized smartphone data from SafeGraph, Inc., and an event-study approach, we document a substantial increase on January 6 in non-resident smartphone pings at the sites of the protest: the Ellipse, the National Mall, and the US Capitol Building. Then, using data from the same source and a synthetic control approach, we find that the Capitol riot led to an increase in stay-at-home behavior among District of Columbia residents, consistent with risk avoidance behavior and post-riot policies designed to limit large in-person gatherings. Finally, while we find no evidence that the Capitol riot substantially increased the spread of COVID-19 in the District of Columbia, we do find that counties with the highest inflows of out-of-town protesters experienced a 0.004 to 0.010 increase in the rate of daily cumulative COVID-19 case growth during the month following the event. These findings are exacerbated in counties without COVID-19 mitigation policies in place.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s00148-022-00914-0.

The limits of reopening policy to alter economic behavior: New evidence from Texas

In the midst of mass COVID-19 vaccination distribution efforts in the U.S. Texas became the first state to abolish its mask mandate and fully lift capacity constraints for all businesses, effective on March 10, 2021. Proponents claimed that the reopening would generate short-run employment growth and signal a return to normal while opponents argued that it would cause a resurgence of COVID-19 and kill Texans. This study finds that each side was largely incorrect. First, using daily anonymized smartphone data - and synthetic control and difference-in-differences approaches - we find no evidence that the Texas reopening led to substantial changes in mobility, including foot traffic at a wide set of business establishments. Second, we find no evidence that the Texas reopening affected the rate of new COVID-19 cases or deaths during the five weeks following the reopening. Our null results persist across more urbanized and less urbanized counties, as well as across counties that supported Donald Trump and Joe Biden in the 2020 presidential election. Finally, we find no evidence that the Texas reopening impacted short-run employment, including in industries most affected by the reopening. Together, these findings underscore the persistence of late-pandemic era private behavior and stickiness in individuals' risk-related beliefs, and suggest that reopening policies may have impacts that are more muted than policymakers expect.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11166-022-09379-8.

COVID-19 and Attendance Demand for Professional Sport in Japan: A Multilevel Analysis of Repeated Cross-Sectional National Data during the Pandemic

In the current investigation, we assess the effect of COVID-19 on intention-based spectator demand for professional sports in Japan captured by eight, monthly repeated cross-sectional national surveys from May to December 2020 (n = 20,121). We regress spectator demand on individual (e.g., gender), prefecture-wave (e.g., COVID-19 infection status), and prefecture-level factors (i.e., with or without quality professional teams). The results of multilevel logistic regression demonstrate that individual (i.e., male, younger, full-time employment, and with children status) and prefecture-level team factors (i.e., with teams) were associated with intention-based spectator demand. Nevertheless, COVID-19-related factors were found to be unrelated to spectator demand. The findings imply that sports fans are likely to return to the stadium once behavioral restrictions are lifted. The current research provided further evidence that individual factors and team quality serve as influential antecedents of spectator demand in the context of the COVID-19 epidemic.

Observation of spectators' mask-wearing behavior at a national basketball tournament

Rationale/Purpose

1.Mass gathering events have resumed with the availability of SARS-CoV-2 vaccines. However, the pandemic is ongoing and such events potentially contribute to upsurges in COVID-19 cases. There is mounting evidence that public health mitigation strategies such as mask requirements, capacity restrictions, and physical distancing reduce transmission risk. However, evidence suggests imperfect compliance with these strategies. This study aimed to quantify spectators' masking behaviors and identify correlates of mask-wearing during a major sporting event.

Design/Methodology/Approach

2.This study used a repeated cross-sectional design, in which trained observers used a web-based application to record counts of mask-wearing.

Findings

3.Overall, 74% of spectators observed correctly wore masks. Mask-wearing behavior was associated with presumed sex, location of the spectator, game competitiveness, and whether the teams playing originated from a state with an active mask mandate.

Implications

4.Understanding the factors associated with masking behavior may help venues prepare for future events and identify innovative and targeted strategies to promote compliance with public health mitigation measures.

Contribution

5.This study makes contributions to understanding how to manage public health risks during a high-profile sporting event, specifically by identifying spectator-, game-, venue-, and state-level factors associated with mask-wearing.

The dynamical formation of ephemeral groups on networks and their effects on epidemics spreading

In network models of propagation processes, the individual, microscopic level perspective is the norm, with aggregations studied as possible outcomes. On the contrary, we adopted a mesoscale perspective with groups as the core element and in this sense we present a novel agent-group dynamic model of propagation in networks. In particular, we focus on ephemeral groups that dynamically form, create new links, and dissolve. The experiments simulated 160 model configurations and produced results describing cases of consecutive and non-consecutive dynamic grouping, bounded or unbounded in the number of repetitions. Results revealed the existence of complex dynamics and multiple behaviors. An efficiency metric is introduced to compare the different cases. A Null Model analysis disclosed a pattern in the difference between the group and random models, varying with the size of groups. Our findings indicate that a mesoscopic construct like the ephemeral group, based on assumptions about social behavior and absent any microscopic level change, could produce and describe complex propagation dynamics. A conclusion is that agent-group dynamic models may represent a powerful approach for modelers and a promising new direction for future research in models of coevolution between propagation and behavior in society.

Measuring the Economic Impact of COVID-19 on the UK’s Leisure and Sport during the 2020 Lockdown

This research evaluates the effect of the SARS-CoV2 pandemic on sport Gross Domestic Product (GDP) and consumer expenditure in the leisure sector in the United Kingdom (UK). The leisure sector is divided into leisure at home and away from home, examining in this way the different patterns that emerged because of the national lockdown in 2020. The effect on sport GDP is examined using the Office for National Statistics (ONS) surveys and the UK Sport Satellite Account (SSA). The study found that, because of its reliance on human contact, sport GDP is likely to decline by more than twice the rate of the overall economy. Furthermore, this finding is consistent with the 2020 consumer expenditure on leisure that shows increases in spending on home leisure but also a huge decline in spending on out-of-home entertainment. The decline in GDP is extremely likely to put pressure on profit margins and hence threaten the survival of private enterprises, raising issues of sustainability under conditions of a pandemic. Increases in long-term public funding for reducing sport inequalities should be considered along with short-term relief packages for the sport sector. Additional policy suggestions are offered to address these issues.

Structural Modeling on the Determinants of Effectiveness of SOPs Containing COVID-19 in Mass Gatherings

The study is aimed to analyze the determinants of the effectiveness of SOPs in mass gatherings for containing COVID-19. The overall design of the study involves a literature review, data collection by field survey, structural modeling, and analysis. The study is built on the experts' opinion of a focus group (representing people who recently participated in and are responsible for mass gatherings). The study uses the discussion of the literature review to identify the determinants, interpretive structural modeling (ISM) for developing and analyzing a structural model, and Matrice d'Impacts Croises Multiplication Appliquée a un Classement (MICMAC) for corroboration of results of the ISM/classification of determinants. From the literature review, a list of determinants is generated and verified by a panel of experts. The results of the ISM revealed that the determinants "legal environment of the country," "practicability of SOPs," "perceived benefit of adapting SOPs," and "possibilities of avoiding gathering" occupied the top of the model, therefore, they are less critical determinants, whereas "nature of gathering" occupied the bottom of the model, and is thus the most critical determinant. The remaining determinants form the middle of the model, and are therefore moderately severe. The results of MICMAC show that the determinant "perceived benefit of adapting SOPs" is dependent, "nature of gathering" is independent, and all others are linked. The results of MICMAC implicitly substantiate the findings of the ISM. The overall results of the study show that "nature of gathering" is the key determinant. This research does not require a priori theory since it is a theory-building study that uses an inductive approach. It is based on real data and it is useful for local authorities, organizers, participants (attendees/visitors) of mass gatherings, health officials/regulators, researchers, and the community at large. This study has fundamental importance for planning and preparing for such events while ensuring the minimum risk of COVID-19 transmission.

Contact and SARS-CoV-2 Infections Among College Football Athletes in the Southeastern Conference During the COVID-19 Pandemic

This cohort study of college football players in a single athletic conference examines the association of close contact events among players on opposing teams and subsequent positive SARS-CoV-2 tests.

Risk avoidance, offsetting community effects, and COVID-19: Evidence from an indoor political rally

The Centers for Disease Control and Prevention (CDC) deem large indoor gatherings without social distancing the "highest risk" activity for COVID-19 contagion. On June 20, 2020, President Donald J. Trump held his first mass campaign rally following the US coronavirus outbreak at the indoor Bank of Oklahoma arena. In the weeks following the event, numerous high-profile national news outlets reported that the Trump rally was "more than likely" the cause of a coronavirus surge in Tulsa County based on time series data. This study is the first to rigorously explore the impacts of this event on social distancing and COVID-19 spread. First, using data from SafeGraph Inc, we show that while non-resident visits to census block groups hosting the Trump event grew by approximately 25 percent, there was no decline in net stay-at-home behavior in Tulsa County, reflecting important offsetting behavioral effects. Then, using data on COVID-19 cases from the CDC and a synthetic control design, we find little evidence that COVID-19 grew more rapidly in Tulsa County, its border counties, or in the state of Oklahoma than each's estimated counterfactual during the five-week post-treatment period we observe. Difference-in-differences estimates further provide no evidence that COVID-19 rates grew faster in counties that drew relatively larger shares of residents to the event. We conclude that offsetting risk-related behavioral responses to the rally-including voluntary closures of restaurants and bars in downtown Tulsa, increases in stay-at-home behavior, displacement of usual activities of weekend inflows, and smaller-than-expected crowd attendance-may be important mechanisms.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11166-021-09359-4.