May 27, 2021

expert reaction to Spanish study looking at safety measures and COVID-19 transmission at an indoor live music event

A study by Spanish researchers published in The Lancet Infectious Diseases looks at same-day SARS-CoV-2 antigen test screening in an indoor mass-gathering.

Dr Julian Tang, Honorary Associate Professor/Clinical Virologist, University of Leicester, said:

“This Spanish study adds to the ever-growing list of event studies designed to demonstrate the risk of ‘opening’ up society to normality again.

“It differs in that the more protective N95 (equivalent to FFP2) masks/respirators were used as standard – which is generally less common in the community as they are more difficult to wear for long periods.  However, they can offer 5-10 times more protection than surgical masks, as shown in this earlier UK HSE 2008 lab-based study: https://www.hse.gov.uk/research/rrpdf/rr619.pdf

“The authors’ comments in the limitations of the study are valid – and may limit the wider generalisation of their findings to other situations – i.e. that the study was conducted under strict conditions with enhanced ventilation, crowd control, as well as pre-entry SARS-COV-2 screening and continuous N95 mask wearing.

“There have been a few studies like this now, including the Liverpool nightclub study, in the UK: https://www.gov.uk/government/publications/guidance-about-the-events-research-programme-erp-paving-the-way-for-larger-audiences-to-attend-sport-theatre-and-gigs-safely-this-summer

“But there is a problem with all of these – which may lead to a sense of false security.

“As for children in schools, if the background community COVID-19 incidence is low, then these events carry low risk – because there is little virus around – and with these planned events/studies, all participants are screened pre-entry for SARS-COV-2 infection, asymptomatic or symptomatic.

“The problem starts when in real-life, there is an unidentified surge in cases in some parts of the population (as we have seen with the Indian variant in various places already) that may not be detected early enough before such events when such events become more widespread – and which are then only detected in retrospect as the virus starts to spread in the local communities of the participants after they have returned home.

“So overall, the COVID-19 national vaccination programme is still the main way that this virus will be controlled – as with other viruses – and we have seen the risks of suboptimal vaccination coverage for the control of measles in the UK recently, to the extent that the UK has lost its measles-free status: https://publichealthmatters.blog.gov.uk/2019/08/19/measles-in-england/

“These event studies are only really relevant at that given time with that level of COVID-19 prevalence for that variant (which may differ in their transmissibilities), in that community/event  setting, with the performance of those screening tests on that variant at that time – and these can change with time.

“So whilst I understand the need for such studies to provide encouraging optics for the UK government, businesses and society, overall, it is the COVID-19 national vaccination programme that will really let us get back to some degree of normality, and the findings and generalisation of all of these studies should be regarded with some caution – until we can vaccinate everyone with at least two vaccine doses.”

‘Same-day SARS-CoV-2 antigen test screening in an indoor mass-gathering live music event: a randomised controlled trial’ by Boris Revollo et al. will be published in The Lancet Infectious Diseases at 23:30 UK time on Thursday 27 May 2021, which is also when the embargo will lift.

DOI: https://doi.org/10.1016/S1473-3099(21)00268-1

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.