Sixty four games featuring 32 teams, over 28 days. More than 1.5 million people from around the world are travelling for the FIFA World Cup in Qatar ‒ a country of fewer than three million people.
Mass gatherings of people ‒ including at sports events, music festivals, theme parks and religious pilgrimages ‒ have long been associated with disease outbreaks. In recent years, multi-country measles outbreaks have been traced back to Disneyland, California, a dog show in Slovenia and a kickboxing tournament in Italy.
It’s not about football or Qatar. It’s about people. Lots and lots of people.
The competition will be the first global football tournament of the COVID-19 era to feature full stadiums. It is also the first football World Cup to take place during winter time in the northern hemisphere, introducing a higher chance that people will arrive in the country with seasonal flu. And, while Qatar has reported few cases of monkeypox, the risk of imported disease remains.
From the archive: Football fans descend on measles hotspot (2012)
Qatar’s COVID-19 vaccine uptake has been high, and routine immunisation, against measles, polio and other contagious diseases, is generally good. However, while the host country may be relatively safe for visitors, football fans pose a risk to local communities and to one another.
‘We are preparing for the safest and healthiest World Cup ever,’ said Dr Soha Al Bayat, Head of Vaccination at the Qatar Minister of Public Health. ‘If a case of measles is detected, we will follow up the patient’s contacts, check their vaccination status and see if they need a booster.’
Authorities are also monitoring wastewater for signs of disease and ‘strongly encouraging patients to be vaccinated against COVID’, she told a WHO webinar in advance of the tournament.
However, Qatar recently dropped the requirement for proof of COVID-19 vaccination for travelling football supporters. Health officials are using the media, social media and an emergency helpline for fans with questions about how to access health services during their stay. They will also monitor social media sentiment for any health-related misinformation during the event.
Any major public health incident could put significant pressure on the health system given the numbers of people who could be affected. The WHO has been working with FIFA and Qatari officials since before the pandemic to prepare for threats including disease outbreaks, terrorist incidents and extreme weather. A series of simulation exercises have been held to help test Qatar’s readiness for the influx of visitors.
Dr Dalia Samhouri, Program Area Manager, WHO Regional Office for the Eastern Mediterranean (EMRO) said huge numbers of people will arrive over a short time period.
‘This may disrupt the [health] system, which is why we have been working to enhance surveillance, ensure health system capacity and improve training,’ she said. ‘The most important lesson from previous mass gatherings is to conduct a risk assessment, including the risks associated with countries from where people are travelling.’
From the archive: World Cup Fever – Brazil fears measles influx (2016)
That was echoed by Amaia Artazcoz, Technical Officer, Mass gatherings, WHO. She said mass gatherings such as the World Cup or Olympic Games can become international super-spreader events and bring other challenges.
‘There is an increased risk of transmission of communicable diseases, including COVID-19, but also other risks such as stampedes and terrorism,’ she said. ‘[However] the ‘zero risk’ event does not exist. Mass gatherings provide an opportunity to strengthen emergency and routine health systems which can benefit the host country long after the event.’
When the final whistle blows in Qatar on 18 December, public health experts will hope the focus has exclusively been on football.