COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region

Abstract

Objectives To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. Design Prospective, population-wide observational study. Setting Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. Participants A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. Main outcome measures SARS-CoV-2 infections detected using audience self-swabbed (5–7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. Results A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. Conclusions We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.

Institutional Hybridity in Networked Cultural Organizations through Boundary Work

“…A literature review on festivals during the pandemic reinforces the significance of the institutionalization as firmly established, but flexible in respect to the challenges related to the lockdown (Ali & Balme 2022;Burnside et al 2024;Dragin-Jensen et al 2022;Moore & Quinn 2023;Ricci & Agogué 2023). During and after the pandemic, new innovations were developed, which were, however, tightly adjusted to the institutionalized pre-pandemic profile and role and the networking pattern.…”

“…In addition, the slow pace of institutional change even during the pandemic and the partners' (stakeholders') resistance to changes due to related high costs (Ali & Balme 2022) are the reasons for maintaining the pre-pandemic festival formats and profiles. The networking pattern has been maintained during the pandemic, even with new practices and tasks related to health regulated during the pandemic (Burnside et al 2024). The sustainability during the pandemic was supported by authorities with pandemic-related funding (Dragin-Jensen et al 2022;Moore & Quinn 2023).…”

Arts, literature, and witchcraft: medicine’s many personalities

“…Sometimes culture and research can be combined, as was the case in examining reopening of cultural events after the pandemic. 2 One way that doctors have traditionally diversified and brokered knowledge is through arts and literature. Once you delve into these worlds you begin to understand the immense contributions that doctors have made, informing their work with their medical experiences but also satiating the fascination of the public for medical matters.…”