Euro2020 generated a 'significant risk to public health' across the UK even when England played overseas. Public Disorder meant Covid19 checks were suspended at the Wembley Final.

 

The UK Government Events Research Programme has published a report on the Public Health Impact of mass cultural and sporting events on the prevalence of Covid 19. LINK

The report covers Euro 2020 matches including the final at Wembley Stadium on July 12th and will feed into various inquiries, hopefully including the two internal inquiries agreed by Brent Council. LINK

The disorder and stadium invasion at Wembley Stadium on July 11th when England played Italy  probably had an impact as did the nature of football crowds and pre-match socialising and drinking.

I reprint the substance of the report blow. A full version with footnotes can be found on the link above.

 

DISCUSSION

 

The increasing number of reported cases across all events reflects the increasing community prevalence of COVID-19 during that period. Both the EURO 2020 matches at Wembley and the All England Lawn Tennis Championships were mass spectator sporting events taking place on multiple days within a short period of time at an outdoor stadium in Greater London. There were similar numbers of spectators and high capacity in the stadia, reaching 75% for the later EURO 2020 matches and 100% on Centre Court at the Wimbledon final. Both required evidence of vaccination or negative LFD or natural immunity as a condition of entry. There are very markedly different numbers of positive cases reported as associated with these events, with those associated with the Wimbledon event more comparable with those reported from the other ERP events running concurrently, and with the numbers testing positive within the wider community at that time. This suggests that the EURO 2020 matches generated a level of COVID -19 transmission over and above that which would be more commonly associated with large crowds attending an outdoor sporting event with measures in place to mitigate transmission.

The number of potentially infected persons attending Wembley stadium increased as the tournament progressed, reaching more than 2,000 at the EURO 2020 final despite event goers requiring a COVID pass for entry; this was in contrast with much lower infectious cases detected at other events occurring in the same month. This raises questions on the utility of individuals self-reporting tests in reducing the prevalence of COVID infection at rare or special occasion events and the longer term deliverability of self-testing as an option to mitigate disease transmission.

Research teams present at each of these events have verbally reported stark differences in crowd and spectator behaviour (personal communication from Dr Aoife Hunt, formal report in preparation). Whilst attendees at Wimbledon were reported to be largely compliant with the crowd management measures in place, at the Wembley stadium the concourse areas became densely populated with shouting, chanting and boisterous behaviour with close contact in these areas before and during the semi-final and final matches.

 

At both venues alcohol was served, but at Wembley attendees were not allowed to take this into the seated accommodation. At both venues the compliance with risk mitigation measures was variable. However, the initial reports from research teams indicate that the Wembley spectators became less compliant with mitigation such as face coverings as the tournament progressed. In addition to this, the carbon dioxide levels reported from the concourse areas were higher than those recorded at other high risk settings in the ERP events, including the densely crowded areas at the Download music festival, and will have compounded the risk associated with the high numbers of spectators potentially infectious at the event itself (personal communication from Dr Liora Malki-Epshtein UCL, formal report in preparation).

 

Finally, the public disorder offences occurring at EURO 2020 have been widely reported, including an undefined number of ticketless fans who gained entry to the stadium. Public disorder in and around the stadium meant that COVID-19 status checks were suspended for the Final.

 

The EURO 2020 events had an increasing impact on a national scale which was not observed for other events within the ERP, suggesting that there were additional factors associated with these events and that the risk of COVID transmission was not mitigated by the control measures in place for entry to the event itself. There was increasing national interest as the tournament progressed, as this was the first time an English team were in an international final for 55 years generating a sense of the final stages being a ‘once in a generation’ occasion. This will not be replicated for all sport tournaments taking place over the winter, nor for all football matches. However, previous crowd behaviours associated with football fans has underpinned the methods used to manage these crowds including the legislation in place governing alcohol consumption within football stadia. In general terms, this has the effect of concentrating people into as few areas as possible while crowd management strategies often hold groups until they can be moved en-masse in a controlled manner. To mitigate the risk of transmission of COVID-19 it would be preferable to dissipate the crowds across as wide an area as possible and manage the movement over long periods of time, as happened at other events including the Wimbledon tennis championships. Further analysis of movement strategies will be reported as part of ERP phase 3 reports.

In addition to the cases associated directly with Wembley stadium, there was a noticeable national impact on COVID-19 case rates for key games including the Ukraine versus England quarter-final (3 July in Rome), for the England versus Denmark semi-final (7 July) and for the England versus Italy final (11 July), reflecting that in the later stages of the EURO 2020 tournament people came together across the country to watch the games and celebrate. There are higher proportions of events coded as pubs or bars on each of these dates compared to other dates for COVID-19 cases in England.

The case numbers associated with the events were detected using the routine reporting systems and were mainly from individuals who were symptomatic. As high proportions of cases, especially in young healthy individuals are asymptomatic, this is likely to be an underestimate of the full impact of these events. In addition, contact tracing is only undertaken for PCR test results and supervised LFD test results (those who are positive on home LFDs are requested to undertake an immediate PCR test) and recall bias of those contacted will vary. While there is no detailed age and sex breakdown for those who attended, it is highly likely that certain sports events (for example, football, golf) were more likely to have higher male and younger demographic attending. The age distribution also likely reflects the impact of vaccination; by 11 July 2021, more than 80% of those over 50 years were fully vaccinated and less than 30% of those under 40 years were fully vaccinated.

Contact tracing information can indicate events or locations individuals have attended while at risk of transmitting COVID-19 or places where transmission may have occurred.

It is not possible to say with certainty how many individuals transmitted COVID-19 at an event or venue, nor exactly where an individual contracted the virus. The Euro Final match did not take place until 8pm, meaning that those attending may have been engaging in social activities during their journey to the match, and prior to entering the stadium itself. Transmission of infection may have occurred at the event itself or during any of the other reported activities associated with the event, of which attending a pub or
restaurant is the most frequently reported.

Neither full vaccination nor a negative LFD test will completely eliminate the possibility of an infectious individual attending an event, but it should reduce the likelihood of someone transmitting highly infectious amounts of virus to a large number of individuals attending the event.  

 

CONCLUSION

 

The EURO2020 tournament and England’s progress to the EURO final generated a significant risk to public health across the UK even when England played overseas. This risk arose not just from individuals attending the event itself, but included activities undertaken during travel and associated social activities. For the final and semi-final games at Wembley, risk mitigation measures in place were less effective in controlling COVID transmission than was the case for other mass spectator sports events.

EURO2020-related transmissions have also been documented in Scotland where 2,632 individuals self-reported attending a EURO2020 event in the UK; and Finland, where 947 new SARS-CoV-2-positive cases were linked to travel to Moscow, Russia.

Whilst some of this may be attributed to a set of circumstances which are unlikely to be replicated for the forthcoming sporting season, other aspects may be important to consider including mitigations for spectators to consider such as face coverings when travelling to and from events and minimising crowding in poorly ventilated indoors spaces such as bars and pubs where people may congregate to watch events. It is also important that individuals are informed to reduce the risk of transmission from aerosol exposure related to shouting and chanting in large groups by improving ventilation in enclosed spaces.

Other risk mitigation measures at high community prevalence include reducing the number of persons entering events or venues who are potentially infectious or at risk of severe disease or hospitalisation by promoting attendance by fully vaccinated individuals will be important. Promoting vaccination and the wearing of face coverings for those attending events will also reduce the risk of transmission associated with the journey to and from the event and associated social activities. Finally, event organisers should consider measures to manage the density of crowds in areas such as hospitality and concessions on the concourses, and entry and exit points to the event.