Mass Events Trigger Malta's Second Peak After Initial Successful Pandemic Suppression

Abstract

The second COVID-19 wave is sweeping the globe as restrictions are lifted. Malta, the 'poster child of Europe's COVID-19 first wave success' also fell victim shortly after it welcomed the first tourists on 1st of July 2020. Only four positive cases were reported over the successive 15 days. Stability was disrupted when two major mass events were organized despite various health professional warnings. In a matter of few just days, daily cases rose to two-digit figures, with high community transmission, a drastic rise in active cases, and a rate per hundred thousand in Europe second only to Spain. Frontliners were swamped with swabbing requests while trying to sustain robust case management, contact tracing and follow-up. Indeed, the number of hospitalizations and the need for intensive ventilation increased. Despite the initial cases were among young adults, within weeks a small spill off on the more elderly population was observed. Restrictions were reintroduced including mandatory mask wearing in specific locations and capping of the total number of people in a single gathering. Malta is an island and the potential for containment would have been relatively simple and effective and permitting mass gatherings was unwise. Protecting the health of the population should take centre stage while carrying out extensive testing, contact tracing and surveillance. Containment and mitigation along with public cooperation is the key to curbing resurgences especially with the influenza season around the corner.

“Mass gathering events and COVID-19 transmission in Borriana (Spain): A retrospective cohort study”

“…MGEs cover different types of event and contexts such as public and private celebrations, festivals, religious events and pilgrimages, sporting and touristic events, and political meetings. The crucial role of MGEs in the global propagation of the disease has been evidenced in several countries, including China [ 3 ], Iran [ 4 ], Malaysia [ 5 ], Italy [ 6 ], Spain [ 7 ], France [ 8 ], Germany [ 9 ], Jordan [ 10 ], Malta [ 11 ], Switzerland [ 12 ], and Malawi [ 13 ]. Significant international efforts have been made to implement specific measures, risk assessment and surveillance, and event cancellations in order to prevent the spread of SARS-CoV-2 from MGEs [ 14 – 17 ].…”

Insight into the Occurrence of Common Non-communicable Diseases at a Population Level and the Potential Impact During the Coronavirus Pandemic — a Need for a Syndemic Healthcare Approach?

“…During this period, the Covid-19 situation was well controlled, with low daily case numbers. The same cannot be said for the second wave [ 16 , 17 ]. Hence, it is assumed that the proportion of the population with NCDs at risk of Covid-19 along with their corresponding burden is much higher than that estimated in this study.…”

“…However, the presence of cardiovascular disease was based on self-reporting data, hence, subject to self-reported bias. The impact of coronavirus among the population suffering from NCDs was based on the assumption that the admission rate among this population remained the same throughout the Covid-19 period as reported by Micallef et al [ 25 ], even though in reality the Covid-19 situation got worse overtime [ 17 ]. Hence, the Covid-19 impact estimated within the population with cardiometabolic NCDs in this current study is expected to be an underestimate of the actual burden.…”

“…Additionally, Malta is a known cardiometabolic-obesogenic country with the highest mortality attributed to cardiovascular diseases [12][13][14][15]. Like the rest of Europe, Malta reported its first Covid-19 cases in March, and has since experienced several waves [16,17]. Therefore, this population provides a unique opportunity to explore the impact of Covid-19 on the population suffering from NCDs, namely cardiometabolic diseases.…”

The Grand Magal of Touba was spared by the COVID-19 pandemic

“…There is now published evidence of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at relatively small gatherings of people, including weddings (Yusef et al, 2020), religious meetings (Gerbaud et al, 2020;Aherfi et al, 2020;Che Mat et al, 2020]), and festivals (Brandl et al, 2020;Cuschieri et al, 2020) (Table 1). The Grand Magal took place on October 6, 2020, in Touba, Senegal.…”