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Lifting restrictions on mass gatherings must happen 'cautiously and gradually', NPHET told

HIQA has advised NPHET on the measures needed to allow large gatherings to happen safely.

Image: Shutterstock/Anton Gvozdikov

IRELAND SHOULD TAKE a “cautious and gradual approach” to lifting restrictions on mass gatherings, public health officials have been told.

The Health Information and Quality Authority (HIQA) has submitted a report to the National Public Health Emergency Team (NPHET) on the measures needed to allow large gatherings to happen safely.

The authority reviewed public health guidance from 22 countries and two international agencies relating to reducing transmission at mass gatherings and looked at research studies published this year into the effectiveness of public health measures.

As of 10 June, six of the countries – Austria, Denmark, the Czech Republic, France, the Netherlands and Portugal – required proof of vaccination or immunity and/or a recent negative Covid-19 test before individuals could access large events.

Belgium, Germany, Italy, Norway, Sweden and Switzerland have plans to introduce some type of similar certification, with a pilot underway in England.

All restrictions on mass gatherings are due to be removed by June 2021 in France and Iceland, by July 2021 in Austria, England and Finland for outdoor events, and by August 2021 in Finland for indoor events.

Denmark, the Netherlands and Sweden have said that mass gathering restrictions will only be removed when specific targets or indicators have been met.

15 of the countries, including Ireland, have held or planned large pilot events, with particularly “comprehensive” programmes in the Netherlands and England.

A blanket ban on all mass gatherings is not necessary, HIQA advised, but different types of events carry a different level of risk and must be handled appropriately.

It told NPHET that indoor events with a large number of people and poor ventilation where there is shouting and singing, insufficient use of face coverings and prolonged contact carry the highest transmission risk.

Deputy CEO of HIQA Dr Máirín Ryan said that “not every mass gathering carries the same risk”.

“While no event is risk-free, high occupancy, indoor events with reduced use of face masks, prolonged contact and poor ventilation pose the highest risk of transmission. In the first instance, any organised gathering should ideally involve shorter duration, outdoor seated events, with significantly reduced capacity,” Dr Ryan said.

“When planning events, risk assessments should be conducted in advance and a number of public health measures such as physical distancing, face mask use, adequate ventilation and hand hygiene should be implemented,” she said.

“These measures should also be encouraged when considering shared transportation and socialisation, before and after the event.”

Transmission can commonly happen during activities before or after a mass gathering event, such as shared transport or social events.

HIQA advised NPHET that a risk assessment should be conducted ahead of any large event and that a range of measures, including social distancing, face coverings, ventilation and hand hygiene, should be implemented.

Congestion control, putting attendees into cohorts, and prohibiting food and drinks should also be considered, the authority said.

“In addition to the recommended public health measures, consideration should be given to the use of pre-event testing and ‘green certs’ (that is, for fully vaccinated people, those with a recent negative test or with a documented history of COVID-19) to gain access to events,” HIQA advised.

“The use of trained professionals to collect and process samples will increase the reliability of any pre-event testing,” it said.

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“While the risk of SARS-CoV-2 transmission at mass gatherings can be reduced by implementing a range of public health measures, it is unlikely that this risk can be eliminated entirely. This should be clearly communicated to those at higher risk of severe Covid-19.”

HIQA advised that any relaxation of mass gathering restrictions should consider the levels of vaccination, rates of community transmission, the risk from variants of concern, and capacity in the healthcare system.

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