A gradual easing of restrictions surrounding mass events is needed to limit the transmission of Covid-19 according to a report from the Health Information and Quality Authority (Hiqa).
Examining how Ireland could see a return of large crowds and gatherings, Hiqa advised that "any easing should take consideration of infection levels in the community, levels of vaccination coverage, the risk posed by circulating variants of concern, and the capacity of the healthcare system".
In forming the advice, Hiqa examined a number of studies, public health guidance from 22 countries and two international agencies.
Two options were examined for pre-event testing, with 12 of the 22 countries adopting some form of screening system prior to large events.
Six countries (Austria, Czech Republic, France, Italy, Norway, and Switzerland) specified the use of PCR or antigen tests prior to the event, while just three countries (Belgium, Denmark and Portugal) required PCRs tests only, and a further three (England, Germany and the Netherlands) specified antigen tests only.
Hiqa noted the timeframe in which the tests needed to be taken varied between countries, ranging form seven days before the event to right before entry, while the sampling method (being taken by the people themselves, or by a test provider) also differed.
Evidence from 11 studies also showed the implementation of a range of public health measures can reduce the risk of Covid-19 transmission at large events, however, "there were important limitations associated with these studies".
"While one included study reported that extremely stringent mitigation measures substantially reduced the risk of transmission, it is unlikely that risk can be eliminated entirely," the report adds.
Layered mitigation approach
As all the studies used a 'layered mitigation approach', meaning a range of public health measures were adopted (testing, use of hand sanitiser, wearing of face masks, etc.), Hiqa stated it is not possible to determine the effectiveness of any single measure.
The report adds positive cases were detected after four out of eight events which trialled pre-event testing. "It is not know if transmission occurred during the event despite various mitigation measures in place, or if these cases were already infected."
Following their research, Hiqa suggested events should be outdoors where possible, in areas with good ventilation, and held over a shorter period of time.
The authority said pilot events in Ireland may provide useful evidence to guide their safe return, while measures around mass gatherings should be eased incrementally, in line with the public health conditions.
Hiqa stated a risk assessment should be carried out prior to any mass gathering and a layered mitigation approach should be adopted to reduce the risk of transmission.
Consideration should also be given to pre-event testing or the issuing of 'green certs' to those who have been vaccinated, recovered from, or tested negative for Covid-19, the report adds.