COVID-19 Diffusion Before Awareness: The Role of Football Match Attendance in Italy

Epidemiological surveillance and infectious disease outbreaks during mass international summertime sports gatherings: A narrative review

The XXXIIIrd Paris Summer Olympics followed by the XVIIth Paralympics Games will take place in France, predominantly in and around Paris, from July 26 to September 8, 2024. Public health stakeholders and decision-makers are called upon to set up or strengthen surveillance systems in areas hosting Olympic or Paralympic Games (OPGs) or large-scale international competitions, the objective being to detect and manage outbreaks should they occur during that period. We undertook a narrative review of the literature so as to identify major reported infectious disease outbreaks linked with or during OPGs / international sporting events during warm seasons. Our review found that since 1992, Summer Olympic and Paralympic games and international football competitions have been associated with sporadic cases of infectious diseases, principally respiratory, gastrointestinal/foodborne, but not with any major communicable or other infectious disease outbreak. Communicable disease risks should be assessed for the population taken as a whole, an integrated ecosystem with several population compartments potentially exchanging pathogens among one another. Although the Games afford an opportunity to federate or invent new surveillance systems to fill a gap, surveillance should be based on existing medical and laboratory systems, proven tools reinforced with the necessary human and financial resources. The performance of the public health surveillance system is ultimately predicated on trust on the part of participating clinicians, policymakers and international partners.

Unlocking the importance of perceived governance: The impact on COVID-19 in NUTS-2 European regions

In the immediate aftermath of the pandemic, governments implemented non-pharmaceutical interventions (NPIs). Previous literature suggests that NPI effectiveness is influenced by governance quality. The acceptance and perceived necessity of these measures by the public are crucial to their success, as NPIs cannot be easily enforced without public support. Does regional governance also play a role? This study examines the correlation between the quality of governance in European NUTS-2 regions and the spread of COVID-19. The findings indicate that overall perceived governance, and its perceived quality and corruption pillars, significantly impact the effectiveness of these interventions. This effect was pronounced during the first wave and then diminished in importance, disappearing before vaccines were available, suggesting that regional governance matters especially in the immediate aftermath of an exogenous shock.

Impact of the Euro 2020 championship on the spread of COVID-19

Large-scale events like the UEFA Euro 2020 football (soccer) championship offer a unique opportunity to quantify the impact of gatherings on the spread of COVID-19, as the number and dates of matches played by participating countries resembles a randomized study. Using Bayesian modeling and the gender imbalance in COVID-19 data, we attribute 840,000 (95% CI: [0.39M, 1.26M]) COVID-19 cases across 12 countries to the championship. The impact depends non-linearly on the initial incidence, the reproduction number R, and the number of matches played. The strongest effects are seen in Scotland and England, where as much as 10,000 primary cases per million inhabitants occur from championship-related gatherings. The average match-induced increase in R was 0.46 [0.18, 0.75] on match days, but important matches caused an increase as large as +3. Altogether, our results provide quantitative insights that help judge and mitigate the impact of large-scale events on pandemic spread.

Attending sporting mega events during COVID-19: mitigation and messaging at UK EURO 2020 matches

The UEFA EURO 2020 football tournament was one of the largest Sporting Mega Events (SMEs) to take place during the COVID-19 pandemic. Mitigating the risk of virus transmission requires a multi-layered approach for any large event, more so in this case due to staging the tournament across eleven host countries. Yet, little is known about COVID-19 risks and mitigation from attending an event of this scale and nature. We examined the implementation of mitigation and messaging at EURO 2020 matches hosted at venues in the UK. The tournament was postponed from the summer of 2020 and played in June and July of 2021. Structured observations were conducted by 11 trained fieldwork-supporters at 10 matches played at Wembley Stadium, London, or Hampden Park, Glasgow. Fieldwork-supporters observed one-way systems and signage, and hand sanitizing stations inside the stadia, but reported significant variation in the implementation of staggered timeslots, testing upon entry, and procedures for exit. Adherence to planned measures by ticket holders and implementation by stewards waned as the tournament progressed culminating in an absence of enforced measures at the final. The non-compliance with COVID-19 mitigation measures was likely to have led to a significantly increased risk of transmission. Future events should consider how COVID-19 mitigation measures could become 'new norms' of fan behaviour, learning from what is already known about football fandom. Tournament organizers of SMEs can use these findings to promote clearer messaging on pandemic-driven changes in fan behaviour and best practices in mitigating risk at future sporting and cultural events.

Narrative Review of the COVID-19 Pandemic's First Two Years in Italy

Italy was the first country in the western world to be affected by the COVID-19 pandemic, arguably among the worst-affected ones, counting 12 million cases and 150 thousand deaths two years since the first case. Facing new challenges, Italy has enacted different strategies and policies to limit the spread of the SARS-CoV-2 virus and treat those affected by COVID-19. This narrative review provided an overview of factors, measures, and actions that shaped Italy's first two years of the COVID-19 pandemic by investigating epidemiological data and using a mixed-method approach. This narrative review aimed to summarize the most relevant aspects and measures and analyze available data to provide policymakers and healthcare providers with the instruments to learn from this pandemic and improve their preparedness for future pandemic events. The first two years of the pandemic differ in that, during the first year, significant necessary changes to the way health systems were organized were implemented, increasing healthcare spending and adopting social and physical distancing measures that were stricter than the ones adopted in the second year. However, as the pandemic progressed, increased knowledge of the virus and related variants, as well as the introduction of highly effective vaccines, which were not equally available to the whole population, resulted in a stratification of COVID-19 infections and deaths based on factors such as age, vaccination status, and individual susceptibility to the virus.

Back to school or … back to lockdown? The effects of opening schools on the diffusion of COVID-19 in Italian regions

The opening of schools that coincided with the beginning of fall 2020 and the arrival of the second wave of COVID-19 in continental Europe has fostered significant debate in several countries. Some contributions have suggested that youngsters play a minor role in the spread of the virus, given the specific characteristics of this infection; other scholars have raised concerns about the necessary movement that involves keeping schools open, and the consequent potential spread of the virus. In this study, we focus on the Italian case, an interesting setting in which to test the impact of opening schools on the spread of COVID-19, because of the different dates at which schools have opened in the various Italian provinces, and because of the different rates at which the virus has spread across Italy. Our results suggest that open schools have a positive impact on COVID-19 cases, whose spread occurs between 10 and 14 days after opening. While closing schools or using distance learning have other social and economic consequences, making it necessary for policymakers to adopt a holistic evaluation, it should be taken into account that open schools have an impact on the spread of the pandemic.

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.