Infectious Disease

Under strict security measures, no participants in a staged concert got COVID-19

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Llibre does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Under strict security measures, no attendees at a staged concert were infected with SARS-CoV-2, according to researchers, who said their experiment was the first randomized clinical trial to assess the risk of COVID-19 at mass gatherings.

Participants were tested prior to the 5-hour concert and were required to wear N95 masks inside, but there were no distance rules and the researchers encouraged them to sing and dance during the performances of two DJs and two live music acts.

Source: Adobe Stock.

Same day point of care screening, combined with masking and active ventilation, could enable mass indoor events like concerts without the need for physical distancing. Source: Adobe Stock.

Only people with a negative test could take part in the study. Half of the approximately 1,000 participants attended the concert at Sala Apolo in Barcelona, ​​Spain, and the other half were sent home.

The results of the study were recently published in The Lancet Infectious Diseases.

Josep M. Book

“We were contacted by professional promoters of cultural and musical activities in Barcelona and understood that if they wanted to reopen safely during the pandemic, they would have high quality scientific data against these events in accordance with the strict recommendations of public health services around the world against these events”, Josep M. Book, MD, PhD, a doctor and researcher with the Fight AIDS Foundation, said Healio.

“Singing and mass gatherings, especially indoor events, were considered high-risk activities for the transmission of COVID-19. It has been estimated that any single person with COVID-19 could spread the infection to 10 to 15 contacts during these events. All major events were banned or the capacities were reduced so much that the events were no longer profitable and the term ‘superspreader events’ was coined. “

For the study, Llibre and colleagues screened the participants with antigen-detecting rapid tests (Ag-RDTs) on the same day. The concert took place on December 12th, 2020. Adults with a negative result, collected immediately before entering the event, were randomly assigned 1: 1 to either attend the indoor event for 5 hours or go home.

After 8 days, the researchers collected nasopharyngeal swabs and analyzed them using Ag-RDT, reverse transcriptase PCR (RT-PCR) and a transcription-mediated amplification test (TMA). The primary outcome of the study was the difference in the incidence of RT-PCR-confirmed SARS-CoV-2 infection after 8 days between the control and intervention groups, assessed in all participants who were randomly assigned to the event and a valid result for the SARS-CoV-2 test that was carried out during the follow-up examination.

A total of 1,140 participants were eligible for the study, including 1,047 who were randomly assigned to attend the music event or to leave. Of the 523 randomly assigned to the experimental group, 465 were included in the primary endpoint analysis. Of the 524 randomly assigned to the control group, 495 were included in the final evaluation.

According to the study, 15 (3%) of 495 people in the control group and 13 (3%) of 465 in the experimental group tested positive for TMA despite a negative Ag-RDT result. In addition, the RT-PCR test was positive in one case in each group and the cell virus culture was negative in all cases. Eight days after the event, the researchers found that two (less than 1%) people in the control arm had positive Ag-RDT and RT-PCR results, while no positive Ag-RDT or RT-PCR results in the intervention arm occurred.

“The transmission of COVID-19 at indoor mass gatherings during the pandemic can be prevented by implementing preventive measures. These results were critical to the performance of concerts with more assistants and the approval of an events program called ‘Events Research Program’ by the UK Department of Health, “said Llibre. “Similar programs are being implemented in Denmark, Norway and the Netherlands, and outdoor activities have a much lower risk and could likely be reopened with all or even some of these three measures.”

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